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There’s often a quiet resilience and dignified reserve among the older Vietnamese patients who come to Boston Medical Center. English is not their first language, and navigating the health care system can be confusing. That’s where medical interpreter Quan Bui steps in. One of the first things he does to win their trust is to mention that he’s related to a popular Vietnamese singer, Ha Thanh. Almost immediately, barriers are broken and a conversation starts. “Interpreting words is not enough. I serve as a cultural go-between as well between these immigrant patients and clinicians,” said Bui, one of 65 interpreters at BMC who also translate Spanish, Haitian Creole, Portuguese, and other languages. Whether it’s explaining surgical procedures, providing family history, or helping decipher a prescription, Bui’s services can help avoid potentially deadly misunderstandings. With health care regulations requiring medical providers ensure equal treatment of limited-English speakers, Bui talked about why language services are an important part of quality care.

Similar to how it’s difficult to interpret humor into another language while keeping the original meaning of the joke, sometimes medical interpreters run into the issue of English healthcare expressions that are meaningless in a foreign language. While an English speaker may not have any trouble understanding the idiom, a patient who speaks little to no English may.

Patients with limited English in the emergency room are slightly more likely to return within days, suggesting their care the first time was not as good as it could have been, researchers say. In a study in one New York hospital, about 4 percent of English speakers made an unplanned return to the ER within three days, compared to 5 percent of people with limited English. Low use of professional translators may partly explain the disparity in care, the researchers report in the Annals of Emergency Medicine.