At its heart, healthcare is a conversation.
A patient needs to explain what is wrong. They need to understand their options. They need to make decisions about their own care.
Clinicians need clear information too. They need to understand symptoms, explain risks, discuss treatment, and check whether advice has been understood.
When information is not successfully communicated, both sides lose something important.
Patients can misunderstand diagnoses, medication instructions, treatment options or follow-up advice.
Clinicians can miss key details, leaving appointments unsure if the patient understands the next steps.
These aren't just minor communication 'glitches', they are significant risks to patient safety and health equity.
What our research found
Our recently published mixed-methods study examined collaboration between clinicians and professional spoken language interpreters in Australia, using the World Health Organisation's interprofessional collaborative practice framework.
We focused on audiology because communication is essential to hearing care, from taking a case history to explaining results and checking understanding. Although conducted in hearing care, the findings are relevant across health services.
The message was clear: placing an interpreter in the room does not automatically good communication. Successful interpreted consultations depend on role clarity, preparation, trust and system support.
Clinicians working without a professional interpreter reported difficulty taking accurate patient histories and uncertainty about whether patients had understood them, leading to longer appointments and reduced information sharing. Interpreters described challenges with specialised terminology and unclear appointment goals.
The most revealing finding was what we called the "vocal box" problem. Many clinicians viewed interpreters as passive conduits - simply converting words from one language to another. In reality, interpreters translate meaning across culture, health literacy and clinical context. When clinicians overlook this, accuracy suffers and trust erodes.
A fixable gap emerged around pre-consultation briefings. Most interpreters wanted a brief conversation before the patient arrived; fewer than half of clinicians agreed. A five-to-ten-minute briefing is not a courtesy. It is a structural safety step that can improve accuracy, efficiency and trust.
Cost and access also emerged as significant barriers. Clinicians who had access to free interpreter services were far more likely to use them. Where services are not funded, the cost sometimes falls to patients - and many go without. Without adequate funding, even the best intentions do not translate into practice.
Why using family members or AI falls short
When professional interpreter access is difficult, clinicians may reach for quicker options. AI translation tools can seem practical. Family members may also be available in the room. Neither is a substitute for professional interpreting.
A recent analysis of international studies found no evidence that AI-powered tools can safely support the live exchange required in clinical consultations. Reported problems included inaccurate translations, missed medical terminology and fabricated text.
Family members carry different type of risks. They may answer for the patient, withhold distressing information, or compromise privacy. In clinical care, convenience cannot replace professional communication support.
What needs to change
The solution is not complicated, but it requires system-level commitment. Our research points to some practical changes:
- Pre-consultation briefings should become standard. A five-to-ten-minute briefing before an interpreted appointment - built into booking systems and clinical workflows - is a small investment with practical returns.
- Both professions need dedicated training. Clinicians need support to lead consultations through an interpreter, including pacing, turn-taking and maintaining eye contact with the patient. Interpreters need access to medical terminology and clinical context.
- Access to funded professional interpreters must also improve, particularly in regional and underserved areas. A patient's postcode should not determine the quality of their communication support.
- Multilingual patient resources should become standard. Clinicians in our study frequently reported having nothing in print except English. Written information, visual aids and culturally appropriate materials can support professional interpreting.
- Interpreted consultations should be evaluated by more than whether an interpreter was booked. Services should also assess whether patients understood their diagnosis, treatment options, risks and follow-up steps, whether they had the opportunity to ask questions, and whether clinicians were confident that key information had been accurately exchanged.
Good communication is not a luxury. It is a precondition of safe, equitable care. When a patient leaves without understanding their diagnosis or what to do next, that is not a language problem. It is a health system failure.
Every Australian deserves a genuine voice in their own health care, regardless of the language they speak at home. That means treating interpreters as part of the care team - not as optional extras, emergency substitutes, or someone who enters the room without preparation.
Dr Mehwish Nisar is a medical doctor and University of Queensland researcher and academic whose work bridges clinical practice, public health research and higher education.
