"Somebody who speaks the language only is not enough. You have to have some medical background to understand the terminology, to explain to the patient what is happening," said Georgeen Newland, project manager and health educator with Celebremos la Vida - Clinica Nuestra Salud of the Lombardi Cancer Center at Georgetown University Medical Center.

Although patients and physicians often use family or friends as interpreters, Rose warns of pitfalls. "There is a greater error rate with friends and family or other untrained interpreters," she said, and there is risk of the family member advocating for one treatment over another or withholding information. Newland, who interprets for Spanish-speaking patients at Lombardi, concurred. "Sometimes the family does not tell the truth to protect the patient. I have witnessed that."

wiley/bw/journal.asp?ref=0017-9124