To the Editor:

Dr. Emily Herndon and Linda Joyce wrote an excellent article regarding “Getting the Most From Language Interpreters” [June 2004, page 37], but not all patients can hear the spoken language. Deaf and hard-of-hearing patients have been notably excluded from their article. Much of the advice in this important article will help to enhance physicians’ interactions with deaf patients, but two of the authors’ guidelines need to be revised for use when communicating with deaf patients:

• When addressing the patient, the interpreter should be next to the physician and across from the patient. This facilitates interactions of facial expressions, which is integral to American Sign Language.

• Phone interpreting services will not work with deaf patients. Offices with high-speed computer connections, a video camera and monitor can use video relay servicing to speak to a sign language interpreter, who then signs to the patient. This may be the wave of the future for communicating with this population. Certified sign language interpreters, especially those with medical training, currently are the ideal solution for helping the deaf patient and the nonsigning physician to communicate.

Authors’ response:

Dr. Hudson makes very good points about how to best work with a sign language interpreter. The scope of our article did not include sign language interpreting, and we should have noted that. Sign language interpreting is just as important and vital for patients as spoken language interpreting. Our health system has successfully used video conferencing for several years and has recently expanded its use.