Cafe Lingo

The COVID-19 pandemic has revealed a major crisis in the U.S. healthcare system: a lack of language support for limited English proficiency (LEP) speakers. Yet the success of the vaccine depends on reaching millions of residents—including those with limited English skills. That means healthcare providers must ramp up their efforts to hire medical interpreters who can bridge the language gap. While the demand for Spanish interpreters is a given, let’s look at the seven fastest growing languages that your patients may speak.


  1. Telugu – Up 86%


Telugu is a Dravidian language spoken by the Telugu people in the Indian states of Andhra Pradesh and Telangana. It’s also a scheduled language of India.


Around 415,400 Telugu speakers live in the U.S. The majority reside in NYC, Long Island, Central New Jersey, Northern Virginia, and Central and Southern California.


  1. Arabic – Up 42%


The official language of 23 countries throughout the Middle East and Africa, Arabic is spoken by 580 million people around the world.


Roughly 1.1 million Arabic speakers live in the United States. States with the largest Arabic speaking populations include: California, Michigan, New York, Texas, Illinois, New Jersey, Virginia, Florida, and Ohio.


  1. & 4. Hindi – Up 32%; Urdu – Up 30%


Registers of the Hindustani language, Hindi and Urdu belong to the Indo-Aryan language family. Both are official languages of India.


Hindi is the largest spoken Indian language in the U.S, with 863,077 speakers, while Urdu is spoken by 507,329 speakers. The majority live in California, Illinois, New Jersey, New York, Virginia, and Texas.


  1. Chinese – Up 23%


The most widely spoken language in the world, Chinese is an official language of Mainland China, Singapore, Taiwan, Myanmar, Hong Kong, and Macau.


It’s also the third most widely spoken language in the U.S., with roughly 3.5 million speakers.

The metropolitan areas of New York, Los Angeles, San Francisco, Boston, Chicago, Baltimore-Washington, Seattle, Houston, Dallas-Fort Worth, and Delaware Valley all have large Chinese-speaking communities.


  1. Gujarati – Up 22%


Gujarati is a Western Indo-Aryan language spoken primarily in the Indian state of Gujarat. It’s also an official language of India.


Roughly 434,264 speakers live in the U.S. Most live in New Jersey and the metropolitan areas of New York, San Francisco, Los Angeles, Washington D.C., Chicago, Dallas, and Philadelphia.


  1. Haitian Creole – Up 19%


A French-based creole, Haitian Creole is the official language of Haiti and is recognized as a minority language in the Bahamas, Cuba, and the Dominican Republic.


In the U.S., approximately 856,000 people speak the language, most of whom live in

Florida, New York, Delaware, Illinois, Virginia, Massachusetts, New Jersey, and Pennsylvania.


Language Support and Boostlingo   


Finding an interpreter can be a difficult task, especially for a less common language. Fortunately, the BoostCare Telehealth platform makes it easy to connect with one remotely, either over-the-phone (OPI) or via video remote (VRI). All you need is an internet connection, computer or mobile device, and a webcam for video calls. Plus, our Boostlingo Professional Interpreters Network (BPIN) gives you access to interpreters who speak over 200 languages.


Want to learn more? Contact us today to start your free trial!


Language barriers pose a major challenge when it comes to accessing health care. Limited English proficiency (LEP) patients often struggle to make appointments—let alone describe symptoms or understand recommendations. Medical interpreters can help, but healthcare professionals don’t always provide one due to the cost. Yet failure to do so can result in serious medical mistakes. In this blog post, we’ll take a look at three medical malpractice cases and how to avoid errors like these.


The Willie Ramirez Case


Often referred to as the most expensive medical interpreting error, the failure to understand one word changed the life of Willie Ramirez. In 1980, the 18-year-old arrived at a South Florida hospital in a comatose state. His Spanish-speaking mother explained that he was “intoxicado”—which meant suffering from food poisoning.


Doctors mistakenly believed that meant he overdosed on drugs or alcohol. But Willie had actually suffered from a brain hemorrhage and was left quadriplegic as a result. Had a neurosurgeon been called immediately, he could have avoided this fate. He won a $71 million settlement as a result.


This case highlights just one reason why family members don’t make the best interpreters. Had doctors connected with a medical interpreter who understood Spanish, Willie could have avoided paralysis.


The Tran Family Case


A nine-year-old girl in California arrived at the hospital with what seemed to be a serious case of the stomach flu. Her parents only spoke Vietnamese, yet the hospital failed to request an interpreter. Instead, the girl and her 16-year-old brother tried to interpret. A doctor sent the family home with a prescription and instructions in English. The girl later had a reaction to the drug and died of a heart attack. The doctor and the hospital settled the malpractice claim for $200,000.


As this case shows, children should never be tasked with interpreting—especially for their parents. They not only lack the proper vocabulary, but the maturity level to fulfill the role.

A medical interpreter could have given the parents proper instructions, and the girl likely would have lived.


The Teresa Tarry Case


A British citizen living in Spain, Teresa Tarry underwent an unnecessary double mastectomy because of a translation error in her medical records. A doctor found a benign lump during an exam, and wrongly believed that she had a family history of breast cancer. Teresa, who doesn’t speak fluent Spanish, claimed she was never offered an interpreter. She sued the hospital for €600,000.


As this case shows, even patients who speak the language may need assistance. An interpreter could have clarified Teresa’s family history, and she would have avoided unnecessary surgery.


Connecting with a Remote Interpreting  


Of course, waiting for an onsite interpreter isn’t always an option. Fortunately, over-the-phone (OPI) and video remote interpreting (VRI) make it possible to connect with one almost anywhere. And here’s where BoostCare Telehealth comes in. This easy-to-use, HIPPA-compliant platform let’s you connect with interpreters who speak over 200 languages in minutes!

It’s a fast, affordable alternative to onsite interpreting.


Want to learn more about how BoostCare can improve your practice? Contact us today to start your free trial!


One of the greatest things about being an interpreter is that you are always learning something new. Interpreters learn deliberately by attending continuing education classes and conferences, by looking up relevant terminology, but also unintentionally, just by virtue of doing their jobs. Any interpreter worth their salt will spend hours if not days preparing for new assignments, whether it is a medical appointment for an unfamiliar specialty or a complex court case. However, sometimes it is worth taking a step back and learning about the profession itself! To help with that, we prepared a selection of our favorite books about interpreting and interpreters. 


Is That a Fish in Your Ear?: Translation and the Meaning of Everything by David Bellos

This book will be of interest to new and experienced interpreters alike, as well as anyone interested in languages and communication. David Bellos writes about the history of interpreting and translation, language, culture and human connection. 


Healthcare Interpreting in Small Bites by Cindy Roat 

Written by Cindy Roat, a national language access consultant and a veteran interpreter trainer, this book is a treasure trove of useful insights and practical tips for medical interpreters. Even the most seasoned interpreter can learn from reading this book – and it is definitely a must-read for those starting out in the field. 


Interpretation: Techniques and Exercises by James Nolan 

This book has everything you need to know about conference interpreting, and more. Despite being aimed primarily at conference interpreters, it will be of interest and use to interpreters in any field. Starting out with an overview of interpreting modes and the difference between interpreting and translation, it moves on to guidance and practical exercises in interpreting everything from political speeches to idioms. 


Lost in Translation: An Illustrated Compendium of Untranslatable Words by Ella Frances Sanders 

This book is an absolute delight and will be of interest to anyone interested in all things language and translation. Containing beautiful and quirky illustrations of over 50 words from the world’s languages, this book is a perfect escape into the peculiar world of untranslatable words. 


Daniel Stein, Interpreter: A Novel by Ludmila Ulitskaya 

This book, translated from Russian, tells the story of Daniel Stein, a Polish Jew who narrowly survives the Holocaust by working for the Gestapo as an interpreter.  While this particular book is a work of fiction, it does have a basis in real life – Daniel Stein is based on a real person, Oswald Rufeisen, a Carmelite priest. Daniel’s story is told through letters and other documents, letting the reader figure out the rest for themselves. 


Happy reading! 

As more COVID-19 vaccines undergo clinical trials, the end of the pandemic may soon be in sight. However, developing a vaccine is only the first step. Distributing it throughout the U.S. population will pose another challenge—particularly in communities of color. Although groups such as Blacks and Latinos are at a higher risk for serious complications, many of them mistrust the medical establishment.


In order to keep all Americans safe, healthcare professionals will need to build trust in these communities through education and outreach. That means medical interpreters will play a vital role in Latino and other limited English proficiency (LEP) communities. But before we dive into the benefits of medical interpreting, let’s take a look at some statistics.


The Trust Gap in Black and Latino Communities


A study by Langer Research found that only 66% of Latinos would agree to a coronavirus vaccine, even if it were free of charge. That number drops below 50% among Black respondents. Doubts about safety and effectiveness seem to drive these numbers as only:


  • 14% of Black people trust that the vaccine is safe, while 18% trust it will be effective.
  • 34% of Latinos trust the vaccine’s safety, and 40% trust its effectiveness.


Black respondents also cited historical reasons for their mistrust. Medical experiments, such as the Tuskegee syphilis study, were conducted without the knowledge or consent of Black participants. Latinos mentioned similar fears as well as lack of trust in the government to have their best interests in mind.


The nonprofit that commissioned the report expressed concerns about a similar hesitancy among Native Americans, Asians, and other non-white ethnic groups.


How Medical Interpreters Can Help


While there’s no quick fix to improve trust, providing accurate information and taking the time to address concerns may go a long way. As healthcare professionals begin outreach, they’ll also need to provide language support for members of LEP communities. And here’s where professional medical interpreters come in.


Although bilingual staff and family members are often called upon to help, they typically don’t make the best interpreters. That’s because medical interpreters are specially trained in interpreting and medical terminology. They also serve as a neutral third-party whose sole purpose is to facilitate communication between the patient and the healthcare provider. Patients may feel more comfortable using an interpreter for this very reason.


Why Remote Medical Interpreting Is a Safer Choice


Bringing an interpreter onsite is often the best option. However, due to the health risks, healthcare providers may prefer to connect with a medical interpreter remotely—either via video remote or over the phone.

Fortunately, the BoostCare Telehealth platform makes it easy to connect with a medical interpreter within minutes. Our Boostlingo Professional Interpreter Network (BPIN) includes interpreters who speak over 200 languages and are ready to assist.


Think Boostlingo may be right for your practice? Contact us today to start your free trial!

Interpreting is a tough job. Beyond being bilingual, professional interpreters need strong listening, communication, and interpersonal skills—not to mention a great memory. On top of that, interpreters who work in fields such as legal and medical typically need to complete a specialized certification program to meet state or federal requirements.


Yet one type of interpreting stands above the rest when it comes to difficulty: simultaneous interpreting. Here’s a look at one of the most famous—though least understood—types of interpretation along with the science behind how it works.


What Is Simultaneous Interpreting?


Like the name states, simultaneous interpreting involves translating a speaker’s words as they are talking. This is in contrast to consecutive interpreting, which allows the speaker to finish before the interpreter translates the message into the target language.


Simultaneous interpreting is typically used during conferences and other meetings that include speakers of multiple languages. (Think the iconic image of interpreters in glass booths at the United Nations.) And while many simultaneous interpreters still perform their role onsite, remote simultaneous interpreting options also exist.


Which Skills Do Simultaneous Interpreters Need? 


Unlike consecutive interpreters, simultaneous interpreters have no room for error. They have no time to ask a speaker to clarify what they said or even take notes. That means they must rely heavily on their short-term memory to reproduce the speaker’s message in the target language. (Consecutive interpreters use both their short-term and long-term memories.)


Simultaneous interpreters must also predict what a speaker will say next. They use the context of the meeting to help determine the message and translate it in real-time. This requires a deep understanding of the subject matter, as the interpreter has little time to recall less familiar terminology or phrases.


Simultaneous Interpreting and the Brain


So, how does a simultaneous interpreter’s brain tackle this daunting task? Although neuroscientists have studied language for decades, some mysteries around simultaneous interpreting remain. However, researchers believe that it partially involves a region of the brain called Broca’s area. This region is known for its role in both language production and working memory.


Using an fMRI, researchers at the University of Geneva observed the brains of multilinguals. They tracked when someone: listened to a sentence, listened to and repeated a sentence, and listened to a sentence in one language and interpreted it into another. The researchers found that Broca’s region was equally activated during all three tasks. However, the caudate nucleus, which is the part of the brain that is responsible for learning and decision-making skills, became more engaged during the interpretation task.


Ultimately, neuroscientists believe that no single part of the brain controls interpreting. Networks across multiple regions of the brain likely contribute to this amazing ability.


Given the brain processing power required, simultaneous interpreters typically work in 30-minute shifts to give each other a break. And given just how hard the job is, they definitely earn it!

Over 25 million U.S. residents speak English “less than very well.” Yet healthcare providers still fall short when it comes to providing language assistance for those who need it. This lack of language support can leave limited English proficiency (LEP) patients and caregivers struggling to navigate the healthcare system. Delays in care, fewer referrals to specialists, and less diagnostic testing are just a few of the consequences.


Fortunately, video remote and over-the-phone medical interpreting services go a long way when it comes to guiding LEP speakers though the healthcare process. Here’s a look at the challenges they face from booking an appointment to understanding treatment options, and how medical interpreters can help.


Language Barriers in the Healthcare System


While communication issues may arise during a medical exam, they often occur as soon as someone calls to book an appointment. During an Academic Pediatrics study, Spanish speaking caregivers reported that they had trouble when they called the facility. Those who made an appointment faced additional obstacles when it came to registration and communicating with office staff.


Once they met with the healthcare provider, some respondents reported that they struggled to understand the diagnosis, treatment options, and follow-up care recommendations. Some simply nodded as if they understood, even when they didn’t. Others relied on their child or other family member to interpret—a practice that medical professionals discourage. Unfortunately, the lack of bilingual staff and/or access to a medical interpreter left some respondents with no other options.


How Remote Medical Interpreters Can Help


Bilingual staff are always a great addition to a medical practice. However, they typically aren’t trained to provide interpreting services. That’s where medical interpreters come in.


Although hiring an onsite medical interpreter is often ideal, it may not always be possible or even necessary. For example, if no bilingual staff member is available, you can help a patient schedule an appointment by connecting with an over-the-phone interpreter. The same is true when patients need assistance with registration.


Video remote interpreting, on the other hand, works well during telehealth appointments and onsite visits. Medical interpreters can glean information from a patient’s facial expressions and body language to ensure there is no miscommunication between them and the provider.


Both options allow you to connect with a medical interpreter within minutes, which reduces wait times and can improve care outcomes.


Connecting with BoostCare Telehealth  


With BoostCare Telehealth, you can quickly connect with medical interpreters who speak over 200 languages. Our HIPAA-compliant platform is easy to use for patients and healthcare providers alike. All you need is an internet connection and a device with a webcam to get started.


Want to learn more about BoostCare Telehealth? Contact us today to start your free trial!


American Sign Language (ASL) is the most widely used sign language in the world. While its roots can be traced back to 18th century France, sign languages existed in the Americas well before the arrival of Europeans. Native American tribes relied on Indigenous Sign Language (ISL) to facilitate inter-tribal communication—in addition to communicating with deaf members. Today, most deaf Native Americans and their families use ASL, but a small number still understand ISL, and they’re working to keep these dialects alive.


Here’s a look at three ISL dialects from the past and present.


Plateau Sign Language


Plateau Sign Language was used across the Columbian Plateau in the present-day U.S. states of Washington, Oregon, Idaho, and the Canadian province of British Columbia. Primarily used by the Salish people, the language went extinct in the 18th century.


Inuit Sign Language


Inuit Sign Language is used within Inuit communities in the Canadian Arctic. As of 2000, 47 of the 155 deaf tribe members used the language in the Canadian territory of Nunavut. While the language doesn’t have legal protection under federal law, it has been used alongside ASL in the Nunavut legislature since 2008.


Plains Sign Language


Plains Sign Language (PSL) has the largest number of users on our list. Once the lingua franca of present-day Central Canada, central and western parts of the United States, and Northern Mexico, it had over 110,000 users in 1885. It was used across at least 37 tribes, and remains strong among the Crow, Cheyenne, and Arapaho. Dialects of PSL include: Navajo, Blackfoot, Cree, and Ojibwa.


Also known as Plains Sign Talk, PSL is the most sophisticated indigenous sign language known. It’s recognized in the official courts, education, and legislative assembly of Ontario, Canada.


Preserving Indigenous Sign Languages


Indigenous sign languages, along with many indigenous spoken languages, are endangered. However, activists such as Nikki Sellars of the Xat’sull First Nation have been working to preserve ISL and improve protections under Canadian law. According to activists, integrating ISL into the curriculum at Native American schools for the deaf will be vital for keeping these languages alive.


Language Support and Boostlingo 


Although our Boostlingo Professional Interpreters Network (BPIN) doesn’t include ISL interpreters, we provide support for ASL and spoken languages such as Navajo, Mixteco, and Quechua. Our platform includes video remote interpreting options for ASL users and over-the-phone interpreting for languages of lesser diffusion, such as the ones listed above.


Want to learn more about how Boostlingo can provide the language support you need? Contact us today to start your free trial!


COVID-19 has exposed a long-standing issue within the U.S. healthcare system: lack of access to language services for people with limited English proficiency (LEP). As hospitals struggled to manage rising caseloads, LEP patients risked missing out on life saving care due to language barriers. Yet the shortage of medical interpreters and translators began well before the pandemic.


According to a 2016 survey by the American Hospital Association, only 56% of hospitals offered linguistic and translation services—up from 54% in 2011. To put this into perspective, a 2010 study found that 97% of doctors have non-English speaking patients. That gap between patients’ needs and the availability of language services can prevent them from receiving appropriate treatments or even seeking care at all.


Federal Funding and Title VI of the Civil Rights Act


However, the need for medical interpreters and translators is well known among healthcare professionals. Organizations that receive financial assistance from the Department of Health and Human Services (HHS) must provide access to language services under Title VI of the Civil Rights Act. Recipients of this assistance include:


  • Healthcare providers that participate in CHIP and Medicaid programs
  • Hospitals and nursing homes (recipients under Medicare Part A)
  • Medicare Advantage plans (e.g. HMOs and PPOs)
  • Human or social service agencies
  • Insurers that participate in Marketplaces and receive premium tax credits


So, why do so many healthcare organizations fall short? The answer lies in insurance reimbursement.


Interpreting Services and Healthcare Reimbursement


Despite federal assistance, few insurers directly reimburse for interpreter services. Aside from some Medicaid plans, healthcare providers typically pay the costs—ranging from $30 to $400 per patient. Meanwhile, Medicaid programs pay only $30 to $50 per patient, which means providers often lose money by treating LEP patients. Unsurprisingly, 25% of clinicians considered interpreting costs a barrier to care. And as revenue falls due to COVID-19, more providers may consider cutting interpretation services as a cost-saving measure.


Telehealth and More Affordable Interpreting


Fortunately, the news isn’t all bad. Due to the pandemic, the HHS has expanded access to telehealth to keep patients and healthcare professionals safe. Using a platform like BoostCare Telehealth, healthcare providers can connect with remote medical interpreters who charge lower rates than onsite interpreters.


Our video remote and over-the-phone (OTP) interpreting options give you access to interpreters who speak over 200 languages within minutes—without the travel expenses. You can easily treat patients via telehealth or onsite without waiting for an interpreter to arrive. All you need is internet access and a mobile device or computer with a webcam.


Think BoostCare Telehealth may be right for your practice? Contact us today to start your free trial!


Anthropologist and linguist Edward Sapir wrote in 1929 that, “In the state of California alone, there are greater and more numerous linguistics extremes than can be illustrated in all the length and breadth of Europe.” You could even narrow that down to Northern California—or just San Francisco, where 112 languages are spoken. And while each of these languages has a unique history and culture, let’s take a look at the five most widely spoken ones in NorCal.


  1. Spanish


It should come as no surprise that Spanish takes the number one spot. With over 10.6 million speakers state-wide[i], 28.5% of the Golden State’s population communicates in Spanish. In Northern California, the agricultural countries of the San Joaquin Valley and the San Fernando Valley are home to the majority[ii].


  1. Chinese (Including Cantonese and Mandarin)


Chinese speakers make up 2.8% of the state’s population, with over 1.2 million speakers state-wide.1 Most Chinese speaking NorCal residents live in the Bay area—primarily in San Francisco, Alameda, San Mateo, and Santa Clara counties.2


  1. Tagalog


An estimated 2.2% of California residents speak Tagalog, a language native to the Philippines. The majority of the roughly 796,000 speakers live in Southern California, but the San Francisco Bay area also boasts a thriving community.2


  1. Vietnamese


Did you know San Jose is home to the largest percentage of Vietnamese speakers outside of Vietnam? With around 559,000 residents, Vietnamese speakers make up 1.43% of California’s population, most of whom live in Northern California.2


  1. Korean


Korean rounds out the top 5 languages with around 368,000 speakers state-wide. Korean speakers make up about 1.08% of California’s population. The largest communities are in Orange and Los Angeles counties, but about 1.3% of San Jose residents and 1.1% of San Francisco residents identify as Korean.[iii]


Honorable Mention


Persian, Japanese, Russian, and Armenian round out the top 10 most commonly spoken languages (along with English) in NorCal. The first three are primarily spoken in the Bay area, while Fresno is home to a large Armenian community.


A Note on Native American Languages

Although the state’s pre-colonial indigenous communities spoke over 80 different languages, the vast majority are now either extinct or severely endangered. Languages such as Karuk, Hupa, and Yurok, which were once common in Northern California, now only have about a dozen speakers.[iv] Chukchansi and Luiseño are also native to the region, and languages from larger groupings such as Athabascan, Algic, and Uto-Aztecan are spoken in small numbers. The San Francisco area has a small number of Navajo speakers as well.


Yet despite the shrinking number of speakers, organizations such as Advocates for Indigenous California Language Survival are working to keep these languages alive through education and community building.


Language Support from Boostlingo


As you can see, Northern California’s linguistic diversity spans across urban, suburban, and rural areas of the region. While each of these communities add to the state’s unique culture, language differences can also pose barriers to communication.


Fortunately, Boostlingo makes it easy to access interpreters for over 200 languages. Our interpretation platform let’s you schedule an onsite interpreter or connect with an over-the-phone or video remote interpreter in minutes.


Want to learn more about how Boostlingo works? Start your free trial today!








If you or a loved one has ever had a medical emergency, your first reaction was likely to dial 911. Now imagine you didn’t speak English. What would happen then? Ideally, the operator would quickly connect you with a 911 interpreter.


These specialized medical interpreters must remain calm in even the most stressful situations. In this blog post, we shine the spotlight on these sometimes-forgotten interpreters and the vital work they do.


What It Takes to Become a Boostlingo 911 Interpreter


First things first. Medical interpreters who join the Boostlingo Professional Interpreters Network (BPIN) are not employees, but are independent contractors. Yet that doesn’t mean we don’t require them to meet strict requirements before accepting emergency assignments.


Below is a partial list of our medical interpreter requirements:


  • A minimum of 60 hours of medical interpreter training.
  • A minimum of 3 years of medical interpreting experience.
  • Completion of required CEUs.
  • Evidence of current HIPAA compliance (must be updated every 2 years).


Given the sensitive nature of emergency calls, we also ask our interpreters to follow a strict code of ethics for the calling environment. It must comply with HIPAA regulations for security and privacy, i.e. no answering calls in public places or in a room where others are present.


How 911 Interpreting Works


When someone places an emergency call, it’s routed to the requested language and type. An interpreter will answer the call with the greeting, “Hello, my name is NAME and my ID number is NUMBER and I am your language interpreter. How may I help you?”


All interpreters who accept these calls are prepared to take them.


Meet Our BPIN Interpreters


The 911 interpreters who join our network have varied backgrounds, but all of them are well trained and meet requirements above. Here’s a brief introduction for just two of them:


Andrea Lane, a Portuguese-English interpreter based in San Diego has a degree in nutrition and previously worked in a hospital. Now, she not only interpreters 911 calls, but provides legal interpreting for government agencies and immigration.


Andres Wallace, a Spanish-English interpreter based in Costa Rica, studied translation before becoming a medical interpreter. Throughout his seven years of experience, he’s taken 911 calls due to domestic violence, stabbings, shootings, and motor vehicle accidents.



During our interview, he recalled a harrowing incident that involved a collision with a heavy motor vehicle. A passenger had fallen unconscious, and Andres had to walk the driver through removing the passenger, ensuring they were still breathing, and interpreting for the EMTs.


Both interpreters emphasized the importance of remaining calm and adhering to the code of ethics they’ve sworn to follow, regardless of the scenario.


Partnering with Boostlingo


As you can see, our 911 interpreters undergo a rigorous training process, and must sometimes interpret during life or death situations. Because of this, our BPIN interpreters are some of the best in the industry.


Want to learn more about how Boostlingo can assist your emergency call center? Contact us today!