Bilingual drug labels: Pharmacists speak out

Feelings have run high since Drug Topics posted “Should states require bilingual drug labels?” on July 31. Both on Facebook and at www.DrugTopics.com, reader comments have been intense. As this issue appears to have struck a nerve with pharmacists - who, after all, are closer to the practical realities of dealing with bilingual patients than, say, California lawmakers or regulators might be - we thought we’d fill you in on what some of your fellow pharms are saying. 

It’ll keep patients marginalized

Speaking of California officials, one reader posted the following comment: “Do the CSBOP inspectors speak all those languages? In the greater scheme of things, it's less expensive to get non-English-speakers to learn English and become constructive members of our English-speaking society than to keep them marginalized in the non-English-speaking society where so many so-called progressives would have them remain. New York made a bad choice, now it looks like California might be headed in the same direction. Sad.”

To which two readers responded, “Agree 100%!” and “This is the United States of America...we speak English!”

More on California's proposed changes: California considering patient-centered Rx labels

Charge for it

Also posting at the website, Dr. JCalvillo made the point that the “last thing pharmacy needs is more mandates that cost us money or increase our liability. As pharmacists, we do this anyway. If they make it mandatory, then I suggest all pharmacies charge for this service, because it's going to cost us in the long run.”

Grandpa learned

Voicing a sentiment undoubtedly felt by many, MichaelSherry wrote, “I say no to bilingual labels. My grandfather was from Holland. No one posted signs in Dutch. He had to learn English, as should all other immigrants.”

Required for citizenship

From Mr. JKramer: “Speaking English should be a requirement for citizenship. It should be up to the pharmacist to decide whether to provide bilingual labeling. Enough already!”

Did they come here to live?

From an anonymous commenter: “Amen! So many people come to this country and expect us to cater to them. Some of them even have the nerve to say that some of my techs shouldn't be working in the pharmacy because they can't speak Spanish. Luckily, I have Spanish-speaking techs to put them in their place. It's getting out of control! Everyone should learn English when they come to this country to live, so they can communicate. We shouldn't have to change everything for those that are too lazy to learn the language of this country.”

I spoke Italian …

FrancisPisano said: “This is the United States of America. We speak English. If a person speaks only their native tongue, maybe it is time for them to learn English. I spoke Italian before speaking English, but I quickly learned that if I was going to accomplish anything in America, I had to speak English!”

Eat a banana

An anonymous commenter made a good point: “Different languages have different alphabets and other characters that may not print on an English-programmed printer. That's a problem. Also, just here in the Western hemisphere, there are probably 20 to 30 different dialects of Spanish alone. The phrase ‘eat a banana’ might just get your face slapped by certain Spanish speakers. That really needs to be considered by the California legislators if they're trying to reach the least common denominator.”

What does Europe do?

Mr. DKarant agreed, saying, “This is the United States, and we should be all speaking the same language,” and added, “But we still must effectively communicate with those who have needs who walk into our pharmacies. So, my question is, how do the pharmacies in Europe address this? Is there any special legislated labeling of multilingual content for pharmacists to use in England, France, Germany, Italy, or elsewhere? Is there a European model that would be good for us to consider?”

P.C. gone wild

Another anonymous commenter pronounced the issue ridiculous, and said, “It’s a California thing. Political correctness running wild.”

Where are the pharmacist groups?

DougBennett asked, “At what point in time does a patient become responsible for his/her care? The patient is better off having a friend or relative translate, someone who can easily be reached by the patient at any time.”

He added, “Where are APHA and CPHA? They should be all over this. We already spend more time on eligibility, formulary, and authorizations than on patient care. Every year we are asked to do more for less.”

It’s a setup

A very practical concern was expressed by Dr. DLevasseur: “How can a pharmacist who speaks one language ensure accuracy in other languages? You can imagine seeing it all over the news. ‘Pharmacist incorrectly translates prescription label, resulting in injury/death.’ This pharmacist would then likely lose his/her job and/or license, all because of a labeling requirement for a language he/she cannot read.”

In a nice piece of tit for tat, this writer added, “I want the CSBOP to write their regulations in all the languages they expect pharmacy labels to be written.”

How ’bout handouts?

Another commenter asked: “What is wrong with drug information handouts in different languages?”

Our folks learned

And yet another commenter echoed thoughts expressed earlier. “My father is a first-generation American, and he always told us that we are in America and we speak English. Previous generations of immigrants wanted to learn English and knew they would have to learn it. Now, we make it too easy for immigrants NOT to learn English.

“When New York was talking about doing this a few years back, I remember reading an article about a women upset and afraid to give medication to her ‘child’ because she could not read the label. Later in the article, we find out that she has been in America for 14 years and has a 14-year-old child. Why can't her child read English after being schooled in America, and why can't she read basic words after 14 years in this country?”

Try fitting 30 languages on a label

And RobertDeBus said, “I basically agree, the patient is responsible. English should be required. However, I had many patients from Somalia (Arabic), Mexico (Spanish), and SE Asia (??), and a couple of Russian and Bosnian patients. Communication was always a problem. As I understand it, in parts of California, there are up to 30 different languages spoken. Impossible to do all of them on a label. Supplying a sheet with a translation should be OPTIONAL. Would help patient care. But a requirement? NO.”

Facebook posters also had opinions to share.

Been doing it

Said Rick McCoy, “We've done it for YEARS and didn't need a law.”

Don’t dispense in an unfamiliar language

‪Jeff Pierce wrote, “A pharmacist should NEVER dispense a prescription if he or she cannot understand the language of the words on the label. This potential requirement does nothing to encourage immigrants to assimilate to learn the English language or American culture. Enough already.”

It’s about healthcare

Responding to the latter, ‪SarahBeth Joachim said, “Jeff, it said ‘bilingual.’ I think most Rxs can print a label in a different language if needed. We did in Arizona. While assimilating, it takes time. If someone can’t read English well, it is more likely there will be noncompliance or even death from misunderstanding. Any healthcare professional should want the patient to be able to read - or even a family member. It’s about healthcare, not politics.”

So there you have it. To some Drug Topics readers, it IS about politics. To others, it’s about healthcare. What do you think? Post your own comment at www.DrugTopics.com or e-mail us at drugtopics@advanstar.com, for sharing with your colleagues.