Does your pharmacy provide the same standard of care in every language?

“Truthfully, everyone needs the exact same standard of care, whether you are proficient in English or not.” In a recent interview, Sharon Blank, CEO of Language Scientific and RxTran, highlighted the commitment to equal standards of care for patients with Limited English Proficiency (LEP). Language access is a regulatory and patient safety issue. It’s also a critical aspect of operational consistency for pharmacies, not something that can be improvised at the pharmacy counter. 

Language access needs a system, not a workaround 

In a recent interview on the Empowered Patient podcast, our CEO Sharon Blank explained that “RxTran’s mission is to provide certified translations of the dosing instructions on prescription labels, and ensure that LEP patients have the ability to understand them. Our primary clients include both small individual pharmacies as well as large chains.” 

Multiple U.S. states now require translated prescription labels. If your pharmacy is in California, New York, Nevada, Oregon, or Washington (pending), you’re already subject to this mandate. But you don’t need to wait for a mandate to act: if your pharmacy serves LEP patients, this is already your issue. 

Many pharmacies are using a patchwork approach to comply with these requirements: bilingual employees, Google Translate, handwritten notes, patients’ friends and relatives, or whatever solution happens to be available that day. 

RxTran is a system, not a roll of the dice. Using a data bank of certified translations, vetted by pharmacists who are native speakers of the language they’re translating into, RxTran’s prescription label translation capabilities combine the speed of an automated system with the reliability of a human translator. 

LEP patients deserve the same standard of care as fluent English speakers, and RxTran is how pharmacies provide that. 

The prescription label is part of the treatment

Patients can’t benefit from medications if they’re taken incorrectly, and that’s often more difficult than it sounds. Prescription labels contain critical dosage and timing information that patients must follow, along with important warnings: “Always take with food,” “Do not drive while taking this medication.” A study of adult primary care patients found that up to half of English-speakers are confused by prescription label instructions. For example, many patients in the study didn’t understand that the instructions “take twice daily,” “take every 12 hours,” and “take morning and evening” mean the same thing. 

Now, envision an LEP patient whose only lifeline is the translated prescription label. This patient cannot ask questions in the pharmacy without an interpreter. They can’t call their doctor’s office or a nurse helpline and clarify the difference between “two tablets,” and “twice daily.” They’re completely reliant on the few words in their own language, on the prescription label. To maintain the standard of care, those words have to be correct, and they have to be verified by a bilingual pharmacist. 

A double standard of care is unacceptable

Think of it this way: would your pharmacy ever knowingly provide an English-speaking patient with dosing instructions that hadn’t been clinically validated? If a patient asks the pharmacy technician, “Can I drive while taking this medication?” would it be acceptable for that person to respond, “I’m not sure, but my best guess would be that you can. It’s probably fine.”

And yet, this “best guess” standard of care is being applied to LEP patients every day. The problem goes beyond the quality of the translation; by using a patchwork of translation solutions, you’re asking LEP patients to accept a kind of uncertainty that would never be tolerated for or by English-speakers. 

Medication instructions are clinical information, not customer service copy, and it’s unacceptable to shift that burden of uncertainty onto the patient. In the interview linked above, Sharon Blank made the point that when it comes to prescription labels, “good enough is not good enough,” and “better than nothing” is a dangerous benchmark. 

Sometimes, health equity and equal standards of care are hard to define. When it comes to prescription labels, these concepts are very concrete. Equal care doesn’t mean that every patient gets a prescription bottle with a label on it. Equal care means that every patient can rely on their medication instructions to the same degree. 

“Probably correct”: Good enough for some patients, but not for others? 

When pharmacies use improvised translation solutions, the assumption is that the translation is “probably correct.” But that’s the wrong question: instead of asking whether the translation is, or is not “probably correct,” we should be asking why “probably correct” is acceptable for LEP patients, when verified instructions are the norm for English-speakers. 

This metric should also apply to the idea that a sub-par translation is “at least something,” or “better than nothing.” Here again, we need to ask, would this standard be applied to other areas of pharmacy practice? Would we refrigerate a medication that is supposed to be frozen, with the justification, “It’s colder than room temperature, it’s better than nothing”? Simply put: no. But yet, many pharmacies apply this same reduced standard of care to the translations they provide to LEP patients. 

As the U.S. LEP population grows, Language Scientific and RxTran continue to advocate for standardized, human-verified translations, to ensure healthcare access, patient safety, and equal standards of care across all populations. Because equal standards of care should mean equal levels of confidence in the instructions patients take home.