Loss of patient centeredness in interpreter-mediated primary care visits

•Doctors express 2.2 times more statements than are interpreted.•Patients express 1.7 times more statements than are interpreted.•Patients and doctors engage in more patient-centered dialogue than is interpreted.•Differences in expressed and interpreted dialogue were found in each study language.•Interpreter based patient-centered dialogue predicts ratings of interpreter listening. To explore consequences of interpreter mediation of visit communication on patient centered dialogue and patient satisfaction with interpreter listening. Fifty-five professionally interpreted primary care visits were coded using the Roter Interaction Analysis System (RIAS). Two corresponding quantitative measures of patient-centered dialogue were calculated as ratios of psycho-emotional to biomedical statements based on (1) patient and clinician expressed codes and (2) interpreter conveyed codes. Multilevel models examined consequences of interpreter mediation on patient-centered dialogue and patient ratings of interpreter listening. Study participants included 27 Cantonese, 17 Mandarin and 11 Spanish-speaking primary care patients and 31 of their clinicians. Overall, clinicians expressed 2.26 times more statements and patients expressed 1.74 times more statements than interpreters conveyed. Interpreters conveyed significantly less patient-centered dialogue than expressed by patients and clinicians. All differences were evident within each study language. Interpreter conveyed patient centered dialogue positively predicted patient ratings of interpreter listening (B = 0.817; p < .007). The level of interpreter-conveyed patient-centered dialogue was both substantially lower than that expressed by patients and clinicians and a positive predictor of patient satisfaction with interpreter listening. Fuller interpretation of patient-centered dialogue may enhance patient experience with interpreters and thereby increase care quality.