Crossing Cultures With Healthcare

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Juan Gutierrez

Written by: Nadia De Leon, Community Engagement Coordinator

Juan Gutierrez

Health Programs Specialist -South Central Kentucky Area Health Education Center (AHEC)

Coordinator of Language Access – TJ Samson Community Hospital

Part-Time Faculty – WKU Department of Communication Disorders

Originally from Colombia, Juan Gutierrez is a doctor by training. Upon coming to Kentucky, he found WKU to be a good institution to help him redirect his professional life, and in 2005 he decided to pursue a second master’s degree and enrolled in the Public Health program. As is often the case, he had a different idea at the time about what he would end up doing with the degree; however, once in his classes, he quickly discovered the myriad of issues related to the language barrier with cross-cultural communication in health care. Because of this knowledge, he began this entirely different field of study and never even thought about going back to what he had originally thought he wanted to do. “Maybe someday when I retire and want to try something new, I’ll go back to medicine and specialize in neuroscience or something,” he jokes.

Nowadays, Dr. Gutierrez is in involved with a number of programs at WKU and in our community. One of them is the Language Access program at TJ Samson Community Hospital in Glasgow. Back in 2005, he was originally brought on by TJ Samson for a consultation while he was working for AHEC. He explains this consultation: “They wanted to implement a language access program according to federal guidelines as part of ongoing organizational changes and I gladly accepted the challenge,” he continues, “… we put this together along with the patient advocate office at the hospital.” It has been growing and evolving ever since. “Today we have the only 24/7 365 days-a-year medical interpreter program in the state,” he adds proudly. Dr. Gutierrez supervises a number of contract interpreters and has an office at TJ Samson. As part of long-term partnership that developed out of this program, TJ Samson pays for part of his salary but he remains a full-time WKU employee at AHEC with other responsibilities.

Coordinating and teaching Bridging the Gap, a 40 hour medical interpreter training program, is one of his AHEC duties. Bridging the Gap was developed in the 1990s by a nonprofit organization, the Cross-Cultural Health Care Program, based in Seattle, Washington. In Dr. Gutierrez’s opinion, it is the oldest and the best training program for medical interpreters in the country. He explains why, “Because of AHEC’s federal funding we are able to offer the training at no cost for people who live within the over twenty counties in our service region – including tuition and books!” He continues: “The average cost for this program in the market at agencies that charge tuition is $600 per person. We are trying to deliver value but offer it for free, because we are very mindful that there is a huge need in this region of Kentucky — particularly with Bowling Green being a refugee resettlement center and such a diverse city.  We need to start changing the providers’ culture to acknowledge that there is this kind of diversity and they need to respond to it effectively.” People come for this training not just from Warren County, but also Barren, Hart, and Christian Counties. For the upcoming session, which will be hosted at the ALIVE Center in January, they are even having people from counties outside of the service region that are paying for their own tuition. In the past five years that Dr .Gutierrez has been teaching this program, he has trained around 100 people. “It is the best class I have ever taught” he states with excitement. However, no matter how good, it is only a very basic training. Because of this, Dr. Gutierrez has now gotten involved with a new certificate program at WKU created as an advanced degree for people who would want to pursue medical interpreting as a career.

This summer, a new WKU certificate program in Cross-Cultural Communication in Health Care was approved and will be taught out of the Department of Communication Disorders in the College of Health and Human Services. “God willing,” he confides, “we will start teaching this Fall.” There are a lot of expectations for this new interdisciplinary program. “I hope it will foster the sometimes very fuzzy connection between programs related to communication, health administration, people who do not speak English, and the public health consequences of such issues” he explains. He would like for the program to promote deeper understanding and help people communicate across cultures, but to also create deeper change by impacting the results of the interactions between non-English speaking patients and the health care system, to the benefit of both sides. He adds, “only that would make the program truly effective and sustainable”. This program will be the only one nationwide that has an administration track for language access planning, the Implementing and Managing Language Access track. Students in the track will learn about legislation, how it works, and how to create programs that are compliant, cost effective, and safe for the patients. The other track, Medical Interpreting, requires that students be bilingual. It is open, however, to students who are fluent in any language. In fact, he states that “by working with DELO we will be able to work with over 120 languages, including sign language. Classes are taught in English with a few structured exercises that are language specific,” he explains, and adds: “The important thing about interpreting, especially for health care, is that this is not a language class … I could not train anybody who was not already absolutely bilingual, and I would also say bicultural.”

Another community partnership program that Dr. Gutierrez has long been involved with is the Horse Cave Health Fair. The fair was initiated many years ago by Pastor Kevin Denton and members of Horse Cave Baptist Church who served the migrant workers who came to the area during tobacco season by giving them free food and fellowship. In the process, they discovered a dire need for medical care among the workers, some of whom had never seen a doctor in their entire life. Pastor Denton decided to call some doctors and dentists who were friends of his and hosted the first fair in the church basement on a Saturday evening. In 2006, after a lapse in the program, the church contacted Dr. Gutierrez because they needed more effective ways to communicate with the workers who were coming to get free medical care. That year, Dr. Gutierrez volunteered to interpret and brought with him some of his friends and volunteers from the community. Slightly concerned about not being able to test these volunteers for proficiency, the following year he started bringing hospital interpreters to the fair, and partnered with Sonia Lenk of the WKU Modern Languages Department to bring her advanced Spanish students. The students benefit from interacting with the community, practicing their language skills, and talking to the workers, while providing a very much needed humanitarian service to the community. “For the students, it is an eye-opener about what you can do with your language skills other than just teach,” he explains. These partnerships have allowed the health fair to provide interpreting services on a continuous basis. Students continue to volunteer at the fair today, and a lot of them have gone through the Bridging the Gap training. “Some of them are even going to go into the certificate program, and I’m very proud of that,” adds Dr. Gutierrez. “It’s all about building community,” he continues, and explains that the church and the community are very grateful to WKU for putting together this effort. “This is a very remarkable event in many respects,” Dr. Gutierrez concludes, “most importantly, because it is all volunteer-based, not a penny of funding goes towards this program. People just come together and do it spontaneously, with no monetary retribution, just a thank you certificate we put in the mail … not just the volunteers, but a lot of the doctors and dentists that give their time are very passionate about it and come very early to see patients for free. It’s an amazing and beautiful example of how you can really turn the tide around when you develop that community consciousness in a group and they start caring about each other as people”

For more information about Bridging the Gap, the Certificate in Cross-Cultural Communication in Health Care, and volunteer opportunities, email juan.gutierrez@wku.edu

 

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