The (un)imagined work of linguistic inclusion

In this episode of the Language on the Move Podcast, Emily Pacheco speaks with PhD candidate Brynn Quick (Macquarie University, Australia) about her 2025 paper, The (un)imagined work of determining patients’ English language proficiency. The conversation focuses on language policies in healthcare, the monolingual logic, and language access.

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References

Quick, B., & Piller, I. (2026). Hospital practices for determining patient language proficiency: A systematic review. Australian Journal of Applied Linguistics, 9, 103359. https://doi.org/10.29140/ajal.2026.103359
Quick, B., Piller, I., & Lising, L. (2025). The (un)imagined work of determining patients’ English language proficiency. Journal of Multilingual and Multicultural Development, 1-18. https://doi.org/10.1080/01434632.2025.2594462

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Transcript

Emily:

Welcome to the Language on the Move Podcast, a channel on the New Books Network. My name is Emily Pacheco and I’m a PhD candidate in Linguistics at Macquarie University in Sydney, Australia.

My guest today is a fellow linguistics PhD candidate at Macquarie, a familiar voice to many of our listeners, co-producer and frequent host of this podcast, Brynn Quick!

Brynn, an American-Australian, holds a Master of Applied Linguistics and a Master of Research from Macquarie University. In her current PhD candidature, she is investigating how language barriers are bridged between patients and staff in Australian healthcare contexts. Her linguistic interests are many and varied, and include sociolinguistics, anthropological linguistics, sociophonetics and historical linguistics, particularly the history of English.

Today we are going to talk in general about language policies in healthcare, and in particular about a recently published 2025 paper that Brynn wrote entitled, “The (un)imagined work of determining patients’ English language proficiency”.

Brynn, a warm welcome to the show, and thank you so much for being on the other side of this interview today!

Brynn: Thanks so much, Emily. It feels weird, but also really exciting to be in the guest seat today.

Emily: Yeah, I’m thrilled to be able to interview you! And so, Brynn, our listeners may have learned a bit about you already through your other podcast episodes that you’ve hosted, but I would love it if you could tell us a bit more about yourself and how you decided to pursue a PhD in linguistics.

Brynn: So, I, um, am what we call a mature age student, and I like to refer to myself as a geriatric PhD candidate. I’m 41. Um, and I’m in my second year of my PhD candidature, so my journey to my PhD was not linear, uh, like it is for maybe a lot of other younger people, such as yourself, when you’re doing this, um, in your 20s.

So, I got my undergraduate degree in 2007, um, in America, and I did a double major. One of my majors was Spanish, which like, makes sense. And then the other major was theatre, so I’m a trained actor, uh, actually. And, so I did that, then I graduated right into the global financial crisis, or in America, as we tend to refer to it ‘the recession’, um, of ‘07- ‘08. I had gone to become a teacher in Spain. I had travelled to Spain, I got my, um, CELTA certificate, so it’s the Cambridge English Language Teaching to Adults certificate there. Um, and then I became an English teacher to adults in Spain, worked there for a while, And, um, loved it. So, travelled around to different corporations in Madrid, and taught in corporations, basically, like, business English.

Um, but then I came back to the States, and all of a sudden, jobs were nowhere to be seen. I did work at an English language school for a while, um, both as a teacher and then as a director. And that was in the Washington, D.C. area. Then, my husband and I decided to move to Australia for a year. I worked as, like, a student services officer, in another English language school here. Then went back to the States for 5 years, and that’s when I left, um, the workforce and had my kids. And I was a stay-at-home mom with them, um, for many years, and then it wasn’t until we moved back here to Australia in 2017, um, that it was, like, in the next year or so, my kids were old enough that they were either in school or daycare, at least part-time, and I thought, like, I really miss working, I miss teaching, um, I’d really like to go back into it, and so I kind of had to start again. I started from scratch.

I had to re-enter school, and I got my graduate certificate in TESOL, so teaching English as a Second Language through Macquarie. And then COVID hit, and I was trying to work during COVID, and also homeschool my kids, and I think any parent listening to this probably, like, shudders when they think back to that time, because it was really, really hard. And that was in 2020, and I realized, like, mmm, I don’t think this is gonna end in 2020. I bet we’re gonna have another lockdown. And I can’t try to work from home and homeschool at the same time, so I decided to go get a master’s degree, and so that’s what I did.

And then I kind of went from there, you know, got my first master’s, um, through Macquarie. That went on to become a Master of Research, and then that led into the PhD. Um, I just really fell in love with linguistics as a field, and especially sociolinguistics. And whenever anyone asks me, like, oh, okay, what is linguistics? What do you do? And I and, you know, of course, I’m sure you’ve gotten this before, how many languages do you speak? And I’ll say, like, well, two, but, um, that parts not important. The important thing is, is that I’m doing sociolinguistics, so I talk and learn about how culture influences language, and how language influences culture. And so that’s what I really enjoy doing. Um, and so that’s what’s taken me here.

If you had asked me when I was in my 20s, you know, are you gonna go get a PhD one day? That was never, ever a thought in my mind. So, um, hopefully that can help anybody who is a mature age, student like me, uh, who might be thinking, oh no, I left it too long, I waited too long, I can’t believe I’m doing this in my middle age. It’s something that we all, when we come to a PhD, I think we all have to get there in our own time, and I’m glad that I got there now.

Emily: Yeah, that’s a lovely story, Brynn. Thanks for sharing, and of course, I’m biased and very thankful that your paths or your journey led you to Macquarie, and um, you’re a great addition to our team and our PhD candidates’ group, and I can’t imagine it without you, so, I think that’s very lovely. So, um, and it also was funny, like, you know, people say, like, oh, you’re doing linguistics, how many languages do you speak? I get that all the time, and I always say, oh, I actually do sign language, and they’re like, oh! So um, yeah.

Brynn: Right. They don’t realize, like, that’s part of it as well. Yep, so it’s a huge field, and we’ve all got our big subdivisions, and little cliques within it, yeah.

Emily: Yeah, absolutely, absolutely. So, to start to shift to the talk today about, uh, your paper, just to foreground our discussion about it, could you explain what work-as-imagined and work-as-done means?

Brynn: Yes, so, this is, um, today we’re obviously talking about my first paper out of my PhD. So, um, I’m doing what’s called a thesis by publication. I know you’re doing that too. And this is different to a traditional thesis by monograph. So, I think when a lot of people think of a PhD, they think of, oh, you’ve got to write a huge book. And that is typically what people have done, historically, and that huge book is called a monograph. But in the past few years, it’s become more and more common for people to do this thesis-by-publication, because as we all know, um, a lot of our metrics, uh, are determined by how many papers we get published in journals. And so, this is my first paper out of the PhD, and it’s the first paper I’ve ever published ever. So that’s very exciting.

Emily: Very exciting! Congratulations again!

Brynn: Thank you. Thank you! So, for this paper, what I was doing, um, it’s kind of like part one of this sort of two-part process. So, my PhD is looking at how do healthcare organizations, so, I’m really looking at the organization itself, how do they ensure language access for limited English proficiency, or LEP patients in the context of, like, Australia, where everything is done in English, right? So, as I was thinking about, okay, how do I do this? I knew that I wanted to look at the actual policies that are on the books. I wanted to see, okay, what are people, quote, supposed to do within a healthcare organization to ensure that these LEP patients, um, get access to things like interpreters or translated documents, and because I feel like we need to start there. We need to see, alright, what are we supposed to be doing, right? So, I was able to find this framework that’s called work-as-imagined, versus work-as-done.

So this is a framework that’s often used to analyse the work that people do in the fields of human ergonomics, so, like, thinking about how people actually work, um, for anyone who ever read the book Cheaper by the Dozen, which I loved as a kid, it takes place in, I think it was, like, the 19…30s or 40s, and, um, the dad in that book I think he, uh, studies human ergonomics. So it’s, like, efficiency of work. How do people work? How do people get things done, kind of like on a factory floor, right? So, this framework is used there, but also, it’s been more and more used in healthcare, which, when I read that, I was like, well, that’s weird. Those seem like two totally separate fields of work, right? But the way that this works in healthcare is, um, it’s used to analyse clinical work in terms of what is, like, supposed to happen over the course of patient care, and then what actually happens.

So, um, let me give you an example. So, there’s a book called Resilient Healthcare Volume 2, um, and it’s edited by several people, and one of the people is Erik Hollnagel, um, and he’s one of the most prolific scholars of work-as-imagined versus work-as-done in healthcare. And in this book, he asks us to imagine this scenario, like, this imaginary scenario, to kind of get the picture. So, the scenario is…A hospital has a policy that all newly admitted patients must have a blood draw with routine blood tests, and this blood draw is to be done by a nurse. Okay, fine, that sounds pretty logical. However, in this scenario, no nurse is supposed to draw blood from an admitted patient until an order is made by a doctor, and a label is already printed and ready to be put onto the vial of blood. However, at this hospital, the nurses often ignore this official policy and draw blood from a patient as soon as they’re admitted, so they’re not waiting for the doctor’s order. And this is because the nurses know that the doctor will request this eventually, so they feel that drawing the blood immediately and having it waiting for when the order does actually come through is a time-saving measure. Even to the point that they kind of unofficially teach new nurses to do this, when the new nurses first start working at the hospital. And so, as the reader, we might ask ourselves, well, why is the hospital policy written so that the doctor has to request the blood draw before the blood can be taken. And, you know, maybe we’re thinking that based on the nurse’s workaround, the policy was written without taking into account the long wait times that actually happen between the patient being admitted, the doctor seeing the patient, the doctor requesting the blood draw, the label being printed, and then finally the actual drawing of blood. So, this is exactly what happens, when work-as-imagined, or what policymakers imagine a work environment and work itself to be, comes up against work-as-done, or how people actually do work based on environmental constraints.

So, the way that I like to explain this in sort of my elevator pitch is to think of, like, expectations versus reality. We’ve probably all seen those, uh, memes online, where you see, like, a really pretty cake, and it’ll say, like, expectations, and then you see a picture right next to it, and it’s, like, reality. And it’s, like, the cake that someone has tried to make, but it’s all smushed, and it looks weird, you know? So, this is kind of what work-as-imagined versus work-as-done is. And that’s not to say that always you know, policy is completely not in touch with how work is actually done. But that does happen quite a bit. And so, I wanted to use this framework to see, okay, in Australia and New South Wales and Sydney in particular, what do these healthcare policies say? What are patients who have limited English proficiency, what are they supposed to be able to access? Who is supposed to give them this access, this language access, and how, versus…What actually happens? So, this paper is the first part that shows us the imagined work, what the policies say should happen. The paper that I’m currently writing is about what actually happens.

Emily: Yeah, yeah, that’s very, that’s a nice, um, setup there, and uh, thank you for explaining that, the framework you’ve used, and um, the meme reference was really good, and it is, you know, it’s a great way to get across what exactly you’re looking at.

So, as you’ve mentioned in this paper particularly, we’re talking about your first paper, um, you’re presenting an analysis of these healthcare policies that relate to the linguistic diversity in Australia, but you find they employ a monolingual logic, and within this multilingual reality. Could you tell us a bit more about, you’ve hinted a little bit, but a bit more about the policies you collected specifically in your data, and how your study is a methodology that we would call a policy ethnography, and tell us a bit more about that, if you could?

Brynn: Yes, so I looked at, um, several different policies, 13 in total, um, and I wanted to make sure that I was looking at policies that came from the four different levels of governance within Australia. So that’s federal, New South Wales state, because that’s the state that we live in, or that I live in, and local health district policies, so, like, each, within a state, it’ll be divided into local health districts, and so each of those local health districts might be slightly different from each other. Um, and then finally, the fourth level is institutional policies. So, I am looking at an entire health network, which I have given the pseudonym Blue Meadow Health, um, and it’s a private health organization in Sydney.

Um, and so I’m looking at policies from all four of those levels, but importantly, the most important sort of overarching policy here is called the Australian Charter of Healthcare Rights. And this charter lays out what patients, any patient within a health system in Australia, should expect from their healthcare encounter, basically. And one of the rights that is guaranteed under the Charter is the right to information. And so, that is then what I based my selection of other policies on, was like, okay, what other policies are there that are guaranteeing a patient the right to information? And how are they saying that people who don’t have English can get that information? So, what I did was I analysed these 13 different policies, and I kind of did this in a linear way. And I did this by asking who do the policies say should assess a patient’s language, English language proficiency before or during a medical encounter? How should a patient’s English language proficiency be assessed in order to determine if they need something like an interpreter. And what guidance is provided to healthcare staff to determine whether communication is successful at any point in the consultation process. Um, and so that’s basically how I coded all of the policies. And that’s how I determined how they were supposed to address a limited English proficiency patients’ needs.

Emily: Um, and as part of that, in your paper, you explain a bit about process mapping as a method of analysis, and so could you explain how you applied that method to your data, and maybe take us through that process itself? That would be great.

Brynn: Yeah, so, um, this is a concept called process mapping. It comes from, um, Debono et al., 2019. And that’s basically where this idea of a linear process of a policy is analysed, in order to describe how the policy is to be enacted on, based on how these policies imagine work to happen.

So again, sort of this overarching theme of, like, what is the work, the actual work, that goes into ensuring that LEP patients get language access, that get care, that, where they can understand what’s being said. So basically, it’s, it sounds fancier than it is. It’s essentially what I just said, where we’re talking about, okay, so, who is supposed to do this work? How is this work supposed to get done? And what is the end result of this communicative work supposed to be? And to me, this was really important because I feel, based on the work that I did with my Master of Research, where I was also looking at some similar things, that we have a lot of really great research that has been done about why do doctors and nurses maybe not use interpreters that much with their patients? Or, we have research about why patients do or do not prefer to use interpreters, like, professional interpreters versus family interpreters, um, within the healthcare context.

But what we really don’t have much of is sort of this nitty-gritty, maybe it sounds boring, but I really like it. Um, this nitty-gritty stuff about, okay, well, how is the work actually getting done? What is the workflow supposed to be? If a patient needs an interpreter, how do I, as a healthcare staff member, actually go about figuring that out, arranging for the interpreter, making it all happen within the course of my workflow. Because we all have jobs, where we have to get things done during the course of a busy day, and for me, I think that this is a really interesting angle to look at this really huge area of research. Because if we don’t know what this actual process is, then we can’t see where maybe the lines of defence are failing and people aren’t getting interpreters.

Emily: And a part of that, you know, we say to get an interpreter, okay, but before you even get an interpreter, someone has to assess, right? Does this person need an interpreter if someone doesn’t request one, or advocate for one? Um, so in your paper, you also talk about, I think it’s really interesting to see who is supposed to do this assessment of a patient’s English language proficiency. And as part of that, you did find some patient work, and you also talked a little bit about how healthcare practitioners are supposed to do this maybe as well, so if you could tell us a bit about that, who’s assessing the need for an interpreter, and how do they do that?

Brynn: Yeah, so according to policy, really, what the policies all say is, hey, patients, if you need an interpreter, like, if you don’t have much English and you need an interpreter, make sure that you tell us, the healthcare organization. Which, again, okay. So, this is where the concept of, you asked earlier about monolingual logic, this is where the concept of monolingual logic comes into play. So, I’m getting this idea of monolingual logic from work that’s been done by Piller, Bruzon, Torsh, and then earlier, the concept of the monolingual habitus, which comes from Ingrid Gogolin. And in the monolingual habitus, which we in Australia, um, often conceptualize as the monolingual mindset, which was proposed by Clyne. But the monolingual habitus means that there are these policies, or these work environments, that come from this logic, or this setup, of somebody who maybe doesn’t understand how languages work, and how multilingualism works. So, when Ingrid Gogolin came up with this concept, she came up with it in the realm of education, so, like, primary, high school, things like that. And she was looking at how multilingual kids were able to access education when they maybe didn’t have the language of the educational institution, right? So, then we kind of narrow down this idea of monolingual habitus into a subsection monolingual logic, which to me, in this case, is saying, okay, so these policies are saying that, hey, patient, if you need an interpreter, come tell us. But we, anybody who has another language knows that when you learn another language, it’s not that easy to then be able to go up to an institution, which is what healthcare is, and say, hi, I don’t speak this language, I need an interpreter. But overwhelmingly, that’s what these policies say. So, the policies will say things like, if you need an interpreter, speak to our staff. If you would like an interpreter, ask a staff member to organize one for you.

But the thing is, the monolingual logic about this is that all of these policies are written in English, so the people who need to know this information, likely cannot access this information because it’s in English. Now, the charter that I was talking about before, um, was translated into, I believe it’s, like, 32 community languages. But it’s only one page, and it’s just kind of bullet point information. It’s not the real substantial information that somebody might need if they’re trying to interact with the healthcare system. And so, you really, if you’re a patient, who has the right to access information that you can understand about your own health, but you don’t have the ability to go up to, or call, or email someone from a healthcare organization to say, hey, I need an interpreter, in English, then you’re not gonna get one.

The policies also say things like, oh, hey, not a problem, we get it, you can download this, I need an interpreter card from a website, and you can, like, present it, because it’s supposed to be in two different languages. But, you know, again, this is, this comes back to sort of an organizational problem, because when I clicked on the link that would have taken me to that card, there was no page. It was, like, 404, error, page not found, you know, so, so again, it’s like they’re saying, yes, yes, we want you to be able to access language and language supports, but we’re not putting in the work necessary to get you there.

Um, something else that the policy said was that even though the patient is supposed to go tell, the, you know, staff that they need an interpreter, that it is the healthcare practitioner’s, quote, responsibility. This kept coming up a lot in the policies. That health practitioners are responsible for assessing a patient’s need for an interpreter and arranging for an interpreter to assist them. So, it was very weird. It’s like, okay, so there are these two different messages that are being sent by policy. Who is supposed to do this work? And again, this comes back to this is actual work that has to get done. This is the stuff that happens throughout the course of the day, that somebody needs to think about as actual work that people are doing. And if we’re going to be saying to healthcare practitioners, hey, you need to be responsible for this, that’s fine, but then we need to give them the tools to actually know how a patient is supposed to be assessed, because the policies later go on to say, uh, okay, you know, healthcare practitioners, if you want to know how to assess a patient’s language, uh, English language capabilities, just, uh, determine if they can speak English. And it’s like…No, that doesn’t make any sense. Um, you know, again, maybe according to a monolingual logic, that does make sense for someone who maybe doesn’t have a lot of experience with assessing language or understanding how, sometimes, when we have another language, we can speak conversationally, um, to somebody. But, if you throw us into a healthcare situation where they’re using complicated medical jargon that you’ve never learned, um, when you might be in a heightened state of emotion, things might feel very high stakes. You know, our ability to then use that other language goes down. Um, and so that’s why it becomes important to get somebody like a professional interpreter. And so, if policies just say, well, figure out if they can speak English. Okay, but you have to tell us how to do that, and that’s what really doesn’t exist in these policies.

Emily: Yeah, that’s, um… That’s a bit crazy to think about. It’s a huge, like, it’s a huge part of getting an interpreter, but how, and who’s responsible, and to keep talking about that, let’s discuss who’s missing from these policies, the medical receptionist. I think it’s interesting you keep saying staff or the policies say staff. And in a medical building, in a hospital, in a clinic, staff could mean so many things. Um, so let’s talk about medical receptionists and how and why they’re an important part of the process that we’ve been discussing so far, and what are the impacts of their work.

Brynn: So, this is, and I keep saying to everyone, I’m like, I will die on this hill. Um, I am so, I really want us to talk about medical receptionists, because we really do not have much research into the role that they play in being part of this journey that a patient goes on throughout a medical system, and it really is a system, right? The healthcare system, it’s like a big machine, and I think we, any of us who have ever been through the healthcare system, whether it’s here in Australia or anywhere else, you know, it’s often… it’s very easy to feel lost in that machine, you know? You feel like you’re just sort of a number, you don’t necessarily feel like you know, the healthcare organization in general is taking care of you. And you know, we’ve made a lot of medical advancements in the last hundred or so years. I’m very thankful for that, and if we get to have longer, better lives because it’s a bit of a machine, I understand that there is that trade-off.

But the thing is, medical receptionists are generally a patient’s first point of contact with a healthcare organization. Think about any time that you’ve had to call, whether this is your GP, or a specialist, or a hospital, and you’ve needed to make an appointment, who’s the first person that you talk to? A medical receptionist. If you go to be admitted to hospital, chances are, the very first people that you see are the admissions department, or, you know, receptionists at that front desk. So, what I really learned from my Master of Research, which was a systematic literature review of 50 different current studies, that were looking at linguistic diversity within the healthcare context, was that all the time, I kept hearing about staff. Staff. Medical staff, front desk staff, receptionists. And so, I was like, well, wait a minute, it seems like these medical receptionists are playing a big role in this patient’s journey. But why don’t we know much about them? Why don’t we know what they do or don’t do in order to get an interpreter for a patient, or what happens if somebody calls them to make an appointment, and the receptionist can tell that the person has a limited English proficiency, what do they do?

So, this is exactly what my research goes into in the second part. Um, so you had asked earlier about what a policy ethnography is. And this is where this comes into play. So, a policy ethnography is where it’s kind of the combination of the two words. We look at policies. So, like, what I did for this paper, sort of an audit of policies. But then we combine that with the work-as-done portion, which is conducting interviews, in my case, with medical receptionists. So, I did that as well. Um, so that I could ask them, okay, what do you do? How do you manage linguistic diversity when you’re also doing 500,000 other things? Like, you know, making sure that patients have appointments and sending emails and taking calls, and you know, dealing with clients or customers or patients that are upset, you know, a lot goes into their day, so, in this policy part, this also, like you said, kept coming up, where it would, the policies were directing patients to go, quote, talk to staff. And inevitably, what that meant was go talk to a medical receptionist, because that’s who your, the patients are going to see in that patient-facing role.

And some of the policies, one in particular, even says look, yes, healthcare practitioners are responsible for making sure that a patient gets an interpreter if they need them, but in reality, medical receptionists are often the ones who need to do this. So, they should be trained as well. But that was it. That’s all they said. And so, the paper that I’m writing now is all about how medical receptionists make these decisions, and sort of spoiler alert, it really does come down to medical receptionists. They are the ones who are really making decisions about whether a patient is going to get a professional interpreter or not. And so, I think that they are really this missing key in the healthcare machine. They’re like a missing cog in the part of the wheel that we just haven’t explored that much, and I think that if we do, we’re gonna find out a lot more about how language access actually works.

Emily: Yeah, yeah, it’s fascinating, and it really seems like you’ve uncovered a really important piece of the puzzle that may have been overlooked. And that is really necessary to take a closer look at.

And so, throughout this conversation, we’ve talked about the policies, how you’ve analysed them, kind of who’s doing what. And so, let’s say, you know, someone does request an interpreter, or someone thinks, oh, this person needs an interpreter. They get the interpreter, can you tell us how the policies you looked at define, okay, now effective communication is happening, or is it happening between patients with limited English proficiency and their healthcare providers, how are they determining that in these policies?

Brynn: Well, that was one of my biggest moments where I, like, gasped out loud when I was reading these policies, was because I did, I really wanted to know, alright, fine. We’re getting an interpreter, or we’re not getting an interpreter for limited English proficiency patients. What is the outcome? So again, it goes back to that, like, process mapping. What is the outcome that we want from this? And ostensibly, the outcome is communication, right? We want the, um, we want the healthcare provider to be able to feel comfortable communicating with the patient, and vice versa. We want the patient to be able to get as much healthcare information as they would get if they were getting the care in their preferred language, right? But what was incredible was that all of these policies define communication with adjectives, and that was it. Nothing else.

So, they were like, well, we want to make sure that there’s, quote, effective communication, or, quote, clear communication, or quote, good communication. And I was reading it, and I was like, but what does that mean, you know? What does that mean, especially when we’re talking about people, the healthcare providers and the patients, who are potentially coming from not only different language backgrounds, but different cultural backgrounds, because that healthcare communication can look extremely different in different cultures, right? There’s something that’s quite common, which in certain cultures, if somebody, especially, like, an elderly relative, if they are given, like, a terminal diagnosis. So let’s say that somebody, um, you know, 80-year-old grandmother has terminal cancer, in certain cultures, it is very common to, for the doctor to not tell that patient oh, you have terminal cancer, because it’s considered to be kinder to not give that information, and to not stress the person out. And so what we see is that this will happen sometimes, even in a healthcare context where, you know, it’s happening in, like, a large GP or a large hospital, where this communication won’t get conveyed, to a person, because If the healthcare provider is coming from, like, you know, an Australian English background, they are saying to the patient, like, yep, you are terminal, you’re going to die, you’ve got cancer, but let’s say that, like, the patient’s family member is there acting as the interpreter, from their perspective, that is not culturally correct, and so sometimes they will then choose not to interpret that information as the family member to their elderly grandmother, they will just say, you know, oh, you’ve got pneumonia, please take this medicine, you’ll feel better, you know. And so, so that’s why we have to have a more robust concept of communication. And we have to consider communication, multilingually and multiculturally. We have to have this known to not just healthcare providers, but all parts of staff, including medical receptionists, that there are these differences in communication that will happen. And so, we need to decide what is it that we expect all patients, regardless of language background, what information do we want them to get? And what information are we okay with being left up to different cultural interpretations or preferences.

Emily: Yeah, thank you so much, Brynn, for taking us through your first paper, and I think, you know, this study definitely, um, has impacts and benefits for everyone to improve the healthcare system, to make it, uh, to have more, quote, effective communication, uh, can benefit all not just people who are multilingual or multicultural.

So, to wrap up our conversation today, I would love to ask, what is next for you in your work? Is there anything else you want to share with our audience today?

Brynn: So, like I said, I’m working on the second paper now, and this paper is going to be about how medical receptionists make decisions around whether or not they’re going to use or allow the use of an ad hoc interpreter, which is, like, this family member that I was talking about, that will often accompany a patient, and the family member speaks English to a higher proficiency level than the patient. So sometimes, healthcare professionals, they will say, oh, that’s fine, you be the interpreter. And there are lots of thoughts and feelings about that in the literature and in different studies. Um, some people say, yep, that’s totally fine. Some people say, nope, that’s never okay. So, what I want to know is what are the medical receptionist’s decision-making processes like? And what is guiding their decision-making processes as to whether a person can use an ad hoc interpreter, or call for a professional interpreter, or choose not to have an interpreter at all. Um, so that’s this paper, and then the paper after that will be about how these medical receptionists that I interviewed discuss using Google Translate when they talk to patients. Which is going to be really interesting.

And then, uh, like I said, with the thesis by publication, yes, you publish papers, but then you have to write, like, linking chapters and a big literature review, so that’s gonna be my life for the next, uh, year and a half, is just all of this writing. But it’s really interesting to see how it all comes together, how these sort of separate papers can all come together to sort of paint one big picture about what’s going on in healthcare right now, and I do hope that it will contribute to allowing for more language access for lots of different people. And helping medical receptionists to incorporate this into their already extremely busy workflows. I really want us to, like, think about the medical receptionists, you know, really consider what this is like for them, and make it as easy as possible on them, so that that knock-on effect translates to the patients.

Emily: Yeah, absolutely. Well, thank you again, Brynn! This has been great. Um, I really appreciated the chance to get to interview today, you today, and hear all about the exciting work that you’re doing. So, uh, thank you for agreeing to join the interview!

Brynn: Thank you, Emily. Thanks for letting me be in this seat.

Emily: Yeah, it’s my pleasure. Um, and thanks for joining, everyone! If you enjoyed the show, please subscribe to our channel, leave a 5-star review on your podcast app of choice, and recommend the Language on the Move podcast and our partner, The New Books Network to your students, colleagues, and friends.

Till next time!