Every Saturday morning, a steady stream of Chinese and Vietnamese patients line up at the Paul Hom Asian Clinic in Sacramento, Calif. Most of them speak little to no English.
Patient assistance director Danny Tao says people come here to get free medical consultations and drug prescriptions. But, he says that when patients take those prescriptions to be filled, they don鈥檛 understand the instructions on the label.
鈥淭hey go pick them up, and we don鈥檛 exactly know if they鈥檙e taking it or not 鈥 or if they know how to take it,鈥 Tao said.
Tao says drug labels at most pharmacies in California are printed only in English. That puts patients in danger of making any number of errors 鈥 taking too much medication or not enough, taking it at the wrong time of day or with the wrong food. Such mistakes can cause serious harm or even death.
Tao says that for the drugs his clinic supplies directly, all have a bilingual label.
鈥淚t鈥檚 going to be English/Chinese or English/Vietnamese,鈥 he said. 鈥淏y the time they get home they know exactly how to take the medication, because it鈥檚 in their own language.鈥
This week California鈥檚 Board of Pharmacy will discuss new regulations that would require all pharmacies in California to provide translated labels on prescription drug bottles. Statewide, 44 percent of Californians speak a language other than English at home. last year to make it easier for non-English speakers to take their medications properly and avoid costly mistakes.
But the California board鈥檚 executive officer Virginia Herold says the move is very controversial. For starters, there is a concern that bilingual labels would mean larger bottles of pills to fit all the text. Patients, she says, don鈥檛 like larger bottles.
鈥淭hey decant the drug out of the large container, put it in a baggie or someplace else,鈥 Herold said. 鈥淣ow, the instructions on how to take it have been separated,鈥 defeating the purpose of the new labels.
Pharmacists don鈥檛 like the proposal because they say it opens them to liability if there鈥檚 a mistake in the translation. Brian Warren is with the California Pharmacists Association.
鈥淚f the label is translated into Russian and there鈥檚 an error, and I鈥檓 a pharmacist that does not speak Russian, I cannot verify that that error exists,鈥 Warren said.
He adds that the labels could increase the cost of malpractice insurance.
鈥淚t鈥檚 an expense that will ultimately make its way down to consumers, and like all other health care costs, will eventually result in higher premiums,鈥 Warren said.
At present, the state鈥檚 board of pharmacy translations of basic instructions such as 鈥渢ake one pill at bedtime鈥 in five languages: Chinese, Russian, Spanish, Korean, and Vietnamese.
Proponents of translating labels say that concerns about the change are outweighed by the problems patients who speak limited English face under the status quo.
鈥淭here鈥檚 a risk right now,鈥 said Sarah de Guia, director of government affairs for the California Pan Ethnic Health Network, an advocacy group. 鈥淭hey can鈥檛 understand anything on their label because the label is not in their language.鈥
De Guia says the expansion of insurance under the Affordable Care Act makes the issue more urgent: 鈥淵ou鈥檙e going to have 1.5 million more limited-English proficient individuals in the health care system [in California] now that the ACA has passed.鈥
The discussions are in the earliest stages, and if new regulations go forward, many details need to be worked out, including how many languages are included and who would have responsibility for translation.
