Discretionary criticality triage by clinicians rations interpreter use and suppresses routine concordant communication

Narrative synthesis #

This is the mechanism-level claim explaining the under-provision documented elsewhere in the graph: clinicians informally sort encounters into "critical" (e.g., obtaining consent) versus "noncritical," and reserve interpreters for the former, leaving routine communication — daily rounds, lactation support, ordinary updates — without concordant access. Because the rationing is discretionary and provider-side rather than driven by availability, it suppresses interpreter use even where the service exists, and it concentrates the measured gaps (e.g., the 14% rounds-coverage in the same postpartum cohort) at exactly the encounter types clinicians judge routine. The evidence is a single qualitative interview study, so the mechanism is well-described but not quantified or generalized; it complements the access-side mechanisms (wait times, equipment friction) found elsewhere in the corpus.

"I also think that we have kind of triaged what's considered critical and what's not. But ... the best case scenario is that ... a patient would have an interpreter with them the entire time they need it, the entire time they're there." (Jensen, 2023, p. 435)