Critical Care, Critical Gap: The ASL Interpreter Shortage in Medicine 

Imagine walking into the emergency room with severe abdominal pain. Overcome by piercing strains and hunched over, you approach the counter and begin sharing your symptoms. The nurse on duty stares blankly back, not understanding anything you’ve shared. Pain is now paired with irritability, the nurse realizes she needs to dial her relay ASL provider to interpret your check-in. The dial symbol spirals on the screen, pain continues, and the late hour leaves you doubtful that you will receive the access you need. 

In healthcare, communication isn’t optional, it can be life-or-death. The national ASL interpreter shortage is hitting the healthcare industry especially hard and leaves the nearly 500,000 ASL users susceptible to a lack of access. Language Services Associates summarizes the predicament stating, “effective communication is key to ensuring equity and fair access in a globalized world. Under Section 504 of the Rehabilitation Act of 1973 and The Americans with Disabilities Act of 1990 (ADA) it is the responsibility of covered entities to provide effective communication at no-cost to the consumer. For Deaf & Hard-of-Hearing (DHH) communities in the US, American Sign Language (ASL) interpreters provide a lifeline in situations where language inequality prevents critical information from being accessed.” This article aims to highlight the scope of the interpreter shortage, explore its effect on the medical field and patients who are ASL users, and provide resource solutions to accommodate considering these odds.  

The Scope of the Interpreter Shortage 

Language Services Associates shares, “according to the National Census of the Deaf Population there are approximately 500,000 Deaf and Hard-of-Hearing Americans who use ASL, and a ratio of roughly 50 Deaf or Hard-of-Hearing ASL users to one ASL interpreter.” This stark reality is uniquely paired with the high-stake needs of the healthcare field, and a lack of experience that further shrinks the pool of available interpreters. “Finding a suitable ASL interpreter is not a mere numbers game. It’s a complex puzzle, intricately linked to individual needs, situations, and contexts. Every Deaf individual has unique communication preferences, and what works seamlessly for one might be less than ideal for another. The nuances of interpretation in educational settings differ vastly from those in medical or legal contexts. Thus, having a rich pool of specialized interpreters is vital to cater to these diverse requirements,” quotes Gateway Maryland. 

After overcoming the national shortage and the field qualifications, many providers are still left with the challenge of accommodating use preferences and unique needs. This may include but is not limited to refusing virtual services due to an onsite preference, requesting a specific interpreter with limited scheduling availability due to a past positive experience, or a request for an interpreter sharing specific cultural, gender, or political views. “A lack of diversity among ASL interpreters is also an issue. In the U.S., 87% of ASL interpreters are white, which can cause communication barriers among Deaf and HoH individuals who speak in an ASL dialect related to their culture. For example, a common ASL dialect is Black American Sign Language, which can have slightly different signs for common phrases than standard ASL,” states Globo. 

Globo reinforces the shortage unique to ASL sharing, “the Registry of Interpreters for the Deaf (RID) is available for service providers to find a certified ASL interpreter in different industries, but there are only just over 10,000 certified ASL interpreters in Canada and the United States combined. Compared to other language interpreters, such as in Spanish, for example, this number is extremely low. Data collected by Zippia found there were nearly 20,000 Spanish interpreters employed in the U.S. in 2021.” 

Why Healthcare Is Uniquely Impacted 

In healthcare settings, accurate communication is a matter of life and death—misinterpretation can compromise diagnoses, treatment plans, and ultimately patient safety. Unlike routine appointments, hospitals often face urgent, unscheduled situations where immediate access to qualified interpreters is critical, yet availability remains a major challenge. At the same time, facilities are under pressure to comply with ADA requirements mandating effective communication, but many still fall short of meeting these standards. The shortage is especially acute for certified medical interpreters, whose cultural and linguistic expertise is essential for ensuring both accuracy and respectful patient care. 

Globo states, “in some areas, ASL interpreters are especially scarce. For example, in 2017, in Southwest Louisiana, there were only three registered ASL interpreters to offer services to around 800 Deaf people in the area. This can make it exceptionally difficult for a service provider to get access to an in-person interpreter when needed.” Rural availability limitations and common onsite preferences double down on availability barriers for many providers and agencies.  

On a systemic level, ASL interpreter certification and qualification must grow in order to bolster the healthcare qualified pool. Growth of the field is dependent on a variety of factors and faces a wide array of challenges. Language Services Associates shares, “becoming a certified ASL interpreter begins with an undergraduate degree in American Sign Language and requires continuous updated education, workshops, and development. On average, it takes anywhere from five to ten years and includes achieving fluency in ASL, understanding Deaf culture, and passing rigorous certification exams.”  

Healthcare is uniquely impacted by interpreter shortages because the stakes are higher, the need is often immediate, and compliance requirements are strict. Yet systemic challenges—such as the lengthy path to certification, rural access limitations, and strong preferences for onsite services—make it difficult to grow and sustain a qualified pool of medical interpreters. These combined pressures create persistent barriers for providers striving to deliver safe, compliant, and culturally competent care to Deaf and hard-of-hearing patients. 

Paths Forward 

One of the most effective ways healthcare systems can overcome access barriers is by partnering with nationwide agencies like Deaf Services Unlimited (DSU). With a broad network of qualified interpreters, DSU helps hospitals and clinics expand availability far beyond local limitations, ensuring that patients have access to accurate and timely communication no matter where they are. DSU also invests in recruiting and supporting interpreters with specialized medical training, strengthening the pool of professionals equipped to navigate complex healthcare conversations. By offering both in-person and video-based solutions, DSU makes it possible for providers to deliver care that is not only compliant with ADA requirements but also safe, respectful, and patient-centered. 

In addition to service delivery, DSU supports healthcare systems through education and advocacy. Many providers are unsure how to request interpreters or how to work effectively with them in clinical settings, leading to gaps in communication. DSU provides resources and training for staff, empowering them to confidently integrate interpreting services into patient care. On a larger scale, DSU actively engages in policy discussions and industry initiatives to promote sustainable solutions for interpreter shortages nationwide. This dual approach—practical services paired with systemic advocacy—positions DSU as a trusted partner for healthcare organizations striving to deliver equitable access for Deaf and hard-of-hearing patients. 

Learn more about DSU’s healthcare services here! 

Q&A  

1. Why is there a critical shortage of qualified medical interpreters in the healthcare industry? 
There is a nationwide shortage of certified medical interpreters due to increased demand,  retirement of experienced professionals, and limited training programs. The need is especially  high for American Sign Language (ASL) interpreters in healthcare, where specialized skills and  certifications are required to handle complex medical terminology. 

2. How does the shortage of healthcare interpreters affect patient safety and communication? 
When patients do not have access to qualified interpreters, they face serious risks including  misdiagnosis, medication errors, and lack of informed consent. In healthcare, clear  communication is critical, and the shortage of interpreters directly impacts patient safety, trust,  and quality of care. 

3. What are the challenges in recruiting and retaining American Sign Language (ASL) interpreters for hospitals and clinics? 
ASL interpreters face high stress and irregular schedules compared to other  industries. In healthcare, interpreters also need advanced medical vocabulary and certifications,  making recruitment and retention more difficult. Many hospitals compete for the same small  pool of qualified interpreters. 

4. How can healthcare providers ensure language access compliance under the ADA despite interpreter shortages? 
Healthcare providers can partner with nationwide interpreting agencies, use scheduling systems  to secure interpreters in advance, and integrate video remote interpreting (VRI) for last-minute  needs. Staying proactive helps hospitals and clinics remain compliant with ADA requirements  while ensuring patients receive equal access to care. 

5. What role can technology, such as video remote interpreting (VRI) and AI tools, play in addressing the healthcare interpreter shortage? 
Technology can supplement the shortage by offering faster access to interpreters through VRI,  especially for rural or emergency settings. AI-driven captioning tools may provide temporary  support, but they do not replace certified medical interpreters for critical conversations. A  blended model of human interpreters and technology can help close gaps in healthcare  communication access. 

Sources: 

https://www.helloglobo.com/blog/why-are-asl-interpreters-so-hard-to-find

https://lsa.inc/why-is-there-a-shortage-of-certified-american-sign-language-interpreters/

https://gatewaymaryland.org/the-impact-of-an-interpreter-shortage/