Communicating in Hospitals and Doctors' Offices
Misheard instructions in a medical setting are dangerous. The ADA gives you the right to effective communication with your health care providers. Here is what that means, how to ask for it, and a one-page plan you can hand to your care team.
Your right to effective communication under the ADA
Hospitals, clinics, doctors' offices, pharmacies, nursing homes and county health departments must communicate with you as effectively as they communicate with people who hear. That is the ADA effective communication rule, and it applies to state and local government facilities (Title II) and to private businesses and nonprofits that serve the public (Title III). You can ask for an auxiliary aid or service, and the provider must supply one unless it would fundamentally change the service or be an undue burden. The cost cannot be passed on to you.
For people who are deaf or hard of hearing, the ADA lists aids such as a qualified sign language, oral or cued-speech interpreter, real-time captioning (CART), a qualified notetaker, written materials, a printed script, assistive listening systems, captioned video, TTYs, videophones and relay services. Public entities must give primary consideration to the aid you request; private providers are encouraged to consult you but must still provide an effective aid.
A provider cannot require you to bring a family member to interpret. It may rely on an adult who comes with you only in an emergency with no interpreter available, or when you ask for it, the adult agrees and it is appropriate. It may never rely on a minor child except in an emergency.
Source: ADA.gov: Effective communication
Make a Communication Access Plan
HLAA's Communication Access Plan (CAP) is a one-page form that tells your doctors and health care team about your hearing status and the communication aids and services you need. Fill it out once, keep copies in your wallet, your go-bag and your patient portal, and hand it over at check-in. It turns a stressful conversation into a checklist the staff can follow.
- Your hearing loss, what you use (hearing aids, cochlear implant, telecoil), and whether you lipread.
- What you need: face the patient, remove or lower masks when safe, written instructions, captioning, an interpreter, a pocket talker or a quiet room.
- How to reach you: text or captioned phone rather than voice calls; who to call as a backup.
- A request to flag your chart so every shift knows.
At a doctor's appointment
- When you book, say you have hearing loss and state the aid you need. Ask that it be noted in your chart.
- Ask to be alerted visually when it is your turn, instead of by name from across the waiting room.
- Bring a companion for a second set of ears, plus your hearing aids, charger and a captioning app on your phone.
- Ask the clinician to face you, speak at a normal pace and lower the mask when it is safe, or wear a clear one.
- Repeat instructions back and ask for them in writing or in the patient portal. Ask for after-visit summaries every time.
- Ask for prescriptions and follow-up calls to come by text, portal message or captioned phone.
In the hospital or emergency room
- Say at triage that you have hearing loss and hand over your Communication Access Plan. Ask for a hearing loss flag on your wristband and door.
- Keep your hearing aids or processor with you and labeled, and ask the nurse where they are stored before surgery. Ask for them back in recovery before anyone gives you instructions.
- Request a hospital communication kit if the facility has one: a pocket talker, a dry-erase board, a captioning tablet, and a clear-mask supply.
- Ask for CART or an interpreter for consent discussions, discharge instructions and any conversation about diagnosis or medication.
- Make sure the bed alarm, call button and phone are accessible: a flashing signaler, a captioned or amplified phone, and a way to reach a nurse by text.
- Have a family member stay for handoffs at shift change when possible.
If a Florida provider will not accommodate you
Start by asking for the facility's ADA coordinator or patient advocate and put your request in writing. If that fails, you can file a complaint with the U.S. Department of Justice through ADA.gov. The Florida Coordinating Council for the Deaf and Hard of Hearing, part of the Florida Department of Health, provides technical assistance to agencies and organizations and has a Medical Accessibility Task Force focused on this exact problem; call (850) 558-9645. HLAA-FL chapters can also connect you with members who have navigated the same hospital system.
ADA.gov: Effective communication (includes how to file a complaint) · Florida Coordinating Council for the Deaf and Hard of Hearing · Advocacy in Florida
Medical communication questions
Does a doctor's office have to provide an interpreter or captioning?
Yes, when it is needed for effective communication. Under the ADA, private medical practices and public health facilities must provide auxiliary aids such as a qualified interpreter, real-time captioning, written materials or assistive listening at no charge to you, unless doing so would be an undue burden or fundamentally change the service. Ask in advance and put the request in your chart.
Can the hospital ask my spouse or child to interpret?
No, the hospital cannot require it. Under the ADA it may rely on an adult who comes with you only in an emergency when no interpreter is available, or when you specifically ask, the adult agrees and it is appropriate. A minor child may be used only in an emergency involving an imminent threat. You can always insist on a qualified interpreter or captioning.
What is a communication access plan?
A Communication Access Plan is a one-page form from HLAA that tells your health care team about your hearing loss and the aids and services you need, such as captioning, an interpreter, written instructions or a clear mask. Complete it once, keep copies handy, and give it to staff at check-in so your needs are in your chart before anyone talks to you.
What does hearing accessible mean in a medical setting?
It means you can understand and take part in your care as well as a hearing patient: visual alerts when you are called, staff who face you and speak clearly, captioning or an interpreter for important conversations, written instructions, a captioned or amplified phone in your room, and your hearing devices returned to you before anyone gives instructions. The ADA requires this level of access.
Learn from people who have been there
HLAA-FL chapter members share what worked with Florida hospitals and clinics. Meetings are free and captioned.