Letters to the Editor

The Cost of Treating Deaf and Hard-of-Hearing Patients


Am Fam Physician. 1998 Sep 1;58(3):659.

to the editor: The article1 and editorial2 on helping deaf and hard-of-hearing patients provide much useful information. I have treated deaf patients in the past and have arranged for medical interpreters. It is interesting that the author of the editorial comments that physicians “seem to have less enthusiasm for their deaf and hard-of-hearing patients than their hearing patients.”2 Unfortunately, no comment is made in either the article or the editorial regarding the unfair financial burden placed on physicians who would like to treat deaf patients.

Frequently, deaf patients have insurance that reimburses at a substantially discounted level. Medical interpreters are extremely expensive. The physician is billed from the time the interpreter leaves his or her door until the time that he or she returns—although the interpreter may spend only 15 minutes actually performing a service. Specifically, this amounts to about two hours at $50 per hour. Assuming that the patient has come to the office for a level III visit and that the reimbursement is from Medicare, the amount reimbursed is $35.41. Add to that the heavy-handed threat of a six-figure lawsuit for not providing an interpreter, and it does not take an accountant to understand why physicians may not be enthusiastic about treating these patients.

It is unfortunate that our society chooses to penalize physicians who treat deaf patients. It would be helpful for us to evaluate alternatives to placing the financial burden for medical interpreting on the individual's physician.


1. The Committee on Disabilities of the Group for the Advancement of Psychiatry. Issues to consider in deaf and hard-of-hearing patients. Am Fam Physician. 1997;56:2057–64.

2. Zazove P. Understanding deaf and hard-of-hearing patients [Editorial]. Am Fam Physician. 1997;56:1953–4.

editor's note: This letter was sent to the authors of “Issues to Consider in Deaf and Hard-of-Hearing Patients,” who declined to reply.


Send letters to afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680. Include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



Copyright © 1998 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


May 2022

Access the latest issue of American Family Physician

Read the Issue

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article