You do not need more healthcare technology.
You need better understanding.
In this episode of Localization Fireside Chat, I sat down with Dr. Nelva Lee, one of the most influential figures in medical interpretation in North America. Her career spans healthcare administration, professional certification, federal compliance, and now the front lines of how AI is being misapplied to language in healthcare.
What she makes clear is simple and uncomfortable.
Language is not a soft skill in healthcare.
It is a clinical risk factor.
Dr. Lee’s story begins in Panama, where she grew up under the Noriega dictatorship before immigrating to the United States. That experience of power, vulnerability, and being unheard would later shape her career in healthcare. When she began working inside hospital systems in the 1990s, she quickly saw something alarming.
Hospitals were serving multilingual populations without any professional language infrastructure.
No training.
No standards.
No accountability.
Patients were being interpreted by whoever happened to be nearby. Family members. Janitors. Bilingual staff with zero clinical training. The result was predictable and dangerous.
Misdiagnoses.
Informed consent failures.
Medication errors.
Legal exposure.
Dr. Lee stepped into that vacuum and built one of the first structured medical interpreter programs at Grady Health System. From there, she went on to become the first Chair of the National Board of Certification for Medical Interpreters, helping create the professional standards that now exist across the United States.
Her core argument is not complicated.
Speaking a language is not the same as interpreting medicine.
Medical interpretation requires mastery of terminology, clinical workflows, ethics, and cultural nuance. A patient saying “I feel dizzy” can mean ten different things depending on context. In oncology, cardiology, mental health, or emergency medicine, that difference can change outcomes.
This is why federal law in the United States requires healthcare providers to offer qualified language access to patients with limited English proficiency. It is not a courtesy. It is a civil rights obligation.
And yet, Dr. Lee explains that hospitals still try to cut corners.
They assume that conversational English is enough.
They rely on bilingual staff without credentials.
They test AI tools that have never been validated for clinical safety.
This is where her perspective becomes especially relevant right now.
We are entering a phase where healthcare executives are being sold the idea that AI translation can replace human interpreters. Dr. Lee is not anti technology. She is clear that automation has a role. But she draws a hard line between translation and medical interpretation.
Translation moves words.
Interpretation moves meaning, intent, and clinical risk.
AI systems today do not understand patient hesitation, cultural framing, or how fear changes speech. They do not know when a patient is downplaying pain or misunderstanding consent. They cannot detect when a phrase that sounds harmless is actually a medical red flag.
Dr. Lee believes the language industry must be the one guiding how AI enters healthcare. Not software vendors. Not hospital IT teams. The people who understand how meaning works in real clinical environments must be at the center of any AI deployment.
Otherwise, we will automate mistakes at scale.
What makes her leadership story powerful is not just what she built, but how she built it. She did not wait for permission. She saw a systemic failure and created structure where none existed. Certification. Training. Standards. Accountability.
That is what leadership looks like in an emerging profession.
And it is the same lesson that applies today as AI enters healthcare language workflows. The future is not human versus machine. The future is whether we allow technology to erase professional standards or whether we force it to respect them.
Dr. Nelva Lee has spent her career making sure patients are not lost in translation.
That work is more urgent now than ever.
Watch the full conversation
Localization Fireside Chat
Unscripted. Unbiased. Unfiltered.
https://www.l10nfiresidechat.com
Robin Ayoub 
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