Prior research has documented that medical interpreters engage in non-conduit roles during medical visits. However, agreement on the appropriateness of these roles and their impact on the medical encounter have not yet been achieved. The purpose of this study was to identify non-conduit behavior (role exchange), elucidate the various forms it takes among different types of interpreters, and assess its potential to affect clinical encounters. Using audiotapes from 13 pediatric outpatient visits, we found that "chance" and uncertified hospital interpreters engaged in role exchange by assuming the provider's role; the patient's role; and taking other non-interpretive roles such as socializing with mothers or acting in one's alternate professional role. These behaviors occurred frequently among both types of interpreters while the provider was actively engaged in conducting the medical visit. In most instances, the interpreter did not make his or her behavior transparent to either the provider or the mother. Implications for interpreter and provider training are discussed. © 2008 Springer Science+Business Media, LLC.