Latinos in Medicine
Sep 15, 2020 Victoria Pelham
Latinos make up nearly 40% of the population of California, but when it comes time to go to the doctor's office, they rarely see a physician of the same background.
Just 5% of the state's doctors are Latino, according to the California Health Care Foundation. And while the numbers are improving, it can still be a lonely road for those who pursue medicine: The Association of American Medical Colleges found about 5% of medical school graduates identified as Latino in 2019.
We as healthcare workers and physicians need to represent the communities that we serve. There are many reasons why this is important, including cultural beliefs, religious beliefs and language barriers. If we represent our community, I think we have better chances with preventive medicine and active engagement.
We sat down with three doctors at Cedars-Sinai Medical Center with roots across Mexico and South America to learn more about their roadblocks, the responsibility they feel to do right by their community and how more representation might help to tackle the disparities Latinos disproportionately face.
Have you faced any challenges in your pursuit or practice of medicine? How does being a Latino doctor affect your work?
Just like other underrepresented communities, I have been subject to both conscious bias and unconscious bias. I oftentimes have been confused as cleaning personnel or as scrub tech in the operating room—which is not denigrating to me. However, it speaks volumes of how other people perceive the color of your skin.
Also, I have an accent. English is my second language. Oftentimes when I have patients from other races, they do a double take, and I feel sometimes that the trust is not completely there because I have an accent.
I've been really fortunate. I've gone to inclusive schools that have really advocated for diversity in their programs. I wanted to work with the Latino population, because I feel it's important to provide that patient population access to physicians who speak their language and can work with them seamlessly.
I have a lot of patients come in that are really elated to have a physician who speaks their language and understands culturally where they're coming from. It allows them to express themselves and get their medical questions answered more thoroughly.
As one of just a few Latina doctors, I've regularly found myself the only one in some rooms. This needs to change.
I was born in Rosario, Argentina, during the Dirty War, a dark period in Argentina's history when a military dictatorship kidnapped, tortured and killed an estimated 30,000 people. My parents escaped one of these death squads and fled to the U.S. with their three small children.
When they arrived here, they immediately started working—often two jobs—to support us and did not know the language, but they knew it was a safer place to be. Political and economic exile is the story of why many Latinx people come to this country.
Why does diversity in medicine matter? How could increasing Latino representation help address some of the obstacles and disparities Latino patients experience?
Dr. Alban: We as healthcare workers and physicians need to represent the communities that we serve. There are many reasons why this is important, including cultural beliefs, religious beliefs and language barriers. If we represent our community, I think we have better chances with preventive medicine and active engagement. Many Latino patients don't understand what their diagnosis is or what their plan of care is—even with translation services, it is very different. When they understand those things, they are more likely to be successful and participate in their own care. And if they feel that they're relating to the person that they're entrusting their care to, they're also more likely to participate.
This could also help to promote investment in programs that will help the community thrive, such as diabetes and heart disease prevention and cancer screenings. In my case, there are a lot of disparities in access to surgical care, because many Latinos wait until the last minute when it becomes a problem instead of addressing it early on.
"Our stories are successful stories filled with hard work and dedication. You can do this. Tú sí puedes."
Dr. Scremin: We need diversity in medicine to be able to appropriately serve our diverse society and create a just and inclusive healthcare system that is able to meet the needs of every person.
Latinos face a multitude of barriers to medical care: no time to go to the doctor because you are constantly working, fear that going to the doctor may expose you or your family to deportation, fear that you will not understand or be understood, and cost associated with going to doctor such as copays and medications.
Increased representation of Spanish-speaking providers and providers that come from similar backgrounds as the patient can help patients feel safe, understood and cared for.
Dr. Padua: The physician-patient trust is really the core of that relationship—you need to trust your doctor to explain the symptoms you're having and go deep into really personal issues. When there's a language barrier, it can generate a lot of mistrust of the medical community.
Patients often get rushed and are pushed to answer questions quickly, and if they don't speak the language, they're not able to fully explain their symptoms or their issues.
If the medical force is more inclusive, patients are more able to effectively communicate with their provider and build the trust they need. Once you have that rapport, you're able to get a patient coming into the hospital or clinic in a timely fashion, as opposed to waiting long periods of time.
Do you see representation improving?
Dr. Alban: Until this year I would have told you I don't see things changing, but I think after some of the national movement that has been occurring and is currently occurring, people are realizing this is a priority. I do see change coming, and I am very excited to be part of the change. I look forward to a bright future where healthcare delivery will be more equal to all.
Dr. Padua: I don't see representation necessarily increasing. There needs to be more efforts to recruit Latino physicians to help address the lack of diversity in the medical field. That is a multifaceted problem starting from the high school level through college and encouraging recruitment and retention of underrepresented minorities at the medical and residency level.
Do you have any advice for aspiring Latina or Latino or Latinx doctors?
Dr. Padua: You have to find a good mentor. You have to find people who will help you navigate the really complicated world of medicine. There's a lot of hurdles you have to go through.
It's a culture that is difficult to break in to unless you have someone who can show you the way. Finding mentors is critical to be able to climb up the academic ladder and to also have access to the type of jobs and opportunities that will make it a fulfilling career.
Dr. Scremin: Don't give up! Reach out and find a mentor. Be your own advocate and practice self-compassion, and be kind and patient with yourself. Enjoy the journey!
Dr. Alban: My advice for people who want to be engaged in the healthcare provider world is to talk to Latinos, look at people like me and some of my colleagues that have gone through this and made it through. These young individuals need that support and encouragement and mentorship.
Sometimes they think these types of careers are not achievable because they think it's only for the privileged. Our stories are successful stories filled with hard work and dedication. You can do this. Tú sí puedes.