Email this page  Print this page  del.icio.us  digg  yahoo!

Latino Medical Report

With few Latinos entering health professions, the need for doctors and nurses rises

In Arizona, there are more Latino faces in the waiting room -- and more are predicted in the coming years.

The need for Latino doctors, nurses and other personnel continues to grow as the state’s population grows. The planned construction of hospitals over the next five years is expected to generate about 15,000 medical jobs. The state’s growing bioscience industry also is expected to add thousands of medical research jobs. And the new partnership between Arizona State University and the University of Arizona medical schools will train more new doctors to fill those jobs.

The burgeoning Latino population is a large component of the increasing need for bilingual and culturally sensitive medical services in Arizona and across the country.

“Latino population growth is a huge factor as we consider how we deliver services,” says Dr. Francisco Garcia, director of the University of Arizona’s National Center of Excellence in Women’s Health in Tucson.

One-third of Latinos in the nation is either underinsured or has no insurance. Arizona has one million uninsured people, according to the Census Bureau. Uninsured Latinos are two to three times more likely to go without needed health care, resulting in higher rates of preventable disease and premature death.

There’s a lack of research on disorders disproportionately affecting Latinos, such as malnutrition, asthma, diabetes, obesity, and certain cancers. In addition, many border or rural Latino communities go medically underserved. One-fifth of Spanish-speaking Latinos say they forgo medical treatments because most doctors can’t communicate with them, or don’t understand their culture.

Latino leaders in the medical field say the Latino community is suffering a health crisis. They add that a relatively low percentage of Latinos in medicine puts all Hispanics at risk.

The lack of Latinos in the health professions and biomedical research also hurts the Latino community’s ability to influence key areas in medicine, says Elena Rios, head of the National Hispanic Medical Association in Washington, D.C.

NHMA represents 36,000 Latino physicians. Its mission is to provide policymakers and health care providers with research about Hispanic health.

Because Latinos are only beginning to enter the medical fields in growing numbers, the increasing discrepancy between Latino patients and culturally competent healthcare providers is a disturbing trend. Hispanics represent less than three percent of all physicians in the U.S., according to a 2006 study by the Association of American Medical Colleges. In comparison, the Census Bureau estimate of the Hispanic population in the U.S. was 42.7 million in 2005, or 14 percent of the total population.

The Census expects those figures to mushroom to 102.6 million by 2050, for 24 percent of the country’s population.

“Latinos are under-represented in medical professions, as physicians, in nursing, in pharmacies, and in the biomedical sector,” Garcia says.

“New cures won’t help our population unless you have Latinos at the table, making decisions and providing medical services.”

Garcia adds that Hispanics comprise only six percent nationally of all students graduating from medical schools. At the UA medical school, that figure for Latinos rises to about 12 percent of all graduating medical students, Garcia says.

The reason for the higher rate at the U of A is due to programs instituted by medical schools across the country that have been designated Hispanic Centers for Excellence.

These and other Latino-directed programs in the nation help find and keep Hispanic students wanting to get into the medical field. Still, he observes, even the 12 percent graduation rate should be improved to reflect the percentage of Latinos – about 25 percent – in Arizona’s population. That percentage is predicted to increase dramatically in coming decades.

There have been attempts to add Latino doctors to the current pool. One Arizona homegrown group – the Arizona Latin-American Medical Association – has tried to advocate for what its leader calls “fast-track” solutions to plugging the gap of bilingual, bicultural doctors in Arizona. But the initiatives keep running into a wall of “arrogance” by the state medical bureaucracy and medical schools, he says.

“There is an arrogance and bias in the American medical system that you if you are not educated and trained here in the U.S – and do that in Latin America – you are not good enough,” says Adolfo Echeveste, head of ALMA and former assistant director for the Maricopa County Department of Health Services.

Founded in 1993, ALMA is a network of physicians and naturopaths primarily serving immigrant families through the discounted, pay-as-you-go, community clinica system.

ALMA also provides Hispanic medical students with scholarships.

Echeveste says he’s experienced years of frustration trying to fill the critical state need for bilingual medical services with Latinos – many who have passed standardized medical licensing exams – but are denied required residencies at hospitals because they were born and trained in Latin America.

Despite the obstacles and problems, leading Latino physicians at hospitals and at medical schools say they are working to make industry changes that will motivate more Latinos to enter the field. And that, they add, is the best single prescription for better health care for all Latinos.

TRAINING ‘CHANGE AGENTS’

In the late 1960s, when the Chicano movement was born, the Latino medical students of Stanford University in California united to form the Stanford Raza Medical Association.

Among its founders was Fernando Mendoza, who remained at Stanford in the Department of Pediatrics following his graduation and went on to become associate dean of minority advising and programs. Today the group has changed its name to the Latino Medical Students Association, and is the model for Latino medical student groups across the country.

Mendoza says these programs are a strong force in promoting the development of Latinos in medicine through education, volunteerism, and professional networking opportunities. Over its life, thousands of Hispanics have achieved successful medical careers, and become role models for other Latinos, he says.

“We train our students to look at themselves as change agents,” Mendoza says.

The medical industry is undergoing “tremendous change,” he says. His medical school teaches Latinos that there are key areas – such as medical school faculties – they can become leaders of that change. Mendoza also teaches that Latinos who become successful in their medical practice of choice inspire other Latinos.

SERVING THEIR COMMUNITIES

Mendoza has observed that Latino medical students and physicians feel a need to give back to their communities.

“I think the strength of the Latino students here is that they have a very strong commitment to make a change and help their communities get better,” he says.

The payback dynamic is played out by Latinos entering medical areas that can impact diseases suffered by Latinos, such as family practice, pediatrics, oncology, women’s health, and elder heath care. Latinos are also entering the research labs, where they might find solutions to diabetes and obesity, he adds.

Yet Latinos are also looking to the future of the industry, Mendoza and other leaders say. Hot jobs for Latinos in medicine are cardiology, ophthalmology, anesthesiology, dermatology and plastic surgery.

Another area where demand for specialists is steadily growing is hospice, internal medicine, gynecology, physical medicine and rehabilitation, anesthesiology, psychiatry, neurology, radiology and surgery – to care for Baby Boomer patients with chronic or terminal diseases.

So how do med students decide what specialties to pursue amid the myriad of fields available to them?

For Latinos, it is a toss-up between commitment to community, quality of life and financial obligations. On one hand, more medical workers are needed in rural and inner city clinics, but the earnings are lower. The reality is that high-income specialties help to offset undergraduate and medical schools loans, amounting, on average, to a hefty $120,000 per student.

Latinos in medicine can help transform the industry and impact their communities anywhere they decide to go, says Mendoza of Stanford.

“People of color in the medical field provide opportunities for their co-workers to experience diversity,” he says.

Latinos who have achieved prominence in the medical field say they feel a responsibility to help others up the ladder. More Hispanics must be motivated to say, “I can do it. I can be a doctor,” says Garcia of the UA.

“We in the field have to provide a supportive environment, and create a culture of inclusion at academic institutions,” he says.

Just as important, “There has to be an increasing presence of Hispanics in the field. That’s a critical piece. That way the medical field doesn’t seem like an alien adventure to Latino students.”

Only then, Garcia and other doctors say, can the promise of today’s new discoveries for cures and better health be realized tomorrow in Latino communities.