By: By Yoshira Donaji Macías Mejía

Access to medical professionals
is a tremendous problem,
which has been exacerbated
by the Coronavirus pandemic.
This shortage is especially noticeable
when examining racial and ethnic minority
physicians, who already make a small percentage
of the total physician population. According to recent data
available from the Association of American Medical Colleges
(AAMC) in 2019, 56% of physicians are White, followed by 17%
who are Asian, 14% are unknown, 6% Hispanic/Latino, 5% are
Black, 1% is multiple races, and 1% are other1. The data highlight
racial and ethnic disparities that exist within the medical
community and show that White physicians dominate the
medical field. Blacks and Latinos are largely underrepresented in
the medical profession. The low percentages of these two groups
in the medical field create many problems for patients seeking
care, but this is particularly alarming for the Latino population.
Historically researchers state, the medical profession has not been
welcoming to racial and ethnic minorities in the United States. Obstacles
have been placed to prevent the admittance and matriculation of Blacks and
Latinos in the medical profession. Historical accounts find that for Blacks in
America it was difficult to break into the medical profession due to slavery
and eugenics, which views Blacks intellectually inferior to Whites. Even
with these institutional and structural barriers Blacks came together as
a community to provide healthcare access to other Blacks. Latinos have
faced similar experiences of exclusion because of racial classifications
in America. Several Latinos and Latinas were not admitted to medical
schools, similarly to Blacks, and were barred from practicing medicine.

Latinos also worked tremendously, similarly to Blacks, as a community
to provide care for underserved Latinos. But the greatest barrier
was the existing and dominant racial hierarchy, which places
structural and institutional barriers on groups, such as Blacks
and Latinos from entering the medical field. These barriers
unfortunately are still present in modern day America.
As of 2022, Latinos are the largest underrepresented minority
group in the United States and still face several obstacles to
medical care. Some obstacles are the lack of Latino physicians
that can cater to the Spanish language needs of this population.
Studies in the medical field suggest that having doctors who come
from the same background is beneficial for patients. Having
access to Latino doctors can provide adequate care for Latinos
through cultural awareness and language proficiency. Latino
doctors that speak Spanish benefit Latino patients because they
can establish trust with their patients, can explain medical
results or procedures in the patients preferred/dominant
language to better communicate steps to treat a disease or to
maintain existing good health, explain medical issues, etc.
When Latino patients are faced with doctors who do not speak
Spanish, they are less likely to trust their medical care because
they do not know if the translations given by medical staff
are accurate or they are not sure the medical staff is relaying
all their concerns to the doctor. Having a Spanish speaking
doctor promotes trust can push Latinos to seek medical care.
Latino doctors bring with them cultural knowledge of the Latino
community. This is especially useful because they can best
treat their patients based on their cultural needs. One example
is obesity. Many diets to help treat obesity in the United States
are based on an American diet and do not cater to other cultural
groups. This makes it more difficult when treating obesity
among the Latino community. With a Latino doctor, patients
can have better access to tailored care with diets, such as telling
patients to swap flour tortillas for corn or whole grain or the
types of rice that are eaten, etc. Latino doctors can discuss
with their patients how to cook their cultural foods to make
them more nutritiously dense. An understanding of cultural
mores and stressors can also minimize the misdiagnosis of
mental health issues that may be related to cultural experiences
or stressors of adapting to a society where Latino culture is
undervalued and misunderstood. These are just some examples
of how culture matters when treating Latino patients.
Other dimensions of health surrounding the importance of
Latino doctors is biases in care. Studies suggest that Latinos
received less preferential treatment from White doctors due
primarily from a lack of understanding of Latino patients’ culture,
language, among other things. This poor treatment is not only
faced by Latinos, but by other non-Whites, which increases health
disparities among non-White patients. Some examples include
the lack of pain management among Latino patients. Latinos
often received lower doses or do not receive any doses of pain
medication because their pain is not taken seriously by White
doctors. Additionally, Latino patients in prior studies also face
misdiagnosis in the mental health sphere. One study comparing
the mental health diagnosis of Latinos when compared to non-
Latinos found that Latinos were less likely to receive an adequate
mental diagnosis, which led to inadequate treatment. These
issues with negative quality of care persist even when accounting
for socioeconomic status and health insurance status. This
demonstrates how important having Latino doctors is for the
Latino community and for improving their health outcomes.
These shortages of Latino doctors are faced across the country,
but especially in states with large Latino populations. One
study found that in California, Latino physicians have a
caseload of 55 percent Latino patients when compared to
22 percent of non-Latino patients. This shows that Latino
doctors are in demand and needed for patient health.
Current health policies have increased the attention and need
for Latino doctors. For instance, the passage of the Affordable
Care Act in 2010 (ACA) allowed for an increased funding for
qualified health centers and providers, created health insurance
exchanges, Accountable Care Organizations, and reductions
in hospital readmissions. By increasing funding for health
centers and providers the ACA has expanded healthcare
access to vulnerable populations, which greatly impacts
Latinos who are vulnerable because of lower SES status, but
also due to lack of citizenship status. These community health
centers have had to adapt by providing care for undocumented
Latinos, non-English speaking Latinos, and created care
surrounding the Latino cultural experience. Additionally,
the ACA is aimed at preventative care, which reduces health
care costs, with an increase of Latino Spanish speaking
doctors there can be an increase of Latino patients that seek
medical care because there is an increase in trust and comfort
that someone who speaks their language and understand
their needs is treating them. This is why Latino doctors are
imperative for creating a healthy Latino community.
Lastly, the UCLA Latino Public Policy Institute (LPPI), as well
as a scholarly study by Daar et al. (2018), identify several steps
that can be taken to increase the number of Latino doctors.
Identified areas of focus include: 1) increasing the number of
Latino students admitted to medical school, 2) retaining Latino
medical graduates who attend medical schools out-of-state, 3)
developing k-12 pipeline programs, 4) expanding the number of
international medical graduates in CA, 5) expanding (California)
medical programs, and 6) increasing the number of CA residency
slots. Other steps not included in the UCLA study are allowing
DACA recipients the opportunity to practice medicine because
the members of these communities are more likely to go back to
their communities to practice medicine, increasing the number
of Latinos in academic medicine, and improve medical school
curriculum to include programs aimed training physicians
to work in underserved communities. While some of these
recommendations are tailored to CA with the exception to the
second study, these steps can still be applied to other states
to increase and retain Latino doctors. Thus, this can be the
beginning of a healthier future for Latinos in the United States.


References

1. Percentages are rounded up.