• Luskin Undergraduate

A Health Crisis Waiting to Happen: Addressing California’s Lack of Latino physicians

By Adriana Bernal (she/her), she is a third-year student majoring in Public Affairs and Education Minor

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In California, Latinos make up nearly 40% of the state’s population, yet they comprise only 7% of the state’s physicians. When my Spanish-speaking grandmother visits the doctor to treat the pain in her knees or to receive a physical, I always hope that she is provided with culturally sensitive, high-quality care. Can the doctor understand her when she shares symptoms she is feeling? How does she know what the doctor is advising her to do? Does she sign the correct forms and clearances? Questions like these linger in my mind when I think about the cultural and linguistic barrier between healthcare workers and Latino patients.

Amidst the physician workforce in California, there are only 62 Spanish-speaking physicians per 100,000 Spanish-speakers. UC Davis Vice Chancellor of Diversity and Inclusion, David Acosta, notes that when a physician speaks to a Latino patient in their primary language, the patient is more likely to follow the doctor’s recommendations and more willing to share their health information. Because they understand the values and experiences of the Latino population, Latino physicians can provide more nuanced and culturally sensitive care to Latino patients. Language mismatch further puts the state’s health at risk, especially for Spanish-speaking Latinos.

In order to address California's Latino physician crisis, we must expand physician pipeline programs that recruit, retain, and fund Latinos. Building the infrastructure for strong pipeline programs will expose college students to medical school and support students in financially investing in a pathway to medical school, which will in turn help reduce disparities in healthcare for Latinos.

Why haven’t state or medical schools addressed the Latino physician crisis? What appears to be going on is a coordination trap between California state leaders and California’s medical schools, where each party is coordinating on the bad outcome of inaction. Policymakers in California have the option to financially support Latino students to expand their presence in medical schools or continue to let the status quo run its course. In order to prevent major health inequities in the future, it is in their best interest to keep all Californians healthy by training more Latino physicians. California’s medical schools face a similar scenario. They have the choice to recruit and train more Latino medical students in California or continue the trends of graduating few Latino physicians. To maintain good relations with state healthcare entities and to do its part in keeping California healthy, California’s medical schools are better off increasing their student diversity. If both the state and its medical schools coordinated on the better outcome of investing in California’s Latino physician development, they would each benefit from improved public health services across the state. California’s policymakers and medical schools can demonstrate communication and leadership by working together to invest in pipeline programs that support the development of the Latino physician workforce.

Recruitment of Latino medical students is critical to increasing the number of Latino doctors. This can be done by implementing programs such as the Health Career Opportunity Program (HCOP). As a federally funded recruitment program, HCOP provides support and opportunities tailored to minority and low-income college students to become competitive, qualified applicants for medical school and other health profession schools. If a program like HCOP is developed in California, over 10 years the Latino health care professionals will see a 20,000 to 23,000 increase. If policymakers and medical schools communicate to invest funding into a program like HCOP, they can make a substantial contribution to reducing the physician crisis and addressing the health needs of the Latino population.

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Once Latino students are recruited into medical schools, it is integral that they are given support within their institutions. Medical schools can offer programs, panels, and workshops that guide Latino students in higher education and help them combat perceived discrimination. According to the UCLA Latino Policy and Politics Initiative, mentors and role models at an institution help Latino students navigate the medical profession successfully. If Latino students are given support through mentorship and resources, they will remain in medical schools and graduate successfully. By implementing resources for Latino medical students, policymakers and medical school leaders can advance the development of Latino physicians in California.

To ensure the successful expansion of the Latino physician workforce, policymakers and medical school leaders need to provide increased financial support to minority students -- namely, Latinos. Attending medical school is a long-term investment that can leave a heavy financial burden. Expanding financial resources can include broadening a student loan repayment program, particularly for Spanish-speaking physicians, in order to incentivize Latino students to practice medicine. In addition, creating scholarship programs for low-income, first-generation, and minority students can increase the number of Latino physicians while also providing care to underserved communities. The University of California, San Francisco (UCSF) has shown that if California implements a full-tuition scholarship program in exchange for service agreements of 1-4 years in medically underserved communities, the physician workforce will increase by 1,707 doctors over 10 years. If California's policymakers and medical schools work together to form funding opportunities and incentives, they can expand the number of practicing Latino physicians.

Some may say that expanding pipeline programs does not necessarily mean that more Latino students will practice medicine in California. Perhaps Latino students complete their residency in California, but will end up practicing out-of-state. However, research refutes this notion and shows that 70% of doctors who complete residencies in California will stay in the state to start their careers. By creating a pipeline that financially supports Latino medical students in their residencies, through scholarships and loan repayment programs, more Latinos will stay and practice in their communities where care is needed most.

To prevent a workforce shortage and to accommodate the state’s growing Latino population, action cannot wait. California’s policymakers and medical schools must communicate and collaborate in recruiting and training Latino physicians to provide healthcare to all Californians, especially to Latinos. By building infrastructure to sustain the development of Latino physicians, we can help California avoid large health disparities in its growing, diverse population. Just as I want my abuela to receive quality care from a physician, Californians across the state want the same for their own neighbors, friends, and families. It is up to policymakers and medical school leaders to increase the number of Latino physicians and ensure that all Californians have access to quality healthcare — a goal we all should prioritize.

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