LATINO HEALTH: Care Barriers Lead to Dangerous Treatments

      In part three of a three-part series investigating underground, often illegal, medical care in Southern California, today's Los Angeles Times examines cultural barriers to quality care. Bewildered by the U.S. medical system and turned off by American doctors' clinical detachment and lack of folk-remedy knowledge, California's 4 million foreign-born Latinos continue to use a "system they consider more friendly and navigable, where druggists readily diagnose and dispense, where access to healers is easy and where everyone speaks their language." The price they pay, however, includes "bad, sometimes fatal, medical advice as well as dangerous drugs." While public health clinics offering free and low-cost care dot the Southern California landscape, immigrants are often unaware of clinics' frequently remote locations and fear that a brush with public officials will lead to deportation. "Fundamentally, I think people in health care have to get out of their offices and get down to these communities ... and ask them what their needs are and how they can help," said Judith Barker, a medical anthropologist at the University of California-San Francisco. Kaiser Permanente, the state's largest HMO, has produced "cultural competence" manuals in an effort to educate providers on Latinos' beliefs and susceptibilities and possibly win the enrollment of a population that is typically young and healthy. Providers who manage to cultivate trust in a Latino patient often gain "the status of a venerated family member," the Times reports. "If we could bring back the humanistic parts of medicine, that would be a big improvement," said Dr. Robert Chiprut, a Century City physician, adding, "it takes exactly 30 seconds to show care, to show warmth to patients. Those things are crucial to (health) care, but we sometimes forget it" (Marquis, 5/25).