MINORITY HEALTH: Paucity of Doctors Serving Ethnic Communities
Physician shortages in minority communities -- especially among those culturally equipped to relate to ceratin populations -- are becoming a major public health problem in various pockets of the country, especially California. Reflecting nationwide imbalances in physician-to-population ratios, the Mar Vista neighborhood of southwest Los Angeles has only two clinics that are "fully equipped to meet the language and cultural needs of the tens of thousands of Latinos who reside in and around [the] 7-square-mile area," the Chicago Tribune reports. Dr. Juan Villagomez, who operates one of them, said, "The issue is there are not enough culturally competent health care professionals to meet the needs of the (Hispanic) community. Care is affected adversely because language and culture can create barriers for diagnosis and treatment." Some Los Angeles neighborhoods have only one physician per 24,505 residents --a ratio comparable to some Third World nations -- while Beverly Hills has one per 254 residents, the Tribune notes. And Latinos represent half of the 7 million of Californians lacking health insurance. Villagomez, who chairs the California Latino Medical Association, is devising solutions, along with state legislators and some medical schools, to increase the number of doctors in minority communities. Among the tactics they're considering are training medical students in Spanish language and culture, encouraging minority students to consider health care careers and "augmenting existing loan forgiveness programs for doctors who serve in under-represented urban and rural areas." Dr. Kevin Grumbach, director of the Center for California Health Workforce Studies at UC-San Francisco, said, "Race and ethnicity are more important in determining where a physician will practice than income," adding that minority "physicians are much more likely to care for their own." Currently, a bill is pending in the California Legislature that would require the state university system to "assess the racial and ethnic composition of medical students 'as compared to the state's racial and ethnic diversity' and to review how it could better place residents and graduates in under-served areas."
Other health care industry experts have assumed a laissez-faire approach, contending that "the shortages are caused by market forces and are much too vexing to be solved with financial incentives and culture awareness programs." Carol Simon, an associate professor in the school of public health at the University of Illinois at Chicago, said, "There are already a lot of federal incentive programs, but they have not radically changed the landscape. A lot of people (in underserved communities) don't have health insurance. Forgiving (medical school) debt is not going to solve that" (Haynes, 6/7).