By James S Grisolía, MD
I´m a neurologist, but once I was called to see a man about a rash. He had long been treated for epilepsy in Mexico, and since crossing the border had not gotten his usual medicine. This landed him in the hospital ER with several seizures. The ER doctor loaded him with Dilantin, a medicine to stop the seizures, but I was called to switch his medicine when he blossomed forth with fever and a total body rash from the Dilantin.
I saw in his ER chart that he had listed Epamin, the Mexican Dilantin brand, as an allergy. Why had the ER doctor given him a medicine he was already allergic to? The Anglo doctor didn´t know Epamin and Dilantin are the same medicine.
This life-threatening complication is only the tip of the iceberg. Miscommunication in health care results from not only language, but also cultural barriers. These problems result in measurable differences in complication rates and lifespan for Latinos and African-Americans in the U.S. as shown in a recent study released by the Institute of Medicine.
The 2000 U.S. Census shows 40% of Californians speak a language other than English at home, and Latino households make up the majority or the plurality in many areas. In a state with around 100,000 physicians, estimates of the need for Spanish-fluent professionals range up to 50,000 doctors over the next few years.
Recognizing the need for more bilingual doctors, the CMA and its medical student section worked hard with Assemblyman Marco Firebaugh, long a champion of health care access for Latinos, to create the current AB 982, with new funding from the Medical Board of California to train California medical and dental students in Spanish and bring them to work in underserved communities in exchange for repayment of some of their crushing medical school debt.
This program is especially welcome at a time when California managed care payments have dropped, so that students with large loan debts are forced to leave the state to practice, to have a more realistic chance of paying back their debts. AB 982 will help protect our state investment in these future doctors from leaving the state, and bring them to local communities with special needs.
AB 982 has bipartisan support, but will need continued community support to ensure that it passes the Senate and is signed by Governor Davis. While this will not solve the Latino community´s need for health care access, it will provide a giant step in the right direction.