(Photo: California Health Care Foundation)
“I didn’t run away,” says Dr. Laura Castro Castrezana, with laughter. A Mexican doctor participating in a pilot program to serve Latino communities in health clinics in California. Initially, nostalgia got the best of her. She came from Mexico City, from an established practice, a job, and a circle of friends and family she misses.
“Besides, I felt like work was very slow. I was seeing an average of two patients per hour, when the number could be higher,” she says. “Although medical practice in California is the same, the procedures are different, and you have to get used to it.”
She was fortunate to join AltaMed Health Services. They made her feel like family and helped her adapt. Soon, her efficiency and connection with patients increased.
LPMPP was introduced as Assembly Bill 1045 in 2001 by California Assembly member Marco Antonio Firebaugh. The State Assembly passed the bill in 2002, allowing up to 30 licensed family medicine and internal medicine physicians with a medical license from Mexico to practice at California Community Health Centers (CHCs) for three years. The program participants are issued a license by the Medical Board of California and a working visa to practice medicine in CHCs.
Currently, around 30 Mexican doctors serve majority Latino/x and farmworker populations in clinics across Monterey, San Benito, Tulare, and Los Angeles Counties.
As of last December, the doctors had treated tens of thousands of Californians, according to the California Health Care Foundation.
“The difference is noticeable when they know you’re Mexican. They feel a great identification with us, they open up more. It’s as if they suddenly found a kind of family in our office,” Dra. Castro Castrezana says.
“It has been fabulous; the impact of these doctors in our clinics has been significant. We have increased access to services. Patients feel very connected; they identify with the doctors, and they understand the challenges because, in the end, they are also immigrants,” says Sandra Sánchez, Licensed Physician from Mexico Pilot Program (LPMPP) at AltaMed, whose clinics are the only ones offering services in urban areas, while the others are located in agricultural zones.
Sánchez adds that, like everything, doctors from Mexico go through a learning and adaptation curve.
“One of them is the use of electronic files since they don’t use them in their country,” she adds.
Castro reinforces this. “It’s wonderful; I wish we had it in Mexico. It’s very useful, but it is indeed very challenging at first. After several months, I’ve started to master it,” she says.
“However, for the patient, when they hear us speaking to them in Spanish, it’s something liberating, a state of liberation. It’s not just medicine; it’s understanding them, sharing a culture, a sense of identity and belonging,” she says.
The Mexican doctor is located in the Huntington Park clinic, a densely Latino city, so she feels less nostalgia. “The program seemed interesting to me as soon as I learned about it. I belonged to the College of Internal Medicine, and after finishing my time there, I had the opportunity to apply for entry into the program, and they accepted me,” she adds. The stay for these doctors is three years; they receive a visa and a permit to practice medicine in this state.
Castro Castrezana has seen a very positive response from patients. “The difference is noticeable when they know you’re Mexican. They feel a great identification with us, they open up more. It’s as if they suddenly found a kind of family in our office,” she says. She hasn’t seen a big difference in the symptoms of Mexicans and immigrants in California. “We have the same habits, we eat tacos, garnachas, we suffer from obesity, diabetes, hypertension. I have also encountered a lot of anxiety, which is related to the challenges of being immigrants,” she adds.
The doctor acknowledges the reluctance of many Latinos to go to the doctor. For her, there is a culture of denial, a preventive culture.
“However, for them, when they hear us speaking to them in Spanish, it’s something liberating, a state of liberation. It’s not just medicine; it’s understanding them, sharing a culture, a sense of identity and belonging,” she says.
Castro does not feel a difference in the quality of medical care. “We have the same strengths and weaknesses. We have very good training. We have to take the good from here and put into practice the good from there,” she emphasizes. She has been so enthusiastic about the program that she would like to continue participating after her three-year stay. “I think I could contribute many things to improve it; it seems fabulous. Let’s see what happens,” she says.
And for Sánchez, it would be a blessing. “There is so much need for more doctors, more care for Latinos and having them as patients for a longer time and in greater numbers would be a great benefit,” she concludes.
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