ccedillo, Author at Prickly Pear Family Medicine
3_rgb_web_nobackground copy

5 things to do if you're hospitalized or in the ER

More and more I'm seeing on how patients are scared for themselves and family when in an emergency situation.  Navigating the bureaucracy of hospital administration and the jargon from medical staff can be complex and overwhelming. Patients and their loved ones are often overwhelmed with emotion and anxious about what's to come.  If you or a family member are hospialized or in the ER here's what you should be doing.

1. Ask for copies of everything before you leave like imaging reports and labs.

Don't accept "Oh your primary care doctor can request it later".  I've requested documents from hospitals that have taken two months to send me information.  That's a long time when dealing with health.

2. Make sure to ask the staff coming in and out of your room to identify themselves.

Are they the doctor or are they a physician's assitant, nurse practitioner or nurse assistant? Knowing who you're talking to will allow you to take your interactions with them into proper context.  A small but critical piece of knowledge when dealing with all the people coming in and out of your room doing any number of things.

3. Make sure you have a charger.

Some hospital systems will give you real time results through your patient portal while you're still in the ER. Long ER waits mean that you could find yourself with a dead phone right when you need the results.

4. Don't go if you don't have to.

This seems like no-brainer.  As an ER director, everyday my waiting room had a number of people who didn't need emergency services for their issue. They would've been better served and saved money by seeing their primary care doctor. Have a conversation with your primary care physician about how they recommend you handle emergency situations.  Due to our broken healthcare system, for many situations people think it's an ER visit, but in reality your PCP can handle it. Each doctor's capacity and ability will vary.  That's why it's good to have the conversation because it can save you an expensive ER visit.  I encourage my patients to contact me  when an urgent situation arises.  I've handled animal bites, broken toes / fingers, workplace injuries and many more in my small clinic which saves my patients thousands of dollars in ER or urgent care bills.

5. Bring someone with you to the ER or have them meet you there.

When it's you that's having the emergency or a close family member, chances are you're not on top of your game.  You need someone you trust that can think a little more clearly.  You want someone that's not afraid to ask question, request help or ask for documentation.  They can also help take notes or help you remember everything that's happening.

Treating Patients, the Way I Treat My Abuelita

As a kid, I saw firsthand how families struggled accessing healthcare and finding a bilingual doctor. I founded Prickly Pear Family Medicine because healthcare shouldn't be a privilege and everyone should have a doctor in the family.

clinic pic 2
Spanish Speaking Doctor Houston

Get in touch, let's get together & talk about your health

As a doctor, only spending 10 minutes with a patient doesn't cut it.  That's not the way I practice medicine.  Patient visits at my clinic are always unrushed. I'm looking to earn your trust, not the blessing of an insurance company.

3_rgb_web_nobackground copy

Community clinics struggle getting Latinos into preventative healthcare

Doctors, community leaders and health advocates have long struggled to get Latinos preventative healthcare. Our community is less likely to have health insurance and more likely to face language barriers, poverty and cultural issues.  Advocates that focus on helping Latinos get regular access to a doctor, which is critical for preventative healthcare and management of chronic conditions, are searching for new ways to engage the community.

Latinos United of Carroll County  health clinic

The Latinos United of Carroll County is a community organization that helps Hispanics in Georgia with immigration, education and health.  Around 2002, board member Dr. Evangelio Gonzalez, took a tour of the local Latino community and decided he had to do something to help improve their health.

He approached the Housing Authority and asked them for an apartment in a Latino neighborhood.  They gave LUCC  an apartment for free, and Dr. Gonazalez was able to set up a small clinic.

By 2008, the LUCC clinic was able to move from the apartment into a house also provided by the Housing Authority for free.  Today, the Tanner Health System provides a full-time nurse practictioner and the LUCC clinic sees about 100 patients a week.  The clinic helps a large number of insurned people .

Getting Latinos prevenative care

Like other clinics and healthcare professionals, LUCC has not been successful in getting the Latino community to turn out for preventative healthcare or education related events.  As a result, they have started to integrate health screenings into their immigration events which typically have better attendance.

"For Latino health, the financial obstacles for patients is the biggest problem. But we haven’t been good at prevention.  We have three or four that come for our prevention classes. The classes that help them to manage their disease they don’t come" said Gyla Gonzalez, Executive Director of LUCC.

Some prevention efforts are proving popular with the community.  LUCC with the help of Tanner Health drives 10 women to get free mammograms. A service that fills up quickly and LUCC struggles to maintain.

"Social media has helped us with outreach tremendously.  A lot of people have started to come to our parking lot Zumba classes" said Gyla Gonzalez.

LUCC believes healthcare is essential to strengthing families and tries to incorporate it into their broad array of services and outreach as much as possible.

Barriers to prevenative care for Latinos

For LUCC and other community clinics the biggest barriers are money and community participation.  It is often hard for nonprofit clinics to collaborate with other healthcare organizations because many are for-profit or under-resourced themselves.  Many of their services are offered either free or at deeply discounted prices so that price is not a barrier to access. A blessing for patients, but the lack of financial resources makes it hard for the clinic to expand services or the number of patients it serves.

Community clinics rely on volunteers to help stay operational. Providing healthcare to underserved communities is complex and requires a lot of communication, logistical and medical support because there are patients that use these clinics for all their healthcare needs. A task these small clinics are often not equipped for.

For patients, the lack of Spanish speaking doctors that understand the Latino experience has proven to be a big barrier especially for immigrant families.

Spanish speaking bicultural  doctors needed 

About half of Latinos report they have a friend or family member that needs a Spanish speaking doctor, and about 30% have friends or family worried about their legal status.  Having a doctor that speaks Spanish helps, but having a doctor that understands both the cultural and language helps Latinos make signficant healthcare gains.

Unfortunately, just 6% of doctors are Latino and an additional 2% of non-Latino doctors speak Spanish.  This is a contributing factor to why Latinos don't seek prevenative healthcare as often as other communities.

The communication gap is exacerbated by the complexity of our healthcare system.  Half of Latinos say healthcare in the U.S. is somewhat or very hard.

Without Dr. Evangelio Gonzalez there would be no LUCC clinic.  Addressing this issue is why I became a doctor. The struggles of today's Latino family are the struggles my family went through when I was a child.

I've learned a lot since opening my own clinic and seen first hand how a bilingual, bicultural Latina doctor can impact a family without breaking the bank.  It's been a steep learning curve. Medical professionals like Dr. Gonzalez and the stories of my patients inspire me to expand my reach to help more people.

Treating Patients, the Way I Treat My Abuelita

As a kid, I saw firsthand how families struggled accessing healthcare and finding a bilingual doctor. I founded Prickly Pear Family Medicine because healthcare shouldn't be a privilege and everyone should have a doctor in the family.

clinic pic 2
Spanish Speaking Doctor Houston

Get in touch, let's get together & talk about your health

As a doctor, only spending 10 minutes with a patient doesn't cut it.  That's not the way I practice medicine.  Patient visits at my clinic are always unrushed. I'm looking to earn your trust, not the blessing of an insurance company.

3_rgb_web_nobackground copy

Spanish Speaking Doctors: Houston’s Medical Unicorns

“Spanish Speaking Doctors Near Me”… if you’re in Houston and search the phrase in Google the results aren’t particularly helpful.  The page is dominated by hospital systems promoting non-Spanish speaking docs, tech companies playing healthcare middleman and useless results from other states. In a city where 38% of people speak Spanish at home, Latina bilingual doctors are hard to find because we’re medical unicorns.

Bilingual Latinas- Medical Unicorns

Latinas are notoriously underrepresented in medical schools. Our enrollment lags behind all men and Asian, White and African-American women.  The medical community has taken notice of the urgent need for more Latinas in medicine.  Since I’ve finished medical school, Latinas went from being 2% of all doctors to 3%.  Encouraging, but hardly enough to address the massive need for bilingual, bicultural doctors in our communities.

There are 2.7 million Latinos in Houston.  Many of these households are increasingly frustrated with the barriers they face in traditional healthcare systems and their inability to access quality primary care.  They’re looking for a physician they can relate to not only through a common language but culturally as well.

While Latinas are slowly making gains in the medical community, not all Latinas in medicine are bilingual or bicultural.  Some are neither.  Even though the community critically needs primary care in underserved areas, some Latinas in medicine choose a different route with their skills and careers.  Primary care in urban areas usually isn’t at the top of the list for medical school graduates because its low pay compared to other specialties and the work/life balance isn’t the best.

Growing up, I went to HISD schools before going to the University of Houston for college. My entire educational journey was full of diversity- which I cherished.  At home, my family spoke Spanish, and we were always in the heart of Houston’s immigrant communities.  Even as a child I knew this was the community I wanted to help.

It wasn’t until I walked through the doors of Baylor Medical School for the first time that I realized how rare a bilingual, bicultural Latina from the barrios is in the medical field. There were about 180 medical students, and I was one of a handful of Latinos. The realization hit me, and it strengthened my resolve to serve the community.

Benefits of a Bilingual Doctor: Better Health, Increased Satisfaction, Lower Cost

Research has proven that healthcare suffers when there is a language barrier between patients and doctors regardless of income or insurance status. A doctor’s ability to explain treatments, obtain a patient’s medical history and answer questions is even more critical considering most  only spend a few minutes with their Spanish speaking patients.

During an exam, patients should be able to communicate how they feel and symptoms they are experiencing. When patients don’t feel understood in the clinic, it limits their ability to express their thoughts, understand medical instructions and properly manage their treatment at home.

Language barriers have been linked to longer hospital stays and higher readmission rates.

Fluent, bilingual doctors have been proven to provide higher healthcare quality that lead to positive health outcomes and better patient satisfaction.  Doctor’s that speak Spanish find it easier to understand questions from patients and properly explain conditions. For the patient this means fewer emergency room visits, better adherence to treatment plans and lower cost of care.

All that research to tell us what Latinos already know.  Bilingual doctors provide better care that results in better health at a lower cost to the Spanish-speaking community.

Medical Spanish in Medical Schools

The dire need for bilingual doctors is well understood by medical schools. Due to the increasing number of Spanish-speaking patients, states like California, Florida, Illinois, Tennessee and North Carolina require medical Spanish courses. Most others offer it as an elective.

There are 48,530 medical students in the U.S. of which only 6% are Latino.  Out of the 158 medical schools in the U.S., 135 offer Spanish programming.  That means a lot of good-hearted non-Latino medical students are learning Spanish which is a positive thing for the underserved Hispanic community.

As beneficial as medical Spanish is, our community also needs doctors that can write and read the language. This is important because writing treatment instructions or prescribing medication in a patient’s native language further lowers the barriers of communications, increases trust and results in better health outcomes for the patient.

While finally finding a Spanish-speaking doctor gives patients and their families a sense of comfort and security, they must understand that having a bilingual doctor doesn’t guarantee they’ll understand the patient’s culture

Bilingual is not Bicultural

Being fluent in Spanish or knowing medical Spanish definitely aids in communicating with patients, but there are cultural nuances within the Latino community that are not language dependent.

One of the biggest is considering the whole family unit. We often have three or more generations living under one roof. Latinos place a higher emphasis on the family in terms of respect, support and obligation.  This means family has a greater involvement when anyone in the household has health issues and should be taken into account when dealing with them as patients.

As a doctor, I have to speak to the parents in Spanish while relaying the same information to the adult kids in English all to support the treatment I prescribed for the grandparents. It’s an incredibly dynamic and beautiful way to practice medicine.

It’s also important for doctors to know that Latinos in the U.S. are extremely diverse.  We come from South America, Mexico and the Caribbean. Each has their own Spanish dialect, beliefs and lifestyles.  Cultural differences even exist between urban and rural Latinos. All of which shapes their attitude towards healthcare. Doctors need to consider each individuals reality as they design treatment plans and deliver medical services.

During one encounter a Puerto Rican doctor wrapped up a visit with a patient believing all questions had been answered. When I followed up, the patient couldn’t understand the bilingual doctor because of how fast the doc talked and due to the doc’s accent.

I’ve found that some Latino patients are not forthcoming with the traditional “home remedies” or alternative therapies they have tried. These traditions are still an integral part of many Latino families that have a custom of self-medicating without a professional doctor’s help. When a patient sees that I understand and accept these customs, they feel more comfortable and I’m able to deliver the medical care they need without devaluing their traditions.

Latino cultural beliefs are the least understood in our healthcare system because public health policies tend to overlook our community and the disparities we face.  As a result, hospitals and clinics around the country are limited in their ability to deliver appropriate care to the Latino community.

My Philosophy as a Spanish Speaking Doctor

As a primary care doctor that speaks Spanish, I can be more responsive and sensitive to the needs of my patients that don’t speak English.  This allows us to form a direct patient-doctor relationship without the need for a translator.

For me, being bilingual is about more than just speaking the language during a patient visit. It’s sewn into the fabric of my clinic.  By incorporating my culture, I am able to elevate the level of care I provide.  When Spanish speaking patients have access to these simple communication tools at a bilingual practice like mine their patient satisfaction increases.

Why I opened a bilingual clinic in Houston

As excited as I am to open my practice and serve Houston’s Latino community, I realize it’s small solution to an overwhelming problem.  We need more Latinos in medicine, and we need those Latino doctors to open their practice in areas that serve our community.

Unfortunately, my fellow Latino doctors typically have $240,000 in medical school debt.  The financial situation makes it difficult for them to pursue primary care in an underserved area because of the low pay, and the uncertainties of entrepreneurship keep them from opening their own practice in our communities.

As my clinic grows, I hope to be able to provide other doctors a pathway to serving underserved communities.

Besides the financial constraints, just getting Latinos into medical school has been a barrier not even the best universities and non-profits have been able to address. The road to medical school starts in high school and is filled with internships and research positions along the way.  It’s a very long, calculated and expensive journey that most Latino families don’t know how to navigate.

I opened my bilingual clinic in Houston because I wanted it to be a hub for everything related to Latinos and healthcare.  Prickly Pear Family Medicine is not only open to families in need of medical services, but a place for future doctors from our community to learn and get mentored.

Bilingual doctors shouldn’t be medical unicorns. I look forward to working with patients and partners to create a healthier community and a pipeline into medical school

Treating Patients, the Way I Treat My Abuelita

As a kid, I saw firsthand how families struggled accessing healthcare and finding a bilingual doctor. I founded Prickly Pear Family Medicine because healthcare shouldn't be a privilege and everyone should have a doctor in the family.

clinic pic 2
Spanish Speaking Doctor Houston

Get in touch, let's get together & talk about your health

As a doctor, only spending 10 minutes with a patient doesn't cut it.  That's not the way I practice medicine.  Patient visits at my clinic are always unrushed. I'm looking to earn your trust, not the blessing of an insurance company.