illegal immigration and impact on medical field

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  • #107581
    sahmdsahmd
    Participant

    I am realistic, too: a lot of immigrants don’t speak English YET. It makes my life — and their medical care — a lot better if I can communicate with them. So I have taken the time to learn Spanish. The Hispanic students in my medical school actually gave a little mini-course to the rest of us! And I continued to learn from patients as the years went by.

    Since my area has a lot of immigrants from a lot of different places, I have also made the effort to learn a little Tagalog and Hindi. Just the important, urgent words, like “pain,” “nausea,” “sit up,” “take a deep breath,” “are you ready to push,” etc., and the polite, friendly words like “hello” and “thank you.” For Chinese, I have the characters written down and can point to them (they are too hard to pronounce properly). The translations were kindly provided by bilingual coworkers, patients and family of patients.

    That is what I have done. There is no way I’m suggesting that every doctor should do that. It is something that I enjoy and it works for me. If people are going to be working with a lot of immigrants, they might consider doing the same. Last I heard, there was also an AT&T Language Line that you could call for translations of various languages.

    As for the immigrants themselves, they should learn English ASAP, and until then, they should bring a bilingual person with them to appointments. It will make their lives a lot easier, and they will get better medical care. Would somebody tell them to do this, please? 🙂

    #107583
    ddadocddadoc
    Participant

    pathdr2b, if you took critisism personally by anything I said, there was nothing directed at you. I had no idea that you were premed and I was just asking what your current situation was. I wasn’t implying any criticism in what I asked. I just wanted to have a discussion, that is all. No one is throwing insults at you or anyone else. This is just something I was hoping to have an open talk about because it had been on the news recently, and I was just hoping to hear some ideas/thoughts from others in the field. I had registered for this site quite a while ago, and had been reading the posts periodically… and I just thought that I would have a go at being an active participant in the forum… but if we can’t just discuss things knowing that we’re going to have differences in opinion, I think I’ll just abstain from further postings. Thanks.

    #107585
    efex101efex101
    Participant

    Same here…I was not (in my post) referring to anything in particular that anyone here wrote…just my thoughts. I still think that if you are in the US that you should learn English and I am not saying that knowing Spanish is NOT a good thing…but to require it would be wrong IMHO. Sure, if you ARE a doc that is catering to Latinos then knowing Spanish is of course a huge asset…but to require it is another whole issue. Of course that all of us here are immigrants for the most part unless you are NA but last time I checked the language “de jour” is English right? so hence my post about having the immigrants learn the language of their new country…

    #107587
    ddadocddadoc
    Participant

    oh, and thanks for your thoughts sahmd and efex…i do have to defend myself on a couple of things… i never said i wasn’t happy doing what i’m doing… i did know what i was getting myself into… and i actually have very few patients i can’t communicate with in my clinic… so for me now, not knowing spanish is not a big hindrance… and i have a nurse and other staff members who can help me out if needed. I don’t necessarily have to “sashey” myself anywhere… I have been on medical mission trips to mexico many times (w/ translators)… i see many patients for free in my own office via a service in Dallas known as Project Access which provides care for working families without insurance, etc… i am also in the process of getting my MPH and going back to fellowship in a couple of months to do endocrinology because there i am aware of its increasing prevalence (esp amongst minorities)… i may or may not learn spanish… if i ever start to feel my patient care is being compromised, i will… but w/services like translators via phone/staff/family members who are much more fluent than i’ll ever be, it works.
    those of us who work in private practice aren’t all in it for the money…
    So can we now get back to the issue?

    #107590
    mrssdmrssd
    Participant

    I think that this is a really important issue and it is always important to think of what we would do if we were in positions to change America policy. I don’t really have a solution but for me it would take a revamping of the healthcare system and isn’t so much about immigrants because I want immigrants to be able to come here and I want the people here to be able to stay here. I think that if someone wants to better the lives of themselves and their family it should be relatively easy for them to be able to do that legally but that isn’t the system here. I have friends who have struggled to stay in this country because they were downsized and were told to immediately vacate the country—never mind that they had been here for years, own homes, and have built relationships with loved ones. We are really fortunate in this country and I can see why people want to come here. At the same time, there need to be more laws so that these immigrants are not taken advantage of. Right now there are illegal immigrants who work really hard and get paid nothing close to minimum wage and they do it because they want to and they have to so they can support their families. A system that is easier to navigate would make things better and then the government could be sure that these people get paid what they are supposed to.
    With respect to healthcare, I believe that everyone in the world should have basic healthcare as a right not a privilege. Would it cost a lot? Yes. Would all of us have to pay to help this work? Yes. Do I think that it would take so much money out of my pocket to burden me? Nope. Do I think without insurance companies all of this would be cheaper? Absolutely.
    I know that it isn’t close to a great solution but like I said, the most important thing is to at least think about it.

    Also, I just wanted to say that some of the earlier posts seemed to confuse speaking Spanish with cultural competency. They aren’t the same thing and I would hope that physicians and medical students were taking the time to be culturally competent over learning to speak one language that some of their patients may speak. As long as you educate yourself on the different cultures and you know how to properly utilize a translator—not a family member—to communicate with your patients you will be way ahead of the game and your patients will get better care because of it. Just my opinion but my medical school has inundated me with cultural competency practices so I am pretty biased.

    #107592
    Doc201XDoc201X
    Participant

    Originally posted by ddadoc:
    pathdr2b, if you took critisism personally by anything I said, there was nothing directed at you. I had no idea that you were premed and I was just asking what your current situation was. No one is throwing insults at you or anyone else. but if we can’t just discuss things knowing that we’re going to have differences in opinion, I think I’ll just abstain from further postings. Thanks.

    Point taken. I’ve seen it on this site way too often that, many docs feel that anyone who doesn’t have an MD/Do and is practicing medicine isn’t in a position to make any statements about the status of the medical field or make suggestions about how to balance a stressful career with family. And after rereading you post, I don’t think it’s reaching to believe that you unwittingly or not, were doing the same. However, one of the great things about this site is that we are usually able to engage in discussions, disagree, fight, and make up again all in the name of presenting different points of view. And I thnk that’s VERY important.

    Now back to you regularly scheduled program! 😀

    PS- The obesity epidemic in this country is going to make you one very busy doc one day!
    😉

    #107594
    AnnaMAnnaM
    Participant

    The AT&T language line charges 6 bucks a MINUTE the last time I checked, which was a few years ago. That’ll eat up what public aid pays for a 99213 REAL quick.

    I’m doing my best to be “culturally competent”, but it’s very hard when you’re working with a number of cultures, and what other country in this world trains their docs to be culturally competent in many other cultures (most foreign countries just ridicule American culture)? My culture of origin (scandinavian) maintains a large personal space and is uncomfortable with hugging. Why doesn’t anyone in this country repect THAT (there’s WAY too much hugging going on in this country).

    #107596
    AnnaMAnnaM
    Participant

    WAAYYY too asinine to respond to!

    Assinine in what way (and can we stop the name-calling please?)

    It’s a legitimate question. You mentioned that doctors should be required to learn Spanish (and btw, I don’t live in a border state but I have plenty of Spanish-speaking patients), and I wondered why not other languages if that’s how it’s going to be?

    And how can you “refuse to assimilate” in the so called “melting pot” the US claims to be?? And what does assimilate mean? Belief that a size 2 with blond hair/blue eyes is sexy?

    Melting pot is one thing, but carving out little countries and making comments like I have seen on the news that “We will take over the US”. Is not what I would call a melting pot. I never said everyone needed to blonde, blue-eyed, and size 2, but English happens to be the language that this country functions on, and those who learn it are the ones who will eventually attain “the American dream”, which is what the folks who have come here over the years have always been seeking, have they not?

    I HAVE made the effort to (re)learn Spanish in order to help these women, but I gotta say, even my translator, who was born in Mexico and is a legal immigrant, runs out of patience with some of the ladies who come to our clinic, and their lack of effort to learn how ANYTHING works in this country.

    #107598
    chalkchalk
    Participant

    I agree with those who have suggested we need to start offering preventative health care options to illegal immigrants, both to provide them with better care and to save on expensive ER visits and undiagnosed conditions.

    I also think it would be a fantastic idea for individual medical schools to start requiring applicants to have studied a foreign language (any language) for at least one year on an undergraduate level. Forget about altruistic motives for a moment–learning a language is cognitively challenging, and surely at least as relevant as calculus or English Literature to the medical profession. I think such a requirement would result in a more intelligent and capable student body overall.

    Lastly, I agree with the suggestion that all humans throughout the world deserve basic health care, and that it is the responsibility of those who can to work toward this goal. I am not particularly religious, but I would expect anyone even remotely so to agree with this standpoint.

    #107601
    Doc201XDoc201X
    Participant

    Originally posted by AnnaM:
    [quote] WAAYYY too asinine to respond to!

    Assinine in what way (and can we stop the name-calling please?) [/quote]The comment was asinine, NOT you so my apologies if you took it that way. But common, I’m not “Boo-Boo the Fool”, I know EXACTLY what you meant when you asked about learing 3 hundred thousand languages. :rolleyes: 😀

    Originally posted by AnnaM:
    [qb] [QUOTE]My culture of origin (scandinavian) maintains a large personal space and is uncomfortable with hugging. Why doesn’t anyone in this country repect THAT (there’s WAY too much hugging going on in this country).

    Uhhhhhh, I think we do, it’s called a “standard of beauty” that has blond hair/blue eyes and wears a size 2! :p

    But don’t worry, in a about a hundred years or so, the standard of beauty with be brown hair/brown eyes with a “badonkadonk”!!! :laughing:

    #107603
    dnw826dnw826
    Participant

    Originally posted by efex101:
    [b] As a Latina this topic hits home really hard. I for one do not think that physicians in any area of the US should “have” to speak *any* language aside from English. It breaks my heart to realize how much America is trying to “accomodate” for ALL folks moving in. If in the next ten years or more we have a huge influx of let’s say Koreans and the map starts changing in some areas should we have to then Korean? this can open a HUGE can of worms. Immigrants that go to any OTHER country HAVE to learn the language that is primarly spoken in that area. I grew up in Spain and ALL folks (Germans,Swiss,French,Italians) that moved to Spain INDEED speak Spanish. Why do we as a country must always have to accomodate ALL cultures/languages that come here AND change the way WE do things? do not get me wrong change to a certain extent IS good to a certain point. I think that we as a country have been more accomodating than any other country in the world!
    About legalizing the status of immigrants I think that there is no right answer. If you do legalize their status how will ALL OTHER immigrants (including Hispanics) that had to go through the proper channels to become a US citizen feel? why do some folks have some rules and others do not? why do people outcry in rage when this Kennedy congressman was allowed to go home w/o a sobriety test (which I think is wrong) and he was given another set of rules YET we are “considering” allowing all these immigrants legal status? I mean this is like an oxymoron. I do agree that these folks ARE providing a lot to our country but they ARE here illegally! and as far as I know that is against the law right? I am not condoning deporting this guys en masse for many agricultural areas will be at a great loss of workers but I am also not for just “letting” them have at it and become US citizens like magic for this would be a slap to the face of the many other immigrants that waited their time out.
    This country is going to go down the drain slowly but surely IF we keep making concessions for ALL folks that come in here. Do you guys think for ONE minute that we could take our little arses to any other country and DEMAND to have physicians that speak OUR language? demand that business have folks that speak our language? demand that they give us instant citizen status? hell no! [/b]

    I agree with you 100%. I would never even travel to a country without learning at least as much of their language as I needed for my trip. I just think that it is ridiculous to ask for everyone in a country to accomadate others who come in and won’t/don’t know the language. I mean, I am already teaching my kids German and French. No offense to anyone who speaks Spanish, but I can’t speak a word of it. I know SEVERAL languages, but for some reason I just have a block with Spanish. I am not going to go out of my way to learn it, either. I think that languages should be taught optionally and with enthusiasm if you are going to, but telling me I HAVE to? Not going to happen.

    Just like when you travel, I have many friends who live in Europe or have traveled. Especially places like France, they are very patriotic, and very much in love with their language. Most of them learn several other languages in school, and I think that is usefull. But the minute you go speak English there and demand they speak it back to you, girl, you are in for trouble. 😮

    I live in an area with a HUGE migrant worker population, and I would say that 90% of the ones I have encountered speak good English. Even in the hospitals I worked at. There was one couple who didn’t, but one of our most awesome nurses was Mexican, and she would translate. I don’t see any need to treat illegals differently medically. But I do not have insurance, and I’ll be darned if some hospitals would see me, we have enough problems with poverty and insurance in this country to allow a huge influx of citizenship to bear a bigger burden.

    I agree, why is it so forced upon us to learn Spanish due to immigration, when I’m sure up farther north by the Quebec border, I am sure it’s not required to know French, right? OR what if there was suddenly a huge Chinese influx, do you really think that we would be bending backwards to learn Chinese? Of course not.

    It would not be fair to all of the migrants who are legal and have worked really hard to become a citizen, and the ones that have broken laws and been illegal just get citizenship with this whole deal.

    I personally think that immigration should be slowed down to almost a halt with all of the terrorism issues. I think that it should be way more selective, if anything. Yes, our ancestors (most of us) were migrants, too. My ancestors personally came over right after the Mayflower, then some as Irish slaves, and I am also part Native American (documentable), and this land was stolen. But just about all land on this earth was stolen at some point in the past or more recently. Including from my relatives, but I am not making a big fuss over what someone’s great great great great grandparents did to my great great great grandparents. That’s the past. Let’s fix the future.

    #107605
    dnw826dnw826
    Participant

    Originally posted by pathdr2b:
    [b] [quote]Originally posted by efex101:
    As a Latina this topic hits home really hard. I for one do not think that physicians in any area of the US should “have” to speak *any* language aside from English.

    When I was a volunteered in the ‘hood, I spoke ebonics with some patients and also served as “translator” of sorts to those PHYSICIANS and nurses who didn’t. I see speaking the “language” just as important as providing healthcare, because your ability speak the language could potentially effect your ability to provide care.

    No, I’d venture to say that the reason folks have their boxers and thongs in a bunch ove rthe immigration issues is because one day, those with brown skin will one day RULE this country. Of course, that means that things will return to the way the USED to be.

    I guess I’m so passionate about this issue because I’m a little bit latina but a lotta bit Native Amercian (1/4). More than that, I haven’t forgotten HOW this country was “founded” and all the tens of millions of lives that were destroyed making this an english speaking country. So this idea that English SHOULD be the ONLY language spoken here is just ridiculous in a country that was 1) STOLEN from the people who already lived here and 2) Is full of so many immigrants anyway. But I guess all this makes me an idealistic premed! 😀 [/b][/quote]Believe me, I am not afraid of “those with brown skin ruling the country some day”. That is just plain ridiculous. I have many minority friends who would all think that this comment is ridiculous. I am dying for some more people of color to run for office. Barack Obama is just about a God to me here in Illinois where I am surrounded by rednecks.

    You must forget that every country around today has been “stolen” from someone else. And the “original” inhabitants didn’t even speak Spanish. That was only when the Spanish and Portugese (mainly, but there were other culprits) came over and raped and pillaged the natives. Thanks smallpox.

    And english is what this country was built on, being “founded” as a country by the English, but also, what about dutch, or french? Because they are the ones that also helped mostly build up this country and “fought against the Spanish for land”, so since we are on the “winning” side of this one, should it be more fair to make French and Dutch secondary languages? We most likely wouldn’t even be a country if France hadn’t helped save us from the British during the American Revolution.

    I think that one of the main reasons I am for an “english only” primary language, is because it will help with assimilating everyone into “an American”. You don’t have to leave your cultural identity behind, you just need a way to communicate effectively to “live the American Dream”. But that’s just my :twocents:

    #107607
    dnw826dnw826
    Participant

    Originally posted by AnnaM:
    [b] The AT&T language line charges 6 bucks a MINUTE the last time I checked, which was a few years ago. That’ll eat up what public aid pays for a 99213 REAL quick.

    I’m doing my best to be “culturally competent”, but it’s very hard when you’re working with a number of cultures, and what other country in this world trains their docs to be culturally competent in many other cultures (most foreign countries just ridicule American culture)? My culture of origin (scandinavian) maintains a large personal space and is uncomfortable with hugging. Why doesn’t anyone in this country repect THAT (there’s WAY too much hugging going on in this country). [/b]

    I agree. I have space issues. 😉

    #107610
    dnw826dnw826
    Participant

    Originally posted by pathdr2b:
    [b] [quote]Originally posted by AnnaM:
    [qb] [QUOTE] WAAYYY too asinine to respond to!

    Assinine in what way (and can we stop the name-calling please?) [/b][/quote]The comment was asinine, NOT you so my apologies if you took it that way. But common, I’m not “Boo-Boo the Fool”, I know EXACTLY what you meant when you asked about learing 3 hundred thousand languages. :rolleyes: 😀

    Originally posted by AnnaM:
    [b] [quote]My culture of origin (scandinavian) maintains a large personal space and is uncomfortable with hugging. Why doesn’t anyone in this country repect THAT (there’s WAY too much hugging going on in this country).

    Uhhhhhh, I think we do, it’s called a “standard of beauty” that has blond hair/blue eyes and wears a size 2! :p

    But don’t worry, in a about a hundred years or so, the standard of beauty with be brown hair/brown eyes with a “badonkadonk”!!! :laughing: [/b][/quote]I am neither a size 2, brown eyed, blond hair blue eyed, nor do I have a nice “badonkadonk”.

    I think that the “standard of beauty” in this country is quite ridiculous, honestly, but you’d have to get rid of tv and the media to revert that one. Or have more beautiful diverse people on there, which I desperately hope happens. But what has this to do with anything? BTW: Salma Hayek is absolutely GORGEOUS, and noone would deny that one. Seen Frida?

    #107612
    Doc201XDoc201X
    Participant

    Originally posted by dnw826:
    But what has this to do with anything? BTW: Salma Hayek is absolutely GORGEOUS, and noone would deny that one. Seen Frida?

    I have seen Frida(although the one eyebrow doesn’t work too well for me personally). Salma Hayek, beautiful? Sure she is, but what dooes THAT have to do with anything?

    The REAL question is can you name 5 other Mexican American actresses? How about 3? Maybe not now, but in another 10 maybe 15 years, hopefully many more than 5! :yes:

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