RUBEN NAVARRETTE JR.: 2 visionaries, 30 Mexican doctors and one great idea
For the farmworkers, this program is a blessing.
January 3, 2023 - 9:01 pm
If you’re like me, a trip to the doctor’s office is usually filled with anxiety and dread.
Unfortunately, physicians can be arrogant scolds who lack social skills. Between dealing with my own health issues and those of my parents and my children, I’ve probably — in the past 20 years — encountered more than 50 doctors. Few had a good bedside manner.
Imagine how frustrating, even frightening, this experience is for poor Mexican immigrants who don’t speak English.
The doctors at Clinicas de Salud del Valle de Salinas, a special network of medical facilities headquartered in the Salinas Valley on California’s central coast, have the antidote.
The string of more than a dozen community clinics provides medical care to agricultural workers and their families. It is also, at the moment, an incubator for an innovative solution to a specialized labor shortage: a lack of physicians with the linguistic and cultural skill sets needed to treat that population.
The Salinas Valley is called the “salad bowl” because just about every vegetable is grown there. The produce is picked by farmworkers whose sweat and toil feed the nation and make farmers rich (even if the growers sometimes forget that). Farmers generally don’t provide these employees with health insurance or time off to see a doctor.
These essential workers often end up in the emergency rooms of public hospitals — if they can drive two or three hours to get there. Most can’t afford to lose a day’s wages to treat a cold so that it doesn’t become pneumonia. So they don’t go. You know the rest.
Those who do seek medical care are likely — even in California, which is now nearly 40 percent Latino — to be treated by a white or Asian doctor who doesn’t speak Spanish and has zero “cultural competence” in dealing with Latinos. For instance, Latino fathers like to think they run the family, but the real decision-makers are our mothers. Also, a warm rapport counts for a lot, and family is more sacred than religion.
And we can’t count on the state’s medical schools — at public or private universities — to offer a cure. They do a lousy job of recruiting, retaining and graduating Latino medical students.
In 1998, a doctor and a policy analyst devised a solution. The doctor was Max Cuevas, chief executive of Clinicas de Salud del Valle de Salinas, and the analyst was Arnold Torres, a Sacramento-based consultant with more than 40 years of experience navigating government.
The idea: Bring in, on temporary work visas, 100 doctors from Mexico to help treat Mexican patients on this side of the border. The doctors would be supremely qualified and board certified in California.
Over the next three years, the pair wrote a bill to go before the state Legislature, found lawmakers to sponsor it, negotiated terms (i.e., 100 doctors got whittled down to 30) and got it to the governor’s desk.
In 2002, then-Gov. Gray Davis signed the bill into law.
Cuevas and Torres accomplished all this with the backing of the Clinicas board and help from allies. These included Diana Bonta, the first Latina director of the California Department of Health Care Services, and — in Mexico City — a handful of officials from the School of Medicine at the National Autonomous University of Mexico.
Yet, getting a law on the books to import doctors from Mexico was just the beginning. The devil, as they say, is in the details.
A cartel of entrenched interests — from medical school officials to bureaucrats to people from the California Medical Association — seemed determined to kill the program. Opponents were apparently so uncaring toward farmworkers in need of medical care that they put its architects through hell. They wanted to make the visionaries give up.
That didn’t happen. Today, nearly a quarter-century after the idea was hatched, 21 Mexican doctors practice in the Clinicas. By March, Torres told me, the final nine will arrive. The cadre will be complete.
For the farm workers, this program is a blessing. When these doctors enter the examination rooms and greet patients with kindness and in their language, patients — particularly their accompanying wives and mothers — just lose it. They hug the doctors and burst out crying. Finally, they will be heard and understood and respected.
If doctors can’t do those three things, they’re in the wrong profession. There is no way for them to deliver effective care.
That’s common sense. Oddly enough, people sometimes take an uncommonly long road to arrive there.
Ruben Navarrette’s email address is email@example.com. His podcast, “Ruben in the Center,” is available through every podcast app.