Dr. Rafael Guillen talks about his experience as a physician in New York, where he serves Latin American migrants.
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Discussing healthcare is a complicated matter. Whereas it surely implies serious consideration regarding how many patients a physician responsibly tend to, and a thorough revision of the actual financial resources needed to provide each of them with adequate service, healthcare should be much more than that.
Dr. Rafael Guillen works in New York, serving a mostly Latin American population. People from many different Hispanic countries in the continent go to see him either in the public hospital or in his private practice. Some of them, especially the elderly, can barely understand English, Spanish being their native language.
“These patients,” Dr. Guillen explains, “often do not know the United States health system well enough, and have limited access to it because they just do not know how to use their insurance plan, or the system itself, in an adequate way.”
Speaking in your own language
For Dr. Guillen, personalized attention is essential. This implies a doctor-patient relationship that is both culturally and linguistically appropriate, requiring dedication and an enormous degree of empathy from the doctor. Being Hispanic American himself —he was born in the Dominican Republic—, Dr. Guillen is in a privileged position to provide his patients with this kind of attention. He speaks their own language —both literally and metaphorically, that is— and knows well the kind of situations migrant patients often go through. Especially, the elderly.
Why is taking care of elderly patients somehow different? “You must consider their cultural situation,” Dr. Guillen explains. “Maybe they are using some medication simply because they were told to do so by a well-intentioned relative or friend, with no professional advice whatsoever. That’s relatively common. The problem is friends and family are not always right. I have met people taking medications to mask (yet not heal) an infection, or who think are quite healthy because they’re drinking smoothies and other kinds of juices, but who by doing so are consuming amounts of sugar that are not beneficial at all.” These are some of the reasons, according to Dr. Guillen, why physicians need to listen to their patients, and get to know more about their lives and environment.
Knowing the family situation of the elderly
According to Dr. Guillen’s experience, it is the elderly who might suffer the most from any economic difficulties families could be going through. “Sometimes grandparents would give up taking their medicine just to give that money to a granddaughter who might also be needing it. That is something an old person will never tell you about. But a doctor should do his or her best to find out if this is happening, to try to help the family overcome those difficulties that end up affecting the patient’s overall health.”
Personalized attention, then, is essential in Dr. Guillen’s practice. This is true of all the doctors comprising the SOMOS network, to which he belongs. For them, their services go beyond a routine medical check-up. This is what makes humane healthcare in New York City possible.
