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Who do you call when you’re sick? For many Latinos/x, the answer is a family member or neighbor — because it’s so hard to reach a doctor. And even if you get through to a physician, does the doctor understand you, both linguistically and culturally?
Shouldn’t contacting your doctor be as easy as sending a text message?
With National Latino Physician Day coming up on October 1, I want to shine a light on a critical issue: While Latinos/x make up 19.5% of the US population, only 6% of physicians are Latino/x — and about one-third of those are women. This lack of culturally and linguistically competent physicians contributes to poorer health outcomes in our community.
If the only solution to this crisis is more doctors, we have a long road ahead. At the current rate of growth, it would take 92 years of a sustained doubling of the number of Latinos/x entering medical schools to bring Latino/x physicians into alignment with the Latino/x share of the overall population. We need innovative strategies now, and culturally and linguistically competent digital health tools offer a path forward.
I am a Mexican American family medicine physician who trained at Harbor-UCLA Medical Center. When I started there in 2021, LA County had just introduced video visits with physicians. Early on, I was told my clinic didn’t offer video visits because “no one wanted them.” But when I spoke to patients, I discovered many simply weren’t aware of this option and would have requested a video visit had they known of it.
Averting Emergencies Caused by Administrative Obstacles
As a family medicine physician, my priority is to be accessible to my patients. I’ve seen too many patients end up in the emergency room with preventable conditions simply because they ran out of medication. One of my most memorable patients was a woman with uncontrolled diabetes who struggled so much to access her doctor that she resorted to buying prescription medications at a swap meet.
We cannot accept an endless cycle of county hospitals dealing with the repercussions of missed appointments, medical non-compliance, and unfilled prescriptions, all of which could be prevented with existing digital health products that are not presently accessible to the communities that need them most.
So, what exactly is the “digital divide”? The Brookings Institution defines it as the gap between those with access to the internet or mobile devices and those without. To measure its severity, digital skills, digital use, quality of infrastructure, and access to content are all considered.
The digital divide is reflected in studies consistently finding that Latino/x patients have lower rates of patient portal access and utilization in comparison to non-Latino/x White patients.
Asynchronous care is a perfect solution for Latinos/x because they are overrepresented in occupations that require them to work for hourly wages in construction, maintenance, and domestic trades. Taking time off requires them to sacrifice pay. The challenge is about more than just awareness; it involves tackling a complex array of issues that includes broadband access, language barriers, and affordability.
Meeting Patients Where They Are
As a group, Latinos/x are tech-savvy. According to the Pew Internet and American Life Project, 87% of Latino/x internet users have a smartphone, and all Latino/x internet users average 10.5 hours per week online — a figure that is 25% higher than the national average. Yet only 33% of Latino/x adults used telemedicine in 2021 compared to 39% of non-Latino/x White adults.
Linguistic and cultural barriers are a significant factor in the lower adoption of digital health technologies among Latinos/x. Few digital health products are created with non-English speakers in mind. When a Spanish-speaking patient’s mobile phone is set to Spanish, the telemedicine interface often still appears in English. This lack of thoughtful design widens the digital divide and worsens health care disparities. When Spanish-speaking patients are asked if they want to use the health portal, but there is no Spanish translation for the word “portal,” why would a patient respond affirmatively? Rather than being an indicator of fault on the part of the patient, that language barrier signals our responsibility as health care providers to meet patients where they are.
In my medical practice, I often ask patients to send me their blood pressure measurements or blood glucose numbers on WhatsApp. When they get excited about this easy access, I explain, “My WhatsApp is called the health portal; let me show you how to use it.” Not one patient has refused my offer to help them.
Revitalizing Relationships with the Health System
Digital health adoption in the Latino/x community is within reach. Latinos/x have higher incidence of chronic conditions, and they can be more severe than those of their White counterparts. Chronic diseases require consistent and effective communication with health care staff, which is what digital health solutions promise.
As for my patient who bought prescription medications at the swap meet, I was fortunate enough to earn her trust and show her how to use the health care portal. The next month, when she mentioned transportation issues, I taught her how to use video visits.
We revitalized that patient’s relationship with the health care system. She said she was ready to control her diabetes, so I introduced her to continuous glucose monitoring. She attended diabetes education classes, and in six months her diabetes was controlled. Yes, her adoption of digital tools took a little longer than it might for others, but trust was rebuilt, and the empowerment she gained was more. Her experience highlights the untapped potential of digital health in Latino/x communities.
On this National Latino Physician Day, let’s commit to building a future where digital health is accessible and equitable for all. All health tech startup founders, medical device developers, investors, and people involved in creating digital health solutions should invite Latino/x physicians into the development and deployment process. Their invaluable expertise is crucial in designing technology that resonates with and serves our diverse communities. Only by including their insights can we bridge the digital divide and ensure that every patient, regardless of background, can benefit from advancements in health care. The responsibility is ours, and the time is now. Let’s build a more inclusive and compassionate digital health future.
Authors & Contributors
Jhaimy Fernandez
Jhaimy Fernandez is a Mexican American family medicine physician in Southern California. She completed her training at Harbor-UCLA Medical Center.
She is co-founder of Alma First: Digital Connection, Human Touch, an organization that bridges the digital divide in health care by training pre-health students as Alma Fellows to compassionately assist marginalized communities with digital navigation.
