TULARE, Calif. – On a recent Thursday afternoon, Rosa Enriquez’s 3-year-old son was due for his annual check-up at the Altura Centers for Health Clinic in Tulare.
During the appointment, Enriquez noticed something different. Her pediatrician, Dr. Rodrigo De la Cruz Santamaria, was speaking to her in Spanish.
Enriquez recalls being surprised at how easy it felt navigating the appointment.
In the years since Enriquez immigrated to the Central Valley from the Mexican state of Guadalajara, she noticed it was difficult to find doctors who spoke Spanish like she did.
“When I speak in Spanish with the doctor, I can understand what’s happening more clearly,” Enriquez said in Spanish. “I feel comfortable asking him more questions.”
In places like Tulare County – where nearly 70% of the population is Latino and roughly half speak Spanish – an unlikely supply of doctors is helping critical language and health gaps for patients.
A 2002 law cleared the way for physicians from Mexico to practice in the United States. In California, only 5% of doctors are Latino.
The law dubbed the “Licensed Physicians from Mexico Pilot Program” allowed Mexican doctors and dentists to work in non-profit clinics in disadvantaged communities across the state under a three-year work visa.
Doctors meet growth of Latinos in California
In order to participate in the program, physicians are required to complete a residency in one of the state's medical schools or hospitals, as well as be licensed by the California Medical Board and learn English as a second language.
That’s on top of needing accreditation from Mexico, which can take up to seven years to acquire.
The legislation was authorized because of the rapid growth of the Latino population in the state and the shortage of doctors.
“We were very concerned that our doctors who don't speak the language could not give them the best care,“ says Arnoldo Torres, a public policy political consultant who authored the bill in 2000. “Our priority became to make sure that doctors that came from Mexico were as good as any doctor in providing the medical care, the protocols, the standards, the quality.”
When you have the confidence of the patient, the patient's going to tell you things that they would never tell somebody, that they don't have ‘confianza.'Arnoldo Torres
Although the program launched in 2002, it was stalled for more than 20 years. The main obstacle was meeting one of the main legal requirements for the program – finding medical schools and hospitals that accepted foreign physicians.
The Journal of Medical Regulation also found there wasskepticism among different agencies in the state about the capabilities of the physicians.
The program brought its first doctors to San Benito County in 2021. Today, there are more than 30 Mexican doctors working in San Benito, Monterey, Los Angeles and Tulare counties.
A shortage of doctors has generally been a problem across the San Joaquin Valley, even as local institutions seek to remedy the issue. Though, some estimate it could take years to fully staff hospitals and clinics with the adequate amount of doctors needed for the population.
For now, doctors traveling from outside the country seems to be an unlikely – but worthwhile – solution.
“They speak the language and they know the culture,” Torres says. “When you have the confidence of the patient, the patient's going to tell you things that they would never tell somebody, that they don't have ‘confianza.’”
Doctors bring shared language, customs
The Spanish word “confianza” translates to "confidence” in English. But for those like Enriquez, who is among those already visiting with doctors from Mexico, confianza means more than words. To her, it means she struggles less to communicate.
“As Mexicans…there are some words and phrases we don’t know how to translate to English,” Enriquez says. “And if our doctor doesn’t understand, then it’s hard to explain what’s happening.”
Her son’s pediatrician, Dr. Rodrigo De la Cruz Santamaria, applied for the program in 2016, but wasn’t fully approved until last year.
He started treating patients earlier this year. De La Cruz Santa Maria, who is from Mexico City, says almost all the people he serves in the city of Tulare are no different than those he would see back in Mexico.
“Many of the people I see here are from Michoacan, Guerrero, Guanajuato, Zacatecas, Jaliso,” De La Cruz Santa Maria says, naming off states in Mexico.
In the few months he’s worked at the Altura clinic, De La Cruz Santa Maria says he’s felt a strong sense of community with his patients – and has even been invited to many family events, like baby showers.
“To work here, where people who left everything behind in Mexico but brought their customs and traditions with them to the U.S. – I’m honored to serve the people here,” De la Cruz Santamaria says.
The program’s first round of doctors are expected to return to Mexico next year. But plans for the program are continuing.
Legislators want to expand the program to more counties and include physicians who speak Mexican indigenous languages such as Mixtec and Zapotec.
This story is part of the Central Valley News Collaborative, which is supported by the Central Valley Community Foundation with technology and training support by Microsoft Corp.
