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“Do No Harm” Oath Extends Beyond the Doctor’s Office


The National Hispanic Medical Association is a nonprofit association dedicated to representing the interests of the 50,000+ practicing Hispanic physicians in the United States.

Elena Rios, M.D., MSPH, MACP

President and CEO, National Hispanic Medical Association

When we begin practicing medicine, physicians take an oath to “do no harm.” But how, in practice, do we carry out this fundamental duty when systemic barriers to healthcare may not be visible on the exam table?

As President and CEO of the National Hispanic Medical Association, I have seen firsthand the disproportionate burden placed upon Hispanic/Latino people and other underserved groups when trying to access affordable and culturally competent healthcare. There is no single explanation for this, but rather a long history of systemic mistreatment and failings — whether it be concerns about immigration status, lack of health insurance or child care, unforgiving work schedules, or misinformation that flourishes unchecked through social media platforms.

The COVID-19 pandemic has highlighted those disparities even more: Hispanics are 1.5 times more likely to contract COVID-19 — an unsurprising statistic considering our overrepresentation within essential frontline workers — and over twice as likely to be hospitalized as non-Hispanic white people. During the first four months of the pandemic in California, Latinos between the ages of 20 and 54 were dying at a rate eight times higher than white people in the same age group.

Barriers to access

The pandemic has also underscored the barriers to vaccine access and uptake among Hispanics. As of July 27, 2022, Hispanics had the lowest percentage of booster uptake among those eligible compared to all other racial/ethnic groups nationally.

Of the 27 states still reporting race and ethnicity data for booster uptake, Hispanic people are lagging behind white people in every single one. In all but four states currently reporting vaccination data, the Hispanic booster uptake rate is 10 or more percentage points behind the white population.

Sadly, many of the factors that lead to these outcomes are built into the very fabric of our healthcare system — and when Hispanic people in the United States make up less than 6% of doctors yet 18% of the population nationwide, these inequalities often go unnoticed.

For example, despite being required by federal law, one-third of hospitals do not offer language services for people with limited English proficiency. Patients that lack access to interpretation services have longer hospital stays and are more likely to be readmitted, which is costly to both patients and physicians.

Patients without insurance wait to seek medical care until it is an emergency.

Even the misinformation that we have been combating over the last two years is based on tenable concerns. One of the most widespread falsehoods about the COVID-19 vaccine is that it can cause sterilization, and while this assertion is verifiably untrue, we cannot fault people for holding onto this fear considering the long history of forced sterilization of Latinas in the United States, even as recently as 2020.

Improving health outcomes

Despite these disheartening realities, we still have the power to improve health outcomes in Hispanic communities and beyond. Roughly 8 in 10 Latinos have at least a fair amount of confidence that medical scientists will act in the public’s interest, putting healthcare professionals in a unique position to educate and reassure community members of vaccine safety and efficacy.

Through the National Hispanic Medical Association’s Vaccinate For All campaign, we empower medical professionals and trusted community leaders with resources and knowledge to combat misinformation and improve vaccine accessibility and uptake through personal connections and community events.

As we pledge to “do no harm,” healthcare providers have an obligation to advocate for patients and change the unfair practices that permit a lower standard of care for underserved populations. For many, that may mean advocating for the adoption of language translation services in your local hospital, countering misinformation with empathy and understanding, or bringing vaccination initiatives to community health fairs.

The care we provide should not just be accessible, but also high quality — and quality care is patient-centered care. It is our responsibility to continue breaking down barriers for a more equitable future.

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