Felix L. Nuñez, MD, MPH, faced many barriers in his winding road to medicine, but the biggest may have been growing up in a neighborhood in which Latinx doctors were invisible, if not nearly non-existent. The son of a factory worker and cashier, Nuñez grew up in a low-income, predominantly Mexican-American neighborhood in Los Angeles. With his mother’s urging and a desire to pursue a higher purpose, Nuñez considered becoming a priest, the only “college-educated, respected role model” he saw. But a chance meeting with Dr. Hector Flores, a family physician, gave him a mentor—and an inspiration.
“I couldn’t really see myself as a doctor because I wasn’t around physicians who were Latino or Mexican-American,” Nuñez said. “But then I met a family physician who was. He really impacted and shepherded me, and he helped me realize that medicine checked a lot of the same boxes in service to a greater cause that I had seen in the priesthood.”
With Dr. Flores’s help, Nuñez entered college and later applied to medical schools. Money was tight, and he lacked the funds to fly out-of-state for medical school interviews—a common financial barrier for lower-income students. Fortunately, Harvard University happened to offer regional interviews in Los Angeles that year, offering Nuñez a vital opportunity.
He took it.
Decades later, Nuñez is a family physician and administrator with years of experience in patient care and public health at community health centers and other institutions in communities like the one he grew up in. He currently serves as the Inland Empire Medical Director at Molina Healthcare of California and as the President of the Association of Clinicians for the Underserved’s Board of Directors. Although Nuñez’s path has taken him across the country, his heart remains with East Los Angeles—and the ongoing need to foster greater diversity in the healthcare workforce to improve patient outcomes.
Why Minority Doctors Matter
Indeed, Nuñez’s journey to medicine was not the norm, but an exception. In California alone, Latinx individuals like Nuñez make up only 5% of doctors, despite being 40% of the general population. It is a disparity reflected across the country: Black and Latinx Americans constitute nearly a third of the U.S. population, but only 10% of doctors, and the proportion of physicians who are Black in the U.S. has increased by less than 5% in over 120 years according to a UCLA study. Furthermore, the same financial barriers that once challenged Nuñez still face minority medical students today: 75% of U.S. physicians come from the top two quintiles of household income.
“That disparity is not a lack of desire, will, discipline, or intelligence,” said Nuñez. “It’s a lack of opportunity that points towards an inequitable system—one that we’ve set up and one that we must take active steps to counter.”
That system has direct impacts on patient outcomes for Americans who are Black, Indigenous, and People of Color (BIPOC). BIPOC individuals experience worse health outcomes than white patients, from higher rates of chronic disease and premature death to higher rates of infant mortality, heart disease, and diabetes compared to whites. The causes are many, from the structural racism that fuels social determinants of health such as poverty, housing instability, and discrimination to an endemic lack of access to care in underserved communities. Yet one of the most critical factors may be the sheer lack of diversity in medicine.
A growing body of research shows that when physicians and patients are of the same race/ethnicity, it has a positive impact on outcomes. In cases where patients and providers were the same race, for example, visits were longer and patients reported higher satisfaction than patients treated by providers of different races. Concordance in race and/or ethnicity also impacts wait times for treatment, patient experience, and numerous other variables in quality of care.
In short, as Nuñez notes, in medicine and otherwise, diversity matters.
“Clinicians, for all that they do, still may not be able to perceive their blind spots,” said Nuñez. “If you have a white physician treating a black patient, for example, they may have a sincere desire to help, but they may still have implicit bias that can affect treatment. Having people treated by healers who have a personal understanding of their culture improves outcomes—maybe not because of any different skillset, but because patients can put more trust in that provider.”
Creating BIPOC Provider Pipelines to Boost Equity—and Patient Outcomes
How can we address this inequity? Despite the longstanding disparity, there are numerous pathways to diversifying medicine. Incorporating holistic review processes in medical school admissions has been shown to increase diversity, as have mentorship programs, partnerships with historically black colleges and universities, and other pipeline initiatives. Greater implementation of justice, equity, diversity, and inclusion (JEDI) principles at both medical schools and health centers and other institutions caring for the underserved can help ensure that not only are pipelines for minority providers nurtured, but that the BIPOC providers they produce will be not only recruited, but retained in the communities that need them most.
And for Nuñez, this process can also begin simply with exposing youths to the possibility of pursuing medicine at an early age—and having BIPOC physicians present in a way that they were not when he was growing up in East Los Angeles.
“Just knowing a doctor speaks Spanish or has a Latinx surname is crucial, and mentorship is key,” said Nuñez. “Being able to see themselves in that person and imagine they could be that doctor—Doctor Hernandez or Martinez—is such an amazing thing.”
Today, Nuñez works with Latinx pre-medical students in a mentorship program in Los Angeles in the hopes of fostering those experiences. For him, he says, “it is a duty” to help young students in the same way that Dr. Flores once helped him—and the results will build on themselves.
“The more Latinx physicians you have, the more that will come in the future—so I think I’m obliged to do it,” Nunez said. “When will we have equity? Let’s make it simple. Let’s reflect who our communities are in the professions that serve them.”
Further Resources on Diversifying Medicine and Diversity, Equity, and Inclusion
To respond effectively to racism in healthcare, it is crucial for health centers to take active steps to develop more diverse, equitable, and inclusive workforces and adopt anti-racist practices. To help address this, the Association of Clinicians for the Underserved’s STAR² Center hosted a free webinar series highlighting strategies for Building an Inclusive Organization from May 18-20. View the series and read our Building an Inclusive Organization Toolkit.
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