Twenty-five years ago, Dr. Miriam Perez moved from her native Colombia to the United States to study neurosurgery. Then, 29 weeks after getting pregnant, she went into premature labor. “At that time, survival without real complications was unheard of,” she says. But after two months in intensive care, her son went home healthy. After this, Dr. Perez switched to pediatric medicine. “I wanted to positively impact families dealing with the same kinds of hardships I had to overcome,” she says. Today, she continues this commitment as a pediatrician at Cleveland Clinic’s Independence Family Health Center and as the founder and director of Cleveland Clinic Children’s Primary Care Pediatric Clinic at Lutheran Hospital. It’s her way of making sure that all children – regardless of their background or legal status – receive excellent healthcare.
The pediatric clinic at Lutheran Hospital, which opened in 2016, was established to benefit Ohio’s underserved African American and Hispanic populations, including the state’s undocumented immigrants. To have the country’s top medical institution actively support and fund such a project sends a powerful message. “We must take a stand against segregation and discrimination in our country. If we don’t, it will be like turning our back on the kids,” says Dr. Perez. “As physicians, we took the Hippocratic oath. We take care of everyone, regardless of the language they speak or whether they’re documented. The mantra of the Cleveland Clinic is ‘patient first.’”
Dr. Perez is now a U.S. citizen, but having a Hispanic immigrant at the helm of the pediatric clinic is invaluable. “We pride ourselves in working in an environment that is culturally competent and sensitive to the needs of the community,” she says. This means understanding how Hispanics approach healthcare specifically and familial decision-making more broadly. For example, Perez says that many Hispanics “don’t usually look for preventative care” for conditions like obesity, asthma, and diabetes, and they don’t immunize their children in large numbers. Instead, women pass down home remedies and defer to their husbands and fathers about bigger healthcare decisions. Changing attitudes about preventative care, then, requires a unique sensitivity and approach. “So we get the whole family in the room and explain to them why prevention is important,” says Dr. Perez. “Rather than waiting, we need to go to where they are.”
Laws should allow foreign graduates to do their training here and then stay.
Dr. Perez notes that this cultural fluency also has a direct economic benefit to Ohio. Being able to prevent or manage chronic conditions means fewer people rushing to the emergency room with complications. “With the integration of preventative care in a culturally competent way, fewer families should be going to the emergency room and spending taxpayers’ dollars. They’ll be enjoying an overall higher quality of life,” she says.
To Dr. Perez, failing to take a stand on immigration is akin to “neglecting the future of medicine.” She explains, “We take care of patients from around the world. We have physicians from all over the world.” This is why the Cleveland Clinic is a global leader in medicine. And wherever the country fails to embrace such a global outlook, it falls dangerously behind. “In rural areas, there’s a shortage of caregivers, nurses, and physicians, which cannot be fulfilled just by the graduating class of medical students,” she says. “Laws should allow foreign graduates to do their training here and then stay, rather than [be forced to go] home for two years. Even if you’re the best of the best, you need to go back. And many of those physicians don’t come back.” In short, “we train them and then we lose them.”