Health care administrators: Where are the Latino role models?

By Hope Gillette, Saludify

Latinos make up approximately 3 percent of hospital board members in the United States, according to the American Hospital Association (AHA), while approximately 90 percent of other health care administrators are non-Hispanic white. This lack of diversity among health care leadership positions means fewer Latino mentors for aspiring medical students as well as a lack of internal support for those Latinos who make it into mid-level management.

In 2012, a report from Witt/Kieffer indicated the lack of Latino health care administrators was a double-edge sword; not only did non-Hispanic white health care professionals complain of  a lack of diversity in the hiring pool, but executive professionals from minorities also confessed to a lack of commitment when it came to hiring minority candidates.

So, not only are there significant fewer Latino applicants to start with, but when they do apply for job positions in management or above, employers put little to no effort into improving their company’s diversification, according to the report.

Al these factors make it challenging for Latinos to pursue a medical and health care administration career and for those who do, to aspire to certain jobs once they graduate. Having a mentor is an important part of developing a medical standard and practice.

“In addition to the financial burdens facing students, we need to consider the lack of role models in senior administrative positions in hospitals, community health centers and medical group practices,” George A. Zeppenfeldt-Cestero,  president of the Association of Hispanic Healthcare Executives (AHHE), told Saludify.

“Now with the growing trend of mergers by hospitals and health systems, too many of our experienced Master-trained Latinos are finding that having an MPH, MPA or even a doctorate in health disparities is no longer a guarantee of job security or a ladder to upper management, particularly if there is a lack of internal institutional mentoring for mid-level professionals.”

Latino health care administrators: Leadership gap 

The United States already has a doctor shortage, regardless of ethnicity.

When it comes to diversification, however, the shortage is even more apparent.

Latinos, for example, make up approximately 5 percent of the doctor pool in the U.S. despite representing more than 16 percent of the population. This means in Hispanic communities, there are often more than 2,000 people per physician.

The shortage of Latino doctors is directly linked to the low number of Latinos entering medical school. Some 8 percent of registering medical students are Latino, and those who make it into programs have significant barriers to overcome. For those looking to become health care administrators, things are not too different.

Not only is the cost of medical school a daunting number–often upwards of $150,000–but overcoming cultural barriers is a challenge as well.

In some cases, traditional Latino family values tend to steer children away from careers that lead to substantial debt. In other cases, medical schools are not available in the area and some Latinos are reluctant to travel to school too far from their families.

Unhealthy lifestyles, discrimination and dangerous neighborhood environments also play a role in the number of Latinos who enroll in medical school. For some, negative experiences with their own health care providers have pushed them away from the thought of medical training; others look at it as something unattainable.

“Certainly at the medical school, medicine has historically been a profession for the privileged,” USC’s KECK School of Medicine Associate Professor of Obstetrics and Gynecology Raquel Arias, MD told Saludify.

“Therefore, it’s not surprising, although still sad, that a service profession is populated by people who are so very different from the people they will be serving. So if all the physicians you see look very similar and don’t look like you, then the odds you’ll consider that a viable profession is low.”

Not all health care administrators are doctors, however, yet the number of Latino applicants for such elite positions remains low. Reasons for this, according to the Wiff/Kieffer “Healthcare Diversity Leadership” survey, have to do with a lack of consistency and dedication among health care diversification programs. While many programs exist in hospitals and clinics around the country, they are often under-funded and have no organized strategies for diversity recruitment.

For some, preconceived notions regarding ethnicities affect their own willingness to put applications in for health care administration positions.

“I am presenting the same kind of CV, but when I get before the panel I think I have a disadvantage because I am black. I think people are predisposed to increasing diversity so it almost becomes a chore for panels to interview diverse candidates,” explains an African American female executive in the report.

Latinos and other minorities who do seek out advanced careers often are doing so of their own accord, not because of organized recruitment programs.

“We use the hope method, just hoping people apply,” said another minority health executive. “There is no defined strategy for the recruitment of minorities, causing minority employees to suffer. I would like to see them (HR recruiters) target some search firms that deal with minorities. I think that would help. The use of social media to contact diverse candidates would also be great and greater participation in minority job fairs would help.”

Repercussions of lack of Latino health care administrators

It is difficult enough to recruit Latinos into the medical field, but even more difficult to encourage them to pursue upper management positions. Many Latino doctors feel the need to serve the communities from which they came, therefore they place themselves in general practice, infrequently seeking out specialty training like advanced surgical care or neurology, or a career as health care administrators.

This is another reason why there are so few Latinos to chose from when it comes to hiring health care administrators and medical executives. That lack of selection translates into a poor support network when a Latino is hired into such a position, and also means there are fewer recruitment programs for Latinos being developed.

“We all too often find ourselves as the only Latinos in management positions with little internal support,” says Zeppenfeldt-Cestero. “Although health executives normally may not have direct patient care responsibilities, they are the individuals responsible for advocating, designing and implementing heath policies which have a direct impact on the health care received by Latinos and other underserved groups. However, we need to see more individual health institutions value their minority talent pool by providing similar initiatives to support both recruitment and retention of their administrative health workforce.”

Zeppenfeldt-Cestero adds aspiring Latino medical students need to be made aware there are mentoring programs available to them. Some forward-thinking organizations, such as the Greater NY Hospital Association, are leaders by supporting undergraduate/graduate summer internship programs, partnering with groups such as AHHE, and linking mentors with mentees, underwriting professional development programs and informing early careerists and managers that there are professional associations available to provide mentoring, career coaching and networking opportunities to advance their careers.

And while there are programs available, more still needs to be done.

The AHHE President indicates the U.S. needs foundations to embrace and fund initiatives tied to the mission of the health workforce by not only providing scholarships but also providing support of leadership development initiatives. These programs will ensure that associations developing the health care pipeline are financially viable and able to continue the mission of nurturing and encouraging culturally and linguistically competent health care professionals.

“As I begin to prepare for the application cycle this upcoming fall, I am faced with the harsh reality that I have no real mentor in health policy,” states the letter of a University of California student, provided by AHHE. “Furthermore, I am the only person within my network of friends who has considered this career choice. Although it’s frightening to think of my future, I am certain that along the way I will have the support from organizations, like AHHE, who support Latinos.”

AHHE was able to link the student with a board member who now serves as her mentor, but many other Latino students do not realize they have this option. Like most health care disparities seen among minorities in the country, education and public outreach tend to be the best methods of improving awareness.