Health care outcomes are already disparate for Latinos. A new California law won’t help

When we make medical appointments, we expect to receive care from a trained and highly experienced physician. Yet the reasonable expectation that we will see a highly trained doctor will soon disappear.

Assembly Bill 890, which goes into effect next year, will make it difficult for the Latino community to have faith in the care we will receive due to the new categories of nurse practitioners created by this law. We have learned to trust a doctor because of their training and experience, but that experienced doctor may no longer play a role in the treatment we receive.

Health care outcomes and access are already disparate for Latino residents of our state. While AB 890 claims to increase access to equitable and affordable care, it likely will not. Instead, the soon-to-be implemented law will create an inequitable system of care for our families and communities.

As the law’s implementation continues to be developed, the regulatory process being formed raises many outstanding concerns and frustrations. Most aggravating is the utter disregard that the Board of Registered Nursing has shown for the Latino population — a population they are allegedly trying to help close the health care gap for with this new policy.

At a Board of Registered Nursing regulatory hearing in November, Latino community members who spoke about their concerns were sidelined and disrespected as their comments — spoken in Spanish — were overlooked and their requests for a translator were disregarded. Numerous letters of concern submitted to the board by members of the Latino community were never acknowledged.

If the attitude toward and treatment of the Latino population by the board in any way reflects the way the new categories of nurse practitioners the board oversees will treat the concerns of their Latino patient population, they have no place in the provision of care for my community.

With this bias in mind, Spanish-speaking patients must be notified clearly and explicitly that they will be treated by a nurse practitioner instead of a physician. AB 890 states that, “A nurse practitioner shall verbally inform all new patients in a language understandable to the patient that a nurse practitioner is not a physician and surgeon. For purposes of Spanish language speakers, the nurse practitioner shall use the standardized phrase ‘enfermera especializada.’”

But a verbal disclosure isn’t enough to inform a patient that they are not receiving services from a doctor and that a doctor may have no oversight of the nurse’s care. In addition to a verbal disclosure, a formal, written disclosure — in a language the patient understands — with corresponding signage in a conspicuous location in each area where the nurse practitioner practices should be required.

Under AB 890, the nurse practitioner is limited to providing certain services. Many times, low-income individuals face life-threatening medical conditions and must be made aware that a nurse practitioner may not provide the urgent medical services they require. The patient should be notified in writing that they always have the right to see a physician, especially in circumstances when a nurse practitioner is required by law to refer a patient to a physician.

AB 890 should be driven by proven metrics to provide respectful, quality and affordable care to patients like those in my community. The current implementation of this bill falls far short and gives me grave concern for the future of care for Latino Californians.

We cannot create an inequitable health care system which would have negative impacts on our communities. Our communities deserve to have the option to see a medical doctor when they are seeking medical services, and the Board of Registered Nursing should pay closer attention to the concerns of the community.