Sacramento doctors: Deportation threats are causing immigrant patients to skip appointments | Opinion
As community-based doctors, we’ve noticed that many of our patients have not shown up for their medical appointments over the past few weeks. We believe that it is fear — not a lack of need — that keeps them away from the doctor.
We are general internal medicine physicians who work at Sacramento County Health Center, a clinic providing primary care to a large number of immigrant patients. The consequences of deferred care are well-known to providers like us, who have frequently witnessed the ways in which delayed care can result in negative health outcomes and more expensive treatments.
Patients who are afraid to seek care for heart failure or a skin infection, for example, that could easily be treated at our clinic may ultimately need a visit to the emergency department or even an admission to the hospital, which can cost thousands of dollars.
Although we have traditionally provided care to patients without insurance, the proportion of patients with insurance has increased significantly ever since California became one of the first states to offer Medi-Cal coverage to all patients regardless of immigration status.
As California increased coverage for youth, seniors and, finally, all adults, we have seen more patients get preventative care. We have seen less cases of people waiting until they become sick enough to go to the emergency department to treat disease.
All of these gains, however, came crashing to a halt when President Donald Trump took office and immediately directed the Department of Homeland Security to engage in raids and the rapid deportation of undocumented immigrants. As we have seen news reports of people detained and deported, the chill felt across the country has hit close to home. The number of patients attending appointments in our clinic dropped precipitously.
Our urgent care clinic, in particular, has remained essentially empty as of recent, with very few patients seeking these services. In our primary care clinic, routine visits were skipped, medications were not picked up and important tests were not completed. Our providers tried to reassure their patients, but federal directives made it clear that healthcare facilities were no longer safe.
This time around, it’s clear people can and will be detained anywhere.
As our country reflects on the profound impact of these immigration directives, it is critical that we all recognize the tremendous health implications they have had on our community and the undeniable instability that has resulted.
Patients who have trusted us to provide them with care are now fearful for their safety, thereby eroding the physical and mental health of these individuals and the communities to which they belong. These patients are our neighbors and co-workers. They play a critical role in maintaining the economic and social well-being of our society.
We all benefit when people in our community are healthy — a key reason our clinic is committed to offering primary and preventive care to all members of our community regardless of immigration status.
As a community and a nation, we must resist and push back against directives causing significant fear in our communities. We must make sure that patients know their rights to seek medical care and urge legislators to provide funding for immigrant legal defense. We also need to work with clinical administrators to establish policies preventing immigration enforcement in clinics and to utilize telehealth again, if needed, to ensure patient safety.
By sharing stories about our patients’ experiences, we hope to inform the public — especially federal legislators — about the immediate impacts we are seeing. It is our duty: As physicians, we have taken the Hippocratic oath.