Caring for underserved populations in Arizona as a locum tenens physician

Many doctors work locums to discover new parts of the country, but emergency medicine physician Dr. Katharine Altieri has learned you don’t need to go far to gain a new perspective. Though she already has a full-time position as an emergency medicine physician in Tucson, Dr. Altieri works locums assignments across Arizona whenever possible. The locations are varied, and she’s spent time in rural areas, with the Indian Health Service, and working with non-English speaking patients.

Helping patients in need

While she was in medical school at the University of San Diego, Dr. Altieri regularly helped with free clinics and other programs for underserved populations. She’s continued this work since moving to Arizona. “When I do locums, a lot of the places are places that other doctors don’t necessarily want to go,” she says.

“The big picture is to help people, and I think medicine is one of the best ways of doing that. It can have a huge impact on not just the patient but also their families,” she says. “I feel like I’m doing what I’ve been put on this earth to do — practice medicine and help people.”

The big picture is to help people, and I think medicine is one of the best ways of doing that.

- Dr. Katharine Altieri

Incorporating cultural differences

Native Americans make up about 5% of Arizona’s population, and Dr. Altieri has spent some of her time treating patients at Indian Health Services clinics. Along the way, she’s learned about different tribal beliefs and traditions.

“One time I was helping deliver a baby, and the patient and family didn’t want any intervention except for catching the baby. They wanted white sage ashes around the room. The person delivering is supposed to be as quiet as possible and not show any emotion,” she recalls. “That was really unique.”

She’s encountered elders who only speak their native language, and she also learned about traditional practices — such as rubbing olive oil on a patient’s stomach — that don’t always match up with the way she’s learned to practice medicine.

Still, she finds a way to treat patients in a culturally sensitive way and respect their traditions. “There’s a medicine man who’s been my patient a couple of times, and he’s really cool, so we kind of blend those two together, what they do and what I do.”

Encountering language barriers

In addition to cultural differences, Dr. Altieri also frequently deals with language barriers. About a third of Arizona’s population identifies as Hispanic, and Spanish is widely spoken across the state. Working in border areas, Dr. Altieri often encounters situations where she can’t directly communicate with the patient. Though she’s picked up some Spanish, she regularly uses translators to help her understand what’s going on.

“Two of the places I’ve worked had a translator phone service, and you can reach anybody with any language in the world,” she says. Other times, she’s had to rely on translation assistance from family members, though she says this isn’t always ideal.

Despite Spanish being a relatively “straightforward language,” Dr. Altieri still encounters cultural differences among her patient populations. Sometimes “if you don’t think you’re getting your message across, then you try to reword things or ask questions, so each person understands what’s going on.”

Transcending politics

Living so close to a national border has put Dr. Altieri in other interesting situations.

She recalls one situation when a van drove through incoming traffic at the U.S.-Mexican border, and its occupants were shot at by the Mexican police. “The patient had been shot in the ankle, so she didn’t have life-threatening injuries, but her ankle was very mangled. I thought it was crazy how they had to have the border patrol in the hospital with her at all times. It was like, she’s not going to run away. We were just hoping we could save what was left of her foot.”

Despite today’s divisive opinions on migrants, Dr. Altieri remains a doctor first and foremost. “I just want to help patients. I’m not there to judge what they do or decide if what they’ve done is right or wrong.”

Expanding her reach

For now, Dr. Altieri plans to continue working with underserved populations — including working with non-English speaking patients — and eventually may work locums assignments outside of Arizona as well.

The impact she’s had on her patients’ lives is clear, and her experiences have also taught her a lot about other cultures and languages. “It’s simple medical care,” she says. “It doesn’t always have to be dramatic or anything, but it’s just really interesting.”

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