Another Cause of Doctor Burnout? Being Forced To Give Immigrants Unequal Care

June 20, 2018

One patient's death changed the course of Dr. Lilia Cervantes' career. The patient, Cervantes says, was a woman from Mexico with kidney failure who repeatedly visited the emergency room for more than three years. In that time, her heart had stopped more than once, and her ribs were fractured from CPR. The woman finally decided to stop treatment because the stress was too much for her and her two young children. Cervantes says she died soon after.

Kidney failure, or end-stage renal disease, is treatable with routine dialysis every two to three days. Without regular dialysis, which removes toxins from the blood, the condition is life threatening: Patients' lungs can fill up with fluid, and they're at risk of cardiac arrest if their potassium level gets too high.

But Cervantes' patient was undocumented. She didn't have access to government insurance, so she had to show up at the hospital in a state of emergency to receive dialysis.

Cervantes, an internal medicine specialist and a professor medicine at University of Colorado in Denver, says the woman's death inspired her to focus more on research. “I decided to transition so I could begin to put the evidence together to change access to care throughout the country,” she says.

Cervantes says emergency-only dialysis is harmful to patients: The risk of death for someone receiving dialysis on an emergency basis is 14 times higher than someone getting standard care, she found in research published in February. Cervantes' newest study, published Monday in the Annals of Internal Medicine, shows these cyclical emergencies harm health care providers, too. “It's very, very distressing,” she says. “We not only see the suffering in patients, but also in their families.”

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