“They think we wear loincloths”: Spatial stigma, coloniality, and physician migration in Puerto Rico

Author:

Padilla Mark1ORCID,Varas‐Diaz Nelson1ORCID,Rodríguez‐Madera Sheilla1ORCID,Vertovec John12ORCID,Rivera‐Custodio Joshua3ORCID,Rivera‐Bustelo Kariela4ORCID,Mercado‐Rios Claudia3ORCID,Matiz‐Reyes Armando1ORCID,Santiago‐Santiago Adrian3,González‐Font Yoymar3ORCID,Ramos‐Pibernus Alixida3ORCID,Grove Kevin1ORCID

Affiliation:

1. Global and Sociocultural Studies Florida International University Miami Florida USA

2. Research Department Behavioral Science Research Institute Coral Gables Florida USA

3. School of Behavioral and Brain Sciences Ponce Health Sciences University Ponce Puerto Rico

4. Social Sciences Department University of Puerto Rico, Medical Sciences Campus San Juan Puerto Rico

Abstract

AbstractPuerto Rico (PR) is facing an unprecedented healthcare crisis due to accelerating migration of physicians to the mainland United States (US), leaving residents with diminishing healthcare and excessively long provider wait times. While scholars and journalists have identified economic factors driving physician migration, our study analyzes the effects of spatial stigma within the broader context of coloniality as unexamined dimensions of physician loss. Drawing on 50 semi‐structured interviews with physicians throughout PR and the US, we identified how stigmatizing meanings are attached to PR, its people, and its biomedical system, often incorporating colonial notions of the island's presumed backwardness, lagging medical technology, and lack of cutting‐edge career opportunities. We conclude that in addition to economically motivated policies, efforts to curb physician migration should also address globally circulating ideas about PR, acknowledge their roots in coloniality, and valorize local responses to the crisis that are in danger of being lost to history.

Publisher

Wiley

Reference38 articles.

1. American Association of Medical Colleges.2019. “Puerto Rico Physician Workforce Profile.”https://Www.Aamc.Org/Media/38031/Download.

2. What the Puerto Rican hurricanes make visible: Chronicle of a public health disaster foretold

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