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

Puerto 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 drivin...

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Published inMedical anthropology quarterly Vol. 38; no. 2; pp. 224 - 239
Main Authors Padilla, Mark, Varas‐Diaz, Nelson, Rodríguez‐Madera, Sheilla, Vertovec, John, Rivera‐Custodio, Joshua, Rivera‐Bustelo, Kariela, Mercado‐Rios, Claudia, Matiz‐Reyes, Armando, Santiago‐Santiago, Adrian, González‐Font, Yoymar, Ramos‐Pibernus, Alixida, Grove, Kevin
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.06.2024
Subjects
Biomedicine
Career opportunities
Caribbean
colonial biomedicine
Colonialism
Crises
Economic factors
Health care
Health services
healthcare systems
Internal migration
Journalists
medical migration
Medical technology
Migration
Physicians
Stigma
stigma of place
Waiting times
United States > US
Puerto Rico
stigma of place
Caribbean
colonial biomedicine
medical migration
healthcare systems
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Summary:Puerto 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.
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ISSN:0745-5194
1548-1387
DOI:10.1111/maq.12857