Culture Matters in Care: How Marta Braña-Berríos, MD, Calls on Her Background to Better Serve Patients

Most patients want a doctor who understands them, including their background. More than two million Hispanic people live in New York City, so having doctors sensitive to their cultures and experiences is critical to providing the best care possible.

Marta Braña-Berríos, MD, a child and adolescent psychiatrist at Columbia, understands this firsthand. Dr. Brana-Berrios is originally from Puerto Rico and is a graduate of Puerto Rico, Medical Science Campus. She comes from a similar background to many of her patients—and is helping families feel engaged, understood, and connected.

In honor of National Hispanic Heritage Month, we spoke to Marta Brana-Berrios, MD, about her upbringing in Puerto Rico and how it affects her approach to patient care.
 

Where did you grow up, and what was your childhood like?
Marta Braña-Berríos, MD: I grew up in Puerto Rico and was an only child in a family of grownups and grandparents. My “abuelitos” were the center of the family, and we would all take turns ensuring that they were taken care of, nurtured, and had meaningful company. I also had a “zoo” of sorts. My community described it as an underground shelter operation because I used to pick up every sick and homeless animal on the street.

What made you interested in becoming a doctor and then a psychiatrist?
Marta Braña-Berríos, MD: Being a part of my grandfather’s care was my first source of inspiration. He wanted to be a physician but could not because, in our culture, the eldest takes care of the family, and medicine was a long and expensive career. He gifted me my first medical equipment, which I still have.

Tailoring Psychiatric Care to Hispanic Communities

Is there a stigma around psychiatry in Hispanic cultures?
Marta Braña-Berríos, MD: There is in many cultures, and that’s true of Hispanic cultures, too. Going to a psychiatrist was taboo until not too long ago. It signified that there was something wrong with you and that people should keep their distance. You were considered either weak or dangerous.  

Why is it helpful for Hispanic patients to have a doctor they can relate to?
Marta Braña-Berríos, MD: Connection is key for collaboration in any physician/family/patient relationship. When patients do not feel that connection, they are less likely to trust you, open up to you, and provide a complete history. It makes it harder to make recommendations that are meaningful in their treatment.

Hispanic people usually do much better when they feel at home, which is why we see positive outcomes when teams are multicultural and bilingual. Understanding and respecting the identity of a Hispanic patient and their family is critical in the delivery of quality care.

When Hispanic families call our clinic, the first question is: “Can you help me connect with someone who speaks Spanish and is Hispanic?” which they often prefer to interpreters. 

What do people need to understand about Hispanic cultures?
Marta Braña-Berríos, MD: We are diverse. We are a heterogeneous group of people sharing much history, and it is impossible to put us in the same category. Each nationality has its dialect, regionalisms, fortunes, and misfortunes. We are proud, yet we are different, but we share some similarities when it comes to our experiences as Hispanics in America.

Are they underserved currently?
Marta Braña-Berríos, MD: Extremely, especially because of the migrant crisis, and particularly in New York City. The Hispanic community faces a gap/disparity in both the access to and the quality of care. According to NAMI, “35.1% of Hispanic/Latinx adults with mental illness receive treatment each year compared to the U.S. average of 46.2%. This is due to many unique barriers to care.” This data does not take into account the mental health services delivered to newly arrived migrants who are just beginning to receive primary care.

Finding Inspiration in Care

How do you specifically relate to patients?
Marta Braña-Berríos, MD: I enable my patients to determine the level of connection they need so that treatment works for them. Some need more some need less. Some need to know where I come from, and where I was born and raised. Some need to talk about culture before we move to medical treatment.

What do you like most about your profession?
Marta Braña-Berríos, MD: Connection and a sense of belonging. I like to accompany my patients through the hard times and good times. Sometimes, I have former patients stop by to tell me when they graduated, got a job, have kids, or to say “hi.”

How did your childhood inspire you?
Marta Braña-Berríos, MD: I saw the disparities in health care resources – people from lower income backgrounds tended to not have access to great health care. I knew I wanted my patients to receive the same high-quality services regardless of their ability to afford such care.

What does your childhood community think about your accomplishments?
Marta Braña-Berríos, MD: That is a fun question. I get different reactions. On the one hand, I did very well in school, so I hear, “Of course, you were a nerd” quite often. On the other hand, I am very extroverted. I danced in competitions, participated in many fundraisers, and was pretty “out there.” Patients expect someone dressed in a suit, severe and pensive. I do not fit that stereotype.

What inspires you now?
Marta Braña-Berríos, MD: My patients and their families. Their strength, resilience, the struggles they go through, and how they fight daily to get better and be better members of our community.

My hat goes off to my colleagues who are culturally sensitive and informed in diversity and apply this knowledge to their practice. The lack of cultural competence can lead to misdiagnosis and improper care.