These Arizona doctors say immigration enforcement is impacting access to medical care

More than 500 people have signed on to an online petition from Arizona health care providers; the petition is asking for a series of changes to the ways in which the Trump administration carries out immigration enforcement that impact residents’ access to — and quality of — medical care.

Sara Beste is a Valley pediatrician and started the petition. She told The Show that this all started about a month ago, during the height of the ICE surge in Minneapolis.

She was getting ready for work one day, and saw a group of more than 20 Minnesota physicians at a press conference, talking about how the operation was detrimental to peoples’ ability to get medical care there.

Nick Sanchez

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KJZZ

Full conversation

SARA BESTE: As many people were feeling that time, I was just, you know, overwhelmed and feeling sad and kind of like, what do I do? And so I just started by reaching out to a couple of like minded, you know, physicians that I knew, just saying, are you guys also feeling this way? What can we do?

And before long, like, that group of two or three physicians ended up being a whole WhatsApp chat group of dozens and dozens of physicians. By the next day, we had organized like the day after this that after texting those friends, we had organized a zoom where we all met to kind of organize further.

And by the following day, I had drafted and written this petition to circulate around the state to physicians of any background for our elected leaders. Partially on a personal level, it was to channel my own, like, you know, how do I channel this into something positive?

But I think as a whole group, we wanted to be able to do something meaningful and consequential with our platforms and with our privilege that we could do for patients.

MARK BRODIE: What did you hear from physicians, both those who were supportive — and I suspect you heard from some who chose not to sign or didn't agree with what you're trying to do. I'm curious what kind of feedback you got on this.

BESTE: For the most part, you know, I did hear from certain people, depending on, like, who were their employers or where they worked. Some people felt like they couldn't sign. But for the most part, people were pretty on board because it's not an outrageous petition. We're not asking for, you know, outlandish things. It's pretty much asking our public leaders to safeguard and keep health care accessible and secure.

And so we, by and large, most physicians that we passed it along to, and it was very grassroots. I mean, it was like, you know, one person reaching out to two or three colleagues, reaching out to two or three colleagues.

And now, I mean, it's about 560 people who have signed on. So overall, I think it was pretty overwhelmingly positive, the response that we got, which was encouraging.

BRODIE: Do you have any concerns or have you had any concerns about sort of inserting yourself into what is a pretty politically charged issue?

BESTE: I have. And at the same time, it feels very just straightforward to all of us, too. You know, this can be construed as a very hot button issue, but again, I think it just goes back to physicians trying to uphold our Hippocratic Oath, which we all take the minute that we get our white coats.

And to me, I feel like all I'm doing is holding fast to the values that I have as a person, but also the professional ethics that we are all given that day you get your white coat, which is to do no harm, protect patient privacy and dignity, and to treat those. And so while it feels a little bit vulnerable and a little bit intimidating because of the way that things can be misconstrued, I also have complete confidence behind the issue because I do feel like this is the right thing.

BRODIE: So I'm curious what kinds of experiences you've had or conversations you've had with patients or, since you're a pediatrician, maybe their families about experiences they've had relative to dealing with immigration enforcement.

BESTE: Yeah. I mean, may I also share some of the experiences from my fellows in the community?

BRODIE: Sure, yeah.

BESTE: Yeah. And so I think anecdotally, doctors across the state and across the nation, you know, anecdotally, no show rates. So a no show rate is just, you know, someone's on the schedule, they don't show up for their visit. And, you know, some of this is speculation, but when we see high, higher than normal no show rates, particularly around vulnerable populations or immigrants, you just wonder what's happening now that we're not seeing the same patient volumes that we used to have.

I do work largely and pretty much, I mean, predominantly with immigrant children. And so, I mean, part of the assessment, when we do our, you know, we look at growth and we look at, you know, development and all of these things, we also assess, like, mental health.

And I had a child as young as 8 or 9. I forget exactly how old. And she was extremely anxious and just having, you know, mom was saying, like, she couldn't sleep, she couldn't concentrate in school. And then when we dug into it a little bit more during the visit, it was because she was scared that, like, her family was gonna be taken or that she was gonna be taken. And so, you know, that was inhibiting, like, her school performance, her sleep, her overall, like, stress and health.

So those are some of the more basic ways. But I've heard from a patient who treats adults that a patient with hypertension, which is the high blood pressure, that not only were they not coming to their appointments to be treated and picking up their medications, but the things that we do to prevent and address hypertension, such as, like, exercise and that they didn't even feel safe to, like, walk in the community. So it's like the stress is increasing their hypertension, and then they're not able to do anything that can really help it.

Another patient, which is a child with special needs that follows up at the children's hospital and had heard that there was ICE in that area, and so she wasn't going to all of her specialty appointments. And that's kind of can be like, very consequential for a child with special needs.

And so over and over and over again, we do see how this is impacting in big and in small ways, patients access to care and even just their quality of care.

BRODIE: So as it relates to access to care, quality of care, things like that, making sure patients feel comfortable and safe going to their appointments, what are you asking for?

What kinds of policy changes would you like to see while keeping immigration enforcement that authorities think they need to do while also allowing for health care to continue?

BESTE: Wonderful question. And that's the basis of the entire petition. Yeah. And so what we're asking for is a few things is just identification so that people actually know. So like having either a badge or some kind of uniform identification for immigration agencies.

BRODIE: For immigration.

BESTE: Exactly. So that people know even who's there if someone else is trying to take them away.

Secondly, that they would always have a judicial warrant to enter clinical spaces, that people in detention would receive access to timely and appropriate care. So what we've also seen is that many women have miscarried due to delayed care, which is a traumatizing event in and of its own. Not to mention, if you're detained at the moment, people with chronic diseases that are detained without their medication. So chronic kidney disease, diabetes, whatever a problem.

And then there's a measles outbreak in the detention facility in Texas right now. So are the conditions sanitary? Are they able to access health care? So that's another aspect for me and for all.

I mean, everyone on the petition, but especially close to my heart, is finding any alternative to child detention. No child should ever be in a detention facilities if there's community options. And so these are a few of the things that we've asked for.

BRODIE: Realistically, what kind of outcome do you expect from this? I mean, it seems kind of unlikely that the Trump administration is going to make radical changes to what it's been doing. So I wonder, like, on a practical level, like, what do you, what do you hope to come from this?

BESTE: I think, Number 1, greater awareness. I think even just having me on The Show today, like, that's going to allow people that aren't in health care to know that, hey, this is an issue that we're still thinking about and affects us daily.

But to answer your question, I was encouraged when I see that on in small ways, other states, other cities have been introducing or passing legislation that does somewhat limit the power or the, you know, the geographic area where ICE can operate in.

Maybe there's something we can do in Phoenix or we can do in Arizona, just moving the needle slightly. It doesn't have to upend the whole process of what they're trying to do.

But I think every state can decide where to put their children, and I think that that's one of the most consequential things, because the impact of detention on a child, even if it's for a matter of days, will affect them the rest of their life.