Name: Carmen Vega-Barachowitz, MS, CCC-SLP
Title: Director, Department of Speech-Language Pathology, Swallowing, and Reading Disabilities Program, Massachusetts General Hospital (MGH); clinical associate professor, Department of Communication Sciences and Disorders, MGH Institute.
Location: Boston, Massachusetts
Carmen Vega-Barachowitz, MS, CCC-SLP
There's little doubt Carmen Vega-Barachowitz ascended to a leadership position at one of the country's leading hospitals through hard work and dedication. But she says she actually owes her start in the profession to her younger sister.
As a child growing up in Puerto Rico in the 1960s, Vega-Barachowitz was responsible for taking her sister (eight years her junior) to speech-language treatments. The treatment room had an observation mirror through which Vega-Barachowitz could watch her sister's articulation treatment. Coming from a family of educators and health care professionals, Vega-Barachowitz was intrigued by what she saw and remembers thinking, "I like this—this is good."
She began college at the University of Puerto Rico, which did not have a speech-language pathology program, and then transferred to Florida State University as a junior. For reasons none other than proximity and her ability to speak Spanish, Vega-Barachowitz chose a hospital setting in Miami for her final clinical placement. This choice would turn out to be the starting point of her professional passion to work with, study, and embrace multicultural patients. Vega-Barachowitz understood the plight of Miami's large Cuban population.
"Accessing the information to receive the right kind of medical care can be challenging," she explained. "Being in Miami and working with clinicians to understand the Latino culture became very important to me and has carried through to this day. Everywhere I've gone it's been one of my key roles."
Vega-Barachowitz continues to explore multicultural populations and was recently named an ASHA Diversity Champion, but she now focuses on understanding diversity in general. Boston is home to a large Latino population (but not as large as the population in Miami), and also to many other cultures—African Americans, Haitian Americans, Chinese Americans, and individuals from Middle Eastern countries, such as Iran and Saudia Arabia. Her refined goal has become to understand how culture—any culture—can affect one's perceptions of and access to health care. She has discovered that patients and professionals both experience a knowledge gap.
"I truly believe people in health care want to provide the best care and do the best for patients and families, but they don't always know what that means," Vega-Barachowitz said. "Why? Because you don't know what you don't know—for example, you may have biases that you aren't even aware of," she explained.
"Then there's the patient experience," she continued. "Let's say the patient's experiences in his native country led him to mistrust doctors, or maybe the patient always did exactly what the doctor said, just following directions without knowing that he has choices and the right to ask questions. One of our responsibilities is to communicate with the patient and family in a way that they feel comfortable sharing their beliefs, past experiences, and health care choices."
The knowledge gap, she said, isn't so broad that it's disheartening. In fact, she welcomes the learning process and sees tremendous progress in health care in the past 15 years. She points to the use of on-site interpreters and cultural brokers and attention to issues of diversity and cultural competence as positive signs of a growing awareness of cultural differences.
For some individuals at the beginning of the learning curve, however, there will be new challenges ahead—some of them uncomfortable. "And that's okay," she said. "I think that a certain level of discomfort is very good. Otherwise you just think you know."
Meanwhile, Vega-Barochowitz is ready to have a long-overdue conversation with her sister, an accomplished pediatric cardiologist whose beneficial speech-language treatment inspired her older sister's burgeoning career.
"Oh my goodness, I don't think she knows!" Vega-Barachowitz said. "I really need to tell her!"
Contact Carmen Vega-Barachowitz, MS, CCC-SLP, at email@example.com.