Puerto Rican doctors are returning to the island to provide patient care based on new technologies and innovations.
Dr. Ismael Valle Irisarri and Dr. Helder Hernandez Rivera, electrophysiologists. Photo: SME Archive
Given the lack of medical professionals in Puerto Rico, some Puerto Rican doctors are joining forces to return to the country and offer patients on the island innovative procedures and technologies that help them cope with cardiovascular diseases. This is the case of the electrophysiologists Hélder Hernandez Rivera and Ismael Valle Irizarri, who together provide medical services to several hospitals in the southwestern part of the country.
Both doctors were doing cardiology internships at the Veterans Hospital in St. Puerto Rico and after completing a fellowship in electrophysiology (the field of medicine that studies the electrical activity of the heart) at the University of Texas Southwestern Medical Center, they returned to Puerto Rico serve their people and somehow reclaim everything they have learned so far.
Several electrophysiologists on the island
“I was particularly aware of the shortage of electrophysiologists on the island. By 2016, when I returned, there were very few electrophysiologists. There were perhaps eight or 10 electrophysiologists, and many fields on the island were opened in this specialty. It was more of a fact. that there were not enough specialists to serve so many patients and an interest in providing services to their people. The awareness of the positive impact that returning here has on people’s health motivated us to return,” said Dr. Hernandez. Rivera, one of about 16 electrophysiologists currently working at Puerto Rico. None of the 16 are pediatric electrophysiologists, so if a pediatric patient needs a consultation, they can see him, but they can’t operate on him, so he must be sent to the United States.
They bring new and more sophisticated technologies and procedures
On the other hand, for Dr. Valle Irizarri, returning to the country is not only about limiting the number of doctors in his specialty, but also about the introduction of complex procedures or new technologies that were not widely used locally. “You really need to bring in new technologies as well, new procedures that are practiced in the United States and that not everyone does in the US. Puerto Rico. There are complex ablations and other hardware procedures. For example, epicardial ventricular tachycardia with epicardial origin, which is the outer layer of the heart. Devices such as what is called “physiological passage”. And we understand that this is a new way to introduce pacemaker technology, which helps to improve the well-being of patients and has a positive effect on the patient’s symptoms and the restoration of cardiac function, ”explained the doctor from Mayagüez. who is new to the country after two years of electrophysiology training in Dallas, Texas.
It is these reasons that prompted Dr. Hernandez Rivera to create a corporation in 2020 called Caribbean Electrophysiology Services, providing electrophysiology services to the San Lucas and Damas Hospitals in Ponce, as well as the Mayagüez Medical Center. “As the doctor said very well, one of the goals of our association is to carry out complex procedures that many patients need, especially ablation, that is, the treatment of cardiac arrhythmias. Ismail and I have already done some complex procedures, he is just getting ready and we have a very positive experience in terms of patient health. Epicardial ablation, which is performed on patients with ventricular tachycardias who are not responding to drugs, is a type of ablation that has not been used in medicine until today. Puerto Rico and we are trained to perform this type of intervention in case of need in any patient,” the specialist explained, adding that they hope to soon offer their services at the La Concepción Hospital in San Germán. And although they currently work in hospitals in the southwestern part, they accept patients from all over the island.
Puerto Rico trains its doctors well
On the other hand, these doctors claim that academic training in Puerto Rico excellent, but economic and technological offerings sometimes force medical personnel to conduct their research and medical practice outside the country. “Doctors training here in Puerto Rico it is perfectly. The fact is that offers come from the USA, the quality of work there, as a rule, is better. The pay is better. I would say that the situation with medical plans here is the most difficult for a doctor to stay on the island, but here we have the opportunity to practice good medicine. We may not have the technology and tools that we had in the United States, but as I tell people who have little, we do a lot. Just having the intention, having the desire, and doing it by calling is the most important thing, ”said Hernandez Rivera.
Meanwhile, Valle Irisarri acknowledged that cardiology can be practiced in Puerto Rico, but unfortunately the electrophysiology specialization in cardiology does not exist as a program in the country. “This is the main reason why we should move to other states of the American nation to be able to train in electrophysiology and acquire the necessary knowledge to be able to return to the island and provide the services that the population deserves and needs. In terms of technology, that’s right, we don’t have the same technology in the United States, but there are hospitals (here) that provide us with said technology, they are making and trying to make an effort to get what we need to offer. You the best service and quality of patient care in Puerto Rico“, he added.
Call for the return of more doctors
Physicians who are still in training or about to graduate are encouraged to return to serve their country, form medical teams, and even take advantage of tax incentives offered by the government to encourage the return of the medical class to the country. “Puerto Rico has a huge health crisis and we understand more every day. And the need for doctors and specialists is huge. That they do not see a solution to the problem in a trip to the United States. If the country gave them the opportunity to practice medicine here, do residency, internship and train as doctors, even if they have to go there for a while to get training or specialty, they should consider returning to the country to return it. support and contribute to the healthcare that is needed here on our island every day,” said Hernandez Rivera. Meanwhile, Valle Irisarri noted that “medicine is moving towards the formation of groups of doctors of different specialties or subspecialties, which also gives you a certain confidence that it will come back. And then there’s the 4% preferential tax rate, which helps a lot with the doctor’s finances and well-being.”