One of the expert’s missions is to be able to create change, educate and positively impact young Puerto Ricans.
Dra. Bárbara Rosado is currently a gastroenterologist with a subspecialty in liver transplantation. Photo: Journal of Medicine and Public Health. Fabiola Plaza.
“My return from the United States to Puerto Rico has been challenging. Our health system can be challenging from the point of view of access barriers to certain treatments such as hepatitis C, which, fortunately, has been released and the restrictions have been fewer and fewer in terms of patient benefits“, he acknowledged, Dr. Barbara Rosado, gastroenterologistswho indicated that initially, “getting therapies from certain populations was difficult and these barriers have been eliminated.”
Dr. Rosado explained that this virus is usually spread through contact with contaminated blood, the use of drugs or by the intranasal route, today it is the number one risk factor.
“Most of the patients are asymptomatic and to identify if the person has the virus, a liver test must be performed or check if any risk factor for infection can be identified in the history,” explained Dr. Rosado.
This disease is predominant in Puerto Rico 2.3% of the general population, the highest figure in the United States (figure taken from the Puerto Rico Department of Health), although there are a variety of treatments, its detection is complex because there are few symptoms.
“This is a disease that has evolved dramatically in the last 2 or 3 decades, we have antiviral treatments today that can cure the virus in more than 95% of cases in various patient populations,” says the gastroenterologists.
necessary treatment
The specialist indicates that the treatment against hepatitis C must be a priority, however, students must have a point of view and factors that can intervene in the patient’s recovery, a prior evaluation is necessary to start therapies.
Every patient who is infected with the hepatitis C virus must be treated, since the only contraindication is that the patient has a low life expectancy or other conditions such as terminal cancer, metastasis, so every infected patient must have the option of a treatment” explains the doctor.
Thanks to a thorough training in medicine, the Dr. Barbara Rosado it is currently gastroenterologists with subspecialty in liver transplantation. He began his studies at the University of Puerto Rico, where he completed a bachelor’s degree in biology, and then entered the School of Medicine of the Medical Sciences Campus.
“I entered the Internal Medicine program of the Medical Sciences Campus, and did an additional year as chief president. Later, I had the opportunity to enter one of the most recognized centers in the United States, the Mayo Clinic, in Minnesota, where I performed my studies in gastroenterology and completed an additional year in hepatology and liver transplantation,” he added. “Then, I return to Puerto Rico, and I join the faculty of the Ponce School of Medicine, being an associate professor at that institution, and that is when I establish my practice in Ponce.”
Dr. Rosado remembers that, during her years at the School of Medicine, she had great mentors, such as Dr. Esther Torres, who was an important pillar in her professional career.
“One of the reasons why I chose internal medicine is because it is a branch that allows me to establish a differential diagnosis for patients. Being already in internal medicine, I realized that gastroenterology was the area that I was passionate about, since that could make diagnoses and early interventions, such as screening for colorectal cancer and reduce mortality from that point of view. Also, there are many diseases associated with women such as Irritable Bowel Syndrome, autoimmune hepatitis, among others”.
During her residency in this area of medicine, the specialist became aware of the high demand for patients who required the assistance of a hepatologist, since many people with advanced chronic disease arrived and, according to the expert, Puerto Rico did not have a center transplant and did not have the specialized human resources, so he took on the task of continuing his studies in gastroenterology
For Dr. Rosado, communication with her patients is essential in treatment. Photo: Journal of Medicine and Public Health. Fabiola Plaza.
After the return of Dr. Rosado to the island, together with other specialists in the area, they took on the task of developing collaborations with other institutions in the United States, such as the University of Tennessee and the Ochsner Clinic, with the aim of providing the patient with the opportunity to receive a transplant in Puerto Rico even without having a specialized center where it was performed.
“In 2005, when I returned to Puerto Rico, I did not have privileges at Hospital Damas, but even so they called me to please see a patient who was very ill. She was a young woman who had developed fulminant liver failure not associated with any viral infection, we understood that it was something autoimmune and it was possible to transport it by air ambulance at that time to the Mayo Clinic in Florida Today, that patient is fine, she is alive, she has a useful life, she has seen her children grow and 17 years later he is still my patient.” “It has been a challenge, but also a very big achievement.”
Women’s struggle for gender equality in medicine
Fortunately, the differential gap between the participation of men and women in certain branches has been narrowing: “we see that women have been overcoming barriers, creating bridges and opening doors”.
“When I was at the Mayo Clinic, we had 85 consultants in the gastroenterology unit, of whom only 2 were women. Between us, we were also only 2 women and the rest were men,” he recalled. “I believe that the fact that women are making their way into branches that have been dominated by men and that we are doing so well, has allowed us to see more and more empowered women who have multiple roles in their lives, occupying important positions of leadership”.
Likewise, the expert emphasizes that it is important for her to make her students and society understand, through education, that a doctor must not lose his human role by being a mother, wife, daughter and professional, and being able to set an example of construction of that balance so that they feel that everything can be done, and it can be done well.
“There has always been the idea that we cannot do everything well, or that if you are a good professional, then perhaps you are not present in your children’s lives. Those are stigmas that must be removed.”
“When that person walks out of my office with a smile, it’s extremely gratifying and no words or material can replace it.” Photo: Journal of Medicine and Public Health. Fabiola Plaza.
Empathy and active listening: main roles of the treating physician
For the gastroenterologists, one of the greatest satisfactions is to make the patient who enters your office feel cared for, listened to and respected. “We shouldn’t just focus on treating or curing, because we won’t always be able to do that, but we can heal and listen,” he emphasized.
Within the roles that a doctor has, they are not limited only to the diagnosis, management and treatment of diseases; on the contrary, the role of a doctor must transcend and become an educator with his patients.
“For my part, one of the things that I am passionate about is contributing to the training of the doctors of the future, so one of the things that I wanted when I made the decision to return to Puerto Rico was to be part of a faculty doctor or a medical school where I could help train future colleagues, students and residents.
State-of-the-art medicine for the benefit of patients
Dr. Rosado emphasized the importance of doctors continuing their education process to be up-to-date on the main needs of the general population, advances in science and technology.
“Medicine is not static, it is changing and that is why doctors must continue this education process in order to provide patients with the best possible quality of service,” he asserted.
Another of the facets to which the expert has dedicated herself has been research. This has allowed him to participate in important studies that have contributed positively to the evolution of treatment for hepatitis C and other conditions.
“Doctors must have an appetite to contribute to the advancement of science; it is something that we wish we could incorporate a little and to which we should dedicate time to be able to develop ourselves, as it helps us create the necessary changes and offer better tools, while at the same time that we better understand our population.
During his stay at the Mayo Clinic, he always had in mind to return to his country and provide a specialized and high-quality service. Photo: Journal of Medicine and Public Health. Fabiola Plaza.
The family, its main engine
As mentioned by the gastroenterologistsBeing able to maintain an adequate balance between her profession and her personal life has been a challenge for her. However, she assures that with the help of her husband, Dr. Francisco Torres, the process has been more bearable and possible in all their years together.
“I have two fabulous children, one is graduating from fourth year and my daughter is in eleventh grade, and that part of educating them, so that they are good human beings, and of benefit to society, has also been one of my great tasks” .
On the other hand, his father, whom he still cares for, has been a central axis throughout his medical career, since he assures that he learned important values from him that, today, govern his life.
“My father always told me, ´I am not going to be able to leave you an inheritance, but the most important thing that I am going to be able to leave you is education´. Since I was 5 years old I used to play with stethoscopes and he told me so and I have internalized it and it is something that I also try to impart to my children and I believe that, within society, it is essential that our children and young people be educated in order to have a better country,” concluded Dr. Bárbara Rosado.