EL PASO, Texas — According to Azucena Del Real, M.D., communication is vital in her specialty. An internist with Texas Tech Physicians of El Paso, she finds that her first hurdle is often dealing with misconceptions. As soon as Dr. Del Real tells someone she just met that she is an “internist,” she knows what’s coming next.
“When I tell people I practice internal medicine, they inevitably ask, ‘what’s that?’” said Dr. Del Real. “Most people don't know that internists can be family doctors, too.”
Internists, according to Dr. Del Real, develop long-term relationships with their patients, like family doctors. This allows them to build a comprehensive understanding of their health histories, manage a wide range of health conditions at hospitals or clinics and provide preventive care. However, unlike family physicians, internists focus on adult care and typically do not treat children nor manage pregnancies.
Dr. Del Real is also an associate professor of general medicine with Texas Tech University Health Sciences Center El Paso, where she teaches the next generation of internists.
As a small child, Dr. Del Real always knew she would be a physician. Her father, a dermatologist, served as her role model. His practice served many small communities around the city of Guanajuato, in central Mexico, some 900 miles south of El Paso.
“My father passed away when I was nine years old. I remember spending Sundays accompanying him to see patients in small communities. He would prepare many medications himself because his patients lived in underserved communities. He had to figure out ways to treat people with certain diseases who had no access to medicines.”
The care Dr. Del Real’s father showed to his patients had a profound impact on her vision of patient care. Lacking resources, her father often served as his own compounding pharmacist, formulating skin medications for those suffering from leprosy, and earning him recognition for his service.
Border clinics like those at TTP El Paso are well-suited to reach and serve underserved communities. Today Dr. Del Real has access to medicines and therapies her father could only dream of. She feels blessed with her access to the myriad of medical resources afforded her as a TTP El Paso physician.
Nevertheless, there is one universal concern experienced by medical professionals across the globe.
Cultural and language barriers can add an additional level of complexity to communication when it comes to providing world-class bilingual care along the U.S.-Mexico border. In the U.S., less than 6% of family physicians identify as Hispanic, while only 20% of all physicians speak Spanish.
After graduating from Centro de Estudios Universitarios Xochicalco School of Medicine in Tijuana, Mexico, Dr. Del Real provided medical care for a small, underserved community in San Jose de Cabo, located on the southern tip of Baja California, Mexico. She then moved to the U.S. She earned her master’s in medical sciences at University of California, San Diego. Before beginning her residency at the University of Texas Rio Grande Valley Doctors Hospital at Renaissance, she worked as a translator in San Diego. It was during this time she became acutely aware of the importance of overcoming cultural and language barriers with her patients.
For Dr. Del Real, every patient visit is an opportunity not just to examine patients but also to get to know them.
“Sitting with my patients and asking what they know about their condition, and asking what they want to know, is vital,” she explained. “Having a good understanding of what's going on is key, because plenty of times patients come, they leave, and they’ve learned nothing. I have to listen to be effective in my job.”
Of particular concern to Dr. Del Real these days is obesity. She is currently training to receive her board certification in this field.
“Obesity is a chronic disease; it’s not a choice,” she said. “It’s hard for my patients to accept this. Many would benefit from treatment with medications, as it would prevent other diseases they are susceptible to, such as diabetes, high blood pressure and even cancer.”
Dr. Del Real wants to make an impact in the fight against obesity. According to the Centers for Disease Control, Hispanics are more likely to suffer from obesity than non-Hispanic whites. Of the Hispanic population, 42.9% of women and 36.6% of men are obese. This is compared with 31.9% of non-Hispanic white women and 29.1% of non-Hispanic white men. Obesity can lead to inflammation and abnormal hormone production, which increases the risks for diabetes and cancer.
It’s exactly these types of conversations with her patients that Dr. Del Real seeks out. Not only do they leave knowing more about their conditions, but they also know quite a bit more about importance of having an internist as a primary care physician.
To schedule an appointment with an internist at Texas Tech Physicians of El Paso’s Transmountain Internal Medicine clinic, call 915-215-8400, or visit ttpelpaso.com.
About Texas Tech Physicians of El Paso
Texas Tech Physicians of El Paso is the clinical practice of the Foster School of Medicine. It’s the region’s largest multispecialty medical group practice, with over 250 specialists providing world-class patient care for the entire family at several locations across El Paso, while also providing a hands-on learning space for TTUHSC El Paso resident physicians and students.
About Texas Tech University Health Sciences Center El Paso
TTUHSC El Paso is the only health sciences center on the U.S.-Mexico border and serves 108 counties in West Texas that have been historically underserved. It’s a designated Title V Hispanic-Serving Institution, preparing the next generation of health care heroes, 48% of whom identify as Hispanic and are often first-generation students.
Established as an independent university in the Texas Tech University System in 2013, TTUHSC El Paso is celebrating 10 years as a proudly diverse and uniquely innovative destination for education and research. According to a 2022 analysis, TTUHSC El Paso contributes $634.4 million annually to our Borderplex region’s economy.
With a mission of eliminating health care barriers and creating life-changing educational opportunities for Borderplex residents, TTUHSC El Paso has graduated over 2,000 doctors, nurses and researchers over the past decade, and will add dentists to its alumni beginning in 2025. For more information, visit www.ttuhscepimpact.org.