Breaking Down Barriers

A steely resolve to improve access to physical therapy among the Hispanic population in Milwaukee - the community in which she was born and raised - has fueled the education and practice of Sylvestra Ramirez, DPT ’10, MS ’11, the 2016 College of Health Professions Alumnus of the Year.

Physical Therapy of Milwaukee (PTM), the first fully bilingual, bicultural clinic in the city, which Dr. Ramirez founded in 2013, is a testament to her passion and her will, and also to the caliber of RFU students.

Who better to break down barriers to care than a highly trained clinician who has herself fought for access, first to graduate school, then to the financial capital needed to start her business, then to a patient population that is unfamiliar with the science of physical therapy (PT).

With the ink still wet on her doctorate degree, Dr. Ramirez applied for a small business loan. Numerous lenders turned her away, despite a business plan that showed a need for culturally relevant PT care for Hispanics, who make up 15 percent of Milwaukee residents. She took a step back, practiced for three years at a local hospital and outpatient clinics and refined her business plan.

... our biggest success is the difference we've made in the community." -Sylvestra Ramirez, DPT '10, MS '11

“I applied for a bank loan again and was rejected again,” she said. “Then I had to make a personal decision: put my dream on the back burner, or risk it all.”

In 2013, she risked it all. Three years later, after draining her personal savings and working many 12- and 15-hour days, her five-employee practice is a resounding success. She ignored advice to wait for a steady stream of physician referrals or seek investors.

“I thought, ‘My investors will be the community,’” she said. “Our passion at PTM is to continue to educate our Hispanic population and work both inside and outside the clinic. Our caseload continues to grow and our brand continues to grow. But our biggest success is the difference we’ve made in the community.”

Dr. Ramirez works to educate her patients about both their injuries and prevention. Many of them put off seeking care. A broken leg, chronic back pain or a knee injury can wreak havoc on jobs, families and incomes. Many people arrive for appointments with no idea what a physical therapist does. “It’s an underused service among Hispanics in Milwaukee,” Dr. Ramirez said. “It’s a cultural tradition to seek advice from family and friends first, then maybe treatment from a ‘curandero,’ a folk healer who may give a massage, herbal teas and prayers.”

Cultural competency is more than knowing the language or culture, according to Dr. Ramirez.

“It’s integrating that culture into the PT plan of care,” she said. “I take a lot of time in educating my patients. I help them see exactly what’s happening in their body. They’re so grateful and compliant and willing to put in the hard work to do PT. For patients injured on the job, I often take the time to visit their employers. The patient/provider relationship will not work without ongoing communication on the end goal.”

Dr. Ramirez and her staff visit senior centers, FedEx, UPS, local manufacturers and other employers to talk injury prevention, safety and ergonomics. The clinic hosted a walk with Milwaukee Mayor Tom Barrett as a way to forge relationships between
the Hispanic community and elected officials. Dr. Ramirez is active in many other civic efforts. She’s a member of the 27th Street Business Improvement District Board and co-chairs the American Cancer Society’s annual Dia de la Mujer Latina health fair. She led a local implementation of Pisando Fuerte, a falls prevention project at the United Community Center, an effort that was published in the Journal of the American Geriatrics Society.

“As the only Spanish-speaking PT clinic in the city, it’s important to us to be visible,” Dr. Ramirez said. “Our commitment and honesty must show through in everything we do. I work to instill those qualities in my employees. They know they’re an extension
of the company.”

After graduating from UW-Madison, Dr. Ramirez applied to many PT schools without success, despite a record of strong academic achievement. It was suggested she would do better in a PT assistant program. She spent a year in AmeriCorps then
applied to RFU.

“I can still remember opening the acceptance letter,” she said. “I stood in my living room and cried. I remember thinking, ‘Now I can start doing what I’ve always wanted to do.’”

Today, Dr. Ramirez lectures as part of RFU’s “Foundations for Interprofessional Health Care” course. Her practice is a clerkship site for RFU doctor of physical therapy students. She also hosts internships for students from Wisconsin universities and mentors high school students to bring awareness about the PT profession.

Milwaukee needs more Spanish-speaking providers, said Dr. Ramirez, who is also receiving inquiries from patients for therapists who speak the southeast Asian language Hmong.

“That’s another example of a language barrier,” she said. “I’m excited for the opportunity to grow. PTM is looking to hire.”

This story first appeared in the Fall 2016 issue of Helix magazine.