Emergency care lacking, but not caring doctors

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When Dr. Karen Phillips walked into the exam room nearly 10 years ago, she was flabbergasted by what she saw.

Mike Stearns-News-Bulletin photo: First Choice physician Karen Phillips completes and examination of Elizabeth Flores, a medical assistant at the Los Lunas walk-in care clinic.

Her patient had a growth on her foot that was the size of an orange and apparently malignant. Phillips explained that patient had not been to the doctor sooner because she did not have insurance and was afraid of not being able to pay.

From Bosque Farms to Belen, health care providers are trying to meet the needs of residents who are disadvantaged by several circumstances.

Almost two issues were universally heard from doctors and administrators in the county. The first was the absolute need for a hospital in the county. The second, that patients delay seeking medical attention because they feel that they can’t afford it.

“There is no doubt that we need emergency care in Valencia County and it is kind of a disgrace that we don’t have it,” said Phillips, a doctor at First Choice Community Health in Los Lunas.

Phillips’ patient was lucky. She was able to get the growth removed, and a series of chemotherapy and radiation treatments, aftercare and rehabilitation were all part of her recovery.

Phillips estimates that it was at a cost of $300,000 to $400,000. Had the growth been caught on the onset, it would have just been about $300 to fix the issue.

“We, as a society, pay for that,” said Phillips, who has practiced medicine in Valencia County for many years.

“It is a train-wreck waiting to happen,” she said. “The people just really need the care. The ability to pay for it has really been an issue.”

Care ranges from individual doctors, small clinics and two urgent care units to take care of the medical needs of county residents. But the goal of nearly all medical professionals is the same — to provide the best care they can and stand in the gap to help in the face of a lack of emergency care facilities.

Tiffanie Mauricio, office manager of Los Lunas Quickcare, explained that this clinic specializes in walk-in care. Most of the doctors in private practice have a full patient load.

Quickcare takes walk-ins and has hours extended to 7 p.m. each week night and the office is open on Saturdays and Sundays.

“We are a non-emergency walk-in clinic,” said Mauricio. “There is really no where else to go after 5 p.m. The owner, Linda Chaves, decided that it would be beneficial to the residents of the county to be open extended hours.”

Like Dr. Phillips, Mauricio noted that they see emergency room-type cases from time to time.

“We come across situations all the time where patients come in and need a deeper level of care,” Mauricio said. “There are numerous times when a patient should go to the emergency room. We are in desperate need of a hospital.”

The clinic sees varying types of medical situations, but is always ready to see patients.

“Sometimes at the doctor’s office, you can’t always just walk-in. If you call and can’t get in for two weeks, then here you can walk in the same day,” said Mauricio. ” I think there are a lot of pluses for a place like ours to be here.”

Dr. Roland Sanchez has been at Family Medical Practice in Belen for 35 years. The office has a large number of patients that are regularly seen by the staff. They also take walk-in patients and have lab and x-ray services on the premises. His son, Dr. Aldofo Sanchez, has joined the staff in the last year.

Sanchez noted that one of the joys of working in a small community is the tight-knit relationship he and the staff have with the patients.

“My home phone number is in the white pages. We have seen people in our homes,” Sanchez said. “Most come within the daytime. But our answering service is 24 hours a day. We do many minor emergencies right here.”

Sanchez explained that in his 35 years of practice, he has given stitches, performed minor surgery and worked on several cases that might have been emergency care. He also said that being a single proprietor lets him makes decisions that other clinics might not be able to make.

“We are more flexible as a sole-proprietor to see the poor, than other clinics,” said Sanchez. “Sometimes the restrictions are such that it is a box that people get put into. You can make a quicker decision on treatment, even as charity, when it is family-owned.”

Of the financial issues for patients, Sanchez felt the ratio of people who will take care of their health with regular visits is about the same anywhere.

“That is a mix of insurance and personality. I am sure that the mixture is the same whether you go to the Albuquerque Heights, Los Angeles or New York City,” the veteran physician said. “Some people will want to use the system only when an acute emergency hits. Then there will be some who will be very meticulous about their health care, whether they have insurance or not.”

Sanchez said that he enjoys being intertwined in the community.

“I enjoy doing a rural practice,” he said. “I grew up with them and they feel much more empowered to talk about their inner fears. It opens up a dialog.”

Aldofo agreed with his father. He said he chose a profession that’s “very rewarding” and enjoys “the connection with people.”

“We shop with them, we play sports with them, we see them at the grocery store and we see them at church,” said the younger Sanchez.

The only urgent care-designated clinics in the county are the Presbyterian clinics in Los Lunas and Belen. The Belen clinic is the larger of the two facilities.

“We are trying to fulfill that need of stabilizing patients and making sure that have some sort of emergency services,” said Manuel Pino, the director of practice operations for Presbyterian.

He explained that urgent care is a level below emergency care and sometimes acts as a step between for patients.

“Pretty much anything can walk through the door,” he said of cases seen at the urgent care clinic. “We can see the whole spectrum and we then stabilize, if we can’t treat it here.

“As a resident myself, it is always nice to know that you have a place to go for emergency needs,” he said.

Pino added that over the last 18 months, the clinic has brought on five new health care professionals, three in Belen and two in Los Lunas.

“That tells me that there is a demand for them. We are trying to make sure that we can be the supply for that demand,” he said of his clinic and other facilities that are growing.

The new First Choice Community Health Clinic in Los Lunas has doubled the ability to see patients. They operate on a sliding-scale for patients who are not insured.

Phillips, who has moved from First Choice in Belen to Los Lunas, explained the philosophy behind an expanded health care clinic.

“The whole model of a patient-centered medical home is what we are trying to do,” she said. “Hopefully, it provides a team, a physician-led team, where you have levels of care. We are kind of trying to develop one-stop shopping for the patient, so they can have access to numerous services in a way that is patient-friendly.”

She also noted that the county is understaffed with doctors and needs emergency care.

“Heavens, no,” she responded to whether the number of doctors was adequate. “Valencia County is very much under-served (with doctors). This end of the county is better off than the Belen end.”

The new facility will help with dental care and better equipment in addition to the expanded space.

“We are trying to consider where we are going with patient-centered medical care. Hopefully with some sort of universal coverage,” she added. “People need to be able to get primary care at a time that is good for them, not wait until they are really, really sick.”

Whether working in a clinic or private practice, all of the medical providers agreed that it is crucial to have regular visits to a doctor for preventative care and that cost should not deter someone from seeking medical attention.

Wellness visits are better than acute situation visits, was the general consensus.


-- Email the author at mstearns@news-bulletin.com.