Starting & Sustaining Your Medical Practice for Hispanic Populations

1. Starting & Sustaining Your Medical Practicefor Hispanic Populations Rene A. Sepulveda, MD, FACS Urology San Antonio

2. About San Antonio • 9th largest U.S city • Bexar Co. seat • Population: ~1.6 M • 58% Hispanic • Ethnic Areas: • Westside 90% • Southside 87% • Eastside 56% http://www.healthcollaborative.net/assessment06/social-environment/social1.php

3. Movers and Shakers • Hispanics in SA very well represented • Mayor Julian Castro – national figure • 60% of city council Hispanic • First Hispanic president of a Health Science Center; now UT Chancellor • Hispanic president of UT San Antonio • Numerous CEOs of various companies

4. About Urology San Antonio • 110,100 visits in 2010 • 26 urologists, 1 NP, 1 radiation oncologist • 9 clinics • Northwest • North Central • Northeast • Southeast • Downtown-The original office started in the heart of SA • Far West • Boerne (1/wk) • Alamo Hts (1/wk) • Radiation Center

5. About Urology San Antonio • President/CEO, 2 of board members Hispanic • 1/3 of docs speak Spanish • 3 women in the group, 2 of whom speak Spanish • Public relations department with emphasis on Hispanic population

6. Accessibility and Integration • Easy access to mass transit, walkable • Provide services in house that keep our patients from traveling while maintaining the highest of quality • When pts are unable to get to us, we provide transportation • Integration = huge component of our success

7. Integrated Services • Imaging • Lab services • Outpatient surgery center • Pathology services • Cancer center for chemo and advanced radiation therapy • Revenue is used to promote and market to the community

8. Personnel • Front office/ Nursing / Medical Assts / Billing personnel • Truly bilingual and bicultural • Preferably “home grown” – can understand local issues • Clinic director is Hispanic nurse • Practice administrator is Hispanic woman • Patient issue can be addressed in either language

9. Patient Education • Registration forms, questionnaires, materials need to be in Spanish • Some of our physician educational seminars are given in Spanish • Cancer consultations when needed are referred preferentially to our Spanish speaking specialty surgeons and radiation therapist

10. Community Service Projects • Screenings, Health Fairs • Need to be in their “backyards” • Venue is important • Ex. San Fernando Cathedral -a trusted, user-friendly location

12. Community Involvement • MAHPA founded in 1983, an outgrowth of the old NCHO effort • MAHPA has provided over half million dollars in scholarship and countless hours of mentorship via Med Prep • Cisneros’ American Sunrise • “You must maintain the pipeline”

13. Political Support • Historically, doctors were the worst • Now more than ever we must support our local, statewide and national politicians and educate them as to the health concerns of our communities • If the future is Accountable Care Organizations, then lets make sure that they are culturally appropriate as they evolve

14. Summary • We feel that all these efforts will not only validate what you do but will underwrite your sustainability • Sustainability = responding to the needs of the community at all levels