Starting & Sustaining Your Medical Practice

for Hispanic PopulationsRene A. Sepulveda, MD, FACS

Urology San Antonio

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

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

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

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

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

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

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

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

Community Service Projects

• Screenings, Health Fairs– Need to be in their “backyards”– Venue is important

• Ex. San Fernando Cathedral -a trusted, user-friendly location

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”

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

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