Monday, October 6, 2008

L.A. Senior Doctor Makes House Calls

Dr. Azmy Ghaly, in front of photos of his three sons.

Dr. Francisco Quijas converses with his patient, Beatrice Cuellar and her husband, Carlos Cuellar. The staff at Senior Care Clinic takes time to get to know each of its patients as individuals.

(LOS ANGELES) – Dr. Azmy Ghaly and his staff at East Los Angeles’ Senior Care Clinic do whatever it takes to make sure their patients receive quality health care – even if they have to make a house call.

Many patients will see Dr. Ghaly, or one of the other three Senior Care Clinic physicians at their office in White Memorial Medical Building, 1700 E. Cesar Chavez Ave, Suite 3900. The other physicians are Dr. Francisco Quijas, Dr. Angelina Espinoza and Dr. Aung Mang.

But they also see patients at nearby White Memorial Medical Center itself, or in many of the board and care homes, and convalescent hospitals in East Los Angeles and nearby communities. Seniors who still live independently can also have a house call, if they’re too sick to travel, but not sick enough for hospitalization.

“If there is no other way, we will make a house call,” Dr. Ghaly said.

Senior Care Clinic primarily serves East Los Angeles. The website says East Los Angeles is 96.8 percent Hispanic, and has a median income of $31,915, with 26.4 percent of the population living in poverty.

“These demographics put patients at a higher risk of contracting certain diseases,” says Dr. Ghaly. “This is partly because low income Hispanics typically have a high-fat diet with lots of lard, and partly because Hispanics from all walks of life are genetically predisposed to high cholesterol, hypertension and other diseases.”

As a geriatric or senior health care specialist, naturally patients are elderly, and many rely on either public transportation or senior housing shuttles to get to the doctors’ office.

Dr. Ghaly has tailored his practice to meet these unique needs.

For one thing, although the Egyptian-born physician came to the United States in 1991 fluent in two languages (Arabic and English), he quickly learned to speak Spanish after opening his clinic in 1994. Later two more doctors (Dr. Quijas and Dr. Espinoza), who were born in Mexico, joined the practice.

The fourth member of the practice, Dr. Maung, is from Myanmar (formerly Burma), and speaks Cantonese and Burmese. After Hispanics, the largest ethnic group in East Los Angeles is the growing Asian population, according to Dr. Ghaly.

Whatever their financial situation, patients won’t have to worry about the expense of health care. Since all Senior Care Clinic patients are at least 65 years old, they’re eligible for Medicare, and the employees of the clinic can help them apply if they haven’t already done so.

For those with insurance, Senior Care Clinic will usually charge only $75 for an initial office visit, and $40 to $45 for subsequent visits.

“Sometimes we will even see patients for free,” Dr. Ghaly said. “If a patient comes in with no money, what can you do? We have a heart here.”

For instance, while Dr. Ghaly encourages patients to apply for Medicare as soon as they are eligible, some newly retired senior citizens have lost coverage under their group plans at their last job, yet are still awaiting Medicare approval. If they need medical attention during that transition, Senior Care Clinic can help.

During an office visit, physicians at Senior Care Clinic spend the time each patient need. An initial visit, during which physicians give their patients a complete physical, takes about 30 minutes.

“We always take time with our patients to sit down and explain things,” Dr. Ghaly said. “For our Hispanic patients, sitting and chatting is part of their culture. If you stand up and talk to patients for 15 to 20 minutes, that is perceived as the worst care. If you sit down and talk with a patient for five minutes, it seems like an hour.”

Senior Care Clinic doctors ask their patients to bring every medication they’re taking with them to an appointment, especially the first meeting. That’s so they can make sure any medications they’re now taking or would be prescribed for their current ailment don’t cause harmful interactions.

“Some patients are taking 30 bottles of medication,” Dr. Ghaly said. “We review their medications with them, and make sure they’re not taking something that would hurt them.”

And if a new medication is necessary, Dr. Ghaly’s staff will assist by phoning the prescription to the pharmacy ahead of time. Pharmacies often verify prescriptions with a doctor’s office, he said, so calling ahead saves the patient from having to wait at the pharmacy while this step is completed

Appointments for office visits are encouraged, but patients are welcome to come in without them.

“If you are sick, and need to see a doctor right away, that’s why we are here,” Dr. Ghaly said. “We’re very flexible. “We try to have patients see the same doctor each time, so they can develop a relationship with that doctor. Still, we know almost all of each others’ patients.”

Since there are four physicians, the clinic can accommodate patients who didn’t make appointments by having at least one doctor available, in the office, whenever it’s open. That doctor can see his or her scheduled patients for the day, as well as any who come in without appointments.

Senior Care Clinic has a relationship with the East Los Angeles senior citizen community that goes beyond taking care of their medical needs. The staff participates in community health fairs and events for senior citizens, and the physicians serve as guest lecturers for schools and community groups.

In addition, Senior Care Clinic is helping The East Los Angeles Community Union (TELACU) to develop affordable housing for senior citizens. TELACU is a non-profit organization founded 40 years ago to improve the economic vitality of East Los Angeles and other southern California neighborhoods.

Senior Care Clinic was established in East Los Angeles in 1994, and is affiliated with nearby White Memorial Medical Center. A staff of four physicians, headed by Dr. Azmy Ghaly, handles all geriatric health care needs. Dr. Ghaly speaks Arabic, English and Spanish. Dr. Angelina Lopez and Dr. Francisco Quijas speak Spanish and English. Dr. Aung Maung speaks Burmese, Chinese and English.

For more information about Senior Care Clinic, call (323) 307-0800.