Monday, June 2, 2008

Flexibility, Respect and Insurance Make Good Business Sense

Dr. Albert Arteaga lectures to students in the Health Care Disparities Course at the University of California - Riverside.

(RIVERSIDE, Calif.) Access to medical care is not equal for all, and that needs to change, according to Dr. Albert Arteaga, owner of LaSalle Medical Associates, Inc.

“There is a real need for some type of intervention in the system,” he said. “Something has to change.”

One way he’s changing the system is by contributing to a Medical & Health Careers course at the University of California Riverside called Health Care Disparities. Dr. Arteaga, who is passionate about providing quality health care to all, visits this class regularly, and recently he served as a guest lecturer.

Dr. Arteaga explained to these students how LaSalle Medical Associates has practiced a different approach to health care. To begin with, he said when he went into private practice in 1984, he followed his own father’s ways.

It didn’t matter that Dr. Arteaga was a pediatrician and his father a Seventh Day Adventist minister. It still seemed to the new doctor that his father had a good way of running his business, which was churches.

Dr. Arteaga recalled that when he was growing up, his father welcomed anyone who even approached the door of the church. And if the people weren’t good Christians, he still accepted them, knowing that in time, most of them would change their ways.

“He never said, ‘oh your late, you must reschedule your service,’” Dr. Arteaga said. “He said ‘come in, sit down, and next time if you are on time you can enjoy all the service.’ After a few free passes, they started coming on time and contributing to his church.”

“So I said, my clinics are going to be run like churches. We don’t exclude patients until their behavior improves so much they are worthy of being seen. We let them in.”

That was 24 years ago. On the first day, Dr. Arteaga and his wife Maria, then employed as his nurse and still his chief assistant, saw two patients. Last year, Dr. Arteaga’s five medical clinics had 108,061 visits, and grossed a little more than $40 million.

Now, Dr. Arteaga hopes to pass his secrets for success on to young people who are entering the medical field.

Dr. Arteaga, who is Hispanic, made some observations about people of his ethnicity that he said have guided how he treats all of his patients, most of whom are also Hispanic. He calls them his “Hispanicisms.”

He noted the phrase “mal educado,” while literally translated into English is “badly educated,” also means “badly mannered.”

“They expect competence and manners to go together,” he said. “We Hispanics can spot mal educado a mile away. Respect is huge.”

Hispanics also want doctors to give them hope, he said. He recalled having to hospitalize a two-year-old boy with pneumonia. The boy’s father, a burly young Hispanic man wondered how long his son would be away from home.

Dr. Arteaga could not answer that question until the boy responded to treatment.

“I could have said there’s nothing I can tell you right now,” Dr. Arteaga said. “But he probably would have jumped over the counter and strangled me.”

Instead, Dr. Arteaga explained to the father that the boy’s mother had brought him in before with a cough, and medication was prescribed. It seemed the boy was getting better, but after a windy day, the mother and father had brought their child in again, and now the boy had a fever, plus Dr. Arteaga heard rattling in his chest that sounded like pneumonia. He wanted to do further tests, then treat the boy with antibiotics until his fever broke, a process that would normally take about three or four days, but could be more or less.

The father accepted that, and thanked Dr. Arteaga for taking the time to explain it, he said.

“You might say, ‘Dr. Arteaga, it’s not just Hispanics who do that, everyone does it,’ he said of his “Hispanicisms. “OK if everyone does it, so do Hispanics. You just proved my point that it makes sense to do business this way.”

Dr. Arteaga also told the students a small birch-bark canoe he and his now 20-year-old daughter built when she was in fifth grade guides him.

One thing he learned while building this canoe, he said, is to start with the bark, then build the frame to fit. Otherwise, there might not be enough bark to cover the frame.

“That’s a good way to run a business as well,” he said.” Most medical practices calculate expenses, and then determine they can’t see patients who won’t pay enough. At LaSalle Medical Associates, we start with what we have. We calculate what our patients will bring in, then fix our expenses to be less than that.”

Dr. Arteaga also learned that in a canoe, if you take it on a river then wish to turn around, all you have to do is face the other way.

“Canoes always go forward,” he said. “So do I. I take a forward approach to making sure people can pay for their health care.”

Patients without health insurance coverage often think they can’t afford medical care, Dr. Arteaga said. But instead of accepting that, he makes it known that LaSalle Medical Associates will help most of their patients find insurance.

LaSalle Medical Associates is one of the top enrollers in California for Healthy Families, a government-subsidized health insurance plan for children from low and moderate-income families. Most patients are eligible for Healthy Families, Medi-Cal or another government subsidy, he said.

“Only 1 percent or less can’t get any insurance,” he said. “We’ll do something for them too. We’ll give them a discount rate to see a doctor., and if they can’t pay we see them for free. When they need medications, we give free samples. So they can afford to get well. We’re not going to turn anyone away.”

Dr. Arteaga said that when he saw patients, he would not just hand them an application for insurance. He would help them fill it out, and mail it to the correct agency or insurance company.

“I went the second mile,” he said. “I was flexible. And at the end of the day, I was successful, because all those patients were paid for.”

Dr. Arteaga told the students he would like to see all physicians take his proactive approach to getting people insured. He also urges all business owners to provide insurance for their employees, as he does.

“I believe there should be universal health coverage,” he said. “And I’m doing my part to bring it about. That is the intervention we need.”

LaSalle Medical Associates, Inc. has 115 employees (including 13 physicians). LaSalle welcomes patients at all five of their Inland Empire clinics: 17577 Arrow Blvd. in Fontana; 1505 Seventeenth Street and 565 North Mt. Vernon Ave. in San Bernardino; 16455 Main St. in Hesperia; and 31762 Mission Trail in Lake Elsinore.

Appointments aren’t required, but are recommended by calling (909) 890-0407.