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