Beleaguered health system struggles to treat poor, isolated patients

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Beleaguered health system struggles to treat poor, isolated patients
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Clinics treating uninsured patients see surges as Medicaid disenrollment looms; local doctors-in-training plan careers around helping those most in need.

As a child living in poverty, Brianna Dolana remembers well the kindness two Tucson doctors showed her family.

"We're not rural compared to other places but we're dealing with the same issues," said Herminia"Minnie" Frias, a member of the Pascua Yaqui tribal council. "We are seeing an average of 35 new patients every month on top of our regular patient load," said Nicole Glasner, executive director of Clinica Amistad."Many in our community have lost jobs and/or insurance, which results in more patients seeking attention for primary care needs."

Gaps in health-care systemThe factors that work against an individual's well-being or a family's health are multifaceted, said Suzanne Teeple, a Tucson attorney who helps underserved populations as director of the Tucson Family Advocacy Program. Several things are compounding Southern Arizona's current problems, and poverty is a significant one.

Teeple's program includes a legal-medical partnership in which she works with family medicine doctors to help patients with health-care access issues as well as what she calls other"health-harming problems" such as evictions, trouble getting benefits or a lack of access to healthy food. During the last year of medical school, students interview for residency slots at institutions where they hope to receive further training. The match is then completed by the National Residency Matching Program, with training through these partnerships typically lasting from three to seven years, depending on the specialty.

It was the kindness of a doctor that also influenced Adam Carl's decision to become a doctor. Carl is a first year medical student at the UA and, when he finishes his studies, he will be one of the nation's first 10 doctors from the Hopi Tribe. The Wassaja Center, which started in 1983, offers support to doctors and nurses training to work in high needs communities.

Sascha Delzepich is attending medical school here on a primary care scholarship, and plans to work with underserved people. "I lost my benefits when I moved here and they didn’t have COBRA plans for Arizona,” she said, adding she's researched her options and didn't find anything affordable.Kohl's husband is on Medicare so the move didn't affect him, but Kohl, at 59, still has some years to go. It was Kohl's uncle who encouraged her to call the University of Arizona's College of Medicine to see if they offer any clinics to help those without insurance.

A lot of people stopped seeking health care during the pandemic, she said, and so lately they've been seeing patients who have gone without seeing a health professional for long periods of time. "The increase in the severity of cases along with the rise in appointments necessitates more funding for basic clinic expenses including PPE, hand sanitizer, germicidal soap, medications, insulin, supplies and consumables," she said.

"Since I graduated in 1981, the areas in Arizona that were underserved then are the same underserved areas now," he said."Thank God for El Rio," he said."They brought several clinics to the south side." Moreno was born and raised on the reservation and said he's known since he was a child that he wanted to work in medicine. Over time, the focus became psychiatry and, particularly, addiction and child and adolescent work.

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