By Jordan Humphreys
For Reporting Texas
AUSTIN — Dr. Matt Masters specializes in helping people overcome addiction, but two days a month, he throws himself into general practice to help the needy community served by the Wallace Mallory Clinic at El Buen Samaritano Episcopal Mission in South Austin.
The clinic provides services for the uninsured at $30 to $50 a visit and specializes in women’s health, mental health, immunizations and general care. Besides two full-time physicians on staff, the clinic is supported by doctors, translators and volunteers from the community.
“Because I’m the only internist on staff, I’m usually the one taking care of serious cardiac problems and conditions like rheumatoid arthritis,” Masters said. “It’s fun to take care of those because that’s what I was trained to do.”
According to clinic director Rae Zayed, 94 percent of patients are Hispanic, and the decor reflects the community heritage. There is an altar supporting a statue of Our Lady of Guadalupe, wool shawls drape the walls, and each of the 12 examination rooms showcases indigenous art. El Buen’s patient demographics are also somberly consistent with an October report by Central Health and community leaders that shows the average uninsured Central Texan is working-age and Hispanic or black.
Cultural richness can hamper effective care for patients. Zully Paulin, a social worker at the clinic, said familial remedies are sometimes sought over medical care. “Sometimes a person with hernia will drink an herbal tea to ease the pain instead of dealing with the root of the problem,” she said.
Many of the area’s residents do seek medical care and are serious about following doctor’s orders, but they have trouble figuring out what is expected of them because of the language barrier.
On a recent afternoon a man suffering from diabetes, hypertension and depression brought his prescription bottles into the clinic to show Masters, which the doctor says is a great way to check that patients are on track. But the man hadn’t understood Masters’ earlier order to increase his dosage, so his depression hadn’t improved.
On the same day, Masters became frustrated with a woman suffering from severe rheumatoid arthritis when she told him she had stopped taking her medication—a decision he said would cause her joints to lock and leave her debilitated. The woman initially told him, via a translator, that she quit her prescriptions when she felt better. Then Masters learned the woman was masking her fear that she would be unable to pay for her next prescription.
“Sometimes when it’s a problem of funding, people are proud and don’t want to admit that they can’t pay,” Masters said as he approved forms necessary to help the patient get prescription funding and passed them onto a nurse.
Austin physicians also volunteer specialized services to help patients receive care they can’t get at El Buen. “If we can’t serve them at the clinic,” Communications Coordinator Iván Dávila said, “we refer them to a specialist in the community, and if they don’t have the funds we have a financial assistance program to pay for a portion of their bill.”
The clinic receives its funding from three primary sources: First, a contract with Travis County Central Health, a public health district, funds clinic patients with significant financial need. In addition, St. David’s HealthCare Network and the Michael and Susan Dell Foundation provide funding for the clinic’s physicians and staff.
According to Zayed, if patients weren’t coming to El Buen, they would be backing up city emergency rooms. “We actually get referrals from emergency rooms in the area,” she said. “And these are patients that would be worse off” if they were served by ERs alone.
Zayed said that along with helping patients finance their medical care, all clinic staff, as well as many volunteers, work as interpreters for volunteer doctors, like Masters, who don’t speak medical-grade Spanish. Then, they stay in the room when the doctor leaves to make sure the patient understands the diagnosis and treatment plan.
The next challenge for Zayed and the clinic is to better deal with problems of chronic diseases like obesity, diabetes and eye problems, as the number of Hispanic diabetics in Texas is projected to double in the next 20 years to 6 million, according to the Central Health Report.
Meanwhile, the volunteers seem to derive value from helping the clinic serve its largely uninsured community.
“Many of these people are working multiple jobs doing hard work,” Masters said. “When they get in the clinic, they’re even more respectful of doctors than the patients I usually see in my practice. They haven’t looked up their symptoms on the Internet to use me like a Burger King for meds.”