RIO GRANDE CITY, RGV – A certain type of diabetes and a lack of primary care doctors are among the biggest healthcare challenges in Starr County, according to local physicians.
Starr County Industrial Foundation and South Texas College hosted a panel discussion recently with three local leaders asked to sum the state of healthcare.
The panelists were Dr. Jose Vasquez, chairman of the board of directors at Starr County Memorial Hospital, Dr. Tony Falcon, owner of a family health clinic in Rio Grande City, and Dr. Carlos Cardenas, chairman and co-founder of Doctors Hospital at Renaissance.
The moderator was Dalinda Guillen, executive director of Rio Grande City Economic Development Corporation. The discussion was titled “The Economics of Healthcare.”
Guillen asked Dr. Falcon to name the biggest healthcare challenge in Starr County. Falcons responded:
“In our area, the biggest thing is the problem with diabetes in childhood and childhood obesity. For years some of us have been trying to change that. The lack of research has hampered our abilities to move forward.”
Falcon said there is no need to find out if there is more diabetes or obese kids in South Texas because that has been established.
“What we do about it is the next big giant step. I know there are some people very actively involved in trying to help. But I think it is going to take a greater effort, with more people working together, the hospital, public health, the commissioners court, the city commission, all working together,” Falcon said.
“We need a greater effort because we are facing a major effort. When I got here to Rio Grande 40 years ago we did not have one single Type 2 diabetic in our schools. We had Type 1 Diabetic, the insulin-dependent diabetic. It is my understanding and I do not do pediatrics any more but we have over 200 children with diabetes in our school district right now.”
Yolanda Morado of Texas A&M AgriLife Services was in the audience. She confirmed the seriousness of diabetes in Starr County.
“We identified them (Starr County children with diabetes) but we lost the funding. If we could identify them at an early age and work with them we could probably get things under control. Some of these kids are already on insulin when they hit junior high and high school. That is unreal,” Morado said.
Falcon agreed. “The time to make a difference is at this early age,” he said.
Morado said a bad diet is part of the problem. “We have to work with the food service directors in the schools. The food is all pre-packaged, there are a lot of carbs,” she said.
Falcon questioned whether students are getting too much food at school. “We are feeding our children too often at school. There is a calorie problem,” he said.
Falcon said Starr County children have a dietary and exercise problem. Morado said education is the only thing that can change that.
“Healthy South Texas wants to partner with Doctors Hospital. We are working in the schools and the community gardens. Children can make the difference. With some parents it is almost impossible. Kids prepare the food (from community gardens) and eat it,” she said.
Primary Care Physicians
Dr. Vasquez brought up the lack of primary care doctors in Starr County.
“A significant problem I see coming, specific to our county, is that we are finding less and less primary care physicians coming to our area. We are seeing more specialty services and that is greatly appreciated. It is much needed. However, the foundation of a healthcare system is the primary care. It has been years since we got our last primary care physician. We definitely have a problem,” Vasquez said.
Vasquez said a new generation of primary care physicians needs to come through.
“We need to incentivize these young doctors to come and serve our community. Twenty years ago, when I came here, there were programs to help. Today it is more scarce. This is not exclusive to us but in rural communities generally (this lack of primary care physicians.”
Vasquez recommended a loan forgiveness program to incentivize budding doctors to go into the primary care field.
DHR Health is forging a close partnership with Starr County Memorial Hospital. Asked what big healthcare challenges face the local community, Dr. Cardenas brought up the need for greater healthcare literacy and the need for improved mobility.
“A bigger question for us as a community is, and a challenge, is the lack of what we call health literacy. That our population really doesn’t understand the factors that are driving some of the problems that we have in our population,” Cardenas said.
“We have to help our own population. We can build institutions, we can do all kinds of things but we have got to get to the heart of the problem. The problem for us is to identify those things in our population and then be able to teach our population how to help themselves. It all revolves around health literacy.”
As for mobility, Cardenas spoke about the Rio Grande Valley in general, not just Starr County. Cardenas mentioned that when he was young he could get to Rio Grande City from McAllen and Edinburg in 35 minutes. Now, he said, it can take up to an hour.
“The truth is 1.4 million people need access to healthcare facilities. Time is everything when if comes to healthcare and an emergency. We need definitive movement in our transportation infrastructure in order to properly attend to the healthcare of our community. That is a must. As a region we deserve it. We need to all band together.”
Cardenas praised the recent merger of the Valley’s three metropolitan planning organizations, which are the conduit for a lot of federal and state transportation dollars.
“This is a great development. Now we can speak with one voice. Our transportation infrastructure is woefully inadequate. I think it impedes the delivery of healthcare and in order to solve that problem for the longterm, health literacy has to go hand in hand with access,” Cardenas said.
UTRGV School of Medicine
While acknowledging Starr County and the Valley generally have a lot of healthcare challenges, the three panelists agreed that positive steps are being taken. All three praised the formation of the UT-Rio Grande Valley School of Medicine.
Cardenas predicted UTRGV is going to be transformational.
“We are on our way in terms of transforming healthcare in our community because we had vision and we invested early on to try to get to where we are today. We basically demanded of our legislature that 1.4 million people needed an institution of higher learning to teach the next generation of physicians and the graduate medical education programs to make that possible because we know that 60 percent of them stay within 150 mile radius of where they train and build that community. I see that for our future,” Cardenas said.
“It is not an experiment. We have proof is in San Antonio of what happens when you bring a medical school to a region and the bio-medical industry that develops around that school, because of the professors that come and the basic scientists you need and the infrastructure that you have to build to support that.”
Cardenas said he thinks the transformation of the Valley will taken place at a faster pace than it did in San Antonio. “I think it is going to happen more quickly here than it did there,” he said.
Vasquez concurred. “I think the fact we have a School of Medicine is tremendous.”
Studying the Healthcare of Hispanics
One thing Falcon wants to see more of is research into diseases prevalent in Mexican Americans.
“Now we have a medical school in the Valley and a flagship hospital such as DHR, there is an absolute need for research to see what we can anticipate in the future. This country in general has lacked the resources to study Hispanic health, Mexican American Hispanic health,” Falcon said.
“Now we have the ability to start more projects, not to have more studies, we have enough of those. Once that research is started and we see what is happening, we will be able to change things, perhaps as early as kindergarten and in our schools, to change the outcome of a certain condition 20 years down the road. We need to do things based on good science.”
Cardenas said Falcon was “absolutely on point” when it comes to research into the healthcare of Hispanics.
“We have a tremendous opportunity in the Rio Grande Valley to be the pacesetter when it comes to treating and identifying diabetes and diabetes-related problems. Liver cancer, we are ground zero for that. We have more of it in our area than anywhere else in the country. We have probably more non-alcoholic-related fatty liver disease and all the problems that come with it than almost anywhere else in the country. We are going to solve that problem down here. We are going to get that one figured out. We already have trials that have begun. We have several trials that have begun in our liver institute. We are enrolling people every day in those studies. It will help to bare fruit,” Cardenas said.
Starr County Memorial Hospital
Vasquez said he was thrilled to see the expansion of the Starr County Memorial Hospital, pointing that his county is the only one in the Valley with a tax-generating hospital district. He said major investment in infrastructure has taken place and important partnerships forged.
“In the last 20 years we have grown tremendous. Our hospital district has the ability to raise funds. If we compare 2000 and 2019, we have grown about three times more than what the hospital was 20 years ago. Now we have general funds of about $50 million, compared to $16 million in 2000. That means a tremendous influx of money in a much-needed community. In 2000 we employed 160 people, now we have 290.”
Vasquez added: “Services we never dreamed of before are going to be provided here on a continuous basis. We are going to break ground on a state of the art imaging center We are very proud, it is a much needed service.”
Cardenas said the future looks bright because of leaders in Starr County such as Dr. Falcon and Dr. Vasquez.
“The foundation for the future is sound because we have people like these two doctors. They are both primary care physicians, that is the foundation of what is a medical community,” Cardenas said.
“We only have divisions because of county lines, we are truly one region. We are a region that is geographically and demographically isolated from the rest of the state. We have been treated that way and seen that way by the federal government, by the state government, and only until recently did we elbow our way on to our place at the table.”
Cardenas added: “Don’t let anybody ever tell you we do not have the intellectual capacity or the intelligence in our communities to be able to build the leaders for the future. Because you are looking at some of them sitting up here and there are others in the audience who have the same vision to make this community of 1.4 or 1.5 million people no different than any other major metropolitan area. It is what we deserve as a community.”
Editor’s Note: The main image accompanying the above story shows Dr. Carlos Cardenas, Dr. Jose Vasquez, and Dr. Tony Falcon. They participated in a panel discussion titled The Economics of Healthcare. It was held at South Texas College’s Starr County campus in Rio Grande City. The moderator was Dalinda Guillen, executive director of Rio Grande City Economic Development Corporation. The event was hosted by Starr County Industrial Foundation and South Texas College.