Northside medical complex staffing up, feeling space pinch

October 22, 2007
By Bill Sontag
Feature Writer

A growing consortium of Del Rio physicians is reacting to a national trend: Medical business diversification.  And they tell LIVE! that, in part, they are responding to institutional foot-dragging, even squelching of patient service opportunities that could bring revenues to the community, and better service to Del Rio patients.

Frustrated with sending their patients to San Antonio or San Angelo for services that doctors are certain can be provided here, Dr. Antonio Cadena, Dr. Veronica Cadena, Dr. Michele Di Blasi, Dr. Tina Di Blasi, Dr. Shamoon Doctor, and more, are making plans and weighty decisions they believe will run counter to a local drift toward stagnation.  Antonio and Veronica Cadena were drawn to create their new Family Practice at Del Rio Heart & Diabetes Center for a host of reasons, not least of which was that the Di Blasis are well-experienced with developing such new enterprise.

But the overarching attraction to the Cadenas is a novel concept in Del Rio.  "The concentration of diverse health care in one place will offer our patients an alternative, a choice," said Antonio Cadena, Monday (Sept. 24).  Veronica Cadena, Antonio’s wife and fellow family practice physician, agreed:  "This builds on the one-stop shopping concept of health care."

In addition to their own family practice, as well as the current care provided by cardiologist Michele Di Blasi and endocrinologist Tina Di Blasi, the Cadenas foresee the complex featuring medical services as diverse as general surgery, home health care, orthopedic surgery, sleep studies, wound care, podiatry, urgent care and a chest pain clinic, ophthalmology, a pharmacy, and more.

The footprint of offices, patient reception and waiting room, and diagnostic laboratories at the current facility, 3809 Veterans Blvd, must expand to accommodate the growing staff and the patients that come with them, and the question on the table now is whether to expand on-site or move to larger acreage with even more potential on Bedell Avenue.

Michele Di Blasi understands the risks, but believes that quality, diverse services will reap good revenues along with healthier, more confident patients.  Di Blasi sees the spurned overtures made by Del Rio physicians to improve and expand diagnostic and treatment options on the campus of Val Verde Regional Medical Center as all the proof he needs to move ahead in the company of forward-thinking, investment-savvy physicians.  "The problem at the hospital is that they go looking at things only from the standpoint of money," Di Blasi said, Thursday (Sept. 20).

Michele and Tina Di Blasi moved to Del Rio from Italy in 2004, convinced that the raging prevalence of diabetes and its attendant side effects – such as heart disease – presented a demand for the knowledge and skills they have honed for years.  They settled into small quarters on Bedell Avenue, quickly outgrew them, and finally remodeled and moved to their current attractive offices.

"When we came to Del Rio, we had two employees and about 1,000 square feet.  Now we have 30 employees, and 5,000 square feet, and it's not enough," Di Blasi said with a mixture of gratitude and alarm.  Space tightened more when their new colleagues, the Cadenas, moved in from their old practice at Vista Verde Medical Plaza.  Though earlier than expected, the Cadenas' move was consistent with long-standing plans for a consortium of several physicians to unite at a new, expanding office complex surrounding the Del Rio Heart & Diabetes Center.

The Cadenas are long-time residents of the community, and are grateful for the large number of patients that followed them to the next location.  Veronica graduated from Del Rio High School in 1984, and Antonio followed the following year. Then, both graduated from medical school at the University of Texas Health Sciences Center, San Antonio.  Their patient load now is robust, to say the least, each seeing at least 20 patients per day, bracketed by long hours of hospital rounds and after-hours paperwork and consults with other physicians.

Dr. Shamoon Doctor, urologist, 1205 Bedell Avenue, has plans in his future to join the northsiders' enterprise, and advised the Val Verde Hospital Corporation Board in February that more physicians are necessarily getting into "the business of medicine."  "Today, the fee schedule from Medicare/Medicaid and insurance companies [is] low, and it is becoming increasingly difficult to earn well to run an office practice by just seeing patients," Doctor told the board.

"Physicians have no choice but to get into the business side of medicine," he continued, explaining that – more and more – doctors are creating and opening diagnostic facilities, office surgeries, ambulatory surgery centers, "and even their own hospitals."  Doctor described what he understands as a national trend, while also portraying the future at the multi-disciplinary medical complex now underway

Di Blasi believes revenue-producing technologies and service opportunities are being overlooked, seemingly deliberately ignored at Val Verde Regional Medical Center, and he sees those lost opportunities as the solid justification that is persuading other physicians to join the diversification project in which the Di Blasis and the Cadenas are now slipping into gear.

Di Blasi illustrates the point with an example.  He states he is the only physician in Del Rio licensed to practice electrophysiology – an examination of the "wiring diagram" of the body’s system sending electrical impulses to trigger muscle and tissue function.  Di Blasi described an electrophysiology and ablation machine valued at $250,000, "collecting dust, unused in a stock room at the hospital."

"With this, you can map the electrical system of the heart, detect the problems and correct them.  It could be providing a service to patients who now have to go to San Antonio, and it could be providing some revenue to the hospital, too," Di Blasi said.

Moreover, Di Blasi disparages notions that his efforts and those of his colleagues to develop a diverse medical business complex will unfairly compete with Val Verde Regional Medical Center.  "Competition will actually result in improved services for everyone in this area," Di Blasi said.  Antonio Cadena concurred:  "Competition is good!"