NPR Interview: “This safety-net hospital doctor treats mostly uninsured and undocumented patients”

Interview Summary: As a doctor in a so-called “safety-net” hospital, Ricardo Nuila‘s daily practice looks quite different from that of his colleagues who work in private or not-for-profit hospitals. That’s because safety-net hospitals treat everyone who walks in the doors — regardless of insurance status.

Many of Nuila’s patients at Houston’s Ben Taub Hospital are dealing with serious illnesses as a result of not being able to get access to basic preventive care. “What we see is that patients’ lack of health care has meant that the disease has been able to grow within their bodies,” he says. “Their cancer is widespread, or we find that they have an infection that has not been treated or discovered.”

In his new book, The People’s Hospital, Nuila writes about his experiences at Ben Taub, which is the largest safety-net hospital in Houston. He says despite the hospital’s budget constraints, the doctors and nurses there still manage to provide quality health care. By limiting the number of patients a practitioner can see in a day, Ben Taub allows physicians to spend more time with their patients than is typical.

“My cap is 15 patients in one day,” Nuila says. “That’s compared to some of my colleagues in the private world, who I’ve heard admit up to 24 patients in one night, or don’t carry a cap.”

Because resources are tight at Ben Taub, there is an emphasis on using them mindfully, Nuila says. Instead of ordering an MRI with the push of a button, for instance, he might talk to the radiologist directly, to find out if extra imaging is really called for. “There are benefits to further discussion between medical professionals about emergencies and how to deal with these emergencies,” he says.

Overall, Nuila says, working at a safety-net hospital allows him to keep his focus on medicine: “I like that I have the time to be able to hear my patients’ stories, that I don’t have to think about billing all the time, that I can sit with them and hear about why they came to the hospital and learn about their lives — and that, no matter what, we are going to be thinking about how best to help them, regardless of whether they have insurance or not.”

To listen to the interview, please visit NPR’s website.