The baby Sheila Avila is carrying is exactly the size he should be at 32 weeks in the womb. His heart is beating a perfect 150 beats per minute. When nurse midwife Jennifer Fields presses against him in his mother’s belly, he kicks back hard.
“Once you push him, he starts pushing you back,” Avila laughs.
Things are going well with Avila’s pregnancy. But without the prenatal care and counseling Avila has received at La Clinica Tepeyac, in Denver’s Globeville neighborhood, the mom-to-be and her fiance, Miguel Cecenas, aren’t sure they’d be approaching parenthood quite so confidently.
“I really don’t know where we would go,” Avila said.
“The level of stress for those who are uninsured is really, really intense,” said Fields, who works most of her week at St. Anthony Central Hospital.
For 15 years, La Clinica Tepeyac has provided primary health care services to the uninsured in north Denver.
Today, as many as 80 patients are seen each weekday at the clinic, a humming nonprofit family practice that medical director Dr. Jim Williams describes as attending to the needs of people “from womb to tomb.”
“If you can get in the front door, we’ll see you,” he said.
Patients, mostly Spanish speaking, pass through one of eight exam rooms, where they receive typical primary care — pap smears and annual physicals, blood tests, treatment for acute ailments such as flu and strep, stitches and casts, screening for chronic illnesses such as diabetes and high blood pressure — from Williams and two paid full-time physician assistants.
About 10 volunteer professionals fill in with specialty care, such as prenatal services, ultrasounds, HIV treatment, physical therapy, acupuncture, mental-health counseling and diabetes education.
Fees at the mostly grant- and foundation-funded clinic are low, but everyone is treated, even if they can’t afford the $20 charge for an office visit.
Patients with serious illnesses are referred to other practices and hospitals, where they receive care at a deep discount.
Fees for outside health care are covered by La Clinica Tepeyac’s patient-assistance pool and then passed on to the client.
“Some people pay over time, some don’t,” Williams said. “But they do the best they can.”
The most frequent diagnosis among the clinic population is diabetes, something Williams attributes to genetics and a diet high in carbohydrates, exacerbated by poverty.
In 2010, Williams says the clinic will begin using a new piece of equipment to screen patients for diabetic retinopathy.
The $26,000 device allows doctors to diagnose the symptoms that can lead to blindness in diabetics.
Williams, who spent 30 years in private practice in Lakewood, says the clinic is operating at 90 percent of capacity, but he knows the number of potential patients is much greater.
“There is pretty much unending need if you serve the uninsured in this decade,” Williams said.
Dana Coffield: 303-954-1954 or dcoffield@denverpost.com
