Tragedy Sparked Birth of Doctor Referral Service

Dr. Jose Lillo remembers the woman who came to him too late.

During her nine months of pregnancy, the 29-year-old Latino woman had never been able to find a Spanish-speaking doctor in Orange County and had received no prenatal care.

When, through a friend, she finally came to Lillo’s office in Santa Ana, it was after she had calculated, on her own, that her baby was overdue.

“She said, ‘I think my baby was due last month; I came to see what happened,’ ” Lillo recalled. “I examined her. The baby had no fetal heartbeat.” The infant had died about a week earlier, he said.

Hoping to avert such tragedies, Lillo, a native of Argentina who has practiced obstetrics and gynecology in Orange County for the last four years, recently persuaded Doctors Hospital of Santa Ana and the Santa Ana Hospital Medical Center to establish a telephone referral service geared to the hospitals’ large Spanish-speaking population.

Called ‘Su Doctor’

The four-month-old service, called Su Doctor ( Your Doctor in Spanish), offers Spanish-speakers a number to call where they can be referred, in Spanish, to a Spanish-speaking physician near their homes or work.

The service is one of what may be very few of its kind in Southern California, say its sponsors. Both the Orange County Medical Assn. and the Los Angeles County Medical Assn. will make referrals to Spanish-speaking physicians--but a caller usually has to ask for the names in English first. (The Orange County Medical Assn. does have employees who speak Spanish and who can help a non-English-speaking person find a doctor, one official said.)

There is, however, “a definite need” for these services in Southern California with its large percentage of Spanish-speaking population, according to David Langness, communications director for the Hospital Council of Southern California. According to the 1980 census, 10.1% of Orange County’s population--or some 196,000 people--indicated that Spanish was spoken in the home.

Such such a referral network, Langness said, also can be a “census building tool” for a hospital--a way of identifying patients for its staff physicians who will eventually refer them to the hospital.

Building the census was partly the idea behind the Su Doctor network. So far, 16 physicians from Doctors and Santa Ana Hospital, with specialties in family medicine, infertility, surgery, pediatrics and obstetrics, have joined the referral list. And so far more than 100 people have dialed its Garden Grove number, (800) 44-DOCTOR, for help.

When someone calls the service hot line, bilingual coordinator Flora Valdez answers with: “Su Doctor. Habla Flora. Digeme (Su Doctor. This is Flora speaking; tell me what you need).” “These are people that have never had a doctor,” said Valdez, who operates the service’s telephone every weekday from 9 a.m. to 6 p.m. “They are in search of a doctor who speaks Spanish.”

Those who use the service are expected to pay for their medical care, but in using the Su Doctor network they are entitled to a 10% discount on each visit. Those who cannot afford to pay are referred to one of the county’s clinics.

The two hospitals, which are both owned by Summit Health Limited of Los Angeles, have spent about $40,000 so far advertising their new service on two Spanish-language radio stations in Los Angeles, in a Santa Ana newspaper called Miniondas and on placards at bus shelters in downtown Santa Ana, said Lizz Mishreki, marketing director for Doctors Hospital of Santa Ana.

Mishreki and Lillo both say that without the referral network, many Latinos in need of medical care have not known where to turn.

Some patients, they say, have delayed seeking medical care until the last moment--doing without a physician until labor pains sent them to a local emergency room.

Others have given up all hope of finding a sympathetic, Spanish-speaking doctor in Orange County, and instead have driven to Tijuana to see one.

“There is the economic factor. An office visit here is about $35, and in Tijuana it is far less expensive--about half that,” Lillo said. Prescriptions are cheaper in Tijuana too, he said.

“They (Orange County residents) go for birth control pills. The one I prescribe here costs $14 for a pack of pills and over there, it’s 60 cents a pack.”

But another reason for making the long trip to Tijuana is cultural, Lillo said; patients want a doctor who will understand them--without a translator.

In addition, those Mexican patients who turn to folklore don’t want to be laughed at, Lillo noted. “There are some old beliefs and superstitions people do have,” he said. Mexican women who are pregnant, for instance, sometimes fear “that if they don’t wear a red band close to the abdomen the baby may have a defect. I have found many people get extremely offended if the physician laughed at that. I do understand that.”

Superstition ‘Not Trivial’

Lillo, who studied medicine at the University of Cuyo in Mendoza, Argentina, and did his residency at Sisters of Charity Hospital in Buffalo, N.Y., emphasized that “I don’t see any scientific value of that . . . but I don’t disregard that as trivial.”

In a marketing research “focus group” held at Doctors Hospital this spring, a Santa Ana factory worker who gave his name as Herminio described his frustration at going to a local emergency room where no one spoke Spanish.

“The doctor wanted me to sign a form, and since I didn’t know what it said, I didn’t sign it and I didn’t get care. I went home with my pain,” Herminio said. “It would be so much better if you find people who speak your native language.”

Lillo agreed. “The reason why I set this up--I saw the need for the people,” he said. “It may sound kind of Don Quixote--kind of a romantic idea--but I see a need, a true medical need.”