For Glenwood doctor, income isn’t a factor | VailDaily.com

For Glenwood doctor, income isn’t a factor

Eben Harrell/Aspen Correspondent

December 13 2003 Glenwood Springs

Inside, Dr. Chris Tonozzi looks out of his office at a waiting room teeming with noise, with children, the old. They are patients at the Mountain Family Health Center, the valley’s only federally funded indigent health care center.

Each day Tonozzi sees approximately 25 patients of all ages, people he describes as the “working poor.”

Many of them work seasonal jobs in the area resorts, a form of short-term employment that rarely offers health insurance. Sixty percent of the patients are Latino. They pay on a sliding scale, depending on how much they can afford. Some Tonozzi sees for free, others manage to scrap together enough to pay the full rate.

Tonozzi, who was raised in Glenwood Springs, played an integral role in the center’s establishment in 1999. Currently, he is one of a staff of 23 at the health center, and, like most of his colleagues, he is bilingual.

In both English and Spanish he talks with the authoritative certitude of a doctor, his face only occasionally and briefly cracking from its stern facade. Underneath the deadpan delivery, however, there is a passionate and unashamed conviction in the morality of his work.

“I come from a socially conscious family,” Tonozzi says. “And when I was awarded the Boettcher scholarship to study medicine at (the University of Colorado), I understood that there were people out there who expected more out of me than just starting a lucrative private practice.”

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Medical benefits

While many of his patients are uninsured workers with a somewhat steady paycheck, Tonozzi also deals with poverty, and all of its related health problems.

He recently treated a case of tuberculosis, a cruelly ironic diagnosis for a town whose hot springs and dry climate once made the town famous for the treatment of the disease. A building down the street from the health center was once a tuberculosis sanitarium.

When the Aspen Valley Hospital’s indigent care clinic in Basalt closes at the start of 2004, the Mountain Family Health Center will be the only place left serving the valley’s medically uninsured. It is already functioning at capacity, and new expansions to the facility can’t begin to match the swell of uninsured patients caused by the skyrocketing cost of health insurance.

Still, with the help of federal funding and the tireless generosity of charities such as the Aspen Valley Medical Foundation and Aspen Valley Community Foundation, it provides the most extensive indigent care on the Western Slope.

Tonozzi believes a strong streak of altruism exists in the medical community. Along with two other doctors, a nurse practitioner and a physician assistant at the health center, Tonozzi relies on the support of a host of doctors across the state.

If an uninsured patient requires referral to a specialist for treatment – for cancer, for example – Tonozzi has to ask specialists to treat the patient for little or no money. The Hippocratic oath, the physician’s pledge to provide care for those in need, still holds sway.

“A lot of begging goes on,” he says. “But I’ve found colleagues want to help as much as they reasonably can. Recently we had a patient who had a life-saving operation to treat a brain tumor. That required a huge staff – surgeons, anesthesiologists, nurses – all working for nearly nothing.”

“Safety net’

Tonozzi’s nurse ducks into the waiting room to call the next patient. She has to shout to be heard. It’s quite a spectacle. With its cacophony of infants’ indecipherable demands, children’s cries for attention and relatives’ anxious chatter in both English and Spanish, the waiting room is probably not unlike what Babel must have looked and sounded like.

Tonozzi takes his first patient into a small examination room filled with a bitter antiseptic smell. Still, Tonozzi’s presence gives the room a reassuring warmth.

The patient’s name is Eva Feldman. She is 87 years old, infirm and in the care of her daughter, who struggles to look after her mother and hold down a job.

Recovering from a dangerous infection in her leg, frighteningly short of breath, Eva inexplicably vomits on herself as Tonozzi examines her. The news is not good. She requires hospitalization. Yet even as she is being wheeled to the hospital, Eva finds the breath to explain why she likes the doctor.

“He’s so good-looking,” she says, managing a smile.

Tonozzi moves quickly to his next patient, a Hispanic child from Basalt suffering from asthma. She’s accompanied by a concerned mother, who clutches a box of asthma medicine tightly in her lap.

The medicine was purchased in Mexico, where prescription drugs are cheaper than in America. In Spanish, Tonozzi reassures both mother and child and prescribes American medication.

He theorizes afterward that the child, who lives in a crowded trailer, may be suffering from mild carbon monoxide poisoning, an under-acknowledged problem Tonozzi believes occurs in trailers with old or faulty heating systems.

Taking a quick break between patients, Tonozzi considers the clinic’s value. He says it’s a service to all sectors of society, rich and poor. Providing primary care to the working poor, he says, takes stress off community hospitals. If he can catch a degenerative disease such as diabetes before it becomes acute, Tonozzi says, he saves local hospitals from tens of thousands of dollars in emergency room care.

“We are the safety net,” he says. “We are here to treat good people who deserve to be healthy.”

By the time Tonozzi finishes his day’s work, the sun has dipped behind the mountains. Soon, Tonozzi will return to his wife, kids and some semblance of health and normality.

Next to the health center, a Catholic church has a statue of an angel on its roof. Draped in ceremonial garb, crowned with a glorious wreath, she proudly holds a torch aloft. Even with her angelic wings, she carries a strong resemblance to the Statue of Liberty.

The statue, looking down upon the Mountain Family Health Center, seems appropriate.