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Rural Medicine Carves Out A Foothold In East San Diego County


There are plenty of primary care doctors, specialists, and hospitals in the City of San Diego, but in some of rural parts of the county, access to care can be tough.

— There are plenty of primary care doctors, specialists and hospitals in the City of San Diego, but in some rural parts of the county access to care can be tough. In the East County town of Campo, there's only one health care provider.

The Mountain Empire Family Clinic is about an hour drive east of San Diego. It's right next to an open field, just off a winding two-lane highway in Campo. Clinic director Heidi Lafaver offers a tour inside a converted double-wide trailer.

"Back here we have four exam rooms, we also have a medicine dispensary, that we use over here, for medications," says Lafaver. "We have our provider room. This is our lab. We do all in-house labs and send them out to Quest, and then our trauma room, which has all of our crash cart. If we have procedures and things like that we take them in there"

The trauma room is where patients can get sutures, stitches, and even broken arms set. Anything more serious requires a call to 911 for an ambulance or a helicopter. The closest hospital is in La Mesa, which is nearly 50 miles away.

"And if I recall last time we talked, you'd been having some problems with your neck….Yeah, really bad headaches, too..." says Dr. Daniel Zanotti, the clinic's lone physician.

When Dr. Zanotti got out of medical school he could have worked in an urban practice, but he wanted something different.

"For me, I feel like I'm doing good work out here, I feel like I am helping a lot of people, and to me, that's what I wanted to do," says Zanotti.

Zanotti says he probably sees more dirt bike injuries and horse bites than city doctors do.

"But in the grand scheme of things, we're still seeing a lot of the same types of problems, which is, you know, chronic heart and lung disease. And, you know, that's a problem everywhere," he says.

The non-profit Mountain Health & Community Services operates this clinic and four others in San Diego County.

Dr. Rafael Rosado is Mountain Health's chief medical officer. He says patients in Campo are among the poorest in the county. About one in four residents are unemployed; most are uninsured or on Medi-Cal.

"We have people who don't have a lot of access to care. So by the time they do get to us, they have multiple medical problems that require specialized care. So getting specialized care is the most difficult part," says Rosado.

But even getting basics like food can be tough. It takes 45 minutes to drive to the closest grocery store.

Judith Shaplin is Mountain Health's executive director. She says the health of local residents goes beyond primary care. Shaplin says that's why her agency operates a community center in Campo with a senior nutrition program. They serve about 15,000 meals a year. They also offer a delivery program for home-bound seniors.

"If a senior, or any member of the community says where can I get food, I need to get my batteries changed for my smoke detector, or I just need access to traveling to the hairdresser or the bank or something, how can we connect those dots? Transportation is our number one problem," says Shaplin.

Shaplin wants to improve access to care by building a much bigger clinic. The two-story medical center would have the area's first pharmacy and dental services. It would have extended hours for primary care. The center is projected to cost $6 million dollars. More than half of that money would come from grants.

Shaplin says if fund raising goes well, it could be built next year. It would be the largest clinic in 950 square miles.

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