For veterans in the San Joaquin Valley, a new kind of clinic

Photo: Keturah Stickann/Flickr



In the waiting room of the new Department of Veterans Affairs (VA) health clinic in Modesto, behind shiny glass doors, a few people sit in new comfortable chairs in a quiet room diffused with light. The peaceful and spacious waiting room is a new experience for VA patients, as is the state of the art facility built to serve the many veterans who live in the San Joaquin Valley.

Before the new health center opened in February, veterans who needed medical assistance had to visit a cramped office, squeezed onto the third and fourth floors of an old building that shared its space with other medical offices.

Equilla Carazo, 59, remembers that it was difficult for veterans in wheelchairs to access the old location. “At eight in the morning, everyone would be backed up five or six feet, trying to get inside for their appointments,” she said. If patients weren’t satisfied with the services offered in Modesto, they had to drive to larger medical centers in Livermore or Palo Alto.

But thanks to money allocated by the federal Department of Veterans Affairs budget to improve health clinic infrastructure nationwide, veterans in Modesto and surrounding communities now have a brand new, stand-alone health center, with twice the square feet of the old location.

It serves around 120 patients a day, and boasts expanded medical and mental health facilities, a new physical and occupational therapy room, X-ray services and a laboratory. There are seven physicians, and David Keller, the clinic’s Nurse Manager, has plans to hire two more. The staff includes pharmacists, so veterans can avoid an extra trip to their local pharmacy – an important service for wheelchair-bound patients or amputees who may have difficulty getting around.

Veterans in the area have noticed a difference. Carazo, who works at the Modesto Veterans readjustment counseling center (a separate facility from the health center) thinks the new facility is a huge improvement. Besides the extra space, there are more staff employees, and everything seems to happen more efficiently.

Carazo’s cancer is in remission, but she still checks in with her physician regularly. “I was excited when I could get in touch with my oncologist by email, and she would email me right back,” Carazo said.

Basil Amesquita, 64, is also a fan of the new facility. “It’s a beautiful new clinic, and it’s located in centralized area, for veterans from all parts of the Central Valley,” he said. Amesquita served in the Vietnam war and is the commander of the nonprofit Veterans of Foreign Wars chapter in Modesto. “Although we still have to go to Livermore and Palo Alto for more of the complex medical procedures, it’s a good thing,” he said.

One of the new center’s biggest improvements is the expanded use of technology. Several conference rooms are equipped with a Telehealth system, which means large screens are set up where patients can see and interact with physicians at other VA clinics. In one room, veterans can take a yoga class taught by an instructor at the clinic in Livermore. Patients have the option of setting up one-on-one consultations with specialists at the VA clinic in Palo Alto, rather than having to drive there. Staff meetings can now include personnel at clinics hundreds of miles away.

These new services come at a time when veterans in the Central Valley face a lot of challenges, especially in light of the recent economic downturn. Keller, the Nurse Manager, said he had recently noticed an increase in the number of homeless vets, as well as the number of patients suffering from the mental and emotional toll of war. “The PTSD (Post Traumatic Stress Disorder) population seems to be growing, especially in our younger vets,” Keller said.

This trend isn’t relegated to the Central Valley. The Department of Veteran’s Affairs recently reported that 30 percent of its patients who served in Iraq and Afghanistan have been diagnosed with PTSD. One way the Modesto clinic is handling this issue is by offering more individual therapy and group therapy options. “The groups seem to really, really help,” Keller said.

The clinic is also offering group nutrition classes to address other disturbing health trends, such as obesity, hypertension and growing numbers of patients with diabetes. “I wish more people would attend these classes, and learn about portion control, exercise, and cutting back on salt intake,” said Keller. Another technique they are using to address this issue is the Home Telehealth system, which requires patients at home to input data into a machine about their blood pressure, blood sugar, cholesterol, and other vital statistics. A staff member at the clinic reads the information, analyzes it, and calls patients to follow up on the results.

Sometimes patients see their high numbers and don’t want to report them, said Mia Alcala-Van Houten, the Telehealth coordinator. But the reporting process is positive in that it forces patients to think about their choices and see the results of those choices. “One goal is to keep them out of the clinics, to help them control their diseases better,” she said. “Just the reporting process seems to make a big difference.”

For veterans in the Central Valley, other challenges remain. One thing the new clinic is lacking is a women’s health section; as of now, Carazo said, she still has to drive to the VA clinic in Palo Alto to access those types of services. But one of her goals is to make more female veterans aware of what health services are close by and available to them, including the various classes at the new center.

For Amesquita, the convenience of the new center is a big boon, but he is disappointed with the Department of Veterans Affairs for other reasons. “We have a hard time getting claims processed,” he said. He’s not alone; according to the Center for Investigative Reporting, the current average wait time for getting a medical claim processed at the VA is almost a year. Amesquita knows about the health problems veterans face first hand, as over the years he has met and worked with many veterans who are still suffering from the emotional consequences of conflict.

He believes strongly in the theory of veterans helping veterans, and in keeping with this concept, Amesquita’s nonprofit chapter organizes social events so that veterans can provide support for each other. “Sometimes a fellow veteran can say, I feel the same way you feel, or I’ve felt the same way. There’s help,” Amesquita said.

He has friends among the staff members at the new clinic, and speaks approvingly of their work. “They understand how a veteran thinks. There are things you don’t open up about, you don’t talk about with someone, even a family doctor, who isn’t affiliated with the military,” he said. “Everybody wants to be back to normal, everyone wants to be happy. They’ve just got to find a way to get back on the right track.”

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