Powerful Primary Care

Posted: Wednesday, October 15, 2008 by MSIDE Magazine

At age 10, Dr. Manuel Quinones and his family were driving home in pouring rain from an outing at his uncle’s ranch when a driver traveling in the opposite direction lost control of his car and slammed into their vehicle head-on.

Quinones suffered a broken arm and third degree burns on his left leg, which resulted in a month-long stay at Santa Rosa Children’s Hospital. The loving care and attention he received from doctors and nurses left a lasting impression on the young boy.

“I always wanted to be a doctor since I was a kid, and that experience of being in the hospital solidified my decision to be a doctor,” says the 52-year-old San Antonio native.

Quinones, a family practice physician at the HealthTexas Medical Group of San Antonio, is also president of the Bexar County Medical Society, which represents some 4,200 physicians in Bexar and surrounding counties.

“As president, you become the voice and image of physicians in Bexar County,” he says. “It’s an awesome responsibility. It takes a considerable amount of time, but it’s something I’ve always wanted to do.”

In this role, Quinones acts as community ambassador of the society. He also serves one year as president-elect and one year as immediate past president. “He is the representative of organized medicine and is the proponent for medicine and for patients in the community,” says Stephen Fitzer,  BCMS CEO and executive director.

“Dr. Quinones is a passionate physician who advocates for patient care,” Fitzer says. “He is a generous and compassionate man who has given much back to the community of San Antonio and Bexar County, both personally and professionally.”

After 23 years of practicing medicine, Quinones has listened to patients’ concerns over the desire for quality healthcare, he has come to know the difficulties of the uninsured, and he is well aware of the liability issues that many physicians face. Today, he advocates for a change in medicine in which, he says, the patient’s best interests must come first.

He believes that over the next four to six years those in the medical field must accept the fact that medicine must go through what he calls a “painful and drastic metamorphosis.”

“Similar to what we had 25 years ago, we must re-orient ourselves to begin to think in terms of primary care as the hub of care,” Quinones says. “We must begin to demand that doctors think in terms of creating a ‘medical home’ for patients – a source of information, entry level care, management of chronic disease states, enhanced and easy access, and the capacity to be referred when appropriate for specialty care to specialists, who share in the excitement of providing the best care in a most efficient and effective environment.”

He says his conceptual ‘medical home’ should be a source of quality care overseen by a well-trained primary care provider, such as a doctor, advanced nurse practitioner or physician’s assistant with best practice goals and guidelines, measurable high-quality outcomes that meet or exceed current practice standards rewarded with autonomy, fair reimbursement and continued protection from unrealistic liability issues.

Quinones would like to see the medical profession train and produce more primary care doctors, although he knows that in doing so, there are issues that would have to be resolved.

“We can’t attract them into our specialty when (a physician’s) income in a specialty field is two to three times what most primary care doctors earn,” he says. “Do we pay primary care doctors more fairly, or do we cut reimbursement to specialists to be more in line with primary care reimbursement? Probably a hybrid of these two.”

As for Quinones, it was during medical school at Baylor College of Medicine, from which he graduated in 1982, that he chose to be a family practice physician because of the mentorship of the former assistant dean, Dr. Major Bradshaw.

“Aside from my parents, I learned more from Major about being a caring doctor and a great person than from any other human being,” the 1973 Holy Cross graduate says. “He taught me that if you take care of your patients like they are your family, you will never make a bad decision; and they will always take care of you.”

Family practice, he says, allows him to assist with surgeries, admit patients to the hospital and take care of a wide spectrum of patients in the office – “everyone from newborns to my 104-year-old patient.”

Yolanda Acosta and her family have been patients of Quinones for 20 years.  She remembers that the first time she made an appointment with him she was surprised that he came out to the waiting room to sit down and have a chat with her before leading her back to one of the examination rooms.

“He is not only a doctor, but he heals people,” the 60-year-old retired hairdresser says. “He is very perceptive and he listens to what you have to say. If there’s a physician who cares, it’s him. Medicine is not his profession. It’s his calling.”

His skills in family practice have earned him quite a few impressive honors, as well. He was named a Texas Monthly Super Doc for 2008-2009 and has been listed in Best Doctors of America from 2005 to 2008.

Quinones, incidentally, has definitely paid his dues on the road to earning his medical degree. While at St. Mary’s University, where he earned a bachelor’s degree in biology in 1977, he was a substitute teacher with the Edgewood School District, sold insurance for Banker’s Life and Casualty, worked retail at Todd’s in North Star Mall, drew blood from patients at the VA Hospital and was an electrician’s helper for a local electrical company. He also was a library assistant at Baylor College of Medicine.

In an ironic twist of fate, Quinones once had the pleasure of encountering the surgeon who tended to his burned leg more than 40 years ago. His name is Dr. Leroy Bates Jr.

“When I applied for staff privileges at Methodist Hospital, Dr. Bates was on staff,” he says. “I showed him my leg, and he was proud of his work. His father had been our Family Physician for many years.”

Quinones and his wife, Gloria, of 31 years have two children, Amy, 25, a clinical psychology therapist; and Manny, 23, a recent Texas A&M – Kingsville graduate  with a bachelor’s degree in criminology. In his spare time, the physician enjoys hunting, fishing  and watching the sun go down at his 150-acre ranch called ‘The Flying Pig Ranch.’

“It’s a tribute to by best friend since childhood, Robert Lopez who died way too young of leukemia,” he says. “I once told him that some day we would have a ranch together. He said, ‘Manuel, we’ll have our own ranch when pigs grow wings.’”