MLKCH's Medical Chief of Staff Dr. Edward Zaragoza talks about why radiology is so important for South LA patients, the pros and cons of high demand, and how our doctors are "lighting a candle" of hope.
One of the many reasons MLKCH has developed a national reputation (and awards) for excellence is because we offer care on par with that found in more affluent areas. Key to that success are strategic partnerships with larger health systems, including and especially UCLA. Part of the original coalition of organizations that helped to bring the “new” MLK Community Hospital to life in 2015, UCLA currently provides 24/7 radiology services to our South LA patients. At the head of this effort – and in the dual role of MLKCH’s Chief of Medical Staff – is Dr. Edward Zaragoza.
Zaragoza is the Vice Chair of Radiology Information Technology at UCLA Health and a chief proponent and architect of providing our South LA patients with the same high level of care as what is delivered on the West Side.
“Our (MLKCH) readers are among the best anywhere,” he says proudly. “They’re extremely well published, they’re very dedicated to the service they provide patients. If you live in the richest home in Brentwood or Holmby Hills – the radiologist who reads your scans is the same radiologist who is interpreting the brain studies for MLK Community Hospital.
We talked with Dr. Z about the challenges MLKCH physicians face, the care they bring and his hopes for the future of high-quality care in our community.
What is radiology?
Radiologists are specialists who allow that emergency doctor and hospitalist to look inside the patient literally and to diagnose problems that can’t be see with the naked eye. Through the use of advanced imaging radiology is able to make accurate and reproducible diagnoses of multiple entities from appendicitis to pulmonary emboli, to various abscesses, sometimes we’ll find infection in the kidneys, pneumonias, stroke, and in the not too distant future we’ll be using our scanners to diagnose problems in the coronary arteries.
MLK Community Healthcare patients are very needy in terms of the imaging. Most patients who come here don’t have primary care doctors. Medically they’re black boxes. They come in and there’s no existing chart to look at. There’s no place to go and see what happened to this patient in the past.
When that happens the ED physicians really have no choice but to look inside the patient using CT and MRI and ultrasound to perform anatomic diagnosis to try and discover what surgeries were performed and what are the acute problems coming out today. So imaging is used very extensively at MLK and UCLA is proud to provide 24/7 support to our patients at MLK.
MLK Community hospital has been dealing with extraordinarily high volume lately. Is there any bright side to this demand?
I think the fact that people come to MLK Community Healthcare is a resounding endorsement of the care we’re providing to our population.
We are incredibly successful. We have an emergency department that was designed to accommodate about 125 visits a day. Our current ED volumes can go over 300 visits a day and sometimes get up to 400 visits a day. That’s about four times what it was designed to accommodate.
A lot of those patients get admitted so our inpatient services are fantastically busy. People aren’t admitted for trivial cause. Our population is very needy.
In prior iterations of the hospital the care was not always deemed to be at a level of excellence. I think we have really overcome that reputation and people who come to MLKCH know that they will be well taken care of and that their providers will do the best that is possible with the available resources.
So I have deep respect for our providers because day in and day out they are providing standard of care or better to make sure our patients are well taken care of.
Providers struggle with the need our patients have and the inadequate resources our state and nation provide to meet this need. Your thoughts?
People who depend on Medicare and Medi-Cal, on government-sponsored healthcare funding, can be very challenged, particularly when trying to receive follow up care after discharge from the hospital.
We are serving an underserved population and we do so through funding that doesn’t begin to meet the incredible demand that we have.
It's a balancing act. A long time ago I used to be really in love with Cirque du Soleil. I got to meet a guy named Andrii Bondarenko who was a superstar performer in the world of Cirque du Soleil. He was a hand balancer. He’d come out on stage and put his hands down on the ground and effortlessly raise his feet into the air in a perfect handstand and do tricks shifting from hand to hand and twisting into weird shapes all the while balancing on one hand.
This is not unlike what our providers do on a daily basis. The balancing act of medicine is to use precious resources mindfully. To make sure we have enough to take care of all of our patients.
Everyone has been back-bending and balancing the practice to ensure the best outcomes for our patients.
What is your vision for the future for our physicians and medical practice?
We want to provide not just inpatient services but also outpatient services. So that patients who are recovering from surgeries, patients who may need elective outpatient medical care and workup, will have a place to go, to be served and taken care of. And so hopefully, we can start to get ahead of some of these advanced presentations we see in the ED.
The huge volume we’re seeing has shown us that we need more hospital resources as well. The challenge and the vision is to grow the practice to give South LA the true scope of services it needs.
What are you proud of from your work at MLKCH?
I feel especially blessed because I not only get to interpret studies for MLKCH patients but it was my pleasure and my team’s effort to design informatics architecture that allows MLK patients to have their studies interpreted 24/7.
During the day we are on site at MLK. At the end of the day care transfers to a teleradiology paradigm. So during 24/7 the brain MRIs and CTs that are performed for MLKCH patients they are interpreted by our neuro-radiology team at UCLA.
I don’t like to be overly self-congratulatory but I know that our readers are among the best anywhere. They’re extremely well published, they’re very dedicated to the service they provide patients, and if you live in the richest home in Brentwood or Holmby Hills – the radiologist who reads your scans is the same radiologist who is interpreting the brain studies for MLK Community Hospital.
I think we’ve done our best to extend the umbrella of academic medicine far beyond the campus and the west side of LA and bring that excellence of care to the community at MLKCH.
Any last words about our MLKCH physicians?
When you look at these life stories and the challenges that face our patients, it can be literally heart-breaking. It’s one thing to be in the dark and curse about it, it’s another thing to light a candle and grow light. And I think that’s what our providers do. We don’t have enough for everybody today but we’ve illuminated the space, we’ve shown the world what the need is, and gradually we grow what we’re doing, we care for each patient one at a time and we do the best we can given our resources.
When you look at the work that people are doing and the challenge of the work that’s being done, you can’t stop but help say wow, what an incredible group of people and kudos to all of us for making it happen.