Dr. Del Morris can see the stress on the faces of the newer patients at the Stanislaus County health clinics.
Some have lost their homes. Others are worried they may never work again. In addition, most all of these new patients are sick.
They are just average working people who lost their jobs, says Morris, the medical director of the Stanislaus County Health Services Agency clinics. They dont apply to the program because they want a health screening. They come to see me because they have a medical problem.
Morris, 62, who started working in the county health clinics in 1999, has seen better times for the county health system. When the county opened the Paradise Medical Office in west Modesto in 2002 and moved the McHenry Medical Office into larger quarters, it was a source of pride for this doctor dedicated to public health.
The countys six primary care clinics in Modesto, Ceres, Turlock and Hughson have long served everyone from the working poor to the homeless of Stanislaus County. Today, the clinics also are a fallback option for middle-class people who lost health insurance in the recession and can no longer afford to see their doctors.
Morris treated a truck driver who was laid off in 2009. For four months, the trucker had been uninsured and not taken medicine for diabetes and high blood pressure and he came to countys Paradise Medical Office for prescriptions.
If he had not resumed treatment, his primary illness could have resulted in a condition called diabetic ketoacidosis, which often requires hospitalization, or it could have made his body more susceptible to infections.
The risks of high blood pressure are premature heart disease and stroke.
Morris believes a lot of victims of the recession are going without care for hypertension, which often does not produce symptoms.
If you cant take medication and you dont feel sick, sometimes that lulls you into thinking you dont have to, he said.
The poor economy also has forced people into stressful or unhealthy living arrangements, such as when members of multiple families share a home.
One patient with a chronic lung condition smelled of smoke when she walked into the examination room, even though she had quit cigarettes, Morris said.
She told the doctor she was now sharing a room with a niece who smokes, causing the patients lung disease to worsen.
The Health Services Agency has tried to accommodate patients despite health service cuts and limitations on clinic space and staffing.
Morris noted that an important tool is a wound clinic, where diabetic patients can have foot ulcers treated. Since 2009, the state Medi-Cal system has not paid for diabetic patients to see podiatrists.
Physician recruitment is another challenge for the Health Services Agency.
The county has openings for two primary care physicians and two pediatricians, but has to compete with groups such as Kaiser Permanente, where the annual pay for doctors is at least $25,000 higher.
Although the county health system has seen better times, Morris said, he focuses on helping patients instead of getting upset.
I dont go home and kick the dog, he said.
Bee staff writer Ken Carlson can be reached at 578-2321.
Capital Public Radio will discuss The Bees series on Insight, its interview program, Wednesday from 10 to 11 a.m. Listen at KUOP 91.3 FM or www.capradio.org/news/insight.