Dr. Silvia Diego became a doctor with a mission of providing health care to the poor and uninsured.
Most people know Diego for her 18 years with Golden Valley Health Centers, half of them as chief medical officer for the nonprofit clinics in Stanislaus and Merced counties.
When she parted ways with Golden Valley, over a clash with new management in 2014, Diego launched a private practice called Family First Medical Care, at 1317 Oakdale Road in Modesto.
In keeping with her mission, Family First has an even mix of insured patients and people enrolled in government health programs. It might not be the best for business, but about 50 percent of the patients have Medi-Cal and Medicare coverage, Diego said.
They are treated like family and offered an array of services including general medicine, prenatal care, women's health, mental health and support groups.
"We were happy to find we could go into private practice and still see the population that you want," Diego said. "The patients we have is exactly what is out there in the community."
Diego has come back into the spotlight as the first female physician bestowed with the honor of Physician of the Year by the Stanislaus Medical Society. The annual John Darroch memorial award, starting in 1998, goes to a physician who exemplifies a high level of professionalism, dedication to patient care, collegial support and community involvement.
A surgeon who nominated her for the award called Diego a delegate and activist to protect health care access and quality, especially for the neediest patients.
Diego grew up where few medical careers begin — in the small town of San Joaquin in western Fresno County. The daughter of farm worker parents, she excelled in science and math at Tranquility High School and attended Fresno State University.
"I have an older sister who believed in me and encouraged me," said Diego, who married as a young adult and also drew support from her husband, Luis. "I was the first out of my family to graduate from college."
After Fresno State, Diego studied at Stanford University School of Medicine, one of the top medical schools in the nation, earning her medical degree in 1994.
Diego returned to the Valley to start a career in indigent health care at the family medicine residency in Modesto. She trained at the county-owned Stanislaus Medical Center before it closed in 1997; there she discovered a love for delivering babies.
As a doctor for Golden Valley, Diego became well acquainted with the health care needs of people who work the fields of the San Joaquin Valley and the urban poor in cities like Modesto and Merced. As the chief medical officer for the clinics, she oversaw care at more than 20 primary care clinics that serve more than 100,000 patients.
Diego dealt with challenges of referring out uninsured patients who needed surgery or specialty care. The clinics were also on the front line of managing patients stricken by the diabetes epidemic.
"There's an ongoing problem with diabetes in the Central Valley," Diego said. "We are getting smarter at diagnosing it better and getting them on medicine when they are pre-diabetic and making them aware of where the disease can take them if they don't take care of themselves."
Diego earned numerous awards and became noticed in political circles. She was appointed by then-Gov. Arnold Schwarzenegger to the Medical Board of California in 2010 and was reappointed by Gov. Jerry Brown.
A hitch in her career came after Golden Valley's longtime chief executive officer, Michael Sullivan, retired in 2012. Diego says the new administration pushed the staff to see many more patients. Diego made a stand, saying that patient care would suffer, and she was fired.
As reported in The Modesto Bee, the personnel action triggered an exodus of Golden Valley staff members. At the time, Golden Valley said the patient visit goals were reasonable and would not affect the quality of care.
In nominating Diego for the John Darroch award, Dr. Kathleen Eve of Modesto said she respected Diego for her courage. "This impressed me as too many times we are pushed to make medicine a successful business," Eve said. "Her heart is with the indigent, and she continues that with her private practice."
Dr. Lisa Gil and some other colleagues from Golden Valley joined Diego at Family First Medical Care to practice medicine without the bureaucracy of a large organization.
"It has allowed me to be in closer contact with patients," Diego said. "We make the decisions on how we provide care."
The Modesto practice has an emphasis on care for the entire family. Most patients are women and children, though some of the dads come in as well, Diego said. "We see many patients needing prenatal care and we deliver babies."
Family First has to follow the policies of large insurance companies and public health programs, but she and her partner have figured out the business side of the practice, she said.
One of the biggest challenges facing the Central Valley is a shortage of physicians, which becomes more acute when retiring doctors are not replaced.
Diego is a member of Latino Physicians of California whose goal is to develop more physicians from that ethnic community. It is working with Kaiser Permanente on a pilot program to help Latino college students with applications to medical schools.
Diego’s family will make an addition to the next generation of physicians. Her oldest son, Jose, is a second-year surgery resident at a program in Bakersfield. Her daughter, Stephanie, is a dental student at UCLA.
Diego chose to practice in the Valley partly to satisfy the terms of forgivable loans for new physicians who work in underserved areas. But she could have left for greener pastures after satisfying the commitment.
"If I had left, I would have gone to a community like this,” Diego said. “I was not seeking the big city.”