Proposition 23 ignores the professionalism of dialysis centers

El Observador September 28, 2020 By Angel Guerrero

Mr. Guadalupe Ramos has been going three times a week to a dialysis center in Hesperia for three years to receive treatment and assures that they have never had the need for a permanently assigned doctor.

“What I have seen is that the three technicians and the nurses are very professional; they do all the work,” said Mr. Ramos in a telephone conversation.

According to Mr. Ramos’s calculations, he would have attended the dialysis center 468 times over three years without any doctor involved in his dialysis without any problem.

“On average, once a week my nephrologist comes to the center to review the results of my blood tests and give me recommendations or tell me to make changes in the amount of medicine or diet if he considers it necessary,” he said.

“That has been all that has been needed from the doctor since I started dialysis,” he explained. “And I’m doing very well.”

The issue of the doctor’s presence at the dialysis center is important to Mr. Ramos when interviewing him regarding Proposition 23 that will be carried to voters on the ballot in November.

The proposition says that every dialysis center must have a full-time doctor for as long as the center cares for patients. This is between 12 and 14 hours a day.

“I don’t see why,” said Mr. Ramos, “the doctor would dedicate himself to talking with the nurses because he would have nothing to do there.” He said that if the center had a doctor “locked up where they don’t need him,” it would neglect patients who might need him, perhaps even in hospital emergency rooms and clinics. As a patient, Mr. Ramos wanted to talk about Proposition 23 because he explained that he is concerned that if the proposal passes, they could close the dialysis center where they treat him or increase the price of services.

“There are not many doctors available,” he said. If the few that there are in California are monopolized by multiple dialysis centers, “many centers would have to close, because they will not find full-time physicians required by Proposition 23,” he said.

In his opinion, this proposition has an unrealistic vision of a presumed need for staff doctors. “I am very afraid that there will be dialysis centers that close because they cannot find regular doctors, and those that do find doctors will be saturated, because they do the work of those who have to close,” he said.

But Mr. Ramos observed another additional problem, because “if some centers close due to lack of doctors, those that continue to operate will surely charge our patients more, because they will have to draw from us to pay doctors.”

His fear is that in overcrowded and expensive centers, the service may no longer be as professional as it has received these three years.

“For me, who goes to dialysis three times a week, Prop 23 is a dangerous proposition because I need that three dialysis a week to survive; is worrying. I think it was not a well thought out proposition,” commented Mr. Guadalupe Ramos.