Community Profile
Arizona Oasis
Physicians find rewards in working with a close-knit, diverse community while
enjoying outdoor pursuits in a near-perfect climate.
Mountain ranges with peaks soaring to 8,500 feet, historic buildings, golf
courses, world-class birding, hiking, bicycling and an international flavor
characterize Nogales, Arizona, and neighboring communities in Santa Cruz
County, at the southern tip of Arizona.
Physicians are needed in Nogales and Santa Cruz County. Filling the regularly
occurring vacancies is a challenge for
medical directors at the area’s health center and the community hospital. That’s partly because small-town life doesn’t appeal to everyone. And in some cases, while the physician is happy with his
or her choice, other family members can’t find the employment or family activities that metropolitan areas offer.
But doctors who’ve settled in the area find that since they’re 60 miles south of Tucson, Arizona, they can easily drive there—on an interstate that’s never congested—for theater and concerts, shopping and restaurants.
Joel Block, MD, who specializes in family practice at the Mariposa Community
Health Center, describes himself and his family as adventurous and says they’re constantly finding new weekend hiking spots in the mountains that surround
the area. He and his wife moved to Nogales in 1992 from Iowa. “My wife did not like the winters in Iowa,” he explains.
With their two daughters, now ages 14 and 15, they’ve found a great home. Block has always noticed the intriguing mix of cultures
and says he and his wife “were attracted to the international flavor on the border.” Many residents are Hispanic, from areas in Mexico, “but all kinds of people are moving here.”
The opportunity to observe migrating and resident birds drew Carol Hippenmeyer,
MD, emergency room director at Carondelet Holy Cross Hospital.
“I trained at the University of Arizona and Stanford and lived in the Bay Area
for a number of years, and prior to entering medicine, I was a birder,” she explains. “So when I left the Bay Area and decided I wanted to pay off my student loans and
couldn’t do that living in San Francisco, I decided to move back to Tucson.”
She says Tucson was “too big” so she moved to Sonoita, south of Tucson and east of Nogales, “because I was familiar with the area from having been a birder.” (The corridor through north Mexico and southern Arizona is a long-established
migration route and there are many locales from which to watch birds—especially hummingbirds.)
Nogales was part of Mexico until the Gadsden Purchase of 1854. The unusual name
came from the extensive spring-fed groves of native walnut (“nogales” in Spanish) trees growing in the vicinity. The glorious weather in this Sunbelt region is something that just about
everyone appreciates. Although Nogales is within the Sonoran Desert,
it’s not the dry, flat and sandy environment of other deserts. Rather, it’s hilly with plenty of hardy trees and shrubs. At an elevation of 3,865 feet,
the summer heat is generally 10 degrees lower than Phoenix or Las Vegas. Winter
days are mostly sun-filled, although in December and January some morning lows
dip into the teens with average daily highs of 65.
Nogales is a small city, with a population of 21,785. Nearby unincorporated Rio
Rico, with about 16,000 residents, is a few miles north. Santa Cruz County’s population is estimated at 45,245 and includes rural communities such as Tubac, Patagonia, Sonoita and Elgin. Incorporated on July
21, 1893, Nogales is located next to the identically named city of Nogales in
the state of Sonora, Mexico. The area has been known as Ambos Nogales (or both
Nogales) ever since that time and a strong flavor of Latin America spices the
community on the U.S. side.
In Nogales, Arizona, sales tax paid by shoppers from Mexico maintains a healthy
economy for this small city. Nogales, Sonora, Mexico has a population of
approximately 400,000, and many of its residents enter the U.S. legally every
day to work, shop or travel north to Tucson or Phoenix. Alternately, U.S.
residents enjoy heading south for shopping, restaurants, nightclubs and music.
Duty-free shops a half-block north of the border add another shopping dimension
with liquor, cigarettes, perfume and other items.
Because the majority of residents are bilingual, the English-only speaker has no
difficulty anywhere in the community. Hippenmayer says language hasn’t been a barrier in her work. Even though she arrived in June 2007 with some
ability to speak Spanish, she‘s found it could take years to have more confidence. “I think I speak Spanish, and then I hang out with the nurses here and I
understand I really don’t speak Spanish at all,” she laughs. “Every day I learn something new, which is kind of fun.
“The physicians who don’t speak Spanish don’t have any problem because we have translators and the staff. There’s always someone available, trained to translate,” she says.
New facility, great opportunities
Hippenmayer’s employer, the 45-year-old Carondelet Holy Cross Hospital with 25 acute care
beds, located just north of the U.S.-Mexico border, is scheduled to be replaced
in the near future. The new facility will be built on land close to the retail
center of the city, near stores such as Super Wal-Mart and Home Depot and a
nine-screen movie theater. Groundbreaking is anticipated near the end of 2008,
says Richard Polheber, the hospital’s chief executive officer. In the mean time, Carondelet is looking for the right
person to fill its new hospitalist position, adding to the staff of 62 active
and provisional physicians, 19 credentialed allied health professionals, 240
associates/employees, and 40 volunteers. The hospital currently offers a
24-hour emergency room, birthing services, diagnostic imaging services,
laboratory, outpatient surgery and testing, rehabilitation, surgical services
and women’s surgical services.
Dina Sanchez, assistant administrator, says, “We’ve started strong recruitment efforts. We’re finding it’s becoming more of a challenge for our local physicians to get away from their
clinics, to get away from their family life, to treat patients in a hospital.
“We found that we were starting to see a trend of patients being sent to Tucson,
so the management of patients could take place over there. In order to help
with that situation, that’s how the hospitalist situation came about,” Sanchez says.
Next door to the hospital at Carondelet Medical Group are the offices of three
physicians and two family nurse practitioners. Many specialists from Tucson
also visit on a regular schedule. Practice manager Mary Beth Klatt says she has
been working for several months to fill a physician vacancy for a fourth
physician.
With three locations, Mariposa Community Health Center is the largest primary
health care provider on the Arizona/Mexico border. The staff includes 13
physicians and three nurse practitioners. Eladio Pereira, MD, medical director at Nogales’ Mariposa Community Health Center, says he has a vacancy at least once every year. The health center operates from
two large side-by-side buildings in Nogales on Mariposa Road and opened a
clinic in Rio Rico in September 2006, while the Patagonia Family Health Center,
operated by the Mariposa Center, has been aiding residents of the rural east
county area for many years.
Physician specialties include family practice, internal medicine, pediatrics and
obstetrics/gynecology. A behavioral health specialist supports and assists the
physicians. There is an affiliated dental program with three dentists. An
award-winning health promotion component titled Platicamos Salud uses lay
health workers who visit residents in their homes and teach about nutrition and
healthy activities.
Another Nogales provider is Pima Heart, which has one full-time internal
medicine physician, a part-time cardiologist, and a nurse practitioner. Based
in Tucson, it was founded in 1981 and has seven satellite locations, including
Nogales.
