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December 9, 2020

On the waterfront

THE FIRST ORDINANCE CORPUS CHRISTI founders passed after adopting the city’s charter in 1876 was to make it against the law to let hogs and goats run loose. From the beginning, Corpus Christi residents knew their slice of South Texas’ gulf deserved the best.

Today, the US Census Bureau figures alone illustrate a city with high standards. The Nueces County population stands at approximately 317,000, with almost 90 percent of residents living within Corpus Christi’s official boundaries - an urban atmosphere, but not a sprawling metropolitan area. Yet the area is growing. Between 1990 and 1996, Corpus Christi’s population grew by 9.8 percent compared with Texas’ overall growth rate of 8.2 percent.

The city’s median age is a young 31.1, with 52 percent of the city from Hispanic heritage and 43 percent Anglo according to Buying Power’s Sales and Marketing Management Survey. An impressive 68.9 percent of persons over 25 hold a high school diploma and 17 percent graduated from college. The largest city on the Texas Coast and the sixth largest port in the nation, picture Corpus Christi as
a regional hub for marketing, processing, packaging, and distributing agricultural commodities for a 12-county trade area.

Of course, this hard data reflects year-round residents only. Thanks to Corpus Christi’s mild weather and flat coastal terrain, hospital spokespeople say the ranks swell by as many as20,000 baby boomers and older retirees seeking warmth from fall to spring. The snowbirds find the area easy to reach, as I-37 originates in downtown Corpus Christi and links to I-35 and I-10 in San Antonio. State
highways (which in Texas are mandated as divided four-lane roads maintained at interstate quality) provide direct routes to the Rio Grande Valley and Houston. Thanks to low-cost carriers such as Southwest Airlines, who service the Corpus Christi International Airport, inter-state air travel can be as low as $29 one way.

Yet such statistics merely provide the warm-up for Patricia Rojas, the economic development director of the Greater Corpus Christi Business Alliance. She takes great pride in her city’s cost-of-living ratings. It earned a 93.6 percent composite score from the American Chamber of Commerce
Research Association in its latest data. The grocery composite was an enviable 84 percent, housing 90.8 percent, transportation 91.1 percent, and health care 95.5 percent. The only outlier is utilities. Its higher 107.1 percent rating reflects several factors: warm weather means air-conditioners
run nearly year-round and the nine telephone communication networks reaching the area offer a
state-of-the-art, digitally-switched fiber optics infrastructure.

Physicians moving to Corpus Christi will find their salaries take them further here than in many  markets. According to Homefair.com’s salary calculator, a $150,000 annual salary here equals $447,676 in Manhattan, $197,773 in Denver, and $160,645 in St. Petersburg’s similar Gulf Coast location. And Corpus Christi crime levels are relatively low. According to data the Federal Bureau of Investigation supplied to the National Archive of Criminal Justice at the University of Michigan,
police reported fewer than 5,000 incidents of burglary in 1997, and fewer than 2,000 motor vehicle thefts. Murder ranks an astonishingly low 19 cases. Homefair.com breaks that down to 150 robberies and 573 motor vehicle thefts per 100,000 people, and assigns Corpus Christi a crime lab index of 124, compared to New York’s 797, Denver’s 127 and St. Petersburg’s 239.

Businesses take full advantage of the fact that the city’s construction costs are among the lowest in North America. Labor costs overall are low, the chamber touts, thanks to extremely low unionization rates of 8 percent in Corpus Christi vs. 11 percent across the Lone Star State. And Texas’ lack of state income tax and corporate taxes plays a huge role in attracting growth. It also means the .33 per $100 valuation property taxes collected in Nueces County fund the hospitals, Port of Corpus Christi, and farm-to-market needs.

Radiologist Harvey Greenberg, MD, a bachelor who moved here from Los Angeles five years ago, knew none of this when he opened a radiology journal to an ad inviting job seekers to visit the Texas Riviera. "The practice opportunity here can’t be duplicated. This is the best job in the world," he
says of Radiology Associates, where he practices with 19 partners. The sheer number of physicians means he enjoys close to 13 weeks of vacation a year to balance his life with hobbies and city-council responsibilities.

Even those perks wouldn’t cut it in another atmosphere, however. "The large groups I worked with in
California sported so many egos. Here, everyone gets along great," he says. Greenberg has capitalized on the opportunity to specialize in his first love, magnetic resonance imaging, almost
exclusively within the group. When he marries next summer, his wife will move half-way across the
country to join him in Corpus Christi.

The teamwork approach, doctors say, extends beyond the cooperation among hospitals and  physician groups. Patients esteem the profession but expect to be an equal partner in their health care. "The camaraderie is excellent," according to Greenberg. "Patients at the breast imaging clinic where I worked in Beverly Hills were demanding and high-handed. Corpus Christi residents
are friendly and want to cooperate. The more you respect doctors, the better the relationship."

Ob/gyn and family practitioner Fernando Carreno, who grew up in Corpus Christi watching his father
practice ob/gyn, knows the importance of this give-and-take attitude. "I had an elderly patient the other day who came in because her previous doctor was the old school: ’I’m the doctor, you’re the patient, here’s the medicine. Be quiet and I’ll take care of you’," he explains. "I practice medicine
as a partnership - I want my patients to help me help them."

"Corpus Christi is small enough that if you want to become involved in the community affairs you can
make a difference," says Gary Bobele, MD, a pediatric neurologist and Texas native who moved here in 1994. "You don’t have to know somebody who knows somebody who knows somebody to run for public office. On the other hand, it’s large enough you aren’t required to do that because you’re the most educated person in the community." Bobele keeps up an active membership in the Optimist Club, participates in the Young Marines (a division of the Marine Corps League) with his daughter, and teaches chess in local schools as a drug prevention activity.

Health-Care Economy

Oil pumps this economy, and the Corpus Christi Army Depot is the largest industrial employer in South Texas. Yet Christus Spohn Health ranks second in the number of employees in the community
(4,500), Columbia Healthcare ranks sixth (2,800), and Driscoll Children’s Hospital 13th (1,100). In plain English, these numbers total more than any other industry category. Linda Gill at the Corpus Christi-Nueces County Public Health Districts describes the impact of health care this way: The area
offers a direct care physician for every 552 residents, one family practice doctor for every 3,247 residents, and one registered nurse for every 178 residents. Every local category is lower than the
statewide ratios. The annual economic impact of health care amounts to more than $898 million.

Three players dominate the healthcare scene: the Christus Spohn network of three hospitals, the six-member Columbia hospital family, and Driscoll Children’s Hospital, the darling of the medical community, which specializes in state-of-the-art miracles for youth.

Driscoll owes its existence to Clara Driscoll, (otherwise known for saving the Alamo from demolition by paying off its mortgage) who willed her estate toward a hospital dedicated solely to ill children. The hospital’s logo reflects the Driscoll family’s cattle brand. Today, thanks to the 33-county region
it reaches - that’s roughly the size of South Carolina - 6,000 children are admitted to the hospital annually, more than 50,000 receive outpatient care, and 40,000 receive emergency care.

"If the children of South Texas need expert medical care, we’ll find the funds to provide it," says Kathryn Hayes, the director of development for Driscoll, of the board’s philosophy toward this private, not-for-profit, tertiary care facility.

Spohn’s hospitals have played a part in the community for the past 95 years, with this Catholic Incarnate Word Health System operating not only the three hospitals in Corpus Christi proper, but an additional three in nearby Kingsville, Beeville, and Alice. In early 1999, Incarnate Word merged with Sisters of Charity Health System of Houston to create the Christus Health umbrella.

"I don’t think you’ll feel a real difference in the local institutions in particular because we’re not in overlapping markets," Linda McClung, Christus Health’s senior vice president of communications told the Corpus Christi newspaper when the merger was announced.

Competition with relative upstart Columbia’s seven area hospitals keeps the heat on, however, for managed care contracts, marketing niches, and physician loyalty. (Most physicians, do hold privileges at both hospital systems to serve patients whose insurance plans cover one over the other.)

Columbia waltzed into town in 1990 on a purchasing spree, but the oldest facility it snapped up was Doctor’s Hospital, built in 1962. Those inexpensive building costs kicked in and Columbia chose this city in which to build its first new hospital in the nation, Bay Area. It followed up with the brand-new Heart Hospital of South Texas in 1998.

"Competition has been healthy," says Mary Jo Curry, the marketing director for Columbia’s Corpus Christi Medical Center, who naturally believes her organization runs ahead of the pack. "Because Columbia was developed in an era of changing medicine, we’re better positioned to read the writing
on the wall earlier, then adapt quicker and more easily than an older hospital. We’ve always operated as a lean machine," she says.

Anything You Can Do…

Currently, Christus Spohn Memorial Hospital runs the only trauma center in the area - a fact  Columbia hasn’t let slip by. "It might be more geographically sensible for ambulance services if this town offered a trauma unit on each side of town instead of only one location, but right now we haven’t really gone there," Curry says.

Although Driscoll’s single-minded focus means there is little competition in pediatrics wards from the other two systems, a majority of women have their babies at one of the city’s downtown hospitals, which compete hotly for ob/gyns and for patients by dangling neonatal facilities and attractive labor and delivery rooms.

In fact, this traffic prompted a unique arrangement at Christus Spohn South, where the sheer number of deliveries meant that hospital needed to address neonatal emergencies. Rather than watch their colleagues incur the expense to build and staff a competing unit, officials at Driscoll stepped to the
plate with a visionary partnership arrangement: Today in the 20-bed unit known as Driscoll Children’s Hospital at Spohn South, Driscoll’s neonatologists and neonatal nurses care for special-needs infants within Spohn’s building, combining what each separately does so well. "Instead
of fighting, let’s find a way to win that’s beneficial to all of us," Hayes says of the partnership. "Together, we’re offering patients the best kind of medicine possible in Corpus Christi."

And this center-weighted gravity means some hospitals in outlying communities, like North Bay Area Hospital in the next county, have closed their maternity wards and dismissed their obstetrics
staff. Of the 540 births in its area in 1998, Corpus Christi’s Caller-Times newspaper reported last spring, 182 were at North Bay - the rest in Corpus Christi at the likes of Christus Spohn Hospital
South and Columbia Bay Area Medical Center’s modern maternity wards. It’s a situation that troubles Dr. Alberto E. de la Guardia, an obstetrician who formerly practiced at North Bay Area Hospital.
"We’ve had patients who came in for delivery who would have never made it to Corpus," he said.

Meanwhile, Carreno now counts 1,000 patients in his practice. He and his father (another solo  practitioner) often cover each other on call, deliver babies together, and occasionally assist in each other’s scheduled surgeries. "I don’t have anyone to gauge my growth against, but I feel we’re doing good. As long as we’re paying the bills that’s OK with me because I’m having a good time working with my father," he says.

Because of the high Hispanic population, diabetes claims 22.9 people per 100,000 in Nueces  County - a 39.9 percent death rate in 1997 for those afflicted with diabetes compared to 23.3 percent
in the United States that year. That’s why Annette Shook, the director of physician services at Corpus Christi Medical Center, keeps an eye peeled for endocrinologists. Her hospital’s diabetes center recently earned its American Diabetes Association certified program designation, a feat that requires tracking patients’ progress diligently over several years.

But the largest health concern throughout Nueces County is heart  disease, which is the leading cause of death, and cardiologists are needed to meet patient demand. "The older population settles here for the winter and darned if they don’t have heart attacks," says Curry. "Or they deliberately come down here to have heart surgery because the recovery is much more comfortable. They can get out to walk and do the things physicians prescribe for their rehabilitation, things they may not be able to do in a colder climate."

The sunny clime spawns yet another health-care concern: skin cancer. The present dermatology practices can’t keep up with the patient needs - Linda Gill ing one of her marketing plans to offer
free screenings to promote Columbia’s new cancer center four years ago that backfired. For starters, she announced it during the local television news.

"We had literally hundreds of people standing in line. I asked a dietitian to bake cookies to keep them happy," she recalls. "The next day we decided we needed to do this by appointment only because we could not handle that many people in one evening, even though we had six to eight docs in each location." Today she conducts the annual event by running a single advertisement in the newspaper, and taking appointments until the clinics reach their capacity for a single evening.

"But overall, we owe much of our medical strength to the geography," Curry adds. "Patients heal better down here when they can get out and enjoy the weather rather than stay cooped up in a home. And we’re in close proximity to San Antonio, Houston, and Dallas, so we tend to get a lot of doctors and specialists who like the water. That’s been a real value to us, because we’re able to convince good doctors to stay."

Overcoming Challenges

Physicians in the area don’t deny that Corpus Christi, like the rest of Texas, struggles with difficult poverty and immigration- based health issues. The Urban Institute attempted to paint a statewide picture of the situation in its Assessing the New Federalism project; its researchers drew these conclusions:

• Texas is a diverse state, with a large low-income population, high levels of uninsurance and many foreign-born residents, mostly from Mexico.

• Its politically conservative outlook translates to minimal health and welfare programs beyond what it takes to draw down a federal match.

• Commercial health-maintenance organizations actively compete for Medicaid business, so the state doesn’t rely on Medicaid-only managed-care organizations.

• Nearly 24 percent of the nonelderly population is uninsured, one of the highest rates of any state in the country.

In a phrase, these authors characterize Texas health-care marketplace as "in turmoil."

Certainly Corpus Christi resembles that remark in some aspects: Nueces County Health Department stats say the county’s unemployment rate stands at nine percent (compared to a statewide five percent), the average monthly Aid to Families with Dependent Children recipients here represents
two percent of Texas’ bill; the annual Medicaid expenditures also comprise two percent of the state’s total. Nueces county has a mere .01 percent of Texas’s 19.6 million people.

The number of legal immigrants admitted to the county jumped from 398 in 1986 to 636 in 1996, according to Immigration and Naturalization Service (INS) - -illegal immigrants, of course, don’t register on official counts. Healthcare facilities in neighboring Kingsville a year ago finally groaned under the financial burden of caring for the uninsured; according to a spokesperson for Christus Spohn (then just Spohn), hospitals in South Texas shelled out almost $14 million in free care in 1997. Jose Ugarte, then chief of staff at Christus Spohn Kleberg Hospital in Kingsville, went on the record saying, "Just because we are near the border doesn’t mean our system should have to shore up all of Mexico."

The 57-year-old Ugarte himself is a Cuban immigrant who moved first to Venezuela, then to Spain to flee Castro’s Communist tentacles. He nearly died of polio in medical school, recovering under the care of an uncle who, though he was Castro’s ambassador to Switzerland, hid the young man in Geneva for approximately 18 months. Ugarte’s frustration in light of this background speaks volumes.

Border hospitals also treat unusual and dangerous diseases in the uninsured and immigrant populations - read malaria, yellow fever, tuberculosis, dengue fever. According to health reports
filed with the county’s health department in September 1999, the area reported one case of polio, one case of dengue fever, one case of malaria, three cases of typhus (murine) and 18 cases of tuberculosis in the first nine months of the year.

Yet physicians here insist the statistics paint an uglier picture than reality. "We’re all immigrants from somewhere," says Bobele. "Yes, our group sees patients who are residents and nationals from
Mexico. And many qualify for certain indigent programs, but just as many from Mexico are paying patients." In his estimation, 5 to 10 percent of the medical services in Corpus Christi fall into the
charity category, 50 percent is Medicaid and the remainder is paid by various insurance
and third-party payers.

A new program promises improved living for the 21 percent of the county’s population that falls below the poverty level. A Better Living for Texans program, funded through the Texas Department of Human Services, aims to increase health promotion strategies that encourage individual and family wellbeing and strengthen basic parenting skills that enhance child health and wellbeing,
among other goals.

Texas A&M-Corpus Christi officials huddle these days to brainstorm a Coastal Bend Health Education Center in South Texas - possibly centered in Corpus Christi’s strong medical culture - to facilitate research on area health con cerns and lend a hand with health education. The initial concept encompasses recruiting area high school students to the medical professions, developing degree
programs in nutrition and dietetics as well as a masters of public health degree, and expanding rural nursing training programs. Additionally, Christus Spohn Memorial, Bay Area Medical Center, and
Driscoll Children’s Hospital participate in an extensive library network that provides up-to-date medical information to health-care providers and students.

Managed care hears its share of boos on the Corpus Christi medical scene, as it has elsewhere across the country. Yet overall, doctors say managed care is in its early stages of integration here and they
remain optimistic that other cities took the beatings for them. "At least I’m able to ease into it as it develops in the community rather than being dumped into it," Bobele laughs. "I’m probably the frog
in the pot that’s warming so slowly, I don’t know I’m directly in hot water yet!"

And the make-up is still diverse enough to allow Carreno solo status. "I did my fellowship in Houston working with other doctors in a group setting and I didn’t like taking orders from somebody else," he says. "I chose medicine a long time ago to be just like my father and make my own decisions.

"On the other hand, I don’t have anything to look back on as some of these older doctors do. They experienced a different type of medicine than the world I will work in. But it’s still positive," Carreno says.

Welcome to the Texas Riviera

The best reason to practice in Corpus Christi, the doctors all agree, is the location. Name the outdoor activity and you’ll find it here: hunting, fishing, water and jet skiing, windsurfing (Corpus Christi
ranks as one of the nation’s windiest cities, surpassing even Chicago), SCUBA diving, and sailing. Carreno participates in nearly every one. "When you think about surfing California comes to mind,
but a lot of us grew up surfing on the beach here," he adds.

Twenty-nine marine mammal species frequent these Gulf waters, to residents’ delight. Atlantic spotted dolphins, bottlenose dolphins, spinner dolphins, blue whales, humpback whales, killer whales, and sperm whales are often-seen friends. Nature lovers can study these species as well as indulge in bird-watching, seashell hunts, botanical hikes, and old-fashioned sunbathing at Padre Island National Seashore, 25 miles south of Corpus Christi. "We just keep recruits on the water and the town is easy to sell," Shook admits.

Piloting also rates as a popular sport. Bobele claims Corpus Christi is one of the best places in the world for private piloting, with 330 good flying days a year and relatively few commercial airline
paths. And much of the Navy’s pilot training takes place at the Naval air station in Kingsville.

"This isn’t the place for somebody who needs to attend a new, live performance of a different play every night or wants to catch a movie at 2 a.m., a la New York or even Dallas and Houston," Bobele says. However, the Corpus Christi Symphony, Corpus Christi Ballet, the Museum of Science and
History, Art Museum of South Texas, and Harbor Playhouse present a broad array of cultural offerings. Many land guest appearances by performers from larger metropolitan cities along the
East and West coasts. There’s even Heritage Park for architecture buffs who want to view homes restored to their turn-of-the-century glory.

The Hispanic culture contributes many joyful fiestas and fireworks displays along the bayfront, most at no charge. Jazz and reggae attract interest as well, perhaps because of the youth-oriented economy Corpus Christi has adopted in the 1990s. Bobele has counted at least 40 new restaurants and five downtown nightclubs spring up in the last few years to entertain residents.

Still, Corpus Christi isn’t the place for every physician, Bobele admits. "We’re not a rich community like a Rochester, Minnesota," he says, and "Selective minorities who have come down here to  interview with me felt uncomfortable with the social support networks available to them." For instance, an Orthodox Jew found conservative temples but not the level of worship he enjoyed in Buffalo, New York. And because of the heavy Roman Catholic influence, a few Seventh Day Adventists echoed this sentiment. Even Southern Baptists can find themselves in the minority.

"On the other hand, I’ve had colleagues from Pakistan, India, Russia, and Poland who enjoy this community and its American flavor," he says. "We’re a warm, welcoming community for people who
aren’t arrogant, impudent, and unfriendly. Someone who comes here thinking they’re king of the world will discover this is their Titanic."

And in the final wash, it’s this friendliness even more than the unhurried pace, lack of traffic jams, and natural beauty that captures the physician’s heart. "I can’t go out of the house without running
into someone - whether it’s the grocery store clerk, my dry cleaner, the banker - who knows my name," says Greenberg.

Julie Sturgeon regularly contributes feature articles as well as community profiles to UO. Her last community profile was on Lynchburg, Virginia.



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