By Sriya Reddy
Renee Thompson has to drive 40 miles round trip to Children’s Medical Center in Dallas from Duncanville monthly to get the insulin that her daughter with Type 1 diabetes needs to survive. The drive takes a considerable amount of her time, but for a while, that was her best option.
When Thompson heard about the newly opened pharmacy at RedBird Mall, she was relieved.
“I think bringing something like Parkland clinic there, especially if they have a pharmacist, I could travel less to get help,” she said.
Thompson said that she has to pay about $300 more for insulin at her local pharmacy. She’s lived in the Dallas-Fort Worth area since 2000 and knows what it’s like to not have options for affordable health care. Parkland Hospital is trying to mend this by using data and community input to fill the medical gap in southern Dallas.
Parkland opened a clinic at RedBird Mall in September through the ReImagine RedBird initiative to bring health care to a medically underserved area. UT Southwestern also will open a clinic there next summer.
Some residents, like Thompson, have had to travel over 20 minutes to fill prescriptions or to see their primary care physician. Parkland shaped the services to fit the needs of its surrounding community using data from the 2019 Community Health Needs Assessment.
Parkland learned that some barriers to health care access included the lack of access to behavioral health, lack of insurance and transportation.
Herron Mitchell, Parkland vice president of practice operations in the southern sector, said this clinic will “close the circle” created by Parkland’s other community-oriented primary care clinics that he manages: Bluitt-Flowers, Southeast Dallas and Oak West Health Centers. Parkland has 12 health centers and 11 school-based clinics. He said the RedBird clinic is meant to provide patients in the area holistic health care.
“We consider ourselves a patient-centered medical home,” Mitchell said. “What that means is that we’re partners with you for your health. For your long-term health.”
How it works
From the Community Health Needs Assessment, Parkland learned that this area of Dallas has high rates of diabetes and hypertension. These diseases can cause poor circulation in the limbs that can lead to amputation or blood vessel damage in the eyes that can cause blindness. This is one of the reasons services like podiatry and optometry were added to the RedBird Clinic.
John Warner, executive vice president of health system affairs at UT Southwestern, said he was able to hear stories from the community through forums on what they wanted to see at the clinic.
“We heard really meaningful conversations and, in particular, a lot of the people during those forums spoke up on how difficult cancer care was for them,” Warner said. “Just trying to coordinate all of the needs of a cancer patient without having a facility nearby was difficult for them. That made a big, big impact on me personally.”
The Parkland clinic occupies about 40,000 square feet and offers residents physical therapy, women’s health and child psychiatry among other services. UT Southwestern’s clinic at RedBird will have about 150,000 square feet for neurology, cancer treatment and cardiac care in partnership with Children’s Medical Center. While Parkland is addressing diabetes and hypertension, UT Southwestern will provide cancer and neurological care.
“We’ve been meeting regularly with them with the idea being that the work that we do there would be synergistic and that we would offer complementary services, and really try to get the biggest benefit we could by having both of us there,” Warner said.
Warner also said UT Southwestern has been traveling to other malls in the country that have revitalized the space for health care, including in Nashville and Jackson, Miss.
While many hospitals have outreach to low-income areas, Parkland officials say long-term, sustained efforts like the RedBird clinic can be done by other hospitals.
“I absolutely believe that this can be replicated in cities for sure, and bringing in other agencies and organizations and individuals to the table to see how they can be a part of the story,” said Angela Morris, senior director of community relations at Parkland.
Morris said it’s important to not only use data to understand what communities need, but also to be intentional about using residents’ voices to contextualize the numbers and build a full picture.
Nancy Berlinger is a research scholar with The Hastings Center, a bioethics research institute based in Garrison, N.Y. She said that not only does the RedBird clinic show that Parkland learned a lot from primary care medical home research and how that benefits patients, but Parkland also went beyond that model by having diagnostic services, child psychiatry and rehabilitation at the clinic.
“This is a project that’s definitely aiming at improving health equity without a doubt,” Berlinger said. “This is beyond convenience. They are aiming for greater fairness across populations.”
Berlinger said an example of that is the Parkland child psychiatry center.
“Child psychiatry is a very hard-to-access service with long waiting lists,” she said. “In some regions of the country, providers don’t take insurance so people have to be able to self-pay, which makes it hard for some families.”
Access to mental health care is one area where Dallas lags across the board. The average wait time for psychiatric beds is over a year for men and about 200 days for women. Also, Dallas is the largest city in Texas without a state psychiatric hospital. The nearest is in Terrell, about 45 minutes away.
The behavioral health component of RedBird came from community input on the services at the clinic. James Perez, vice president of clinic operations, said that hearing stories at the town hall meetings from residents whose family members have had behavioral health issues has been impactful.
“If we’re able to identify these learning disabilities or behavioral issues early in that child’s development, then we’re able then to provide that information to the parent [and] to the school district,” Perez said. “And the school district can then make accommodations for those individuals so they don’t get labeled, at an early age, as a troubled child.”
Why southern Dallas
Parkland’s Morris has spent a lot of time talking to Dallas residents. She and her team figure out which areas of the city need what services and bring Parkland out to the community for these specialized programs. The programming can be anything from vaccine drives to cooking classes.
Morris meets regularly with residents and builds a bridge between Parkland officials and community members. She heard from the RedBird community that residents wanted a clinic nearby.
“We learned we need an access point in RedBird and it was just as powerful again because this is the community specifically telling us the direction that we want to go,” she said. “The stars really aligned with the data that shows that here’s a pocket, which is the RedBird community and its surrounding neighborhoods, that people are missing care.”
Berlinger has seen similar health care centers like the RedBird clinic in San Diego and Loma Linda, Calif. She said the space required to implement a plan like this may be more difficult to replicate in other parts of the country.
“You have a lot of land in Texas,” she said. “So there may be aspects of what is possible to do in Texas that would be harder to do in a place where I live like New York City, which is very dense.”
Berlinger said that there are ambulatory clinics in New York, but that the range of services being put under one roof at RedBird is extraordinary.
RedBird Mall holds sentimental value to the residents of southern Dallas. Many remember going there as teenagers or performing with their school choir in the center of the mall. Matt Houston grew up in RedBird and has watched the mall grow and fall during his time in Dallas.
“It was a very warm place,” Houston said. “That’s where we get our clothes. Our moms would shop there. It was the center for activity in our youth life.”
Minerva Rodriguez echoes Houston. The DeSoto resident said the entire ReImagine RedBird investment shows that people care about southern Dallas.
“I think that southern Dallas has often been neglected and not seen as an area where there’s a lot of viability,” Rodriguez said.
She said the RedBird clinic can serve more than just area residents; it can serve anyone who lives south of Interstate 30.
Some residents, like Edna Pemberton, a cancer survivor, already had a good relationship with Parkland, where she found a network of support during her treatments.
“I want people to know if it had not been for Parkland, what they did and everybody, I would not be alive today,” she said.
Morris said she heard many testimonials like this from individuals saying they are grateful for Parkland’s presence in their community.
Houston also said the name recognition of Parkland will encourage people to go.
“I think everyone has hesitancy, going to health care spaces,” he said. “I think what happens is you can add another layer of hesitancy if you don’t have a known facility close by.”
Benefits for community
Chantel Thomas lives nearby and goes to the physical rehabilitation center at RedBird for the tendinitis in her shoulders. Before the RedBird clinic, Thomas would travel to Parkland’s main campus or the deHaro-Saldivar Health Center for her care.
“The fact that Parkland is branching out with a couple more clinics makes it easier to get care,” Thomas said. “People don’t have to worry about making it to their appointments, or finding a ride, or if the bus will be there on time.”
Thomas is one of many patients that the new physical rehabilitation center at RedBird has seen. This is the first time Parkland is providing this service outside of its main campus. Karen Tsoi-A-Sue, a senior physical therapist, has heard stories like Thomas’ from her patients as well.
“They are so excited to have it so close by,” she said. “I had one patient who said that this was five minutes away from her house and she’s been watching it being built for months now. She’s had surgery recently so she sees us often and this makes it convenient.”
Tsoi-A-Sue said that coming to Parkland’s main campus is such a task and now that they have a center closer to some patients, attendance and compliance with certain exercises will be better. She also said they are getting busier and busier as word gets out.
“If it took you two hours to get to your appointment and you had to go every week, and maybe one day you don’t feel like taking the bus, or you missed the bus and it’ll be 30 minutes to get the next bus, it would be hard to get to your appointment on time and regularly,” Tsoi-A-Sue said.
Berlinger said it isn’t just physical therapy patients who will benefit by coming to appointments regularly at RedBird because of the range of services offered under one roof.
“People are given a referral but they never follow up because something is simply too far away, or they’re not quite sure. ‘Oh, who is this other system? I don’t know these people.’ But if it’s all in one place, that really helps.”
Editor’s Note: This article is part of our State of the City project, in which The Dallas Morning News explores the most critical issues facing our communities. To see previous installments in the series, go here.
CORRECTION, 11:20 p.m., Nov 22, 2021: An earlier version of this story incorrectly stated Dr. John Warner’s title as executive vice president of external health affairs.