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FEATURED: Carlos Cárdenas, MD, Chair, Board of Managers, DHR Health. “This Level One Trauma designation is a reflection upon the work and the belief and the vision that all of you have had,” he said at the Edinburg Conference Center at Renaissance on Wednesday, September 8, 2021, shortly after Gov. Greg Abbott announced that DHR Health had been designated as the top trauma center south of San Antonio. “I have come before many of you many times over the years and talked to you about our vision here at DHR Health. It’s always been a vision of transformation. It’s not just about of the delivery of health care, but lifting up an entire area because 1.4 million people deserve the best.”

FEATURED: Carlos Cárdenas, MD, Chair, Board of Managers, DHR Health. “This Level One Trauma designation is a reflection upon the work and the belief and the vision that all of you have had,” he said at the Edinburg Conference Center at Renaissance on Wednesday, September 8, 2021, shortly after Gov. Greg Abbott announced that DHR Health had been designated as the top trauma center south of San Antonio. “I have come before many of you many times over the years and talked to you about our vision here at DHR Health. It’s always been a vision of transformation. It’s not just about of the delivery of health care, but lifting up an entire area because 1.4 million people deserve the best.”

Photograph Courtesy DHR HEALTH FACEBOOK

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DHR Health’s Level One Trauma Center is “lifting the entire area because 1.4 million people deserve the best” medical care – Carlos Cárdenas, MD

By DAVID A. DÍAZ
[email protected]

Almost exactly three years to the day that DHR Health leaders first publicly began their crusade to become a Level One Trauma Center to serve deep South Texas, that far-reaching goal officially became a life-saving reality on Wednesday, September 8, 2021.

A Level One Trauma Center provides the highest level of surgical care to trauma patients.

The DHR Health Level One Trauma Center is located at its main hospital, 5501 S. McColl Road, Edinburg.

A Level One Trauma Center is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries that result from falls, motor vehicle collisions, knife or gunshot wounds, or other catastrophes that threaten a person’s life or limbs.

Thirty-six months earlier, on Monday, September 10, 2018, at the request of DHR Health officials, the McAllen City Commission approved a city resolution endorsing state legislative efforts “to make funding available to strengthen the Texas Trauma Network and ensuring the residents of the Rio Grande Valley have timely access to the highest level of care when facing a severe traumatic incident.”

(In the Fall of 2018, the Texas Trauma Network was made up of 288 designated trauma hospitals, first responders, and emergency medical service providers.)

That action was the first of what would be a coordinated effort by DHR Health officials and the Rio Grande Valley state legislative delegation, along with leaders of other local and county governments in the Valley, to eventually secure that impressive Level One Trauma Center designation by the state.

Three years later, state and DHR Health leaders reflected on the magnitude of earning the Level One Trauma Center designation for the Valley and state.

“I have come before many of you many times over the years and talked to you about our vision here at DHR Health,” Carlos Cárdenas, MD, Chair, Board of Managers, DHR Health, reminded the full house of medical, public safety, and emergency medical services professionals – and which featured Gov. Greg Abbott – at the Edinburg Conference Center at Renaissance on Wednesday, September 8, 2021.

“It’s always been a vision of transformation. It’s not just about of the delivery of health care, but lifting up an entire area because 1.4 million people (in the Rio Grande Valley) deserve the best,” Cárdenas proclaimed.

“It took all of us in every realm that we have to achieve this. Whether it was in leadership at the community level, the city level, leadership out in the field, leadership in health care, political leadership and will, to make these things happen,” he noted. “That’s the miracle that has occurred here today.”

So important for South Texans was DHR Health achieving the Level One Trauma Center designation that Abbott flew down for the Wednesday, September 8, 2021 gathering at the Edinburg Conference Center at Renaissance to formally announce another health care masterpiece for the hospital system and the impact for the 14 South Texas counties that are now being served.

“It was pretty amazing when I first began to talk to your leaders, who are up here with us today, several years ago and learned then for the first time that you did not have a (Level One) trauma one center in the Rio Grande Valley, and that the closest one was in San Antonio,” Abbott recalled. “Especially considering the size and the trauma that too many people in the region have to experience. It needed to change. You needed and you deserved to have a Level One Trauma Center here in the Rio Grande Valley. That is now true today.”

Being treated at a Level One Trauma Center increases a seriously injured patient’s chances of survival by an estimated 20 to 25 percent. It has a full range of specialists and equipment available 24 hours a day and admits a minimum required annual volume of severely injured patients.

“That’s what this community has done because this is your trauma center. From Starr County to Cameron County and the 14 counties we will now have in our region, this is that achievement,” said Cárdenas.

In the United States, trauma centers are ranked according to standards established by the American College of Surgeons, from Level I (comprehensive service) to Level III (limited care). The different levels refer to the kinds of resources available in a trauma center and the number of patients admitted annually.

https://www.utmbhealth.com/services/uc-er/level-1-trauma-center

“As several of us talked, several years ago, they told me that their number one priority was to make sure that you did have a Level One Trauma Center. I promised them I would go to work. I would make sure it happened,” Abbott said. “Like a lot of big things that happen, it didn’t happen overnight. It took several years to happen. But, today is the day. Today they are now making history with the official designation of a Level One Trauma Center in the Rio Grande Valley of the great state of Texas.”

Prior to DHR Health’s designation as a Level One Trauma Center, the Rio Grande Valley was served by three Level Two trauma centers – DHR Health in Edinburg, South Texas Health System in McAllen, and Valley Baptist Medical Center in Harlingen.

Anchored in southwest Edinburg on a 130-acre site, with a growing presence in neighboring McAllen, Rio Grande City, Mission, and Brownsville, DHR Health offers some of the most comprehensive medical care on the U.S. southern border, with more than 1,400 nurses and 600+ physicians providing care in 70+ specialties and sub-specialties.

DHR Health is the flagship teaching hospital for the University of Texas Rio Grande Valley School of Medicine and encompasses a general acute hospital with the only dedicated women’s hospital south of San Antonio, a rehabilitation hospital, a behavioral hospital, more than 70 clinics Valley-wide, advanced cancer services, the only transplant program in the Rio Grande Valley – and as of September 8, 2021, the only 24/7 Level One Trauma Center south of San Antonio.

Doctors Hospital at Renaissance, Ltd (“DHR”) and its general partner, RGV Med, Inc. (“RGV Med”) own and operate a 519 licensed bed general acute care hospital located at 5501 South McColl in Edinburg. The facility is one of the largest physician-owned facilities in the United States that began as an ambulatory surgery center in 1997.

Highlights of the remarks delivered by Abbott and some of the top leadership of DHR Health during the Wednesday, September 8, 2021 event at the Edinburg Conference Center at Renaissance foll0w.

Manish Singh
Chief Executive Officer
DHR Health

Good afternoon, everybody. What a momentous day. At the heart of everything here that we do at DHR Health is our community, the whole Rio Grande Valley. Twenty-four years ago our founding partners came together with a joint vision, to bring the most advanced healthcare services to the Rio Grande Valley. They saw a future where you would no longer have to travel up north hundreds of miles to receive the healthcare you need and deserve. I have the privilege of standing up here today to say that day has come.

A Level One Trauma Center is the game-changer for all our community. This means you now have access to the highest level of trauma care, 24 hours a day, seven days a week, and every single day of the year.

We could not have done this alone. This support from the local cities, elected officials and state leaders who supported this issue has been critical and essential to making DHR Health the first and only Level One Trauma Center south of San Antonio.

I would like to introduce and wholeheartedly thank our esteemed governor, whose leadership on this issue has helped shed a spotlight on the need for a Level One Trauma Center in the Rio Grande Valley, and who fought to make it a priority in the Texas Legislature.

Governor, we owe you our thanks. Ladies and gentlemen, the Honorable Gov. Greg Abbott.

Gov. Greg Abbott

Well, thank you, Dr. Singh and I wanted to say thank you to all of the doctors, all of the nurses, all of the staff, everybody who works in the healthcare sector. We know the magnitude of the challenges that you have faced over the past year and a half. But, candidly, we know the magnitude of the challenges that you face every day. And we applaud what you do, for the role that you played to make the RGV as well as the entire state of Texas a better place.

Today is a day of remarkable achievement for the Rio Grande Valley, for DHR.

It’s an issue that has been focused on for years now. It’s always so rewarding when you have a goal that you want to achieve, you put the effort into it to achieve that goal and then you ultimately achieve it. And so, as we talked earlier today in a meeting before we came in here, this is a substantial milestone for DHR Health and for the Rio Grande Valley.

However, it really is not an end unto itself. It really is a stepping stone toward an even broader and better pathway forward. I want thank everybody here for the work they do every day. This is especially true because of a fact that we all know. And that is, the Rio Grande Valley, it continues to grow in population and in size. And as you grow in population and size, also your healthcare needs similarly grow and seek greater demand.

As a result it was really pretty amazing when I first began to talk to your leaders who are up here with us today, several years ago, and learned then for the first time that you did not have a Trauma One Center in the Rio Grande Valley and that the closest one was in San Antonio. Especially considering the size and the trauma that too many people in the region have to experience. It needed to change. You needed and you deserved to have a Level One Trauma Center here in the Rio Grande Valley. That is now true today.

As several of us talked, several years ago, they told me that their number one priority was to make sure that you did have a Level One Trauma Center. I promised them I would go to work. I would make sure it happened.

Like a lot of big things that happen, it didn’t happen overnight. It took several years to happen. But, today is the day. Today they are now making history with the official designation of a Level One Trauma Center in the Rio Grande Valley of the great state of Texas.

It is a monumental day for this hospital but, equally important, it is a monumental day for the health and safety of everybody in the entire Rio Grande Valley region.

One thing that I know you know but must be emphasized and that is, in trauma care minutes matter. Because of this new Level One Trauma Center, lives are going to be saved and better outcomes are going to be achieved because a Level One Trauma Center now exists in the Rio Grande Valley.

Things like this cost money. And this was one of the things I talked to local leaders about, to make sure you had the resources that are needed to make sure you did have this Level One Trauma Center.

Funding for this designation was a priority in the 2019 legislative session. Sen. (Juan) Hinojosa (D-McAllen) led the way to secure the state funding that was needed for this designation. He, obviously, was helped by the entire Rio Grande Valley legislative delegation. And I want to thank the Texas Legislature for improving access to healthcare in the Rio Grande Valley.

While I am here with you I want to take just one moment to provide you some additional information about a law that was passed this session (Spring 2021) that does even more to improve healthcare in the Rio Grande Valley. There are actually multiple things that were done but only one of which I will announced today.

In fact, I am going to sign the bill today of what was done that will help everybody and, as I will articulate, especially help people in the Rio Grande Valley. The Legislature took action this session to pass a law to help Texans with diabetes, which obviously is a major healthcare challenge for people across the entire state of Texas.

One of the treatments for people with diabetes is insulin and that’s a constant ongoing, need. As you know, the cost of insulin had just skyrocketed. In fact, it has more than tripled over the past 15 years.

Insulin, candidly, has become unaffordable for too many Texans, including Texans in the Rio Grande Valley. As a result it compromises their healthcare. So, right now I am going to sign a law to keep insulin affordable in the state of Texas. What the law does is this: it limits copays to $25 per insulin prescription for a 30-day supply.

This is going to cut the healthcare costs for Texans with diabetes and Texans who may otherwise face exorbitant out-of-pocket costs. I want to thank in particular Sen. (Lois) Kolkhorst (R-Brenham) as well as Rep. Eddie Lucio, III (D-Brownsville) in the Texas Legislature for helping to lead the way in making this law possible.

(Signs Senate Bill 827)

Insulin is now cheaper for Texans across the entire state including those in the Rio Grande Valley.

Marissa Castañeda
Senior Executive Vice President
DHR Health

Thank you, Gov. Abbott for your leadership and making this so special. What an honor it is. We appreciate being able to witness this signing of Senate Bill 827.

This important piece of legislation will help so many. It will make such a difference for so many of our patients here in the Rio Grande Valley. They will no longer have to face excessive, out-of-pocket costs for life-saving drugs. We can’t thank you enough.

Additionally, as Dr. Singh mentioned, we appreciate the state’s unwavering support in helping to bring the highest level of trauma care to the Rio Grande Valley. At DHR Health, our cornerstone is the community.

We don’t back away. We step up, we get as close as possible, and we get it done. So today is proof of that. You being here to be able to help us help so many more of our patients is critical.

As a Level One Trauma Center, we count on tremendous commitments and a team of individuals who truly dedicate their lives to alleviating suffering and pain for our patients.

Proudly leading this team – our team – is a true visionary whose relentless passion for the well-being of our patients is second to none.

I am so honored, emotional, and really happy to introduce DHR Health’s trauma medical director, Dr. Jeffrey Skubic.

Jeffrey Skubic, D.O.
Medical Director
DHR Health Trauma Center

Thank you for the kind introduction. Thank you again, governor. It’s a pleasure to have you here.

Welcome again to our esteemed guests, our doctors, nurses – I see many of our emergency room nurses here. Our staff, our administrators, I see many politicians, EMS providers. Welcome to our families and our supporters.

As far as our trauma program, I say to all of you, welcome to the miracle.

The Spanish explorer, Alvar Nunez Cabeza de Vaca became shipwrecked on the Texas gulf coast in 1528. He then roamed the wilderness on foot for eight years, including being enslaved.

Dr. Cárdenas had told me a lot about this story. Apparently, his ancestors were there, too.

He eventually made his way to California, then he made it to Mexico City, and he finally made it all the way back to Europe. During his time in Texas, he performed the first surgical operation by a European in the Americas.

Here’s a quote from his operative note from 1535:

“Here they brought a man to me and said that he had been wounded by an arrow through the right shoulder, and the arrowhead was lodged over his heart. He said that it gave him much pain, and for that reason he was always sick. I touched him, felt the arrowhead, and saw that it traversed (moved through) the cartilage.

“With a knife, I had opened his chest to the spot and saw that the point was crosswise, and was very difficult to remove. I continued to cut and inserted the point of the knife, and with great difficulty, I finally extracted it. It was very long. With a deer bone, using my knowledge of surgery, I took two stitches, following which he profusely bled all over me.

“Another day I cut the Indian’s two stitches, and he was well. And this cure gave us among them and throughout the land control of all that they considered valuable or cherished.”

And that’s from his operative report from 1535. Álvar Núñez Cabeza de Vaca.

In this case, he was the miracle.

I find it ironic that the land (Texas) where the first operation was ever performed in the Americas by a European is the last large urban populated region in this country to acquire a Level One Trauma Center.

It isn’t that dissimilar (different)to the story of DHR Health. From this original small surgery center that was started by just a handful of physicians – some of them up here today – arose the largest medical campus South Texas has ever seen. It’s now over 500 beds.

Talk about a grass roots movement. This entire campus was constructed at the pushof physicians and nurses who want the best for their patients, no matter what. That is what this Level One Trauma Center represents for this region. This is our promise to the community: the absolute best level of care for the sickest of patients, 24/7, 365, just as good or better than other major cities in the country.

This trauma center is not simply built for us physicians, and nurses and staff. This trauma center is built for the region. It’s built for the Rio Grande Valley and all of Texas.

DHR Health has again raised the standard of care for millions of people. These people are our families, teachers, elected politicians, administrators, recent immigrants from other parts of the United States or even Latin America.

Should anyone in your family be terribly injured, don’t they deserve the absolute best?

In surgery, we have a saying: “We stand on the shoulders of giants who have come before us.”

This moment is notdissimilar (different). I truly had a mountain of giants standing underneath me.

However, I was not standing on top them, climbing over them to the top. They – these people you see here – they were pushing me above them, pushing me to the top. In the end, holding me at the apex (high point), so we could complete this journey together.

This trauma center was taken from a no-designation trauma hospital, to a Level Three, to a Level Two Center by Dr. Raúl Barreda and Dawn Woods and Darlene Martínez, and that’s no small feat. Not small miracles by any means.

There are too many people to name, to thank, who helped us along the way, but some of them are Dr. (Manish) Singh, Dr. (Armour) Forse, Dr. (Janete) Sheiner. Your unending support and guidance to me, to the trauma department and someone who had no previous administrative experience. Thank you.

Mr. Alonzo Cantú, without your drive and support, none of this be here, none of this would have happened.

Gov. Abbott, without your backing and support, South Texas would not now have a Level One Trauma Center.

So the miracle here is the people. The people is the miracle.

At this time, I just like to say thank you to all of our trauma department and the nurses.

Thank you.

During our review by the American College of Surgeons to receive verification, the lead reviewer said to us, and I quote: “In my 20 years of reviewing trauma centers for the American College of Surgeons, I have never seen a hospital go for a Level One survey on the first attempt and receive zero deficiencies.”

Which shocked us all, but we were grateful.

Then he said, “What you have all accomplished here is nothing short of a miracle.”

So what’s the secret? How do we do it? Who’s the miracle? Well, you’re looking at it. It was the (trauma) team you just saw here. It’s the community. It’s the EMS providers. It’s all the doctors and nurses and staff, it’s everybody. That’s the secret. They are the miracle.

And our surgery residents. If any of the residents weren’t here, we wouldn’t be able to do what we do. They’re the young doctors that we are training to become the next generation of surgeons, physicians, emergency medical physicians, trauma surgeons like me. They’re going to be taking care of us in the future. They are so important to this, too. These guys help us staff the whole trauma bay. In addition to us, three of them sleep in the hospital every night, 24/7, 365, to take care of these patients.

The miracle is the people.

So now, verified by the American College of Surgeons, and designated by the State of Texas as a Level One Trauma Center, that truly is a miracle.

So where do we go from here? Up and up, is the only answer.

I believe our lessons learned here can be of use to other regions that have little to no organized trauma systems, and we don’t have to look very far, meaning 10 miles south of here, just over the (Rio Grande) river. We must expand our research activities and publish widely on our unique and special problems and population here in the Rio Grande Valley.

Becoming a Level One Trauma Center isn’t winning the race. It is the entrance path to enter a bigger race for our region. We now join the ranks with large university hospitals all around the country, participating in the highest level of trauma care and studying it together. We need increased collaborations with our educational partners. We can keep building a better system, and continue training better doctors, better nurses, physician assistants, ultra-sound techs, emergency medical services personnel.

COVID-19 had been a horrible era to live in, I think we can all agree on that. But we all agree on one thing: It pushed us to the very limits of efficiency and capabilities to take care of our population.

Our DHR Health Institute for Research & Development, led by Dr. (Sohail) Raoand Dr. (Mónica M.) Betancourt-García, did amazing trials with COVID, and they’re doing the same with trauma. Where else do we go? Research is a hard, usually not very much thanked effort, so thank you.

Where else do we go?

As we expand our reach from trauma patients from four counties to 14 counties, we must rely heavenly on our EMS (emergency medical services) and our sister hospitals, which are Level Two and Level Three Trauma Centers. Dr. Ronald Stewart (Professor of Surgery and Anesthesia, The University of Texas Health Science Center at San Antonio) is always telling us that we have to work together as a system with all the rest of the trauma systems and hospitals in our system to take the best care of our patients.

This Level One Trauma Center is the beacon for what we can achieve, and now acts as the capstone (most important achievement) that completes our health system here in the Valley. We now have a complete trauma system that, for the first time in its history, is not dependent on San Antonio as it has always been.

We can stand on our own two feet, and our patients can stay right here in the Valley with their families.

Why were we successful with in venture, and the other ventures DHR Health does?

If you put the individual patient at the center of each decision that we do, suddenly the right path forward becomes clear. It’s as easy as that. Do the right thing for the right patient at the right time of day or night, every single time. That’s the secret.

At a Level One Trauma Center, it doesn’t matter what day of the year it is. For example, a holiday or what time of the night it is. When the patient arrives at the center, the hospital is ready to give the best care possible to any patient at any time. That is what we do each and every single day, and why we are successful.

Remember the parable of the Good Samaritan? A man who stopped to help a sick man at the side of the road, a man from an enemy nation? That is how we are supposed to behave, is it not? God gives us incredible stamina and abilities to do what we do. Modern day miracles in health care, so I must say thanks to Him.

Our families who put up with this health care lifestyle.

Amazing. God bless you for putting up with us and thank you for supporting us so that we can support our patients.

For closing, I just want to say, let it be known that there is life in South Texas, and say it loudly. We will be second to no one in regards to having the best amenities in health care that the world has to offer for our patients and our families. We search for the best way possible to bring patients care, and when we find those things that don’t exist here, we will build them together.

All of you are the miracle.

Thank you for bring me and my family into your region, your state, your families and into your lives. God bless you. God bless this trauma center. God bless the Rio Grande Valley, and God bless Texas. Thank you.

Marissa Castañeda

Thank you, Dr. Skubic, and thank you for leading our miracle each and every day here at DHR Health. We take a good look in the mirror, and we work on improvement. We work on getting one or two or three percent better than we were yesterday.

Someone that continues to lead that has become here is you, Dr. Skubic. Thank you so much.

You talk about iron sharpening iron, and helping to improve and working together for community. That is what we do here.

At this time, I would like to ask Dr. Cárdenas, our Chairman of the Board at DHR Health, to share some closing remarks.

Carlos Cárdenas, MD
Chair, Board of Managers
DHR Health

Welcome, everybody. I know all of you are breathing a big sigh of relief because I promised not to go on and on. I will be brief. I promise. I really do.

The energy we have as physicians, as so eloquently put before you just a minute ago, comes from the physician-patient relationship. That’s what fuels us who we are in health care every single day. It happens at the base of the pyramid with every provider, with first responders, with leaders in our community.

This Level One Trauma Designation is a reflection upon the work and the belief and the vision that all of you have had. Those on the front lines who knows what it means when we have an officer down, and that person needs to be cared for, and they don’t have to travel 240 miles to get to a Level One Trauma Center. Those days are over.

That’s the miracle that has occurred here today.

That’s what this community has done because this is your trauma center. From Starr County to Cameron County and the 14 counties that we will now have in our region, this is that achievement. It took all of us in every realm that we have to achieve this. Whether it was in leadership at the community level, at the city level, leadership out in the field, leadership in health care, political leadership and will, to make these things happen.

I have come before many of you many times over the years and talked to you about our vision here at DHR. It’s always been a vision of transformation. It’s not just about of the delivery of health care, but lifting up an entire area because 1.4 million people deserve the best. That’s who we are.

With that, I want to thank Gov. Abbott for his leadership, his steadfast support that has made this possible. I want to thank every member of our leadership team, some of who began this journey in 1997 and are here today, nothing short of the miracle that Dr. Skubicjust described.

Thank you.

Marissa Castañeda

On behalf of DHR Health, you were all part of our family, and now part of history in the Rio Grande Valley. We thank you so much. DHR Health remains committed to excel, to innovate, and to bring the very best of health care to South Texas and the Rio Grande Valley.

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For more on this and other Texas legislative news stories that affect the Rio Grande Valley metropolitan region, please log on to Titans of the Texas Legislature (TitansoftheTexasLegislature.com).

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