Tensions have been rising in the Sierra View Zone 1 race between Ela Pandya and Dr. Bindu Sagar Reddy as barbs are exchanged in newspapers, social media, and campaign ads.
But Zone 1 isn’t the only election on the ballot. Zone 2 incumbent Dr. Gaurang Pandya, Ela’s husband, is being challenged by Dr. Kuldeep Jagpal. And in Zone 4, Incumbent Dr. Rakesh Jindal has two challengers, business owner Victoria Porter and Physician assistant Liberty Lomeli.
A Chance for Diversity on the Board
Zone 4 has been the most civil of the three races. No criticism was spoken and no endorsements were made for the other two districts.
Liberty Lomeli is the only Hispanic running for the board in a hospital district that is predominantly Hispanic. He brings a rich background of experience working in the fields as a teenager and then spending 10 years in the military as a medic. After the military he went to Fresno State then continued his education at Stanford, receiving his Physician assistant degree. He currently is the assistant medical director at Family Healthcare Network (FHCN.)
Lomeli believes he can raise the quality of care in terms of the hospital’s performance and in its statewide scores such as Leap Frog. If Sierra View compares its performance with cath labs around the country, he believes it will provide local doctors with a reachable goal and improve quality of care.
A similar system succeeded at improving care at FHCN while he was assistant director.
“World class care here can come if the doctors are given feedback on how they are doing.”
Lomeli would also like to see more collaboration between local health clinics and the hospital, which he says is currently non-existent.
“I’m all for the community. Whatever is best for the constituents,” said Lomeli.
Victoria Porter has built a medical office from the ground up, helping her husband set up his practice as an orthopedic surgeon. Porter is very familiar with the business side of medical care and with the hospital.
And Porter hears firsthand the patients’ concerns about the hospital.
“Not a month goes by that I don’t hear a patient complain about the hospital. The out migration needs to be addressed by the Sierra View District.”
She said the quality of care and bedside manner are the most common complaints. Porter says that it is the way these problems are addressed by Sierra View that concerns her the most.
She has seen improvement, though. “Over the last few years the hospital has hired a patient liaison which was a positive step,” she said.
Porter said the communication between the physicians, administration, and the community could be a lot better. That in turn would attract more doctors which the Valley sorely needs. Sierra View needs to do forums, she said, like the ones held by Kaweah Delta that involve the health community and the general public instead of just taking surveys.
“It’s even more challenging in small communities to combat rumors. So communication needs to be even better,” said Porter.
She is challenging the incumbent because in the four years that Jindal has been on the board Porter has not seen the hospital’s issues being addressed. She has also not observed that the community is more comfortable with the hospital.
”The community does not feel like it is being heard. It really needs to change.”
“I just hope that no matter who gets elected that they can bring that change,” said Porter.
The incumbent, Jindal, ran for the board four years ago because, “I raised three kids here and have been in practice for 42 years. The community has been very good to me.”
He says that he brought a lot of leadership experience with him when he won in 2016. He had been Chief of Staff twice and was the president of a medical care management organization. Jindal was also Chair of the board three of the four years. “That speaks to the confidence that the other board members have in me.”
A lot has been accomplished during his term, which he attributes to the entire board not just himself.
The Cath Lab has been expanded and the urology and cancer centers have been opened. Jindal said that these improvements are the result of past boards that made good decisions and he was proud that the current board was able to complete its vision.
The current board has made a Joint Powers Agreement with Kaweah Delta Health Care District to share resources and spread the risk of uninsured patients. They have also developed a Graduate Medical Education program that will bring in residents starting next year. He also said that Sierra View was just starting to open its own medical clinics to expand care.
Jindal wanted to point out that all the accomplishments of the board were made possible by the adept leadership of Sierra View CEO Donna Hefner.
“Our board has given clear-cut, unambiguous, good direction to the administration and I would like it to stay that way.”
Asked who he endorsed for the other two zones, Jindal said he had some good advice.
“All you have to do is pick up the phone and talk to your doctor to get some unbiased information. Most doctors and hospital staff are well informed, especially in this small district.”
Mudslinging continues in Zone 2
The battle extends beyond the ballot box for Sierra View Hospital District 2.
Incumbent Dr. Gaurang Pandya has been critical of Sierra View’s contract with Comfort Care Anesthesia. His challenger, Dr. Kuldeep Jagpal, owns the company.
Pandya claims that Comfort Care is overpaid for the amount of services and quality of care provided. Jagpal says his company gets market rate, or maybe even less, pointing out that the company has a huge overhead with insurance, accounting, and employees.
Jagpal says he has been able to build an excellent team of anesthesiologists in a very competitive market and in a very challenging region such as Tulare County. “But we don’t provide anesthesia services to his (Pandya’s) surgery center and won’t. Other providers have also said no,” according to Jagpal.
“I think Dr. Pandya is just jealous of our contract. My goal is to just ignore it completely.”
Jagpal says Pandya is “causing trouble as a director and intimidating, harassing and bullying the surgeons and staff.”
“I have been vocal while on the board,” said Pandya, “and that makes the administration uneasy.”
Zone 1 candidate Ela Panya has been severely criticized over her residency, but questions about Jagpal’s primary residence have also surfaced.
Jagpal’s facebook says he lives in Morgan Hill and his phone number has a 408 area code. His facebook highlights some of his favorite restaurants in the city.
Jagpal says he has houses all over but is registered to vote and spends most of his time in Porterville. To administer his company’s contract with Sierra View he says he has to be available and that his house is located close to the hospital.
“It’s an old facebook and has not been updated,” said Jagpal.
Jagpal’s first real job after his residency in 2000 was in Porterville. He then moved to the Bay Area for a few years but then moved permanently to Porterville in 2008.
While candidates have criticized the number of doctors on the hospital board, ironically four doctors are running in this election, including both candidates for Zone 2.
Even Dr. Bindu Sagar Reddy, candidate for Zone 1, said he would prefer more community business people rather than doctors on the board.
But Pandya disagrees. He says the business community gives guidance on how the hospital can make a lot of money or pull in a 10% margin. Pandya said that business mangers on the board wanted to get rid of the hospital’s eye clinic.
Past hospital boards invested well so he said the district is on good financial footing. But Pandya wants the hospital not to make ends meet through its investments but though the income generated by day to day operations. The money made on the investments he feels should be used to improve quality of care and services offered to the constituents in the district.
Pandya feels he should be re-elected because he and his fellow trustees have done a good job over the eight years he has sat on the board, and he has seen improvement at the hospital.
Jagpal counters, “Most employees have appreciated what I have done for the hospital and my neighbors want me to be on the board. Sierra View feels like a family and the hospital feels like home.”
He said that the last article published by the Valley Voice concerning the election critical of his company actually helped him.
“If honest, hard working, and good at what you do you don’t have to worry about anything else.”
Husband and wife on the same Board buying a house in the zone means they have an agenda. Do NOT vote for either Pandya!! Their disgraceful comments about Donna Hefner, the hospital and other Board members are proof enough that neither one is professional enough and fit to serve on the Board.
In spite what Dr. Pandya and his family says Out The Anesthesia group We strongly encourage to call any Surgeons , Nurses,, Techs , RNFA at Seirra view Hospital Poterville CA Also Employees and our Patients . You will be surprised to know that we have very high favorable ratings..
Also we have a very good track records. By giving false statements about The Hospital Dr. Pandya either are hiding their own deficiencies or they have personal vendetta against The Hospital staff and the care providers.. Please do your own inquiry and research before believing anything Pandya’s are writing, adverting and saying. Also wishing Pandya”s good luck and advising them to pay attention to their own Practice instead always looking for confrontation and spreading misleading statements. Wish Dr. Pandya and his family all the best in life.
My name is Carlos Leyva Moreno, MD. I was raised in Tulare County. I completed elementary school at Fairview in Visalia as well as Valley Oak Junior High and finally Redwood High School, Class of 1981. I went on to attend Fresno State, Graduate from Oregon State University, Oregon Health Sciences University School of Medicine and finally completing my anesthesiology residency training at the University of Michigan. I have been in private practice since 2004. I am licensed to practice medicine in Michigan, New York and California. Since 2012 I have done strictly travel job assignments throughout the states that I am licensed in with the majority of my work being completed in hospitals throughout my beloved Central Valley. I have most recently become aware of the heated hospital board elections for the Sierra View Hospital Board. Speaking as someone who has never had any litigation, limitations or restrictions brought onto any of my medical licenses, I have worked at this hospital and can say with assurance that the level of patient care that I had the privilege of taking part in was on par with patient care given at any of the local hospitals. That said, almost every hospital within the greater San Joaquin Valley, like many other rural communities across the US have experienced significant decline in practicing physicians over the past twenty-five years.
The physician shortage has been driven primarily by demographics. Estimates indicate that by 2033, the number of Americans over age 65 will grow by 45%. Because seniors are the population with the greatest health care needs, in both primary and specialty care medicine, the supply of doctors must increase to keep pace. The Association of American Medical Colleges projects there will be a shortage of between 21,400 and 55,200 primary care physicians by 2033, making it difficult for millions of people to get preventive health care services. Equally troubling is the projected shortage of between 33,700 and 86,700 specialists, leaving patients with debilitating neurological, pulmonary, cardiac, gastrointestinal, orthopedic and other medical ailments without any immediate access to necessary primary or specialty medical care.
In response to the growing physician shortage, medical schools have increased their enrollments. However, without raising the federally imposed funding cap on support for graduate medical education (GME) — which has been effectively set and unchanged since 1997 — and without expanding training capacity, the increase in medical school graduates will do little to help the growing demand for physician services, especially in rural cities not able to offer the pay scale and lifestyle that larger cities can offer. Where does this leave cities like Porterville, Visalia, Tulare, Exeter, Woodlake, Orosi?
With regards specifically to anesthesia services at Sierra View the following is a generalized outline of how these services are rendered. Anesthesia groups vying for the contract to provide anesthesia services bid for the contract to provide anesthesia services to Sierra View Hospital. After the contract has been granted by the hospital to a group each practicing member of that group must be credentialed, vetted, and given the right to provide anesthesia medical services for the hospital. In the effort to meet the bid guidelines anesthesia groups have used non-physician nurse anesthetist to provide anesthesia services WITHOUT physician supervision. This is because of laws passed over a decade ago in California which stated “Because they are highly trained specialists, California, like many other states, allows CRNAs (certified registered nurse anesthetists) to administer anesthesia WITHOUT physician supervision. That practice is supported by the fact that CRNAs are independent practitioners who are legally responsible for their own actions and mistakes. September 21, 2009”
Thus today Sierra View Hospital like many other hospitals has had to seek out medical providers from a shortage of a limited number of providers that are available. As hospitals are turning to other alternatives: nurse anesthetists and foreign medical graduates the healthcare consumer must be aware . As the market for providers gets more competitive with larger cities and metropolitan regions attracting more US trained physicians rural cities like Porterville will be subjected to not only the budgetary restraints of what hospitals can afford to competitively pay physicians in rural areas but who will be ultimately in charge of your healthcare.
To conclude, the medical care provided all of the patients of Tulare County should be driven based on scientific evidence and clinical science. Patient safety should ALWAYS take paramount to any other force guiding medical care. A few things any patient can do on their own is ask their healthcare provider these simple basic questions that should always be answered openly by providers.
1. Have you had any to litigation brought against your medical license? Have you had any restrictions or limitations brought against your license? If yes, how many?
2. Have you had any adverse complications arising from medical care you provided? If yes, what were the complications.
3. Where did you complete your training and how long have you been practicing?
4. Are you a doctor or nurse? Are you board certified?
Lastly individuals who are responsible for making any healthcare decisions that impact a community should be of the community from which they represent, with a sense of how their community works and what things may help that community to provide the safest, most up to date medical care available. In Porterville where the city that has large Latino and Native American communities it would be prudent to have people that truly represent those communities at the table as well as women from the community when decisions guiding the healthcare for Porterville are being made.
Furthermore, it should be key to forge alliances with major training medical centers to introduce medical students to the Central Valley for exposure to rural medicine. Establishing strong alliances between Stanford, UC San Francisco, USC, UC Irvine, UC Davis with support from local communities to introduce medical students from these schools to the San Joaquin Valley would be a good start for any rural community looking to attract the next wave of the best and brightest.
Kuldeep for the win!
My name is Jp i am an anesthesiologist working in Sierra view. I feel sorry for patients and families Pandya’s have killed.they have killed people.Go to hospital records.tegal Pandya doesn’t know how to do surgery.even minor cases.she want her dad who is another not knowing.they are for money.if I am not truthful go to public records.you will find.both father and daughter are disastrous and I refuse to surgery with them.i request my dear people in case you end in emergency room who is my surgeon.if you hear Pandya ask what my options are.They will butcher you.There are other options for surgery better than pandya.father and daughter will kill you.really upon Jesus Christ.