OVERSEEING STATE MEDICAL PRACTICE
S.A. doctor serves on Texas’ regulatory, licensing board
Mounted antlers — some dressed with hats — line the hallway to Dr. Manuel “Manny” Quiñones’ examination room. When he’s not seeing patients at the San Antonio clinic or in meetings of the Texas Medical Board in Austin, he’s at a ranch west of San Antonio with his wife, who loves to hunt.
“We enjoy doing all the work ourselves; we do all the ranching and farming ourselves,” said Quiñones, a family physician with Health Texas Medical Group of San Antonio.
Republican Gov. Greg Abbott this year appointed Quiñones and four others to the Texas Medical Board, with terms that last until April 2023. Quiñones is one of three San Antonians on the board, which regulates the practice of medicine in Texas and oversees physician licensure.
Quiñones grew up in San Antonio, in a home he shared with aunts, uncles, his parents and his sister. He’s been practicing family medicine for more than 30 years, since graduating from Baylor College of Medicine.
Quiñones recently sat down with the San Antonio ExpressNews to talk about the future of medicine and the board’s work. Here’s an edited transcript of the conversation:
Q: How did you get on the path to becoming a physician?
A: When I was 11 years old, we had a motor vehicle accident, a big one. We were driving back from my uncle’s ranch. A car lost control — it was a two-way highway, it was raining terribly and a car lost control and hit us head on. I was the last one that got pulled out.
I spent about a month in the hospital. I’ll never forget. I think that’s what sparked my interest in medicine. I literally lived in the hospital for a month and got to see how things happened, and I thought, “Oh, this is pretty cool, I think I’d like doing this.”
Q: What’s the part of family medicine that you liked the best?
A: The diversity. I can see 25 patients and 25 different problems. Invariably, somebody comes in and says, “By the way, I’ve got this mole, can you check this mole for me?” OK, I can take care of that. And, “Oh listen, my daughter, my grandson just got diagnosed with ADHD, what should we do?” It’s just the diversity of problems and diversity of people that I get to take care of.
Q: What’s the toughest part? A: The thing that I dread the most is the thing I embrace the hardest, and that is having to give people bad news. Gosh, one of the worst ones was pancreatic cancer. I don’t know what’s going on, but we’re diagnosing it — at least I’m seeing it — in younger and younger patients. It’s a devastating disease. Rarely do you hear of a cure, and rarely do you hear of anybody surviving more than a year.
Q: How do you make sure that you don’t take those diagnoses home with you and live with your patients’ pain or hardship?
A: When I teach residents and medical students … I take them in a room with me when I have to give bad news, too, and I tell them, “Every time you do this, it has to hurt you enough to cry.” … The challenge is feeling it that hard, but then being able to shake it off and walk into the next room and take care of that problem, too. You can’t go down with the problem because you’re not any good to anybody.
Q: What’s the best health advice that you’ve ever received?
A: You know, my mom’s uncle was 104 years old when he passed away. I’m hoping I got some of his longevity genes. He told me, he used to be my patient, “Todo en
moderación. Everything in moderation.” Everything this man did, he did only a little bit of. He would wake up every morning and he would have two fingers of George Dickel whiskey. He’d pour into a glass and he’d put it on the nightstand and he would tell it in Spanish, “I’ll see you in the morning.” He would wake up, take a little sip of his whiskey and sit there and do his exercises on the edge of the bed … This little guy, he lived by himself until he passed away.
Q: What’s the health tip that you find hardest to follow yourself?
A: A good diet. My wife and I are foodies. We love good food. One time my dad told me, “Whenever you’re eating something this good and it tastes this good, spit it out because it’s probably bad for you. If you’re eating something that tastes like cardboard, that’s OK, you can swallow it.”
Q: What do you see as the biggest health challenge facing Texas right now?
A: I think that one of the think what we need to start to do is practice value-based medicine. Doctors need to embrace that and change that, but it’s hard. We do it in our group. We’re very, very conscious of that, and we’ve made some tremendously big changes in our practices and through the years, through the last 20 years, 25 years, our group has become head and shoulders over everybody around them in terms of practicing value-based medicine, but I think a lot of doctors don’t embrace that.
Q: What do you think is the most promising advance in medicine on the horizon?
A: I think that creating awareness in our patients, and letting patients have access to the internet, has a tremendously powerful strengthening of patients’ voices. I love it when my patients come in, they’ve got three questions or 10 questions because they read something on the internet. And the first thing I tell them is, “First of all, don’t believe everything you hear. I’d love for you to ask me questions, but don’t believe
everything.”
I think the advent of electronics and patient access to information is one of the most tremendous things that medicine has experienced. When I started off in practice, I used to practice with a guy that kept his medical records on an index card. Today, my computer is the size of an index card and I can be sitting on the back porch of my ranch house, and I can access my patient’s medical records from my smartphone.
Q: Do you go to your own doctor?
A: I learned my lesson about 10, 12 years ago. I was just drinking way too much coffee. I would drink 10, 12, 15 cups of coffee a day; and my stomach, I just tore it up. I went to go see a gastroenterologist, a very dear friend of mine, and he did a bunch of studies on me and he said, “OK, here’s the deal, I’ll take care of you, but you can’t take care of yourself anymore. You can’t be trying different things to see if it works.” … That was my advent.
Q: Did you cut out coffee? A: Yes. I did. I love coffee. I drink a little bit of it, but I drink mostly tea.
Q: What shocked you most when you started delving into what the Texas Medical Board does?
A: I’ll tell you what was really, really surprising was
the amount of work that goes into doing what the board does. There is literally a small army of investigators, and attorneys that are incredibly dedicated to doing that they do.
Q: Have you been on a team who’s had to admonish or revoke the license of any physicians?
A: Oh yes. It’s a sad thing to do, but it does happen. Most of the time it happens with lots of warning and lots of chances to make changes, but somebody has to be the parent and step in and make decisions.
Q: Is it hard to do that? A: Incredibly hard. Because I think what impact my medical license has on my life, and my ability to earn a living. But when you’re doing something bad, that’s the least of my concerns.
Q: What are some of the reasons why those people’s licenses have been revoked?
A: Sometimes people ignore things. Sometimes the board says, “Hey, you’ve got to go do the (continuing medical education), you got to take this course to learn how to do this different.” Sometimes they just ignore it. I guess they must think, “If I ignore it, it’s going to go away.” It doesn’t go away, it just gets more and more and more serious.