Member Highlight: Dr. Ray Altamirano of Casa Salud

Dr. Ray Altamirano, San Antonio Business Journal 2020 Man of the Year, standing next to his lion portrait

For our May issue of the San Antonio Free Market Medical Association, Shankx Web Development chose to highlight the outstanding Dr. Ray Altamirano of Casa Salud Family Medical Clinic .

Dr. Altamirano was chosen as 'Top 40 Under 40’ and ‘2020 Man of the Year’ by the San Antonio Business Journal. He has been featured in San Antonio Current, Fox News, La Prensa, The Kelly Clarkson Show  and  The Doctors.

His collaboration with other brilliant leaders in the medical community around San Antonio has been featured on local news outlets like KSAT this month for helping to contact trace by delivering to-your-door COVID-19 testing.

We have a home 24/7 for those who have tested COVID positive and they can come here to get treated.

How did you become involved in testing?

I reached out to people who were in this group of creative and eager social entrepreneurs like, 'hey, let’s find another way to get tests out there.' What we did is not a matter of competition, the goal is to test as many people as possible. When you look at the objective of testing it’s to help the current system in place, which is Metro Health locally. 

​Metro Health is hiring more contact tracers. If you get more contract tracers you can nip this thing and it’s usually the asymptomatic tracers that are spreading it. That’s what we’re trying to capture by testing more people.

What do you do specifically after testing?

I help those who test positive.

Part of what separates what we’re doing is that we include a telemedicine visit for those who test positive and for those who test negative but are symptomatic they can go to their doctor, or Casa Salud.

How has COVID changed visitations in your clinic?

These last few weeks with this demographic, there are so many courtesy visits that I’m doing without them paying because they can’t. I think [about] doing the right thing for people.

I saw a highlight of you on Univision where you said Texas ​could become the next epicenter. Is that still true?

It’s hard to predict who is going to get super sick.

At first, they thought it was only the elderly, but if you start looking at diabetes and obesity, San Antonio is the diabetes capital of the United States. Maybe you don’t have it but Gramma could get it.
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The more you can test, the more you contact trace.

Is there value in people of color joining the free market?

​I’m from the south side. I’m very proud to be Mexican. I’m proud to cater this demographic that doesn’t exclude anybody but serves more blue collar workers that are just working contributing to this country.

They need access. And good access--not just any access. I decided I was not going to wait for a government agency to do it. It has to come from us.

I said, ‘the only way I’m ever coming back to primary care is on my own terms' because I don’t want to be working in the system contributing to these money games with diminished care.

Dr. Altamirano’s Drive

I wanted to be back in the community through primary care and I knew the only way that would work is to be outside of the world of insurance, so that’s why in March of last year I formed my clinic, Casa Salud Family Medical Clinic.

Casa Salud Versus Traditional Practices

There’s definitely more liberty to treat how I see fit. There’s luxury that I have working outside of the world of the networks of insurance. For me, I like staying fee-for-service mostly to fit my demographics. However, I have the luxury of having my ER job and I see my clinic as more of a service for people who don’t have insurance and I’m able to have some staff.

‘No Insurance’ and the Free Market Medical Association

It’s a matter of creating a free market and what I’ve learned about insurance and about labs that take insurance, about imaging centers, etc., is the prices they fill out are completely arbitrary. There are numbers much less than that they’re willing to work with if you’re paying with cash, So that’s definitely what I love about my clinic and how I feel that freedom.

Teaching Cost-Conscious Medicine

The most important thing that I’m doing outside of treating patients is training mid-levels. They learn conscious medicine, putting prices on what they need to do because that’s what people are most worried about.

​Patients are more concerned about what it costs than why they’re sick.

When they see there won't be any back billing that will put them in bankruptcy for a procedure or for anything because I was able to negotiate upfront a price and approach the problem with a price tag to it, it is more effective.

Casa Salud and the San Antonio Community

I really like the service in my community. I think what I’m doing serves as a blueprint for anyone who wants to do that for their own community. If they want to train under me that’d be great. I tell everyone that there is a way to make money and you don’t have to be a specialist. 
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You can be a primary care doctor and still earn a good living through this model and be completely free and have the liberty to practice as you choose and you’re working for your patients not the payer,

​so that’s exactly why I do what I do with my clinic.

Zip Codes Matter

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​"The zip code where I grew up in, that’s where I focus my clinic.

​If you draw a line halfway, highway 90, in the middle of San Antonio, what you see is a 6-1 ratio for doctors in San Antonio in the south.

​There’s less care here for more unhealthy people.

I have hope with the new medical school being nearby. If I could help capture them now and show them by thinking outside of the network of insurance,​

'You’re free. You can make money. You can do it.' There’s no need to go anywhere else.”
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Amar es Vivir: To Love is To Live

Pictured above: Member of the San Antonio Free Market Medical Association Dr. Ray Altamirano of Casa Salud Family Medicine Clinic holding his artwork from his collection that can be found on Facebook page ‘Amar es Vivir.’

I ran into a patient who needed knee injections, very expensive, he couldn’t afford it, so I was able to convince a pharmacist to sell it for me at wholesale and then retail it. I started selling all my art prints to pay for him and that got on the Kelly Clarkson Show, The Doctors, national TV. We were able to sell enough of my art prints to pay for this man and beyond him that we had people come and donating for other patients.

​That’s how that evolved and the art is definitely me, it’s a hobby, release, a form of therapy for me. The name of my art is Amar es Vivir, more of a motto of how I want to live and that translates into my practice. My clinic is my gallery.

Interview brought to you by Shankx Web Development and Consulting. For more information, please visit https://shankxwebdev.com

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The FMMA was founded in 2014 by Jay Kempton and Dr. Keith Smith based on their mutual desire to fix our broken system. They founded the FMMA based on three pillars. 

1. Price is not a product. 
2. Value is mutually determined and requires transparent pricing and quality. 
3. Cash is king, the equality of price is critical.The FMMA connects true buyers and sellers of healthcare, educating and motivating them to work together based upon a mutually beneficial relationship built on the pillars.

​To learn more, contact sanantonio@fmma.org.