ALPINE — Controversy is brewing in Alpine after a pediatrician at Big Bend Regional Medical Center sent out letters abruptly severing doctor-patient relationships with multiple children.
While the hospital has not yet publicly addressed the move, the affected families believe it was retaliation for their opposition to coronavirus emergency measures.
The pediatrician in question, Ekta Escovar, is a member of the local COVID-19 task force and the local health authority for Brewster County. She’s become a prominent face of emergency measures in the tri-county, fielding questions from reporters and concerned residents about the pandemic and what local officials are doing to handle it.
Rick Flores, CEO for BBRMC, did not respond to a request for comment. Escovar declined to comment, instead referring The Big Bend Sentinel to a hospital spokesperson.
A spokesperson for the hospital also declined to comment on the situation, citing “pending litigation.” But in a statement, she stressed that “Big Bend Regional Medical Center remains committed to improving the health of all people in our community in a caring, quality-focused manner.”
The fallout started earlier this month, when Adam Brant, manager of the Bargain Barn in Alpine, received a letter from the hospital’s clinic, the Big Bend Regional Health Center.
It said he was no longer “aligned” with Escovar’s recommendations for his children’s care and that a “successful patient physician relationship does not seem possible at this time.” It asked him to call the hospital so that “we may transfer your records to your new doctor.”
“It was a shock,” said Brant, who used the hospital for medical care for his three children, aged 4, 6 and 8. “We’ve never had any issues with care for our children. This really came out of left field.” He wondered if his opposition to coronavirus emergency measures, including viewpoints he expressed at an Alpine City Council meeting against a proposed mask ordinance, had caused the termination.
A few days later, another Alpine parent, Lynette Barboza, received a letter with the same wording. She’d also used the clinic for pediatric care for her two children, including her three-year-old with cerebral palsy.
While Barboza says she hasn’t spoken about coronavirus health measures publicly, her mother, Monica Quiroga, has. Barboza also works at Old Gringo Cafe, her family’s bar and grill that has reopened with limited capacity in compliance with state “reopening” rules.
Like Brant, Barboza was surprised and frustrated by the letter. “I’ve got enough to worry about,” she said in an interview last week. “I’m a single mother, I’ve got two kids — and one of my kids has disabilities.”
Her kids had “adored” seeing Dr. Esovar, she said. But with no other pediatricians at the clinic, she worried she’d have to start making long-haul commutes to get them care.
Due to her son’s cerebral palsy, Barboza already travels to Fort Worth for specialty care. But having to travel for regular check-ups felt like a logistical nightmare, for a number of reasons.
“We’ve got to get used to a whole new set of medical professionals,” Barboza said. “That’s a bit of a challenge, with the sensory overload” for her son with cerebral palsy.
It remains to be seen how the situation will play out, or whether BBRMC will present an alternative explanation for the termination. But the controversy bubbled to the surface earlier this month, after Barboza’s mother, Monica Quiroga, posted a lengthy statement on Facebook.
“I’ve been a vocal proponent of local business in Alpine, Texas, being open,” Quiroga wrote. Escovar didn’t like those views, Quiroga wrote, “so is refusing to treat my grandchildren from now on.”
She accused Escovar of “publicly funded bullying” and says she’s “legitimately concerned that the boys will not receive adequate care in an emergency.” (Escovar is uncompensated for her public work as the Brewster County health authority and as a member of the local COVID-19 task force.)
“Neither of the boys have been to Ekta since well before the Coronavirus shutdowns, so she hasn’t advised my daughter in any manner relating to the virus,” Quiroga added. “Therefore, it is impossible for Lynette Barboza to not be aligned with her.” She shared several photos and videos with the post, including photos of her grandchildren and the letter from the hospital.
A day after receiving the letter, Barboza spoke on the phone with BBRMC CEO Rick Flores.
In a recording of the phone call, which was also shared in the social media post, Flores says he’s “gotten a lot of intel” about the letter but is “kind of at loss” about the situation and is “not a happy camper.”
He said he’d heard from the clinic about concerns with doctor-patient relationships and that the “next thing I know, we’re getting hammered about letters we sent out.” And he says he was aware of the budding controversy on social media.
“It’s not my business, or the hospital’s business, when you open,” he said to Barboza in the phone call. “That’s between you and the county.”
In a follow-up call the next day, Flores said he wanted to meet with Barboza and Escovar to “resolve some simple communication challenges.” And while he did not directly acknowledge why the clinic had terminated pediatric care for Barboza’s children, he referenced statements on social media and said that “Escovar may have perceived those as questioning her ability to provide care.”
Barboza, though, stressed that she hadn’t made any critical comments of Escovar. “I’m just a little confused,” Barboza said.
“Me too,” Flores agreed.
In the end, though, no such meeting happened. When Barboza said she wanted to bring a supportive party to the meeting, Flores apparently thought she meant a lawyer. “Wow,” he said. “I’m not going to allow an attorney in.”
Barboza quickly stressed that didn’t mean an attorney and that that “wasn’t where I was going at all.” But in a follow-up interview with The Big Bend Sentinel, Barboza said the statement “felt like an escalation” and made her second guess whether she should meet with Flores and Escovar.
Instead, Barboza did ultimately retain a lawyer. In a letter to Flores last week, she accused Escovar of acting in an “unprofessional and discriminatory” manner towards her children and said the hospital “will likely hear from our counsel in the coming days.” She also said she might file complaints with the Texas Medical Board and the American Medical Association.
The letter makes three demands: A formal apology letter from Escovar and the hospital, a “reprimand and/or removal” of Escovar from any administrative positions at the hospital and assurances to Barboza and any other affected families that their children “will not have their care affected by personal vendettas.”
Barboza added that she intends “to settle this matter amicably” but stressed that Flores had given her a new perspective on the situation by bringing up lawyers.
“You expressed hesitance to meet with me and a witness and gave me pause when you brought up the idea of having attorneys present,” she wrote in the letter. “As I thought about your words, I realized that you are probably right; I do likely need an attorney to represent my children’s interest, and ensure that they receive appropriate medical care when seeking treatment in our rural hospital and clinic.”
Barboza’s lawyer, Art Martinez de Vara, said in an interview Tuesday that he had filed a complaint with the Texas Medical Board and was also considering filing a lawsuit over what he described as a “blatant violation” of the civil rights of Barboza’s children.
“They’re a governmental entity as a public-health district,” he said. “They have to treat everyone equally. They can’t discriminate.” He called it “very bad practice” to “deny a child health care because of the parent’s political stance.”
In interviews with The Big Bend Sentinel, neither Barboza nor Brant seemed happy about the escalating situation. But both said they were just worried about the safety and well-being of their children.
“My concern is — should we have a medical emergency and I take him to the hospital — will I still get the same treatment for him as I would under normal circumstances?” Barboza asked. And with a child with cerebral palsy, medical emergencies are “not a matter of if, but when,” she said.
Brant felt similarly. He said he didn’t begrudge Escovar’s viewpoints and might have viewed the situation differently if she was in private practice. But with Escovar serving in a “public leadership position” during the coronavirus crisis, he said the situation was a “violation of the public’s trust.”
Asked if he thought that trust could be rebuilt, Brant didn’t think so.
“It’s too little, too late,” he said. “She’s burned bridges. How can you put them back together?”