MODESTO BEE
ORIGINAL ARTICLE

By KEN CARLSON
BEE STAFF WRITER

Last Updated: September 19, 2005, 06:04:52 AM PDT

Jeannine Birmingham, who had her first son at age 16, always worked to help pay the bills.
She punched cash registers in convenience stores and computer keyboards for an equipment rental business, leaving her with carpal tunnel syndrome in her hands and wrists.

Now 38, she needs surgery to relieve the shooting pains in her shoulders and numbness below her elbows. But like many in Stanislaus and Merced counties who are in the state's Medi-Cal program, she can't find a specialist to perform the operation.

"I have worked all these years; it's not like I am living off the system. I actually need the help," said Birmingham, a Stevinson resident whose 22-year-old son has served with U.S. forces in Iraq. She also has a 4-year-old son at home.

Birmingham's situation is not unusual, according to health professionals who work with Medi-Cal patients and the uninsured in the valley.

For years, low-income patients from the valley have had a tough time finding doctors, but the situation has become critical for those needing the skillful hands of a surgeon, health workers said.

Birmingham said she was denied by every orthopedist she called between Sacramento and Fresno. She also was turned down by University of California at Davis Medical Center and Bay Area university hospitals, often the last resort for uninsured patients.

"None of the university hospitals will take elective surgeries like this," said William Dennis-Leigh, a physician's assistant at Delhi Medical Clinic who has made calls on Birmingham's behalf.

"The private sector has simply abandoned Medi-Cal patients," he said. "The system is collapsing."

The Delhi clinic also has trouble referring patients to ear, nose and throat specialists, and there is virtually no access to rheumatologists and dermatologists, he said.

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