What would you do if the mother of a sick baby came to you overwhelmed, obviously on the brink of depression? Would you quickly write a prescription and send her on her way? Or would you do the unthinkable: take the child in for the weekend to give the mother a break? Sue Chan, M.D., a pediatrician at Asian Health Services, did both.

“That’s who she is — very dedicated, principled,” said Karen Mori, an RN who hired Chan decades ago as the first paid doctor at the AHS, a community health center that serves low-income immigrants and refugees in the heart of Oakland’s Chinatown.

Now celebrating its 35th anniversary, the AHS started as an all-volunteer group that offered two days of clinic a week, but has grown into an organization that provides primary, dental and mental health services in 10 languages to 20,000 patients a year. Nearly 90 percent of the patients are non-English speakers, one-third are uninsured and 98 percent are below the poverty level.

Chan, who’s served as the medical director of AHS, is an extremely dedicated physician who helped set the tone of the organization.

One reason Chan is so passionate about AHS is that her background is quite similar to many of the immigrants served by the clinic. She was born in Shanghai during World War II, a time so bitter that her family had difficulty getting adequate nutrition. When the war ended, they moved to the United States, where her father had great difficulty finding adequate work, despite his Ph.D. in chemistry from the University of Michigan.

“He was given almost nothing [in terms of pay],” she recalled.

Meanwhile her mother, who had studied chemistry at Shanghai University, was hugely embarrassed to hold a job where she stood for up to 10 hours a day stuffing vegetables into cans.

Chan had several uncles, cousins and grandparents who were doctors, but she never considered the field because she didn’t think she was smart enough. But when she entered college, she participated in a work-study program that spurred her to perform research at Memorial Sloan-Kettering Cancer Center and Jefferson Medical College. At Jefferson, she met an Indian surgeon who encouraged her. “You can do [medicine] if you have dedication and an interest in helping people,” she recalled him saying.

The surgeon took Chan to an operating theater to observe a caesarean section. Blood gushed up, almost hitting the glass ceiling. “This looks pretty interesting,” she thought.

After college, Chan went to Hong Kong and Taiwan for 18 months to study Chinese and figure out her life’s direction. When she returned, Chan decided to attend medical school at Ohio State University, then completed her internship at the University of Chicago and embarked on a pediatrics residency back at Ohio State.  

She then relocated to the Bay Area to earn a Masters of Public Health at UC Berkeley. The Bay Area was the first place (aside from Asia) where she wasn’t one of just a handful of Asians. And she loved it.

Chan graduated in the early 1970s, on the heels of the Civil Rights movement. It was a time when many minority communities were agitating for equal access to schools, housing, health care and jobs. A large influx of Asians were arriving in Oakland, prompting a group of community leaders, health professionals and students to survey the 40-block area surrounding Chinatown. They discovered that those residents were getting health care services at half the rate of the mainstream population, probably because there was only one doctor in Chinatown.

The Chinatown community was predominantly uninsured and extremely low-income. They faced language, transportation, economic and cultural barriers to quality medical care. For example, immigrants from rural China even today can be uncomfortable with answering questions about sexual health or undressing completely for pelvic exams.

And so, as the pressing need for health services for the Chinatown population was established, AHS was born. Very soon thereafter, Chan joined the staff part-time, volunteering more than double her paid time. “That was tenor of the time,” Chan laughed.

Today, Chan is beyond pleased that AHS has expanded so greatly — it now offers acupuncture, minor surgery and some specialty services including cardiology, neurology and dermatology. There are interpreters for nine languages including Mongolian, Khmer (Cambodian) and Mien. As of 2005, the organization employed 161 staff including 41 doctors, nurses and physician assistants and had an operating budget of $16 million.

And the AHS does more than just provide medical care – they organize the community, doing everything from encouraging patients to vote to bringing patients to Sacramento to speak out against proposed Medi-Cal cuts.

They also teach patients to advocate for themselves. “We explain their condition, why we’re thinking about this treatment option, and they ask questions so they’re empowered,” Chan said. “It’s not like that for a lot of patients who come from other countries or down the street from another doctor and have no idea of their diagnosis or why they’re taking medicine.”

Not only has Chan contributed to AHS, but she’s also learned a lot from her experiences, especially as an activist. As an immigrant whose native tongue was not English, she was often reluctant to speak out for the community. “I’ve been growing up with the organization,” Chan explained.  

“I’m 68 years old and still happy to be here,” she said. “I look forward to coming back to see patients. People who come to work for the organization are just exceptional. I’m in awe of them, their commitment to community and wanting to make difference.”

In many ways her story is similar to those immigrants she serves, who may have been doctors or professionals in their own country but end up working in a supermarket or restaurant in America.

It was those meager beginnings that inspired Chan not only to become one of the first doctors at AHS, but also to dedicate herself to helping immigrants make a successful transition to a long, healthy life in their new home – even if it requires the occasional babysitting of newborns.

Alice Chen is a freelance writer in the Bay Area.

In May Santa Clara County Medical Association absorbed the administrative functions of the Monterey County Medical Society to help sustain the waning and financially struggling society. But the move could cause a ripple effect stretching beyond Silicon Valley; it could act as a model organization for other small physician associations struggling to stay afloat.

In fact, the Sonoma County Medical Association manages the Marin Medical Society in a similar arrangement to the one brokered by Santa Clara and Monterey, and the benefits of such a model are many, according to Santa Clara County Medical Association executive director Bill Parrish.

Many small county medical associations are facing a serious problem during the next several years, Parrish said. The executive directors have likely been with the organizations for years and are up for retirement and it’s more difficult to find replacements, especially for the salary many of them can afford.

As was the case at Monterey County, as membership numbers drop, benefits are cut. Then more members leave the organization rather than pay the same amount of dues, or even higher, for fewer benefits. Monterey’s society has about 250 members this year, down from nearly 265 in 2007.

Instead of closing their doors due to trailing membership numbers and sinking profits, some small medical societies are opting to join with ‘parent’ associations, like the agreement between Monterey and Santa Clara.

“This arrangement is good for both organizations,” said Parrish, who brokered the deal between Monterey and Santa Clara.

In this case, the medical society will continue to have a board in Monterey County to represent its physicians, but all other functions will be operated out of the San Jose office for the SCCMA.

Monterey County physicians will be offered more services, benefits and even lower annual dues under the new arrangement. Now, the dues are $350, down from $360 last year.

Under SCCMA, Monterey County physicians will be offered assistance in solving problems with insurance companies, more continuing education workshops and a 22 percent discount on Verizon and other equipment for a physician’s office.

“Just last week a physician from Monterey called us upset. He had hired a consulting firm, but felt he got ripped off,” Parrish said. “We helped him negotiate a better deal.”

This will become a model organization and partnership for more medical associations across the state, Parrish said.
The decision to partner with Santa Clara came after Monterey County Medical Society, a nonprofit organization, suffered financial losses of $124,329 in 2007. During the same period in 2006, the association made a profit of $7,010, according to the latest 990s filed with the Internal Revenue Service.

The medical society had a $161,691 in revenue for 2007, while its Executive Director, Ivey Zinaida, was paid $99,266 a year in salary, according to federal documents. Zinaida retired in 2007.

The Healthcare Journal was unable to reach Monterey’s board members for comments on this story.

Santa Clara County Medical Association, on the other hand, is one of the largest medical associations in California. In 2007, the association had a profit of $53,920 on $1.2 million in revenue, according to 990 filing with the IRS. Bill Parrish, the executive director, earns a salary of $364,000 a year.

Now that the merger is complete, one primary objective for the SCCMA is to grow membership. Given that there are 600 physicians in the county, Parrish said, there is plenty of room for more among the medical society’s ranks.

Troy May is a contributing editor of the Healthcare Journal. He may be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .