About
Topahkal or, House of Medicine, was the original name given to the clinic that began in a two-bedroom casita in the heart of South Valley, Albuquerque. Nearly twenty years later, that clinic stands as Casa de Salud—its new name voted for by the patients themselves—a pioneering alternative healthcare provider that treats thousands of low income and uninsured patients each year, trains medical professionals in human-centered and dignity-based clinical care, and coordinates action to eliminate structural barriers to their community’s best health.
When it first opened, the clinic offered affordable services, human-centered care, same day medical services including evenings and weekends, and non-Western healing services such as límpias, reiki, and massage therapy. Shortly after its founding, Casa became more deeply engaged in substance abuse treatment and recovery services and is now one of the most accessible medical clinics for opiate addiction treatment providing buprenorphine (suboxone) medication services.
In 2018, the clinic exchanged over 1 million syringes, enabling community members to use more safely and reduce the spread of HIV and Hepatitis C. Casa’s commitment to dignity-based care is evidenced through their drug use and addiction treatment services. Although the practice has now been adopted nationally, the clinic was among the first to provide suboxone for take home use so that patients could opt out of direct observation as they coped with withdrawal.
Today, sixty-five to seventy percent of Casa’s patients are monolingual Spanish speakers, 15% are either active drug users or individuals in recovery or treatment for various addictions, and Casa is one of the few healthcare providers that offer gender and sexuality affirming care and treatment to LGBTQIA2S+ community members in Albuquerque. Seventy-five percent of Casa’s patients are uninsured, roughly 20% are enrolled in Medicaid, leaving only about 5% of their patients who hold private insurance policies.
When they began, Casa charged its patients 25$ per visit. Patients paid if they were able and suffered no consequences if they were not. The organization has never and will never send a patient’s account to a collections agency for failure to pay. In this way, Casa provides a transformative and revolutionary model of what it looks like to provide quality, low cost and culturally competent healthcare to patients who are uninsured or under-insured and in most need of care.
Anjali Taneja, MD, MPH , who participated in the organization’s founding returned to Casa later in her medical career to serve as the organization’s Executive Director. Dr. Taneja has always known that the organization was called to do more than provide exceptional clinical care. With the support of the current governor and under Dr. Taneja’s leadership, Casa has worked with community leaders to craft legislation that can expand access and make health outcomes a priority for New Mexico’s legislature. It’s taken years for some of their policy interventions to gain momentum, but Casa proudly reports that three major pieces of health equity legislation that directly represent the community’s voice and communicate its needs have gotten a step closer to being signed into law.
Casa’s apprenticeship program ensures that the organization’s values will live beyond the clinic’s walls. Health Apprentices at Casa are trained as medical assistants and learn skills such as how to draw blood or perform an EKG. The bilingual high school and college students from the surrounding community—the overwhelming majority being young women—dedicate 500+ hours of service to neighbors, relatives, and other community members they know who receive healthcare services at Casa De Salud.
Graduates from the apprenticeship program leave Casa dedicated to treating and healing the underserved. Whether they become physicians, researchers, pharmacists, or physical therapists, each finds a way to apply what they learned at Casa about stubborn structural barriers to healthcare equity and how healthcare professionals can practice medicine with respect and preserve the dignity of all patients.
The Covid-19 pandemic exposed fractures in our healthcare system and led many Americans to reevaluate its merits. Casa has emerged as one of the most revolutionary healthcare models available and people are hungry to learn how to transform healthcare in their respective communities. For Casa, this is the path forward. If more individuals and organizations adopt their model of human-centered healthcare, the more evidence we have that low cost, dignified healthcare can be made widely available to all.