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<\/p>\nEL PASO, TEXAS (KFOX14\/CBS4) \u2014 Facing mounting administrative burdens and a growing demand for specialized care, pediatric endocrinologist Dr. H\u00e9ctor Granados is restructuring his practice in a move he says will ultimately improve access and quality of care for children in the region.<\/p>\n
Granados, a specialist in pediatric endocrinology, has served the El Paso community since 2014. <\/p>\n
After years in academic medicine, including training at New York City Health and Hospitals, NYU, and Connecticut Children\u2019s Medical Center\u2014he returned home to address what he describes as a deeply underserved population.<\/p>\n
“I think it’s a very underserved population. And something that I always predicated is the social responsibility that I have.”<\/p>\n
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Dr. Hector Granados, pediatric endocrinologist. (Credit: KFOX14\/CBS4)<\/p>\n
RELATED: El Paso families worry as local clinic stops accepting insurance; switches to cash-only<\/a><\/p>\n That need has only intensified. <\/p>\n A persistent challenge facing El Paso\u2019s healthcare system is the difficulty in attracting and retaining specialists; an issue Dr. H\u00e9ctor Granados says directly impacts patient access to care.<\/p>\n When Granados first joined Texas Tech University as faculty, he was part of a team of five pediatric endocrinologists. <\/p>\n Over time, however, the others left, leaving him as the sole provider in the region for several years.<\/p>\n \u201cPeople have different reasons for leaving,\u201d Granados said. \u201cI don\u2019t want to speculate too much, but some may not have felt supported or found the workload sustainable.\u201d<\/p>\n He points to a combination of factors that make recruitment difficult: high patient demand, limited specialist support, and the expectation of being on call far more frequently than in larger metropolitan areas. <\/p>\n In cities with larger medical networks, endocrinologists may share call duties among a dozen or more physicians. <\/p>\n In El Paso, that responsibility often falls on just one or two.<\/p>\n Granados and his colleague, Dr. Sanjeet Sandhu, are currently the only pediatric endocrinologists on call serving a wide swath of West Texas and southern New Mexico. <\/p>\n Together, they provide around-the-clock care, consulting with hospitals and emergency departments across the region, including in Albuquerque, Deming, and Ruidoso.<\/p>\n Dr. Granados mentioned he recruited Dr. Sandhu to his practice six years ago in hopes of providing more medical service to patients in need. <\/p>\n He also said his practice handles more than 1,200 visits per month and treats more than 8,000 patients each year.<\/p>\n \u201cWe take care of being on call 24\/7,\u201d he said. <\/p>\n Granados explained his practice is dropping private insurance and moving out of network on commercial plans as his practice transitions to a Direct Patient Care (DPC) model. <\/p>\n Under the change, families would pay out of pocket rather than having visits billed through private insurance.<\/p>\n According to Dr. Granados’ website<\/a> the DPC model offers:<\/p>\n $350 consultation fee for new patients and non-membersBone age X-rays available on-site for $30 for non-members; members receive two free X-rays annuallyMonthly membership options include:$50 basic plan covering thyroid conditions, puberty, growth, obesity, and weight management$150 comprehensive plan covering type 1 and type 2 diabetes<\/p>\n Dr. Granados also offers services based off of diabetes, <\/p>\n He said the shift is intended to reduce administrative workload, adding it \u201cis going to allow us to have less burden on processes that are administrative that really take a lot of time and effort.\u201d<\/p>\n The change, Granados says, is driven primarily by administrative challenges rather than financial gain.<\/p>\n \u201cI have four full-time employees just handling insurance billing,\u201d he explained. \u201cThat\u2019s time and resources that could be spent on patient care.\u201d<\/p>\n Dr. Hector Granados’ office and health center in East El Paso. (Credit: KFOX14\/CBS4)<\/p>\n He also cited frequent delays caused by insurance requirements, such as prior authorizations and limits on the number of visits per year. <\/p>\n These barriers often lead to missed appointments and delayed treatment, particularly problematic for chronic conditions like diabetes that require ongoing monitoring.<\/p>\n \u201cWith DPC, patients can be seen as often as they need,\u201d he said. \u201cThere are no co-pays, no caps, and the entire care team is available to them.\u201d<\/p>\n Granados adds the decision follows years of frustration with insurance denials and the time required to appeal them.<\/p>\n \u201cWe get a lot of denials for services… And then we have to work on appeals and trying to recoup that amount of money,\u201d he said.<\/p>\n KFOX14\/CBS4 asked how often appeals are approved, Granados said, \u201cAfter going through the motions of sending documents and talking to people, I would say like 50 to 70% would get approved, but you already spent all that energy in trying to get that covered.\u201d<\/p>\n He also pointed to delays tied to prior authorizations and to missed appointments. <\/p>\n \u201cAnd then we have a big issue with no shows and cancellations… we have a no show cancellation rate of 30-40% daily, which is a lot, I think,\u201d Granados said.<\/p>\n Granados said he tried reaching out to insurance companies for help addressing the financial impact of missed appointments but said those efforts did not lead to changes.<\/p>\n \u201cI reach out to the insurance\u2019s asking for capitation asking to relieve that problem to help us cope with the fact that patients have a very high no-show cancellation rate and then they ignore us,\u201d he said.<\/p>\n As KFOX14\/CB4 has reported<\/a>, some families have raised concerns about affordability and access. <\/p>\n Brianna Reese spoke with KFOX14\/CBS4 on Wednesday stating, \u201cI couldn\u2019t even pay out of pocket if I wanted to the only unless I joined the membership.\u201d <\/p>\n Brianna Reese, type 1 diabetic, mother of 10-year-old Rockwell Reese. (Credit: KFOX14\/CBS4)<\/p>\n Reese adds, \u201cFor other families, like $150 is, you know, they\u2019re electric bill. So it\u2019s, I don\u2019t know, it\u2019s a lot.\u201d<\/p>\n Reese also added concern over possibly traveling hours away for the next nearest pediatric endocrinologist that will accept her insurance. <\/p>\n Granados said families concerned about having to travel long distances to use private insurance should contact his office.<\/p>\n \u201cWe understand that every family\u2019s situation is different,\u201d he said. \u201cWe\u2019re willing to work with them to find solutions…For example, patients that we take care of who have more than one child that needs to be seen, we’re going to accommodate those patients.”<\/p>\n RECOMMENDED: El Paso IDEA Edgemere principal arrested in off-campus DWI case<\/a><\/p>\n KFOX14\/CBS4 asked Granados what would he say to parents who now are facing possibly a four plus hour drive for specialized care to use their private insurance?<\/p>\n KFOX14\/CBS4 reporter Julia Spencer interviews Dr. Hector Granados. (Credit: KFOX14\/CB4)<\/p>\n Granados responded, “They can come to the office so we can explain in detail. Maybe they have a different understanding of what we are doing and why we’re doing it, but they don’t have to go elsewhere. We’re here to take care of them. It\u2019s just a different way of paying for the services, but we\u2019re not the only ones doing this,\u201d he said.<\/p>\n He also emphasized that the practice will continue to provide hospital care regardless of a patient\u2019s insurance status.<\/p>\n \u201cWhen a child shows up in the hospital, we don\u2019t ask about insurance,\u201d he said. \u201cWe just take care of them.\u201d<\/p>\n Granados shared with KFOX14\/CBS4 that more specialists nationwide are exploring direct care models as a way to reduce burnout and improve patient relationships.<\/p>\n Granados mentioned:<\/p>\n Dr. Amy Burton<\/a> in Plano, Texas who charges a $150 DPC membership fee for a comprehensive plan. Dr. Penelope Pauley<\/a> in Ocoee, Florida who charges a $195 DPC membership fee for a comprehensive plan. .Dr. Robert Ferry<\/a> in San Antonio, Texas who charges a $100 DPC membership fee and limits his services to 300 patients total. <\/p>\n Despite the move away from private insurance, Granados said his commitment to patients remains the same. <\/p>\n \u201cIf I don\u2019t take care of these vulnerable population, who\u2019s going to do it?\u201d he said.<\/p>\n KFOX14\/CBS4 spoke with the El Paso Center for Diabetes who states that two other endocrinologists are currently accepting pediatric patients for type 1 diabetes; Dr. Benito Marranzini and Dr. Sergio Rovner. <\/p>\n![\"Dr.](\"https:\/\/www.newsbeep.com\/us-tx\/wp-content\/uploads\/2026\/05\/5bb02be2-50cf-4e1b-a0a7-f78364bc9f28-c6ce587e894e46f0bd2d6f1f954de032.png\"\/)
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