The patient stormed out of the doctor’s office and headed straight for the reception desk, banging on the plexiglass partition that (since Covid) separates patients from receptionists in this busy Mission District primary care practice. The lead front desk worker, Kattia Balestier, looked up calmly at the man (red-faced, glowering, 60’ish).
“You were not happy with the services?” she asked mildly.
She patiently listened to his concerns, then offered him an appointment with another doctor in the practice.
Balestier, an immigrant from Costa Rica, has been working for this same practice (now called Altais Medical Group Baywest) since she arrived here over 40 years ago. She presides serenely over the hectic front desk, effortlessly switching between Spanish to English, her deep-set brown eyes shining sympathetically as she talks with patients.
The practice, originally called BayWest Family Healthcare, was founded by four family practice doctors, on Silver Avenue in the Excelsior. When the office moved to Valencia Street, she followed. At 63, she has outlasted all four founders. Since the last doctor who founded the practice retired last year, “no one has been there as long as me. “
She has watched the changes in our healthcare system from the frontlines, manning the front desk of a practice that serves many immigrants, low-income families, and working poor. And while she is nostalgic for the days when the office was more like a family, when patients had a closer relationship with practitioners, and one of the doctors dressed up as Santa Claus every Christmas, she has no plans to retire anytime soon.
“I have seen patients who were babies and now they come back to me with their own kids. Babies that now are adult patients, that is so amazing to me.”
Balestier was born in 1962, in Guadalupe, a suburb 15 minutes outside of San Jose, Costa Rica. Her father owned a successful supermarket, and when her beautiful mother came to work there as a cashier, he courted her. Her dad was 32 years older than her mom, and they had three kids; Balestier is the youngest. She was named Kattia, an unlikely name for a Latina, her mother heard it in a Russian film.
After one year of college, at 19 and unsure of her direction, she decided to visit her aunt and uncle in San Francisco. “The plan was to stay for three months,” she recalls, but she wanted to avoid a problem boyfriend back home, and San Francisco was seductive: “It was so exciting, just amazing, the people were so friendly, and then the city itself: so so beautiful.”
She babysat for her cousin’s small kids, took English classes at the Senior Center on 30th Street (now On Lok), and attended a Pentecostal church, Lirios de los Valles, (Lilies of the Valley) where she met her now ex-husband, Louis Balestier.
He was a musician born in New York, the son of Puerto Rican immigrants. He played drums and composed Gospel songs, and she married him at age 20.
“His sisters said I married him for his green card, and to prove I didn’t, well, I never even applied for it till some years later.” Not one to embrace rapid change, she became a U.S. citizen at age 55. Her parents came for her wedding, stayed on and took odd jobs, one of which was cleaning offices. Sometimes she went along to help. That’s how she came to Bay West Medical, where the office supervisor hired her part-time to do some filing and setting up charts.
Her daughter Priscilla was born in 1984, then Olivia in 1987. When her youngest turned seven, she went fulltime.
“I was fine just cleaning the rooms, filing, and putting together medical records. Then they put me on the phones.” Initially she found it overwhelming to field calls from brusque physicians and spell arcane medical terms, but when it came to dealing with patients she was a natural.
“I could relate to them; I can be very patient,” she says. “I liked it from the beginning.” These days the patient load is roughly 60 percent English speaking, 40 percent Spanish speaking.
Her daughter Priscilla was a little girl when Balestier started, and now, at 40, she works alongside her mom as a medical assistant, taking vital signs, giving vaccines, and assessing patients ahead of the doctor’s exam.
Kattia Balestier and her daughter, Priscilla. Photo by Colin Campbell“I have seen so many changes in healthcare, and it’s sad, it’s very sad— the older patients need more time, more care, more medications. But I see them not get the meds they need cause Medicare doesn’t cover them, and they don’t understand.” She sends them to Medicare and Medi-Cal for help. Even more educated patients, professionals with employer-based health insurance, don’t always understand their plans.
“It’s so hard because the insurance companies try not to pay, and it’s a whole process to appeal. I explain all that.”
In the old days, she says, “This place was always so busy, two of us checking people in, lines out the door and the waiting room packed, now we have traveling doctors, we use them because we need to, but the patients get bounced around and don’t have the same relationship with one established primary care doctor like before. Since we were bought by a corporation seven years ago, things are much more rigid. Even my manager has a manager.”
In her free time, Balestier enjoys taking long walks, exercising, and crocheting and knitting, and following the Giants, “one of my favorite things to do during baseball season.”
Colin Campbell shows his arm to Kattia Balestier, Photo by Colin Campbell
English (US) ·