The Chile Wire with Abe Baldonado. Hey, everyone. Welcome back to The Chile Wire. I'm Abenicio Baldonado.

Season's greetings. We're coming up on Christmas time and I would like to call this a special Christmas edition of The Chile Wire. And we have a very special guest with us today, Doctor. Nathaniel Roybal. Doctor.

Roybal, thank you for joining us.

Super fun to be here, Abe. I prefer Abenicio, though, and excited to be here for this Christmas special,

for My dad would say the same. He would say, I named you Abenisio. Go by Abenisio. So I completely agree. And, dad, I'm sorry.

I'm still going by Abe. So Yeah. Doctor Roybal, just wanna before we jump in here, we're gonna have a pretty jam packed conversation on medical malpractice, but want to open it up for you to share a little bit about yourself, who you are, where you hail from. We're both Northern New Mexico kids, and so I'd just love for our audience to get to know you, and then we'll dive into some of the more complex issues.

Yeah. No. I think before we get into the nitty gritty, it's nice to talk just a little bit and get a little bit grounded. Native New Mexico kid. I grew up in Mora, New Mexico up near and between Las Vegas and Taos.

Graduated from the smallest school in New Mexico, which was Mosquito, New Mexico. I'm a graduate with one of five kids, which means I graduated in the top 10 of my class, which is You pretty know, you can't go wrong with that. And it's a good stepping stone to go on to medical school. But the truth of the matter is just being a rural kid, learned a lot about hard work, work ethic, and that's what's really translated into success as a physician. One of nine kids.

My parents are both teachers, so deeply invested in education and family. And I run Retina Consultants of New Mexico. I'm a retina surgeon here in the city of Albuquerque. We love our patients. I think that's what makes me a great doctor.

Of course, I was benefited from having an amazing education. But just the fact that I'm from New Mexico, I love the New Mexico patients, and we try to bend over backwards to help as many patients as innovatively as we can. And so because it's that same drive that's got me involved with organized medicine trying to improve health care in New Mexico.

Absolutely. And Doctor. Rabaul, I grew up in Las Vegas, New Mexico, so not too far from you. And I didn't know that you went all the way to Mosquito for your primary and secondary education. So yeah, that's a big trek.

So Mosquito, was there my junior and senior year, really small school. My dad got a job as a superintendent.

Oh, Okay. So you just commute with him.

And when you take in nine kids to a really small school district, they're going to hire you for sure. I think we doubled the size of the school. But really, a small town out in Northeastern New Mexico, which is just a beautiful place to grow up. A lot of freedom that rural kids enjoyed back then. I hope they still do.

Yeah, I think they do. I went home for the holidays, and Las Vegas still has that small town feel. And it actually took me back to just remembering my childhood of playing outside. You know, you could sleep with the doors unlocked. I don't know if that's still the case today, but, I grew up in that same sense of community and culture where, you know, everyone knew everyone and, you know, you were safe.

Your parents could let you play outside all day, and in fact, they encouraged it. I don't know how much of that's true today just given technology and, you know, we have laptops and phones ruling the world, but I I think there's still a sense of that rural community still out where we grew up.

Well, it's one thing to have to lock your your door at night and lock your car. We certainly did not do that growing up. Yeah. But I think the even bigger deal that is happening now, particularly in the cities, is the school playgrounds and gyms are locked. And in these small towns is pretty neat, because we'd go play basketball in the gym at night or go to a karate class.

And I think that that's really great for our youth, it was good for me, for sure. It keeps a lot of kids out of trouble, but that's just not available to them. And so I wish we would quit shuttering our local institutions and playgrounds for our kids.

I agree. And on that note, it seems like we're shutting out even doctors from our state. And so now to transition to some of the more unfortunate conversation, but it's actually I I look at it as fortunate because we have someone here. Doctor. Riboll, you are a practicing physician.

We've heard it too many times that doctors aren't leaving our state because of medical malpractice, laws. But, you know, talking about rural New Mexico and, you know, oftentimes growing up and even now as an adult, I hear that New Mexico is a poor state. You know, we're small. But I wanna get down, how did we get here? How did we get to losing doctors?

Where did we get to this crisis now where we see ourselves? And I know it starts back in 2021, but with your experience, I want you to fill in our viewers of how we got here and how right now we are in a battle to change New Mexico for the better. And and you talk about earlier of our kids growing up and our youth having opportunities. And I think oftentimes our youth and I go back to myself at 20 years old, I wasn't thinking about, you know, I need a doctor or I need a primary care physician or if I need surgery, I need to make sure that I have access to the highest quality doctor, whether it's a cardiologist, neurosurgeon, whatever it may be. And now that I'm in my thirties, late thirties, you know, I think about my parents, but I also think about myself now, and I also think about my future children.

And so look at the world that we're living at today here in New Mexico, and we are in a crisis.

And I don't think the word crisis is too strong. Certainly it's not being misused in this area, because when it comes to people's health care, there's two things, and I know this now being a parent, that when you put your babies to bed that you hope and pray for.

You hope

the first two things are that they're safe and that they're healthy. Those are the two things that you really want for everybody that you love and care about.

Absolutely.

And so when that becomes unavailable to you, if you do need a doctor and there's not a doctor there for you and I give talks around the state, and it's impressive. That's the single unifying factor for New Mexicans right now. You say, How many of you have lost your primary care doctor? And you just see everybody in the room's hand raises. And that's concerning, and that is a crisis when you're talking about the health care of New Mexicans, because literally lives depend on us having some success here.

And so I'd like to you asked a lot of questions I threw a

lot at you right there, right

away. A really good introduction to the topic, though. I think we have to take a step back. Both of us are small town kids. I certainly did not grow up in a wealthy family, and most people who grew up in Las Vegas, New Mexico do not either.

And that's Okay. Very modest families. It was great. But I'd like to address this, New Mexico being small and New Mexico being rural, and that's why we'll never have great health care. And that is just absolutely false.

And I think one of the things that I'd love to see us change in New Mexico is how we think about these issues and how we talk about them. But let's have some expectation. And what's wrong with a grandiose expectation in saying, I want amazing health care. I want the best health care in the country right here for New Mexicans. And why don't we work towards that?

Instead of working towards just the next measure to move us just a tiny bit more forward down the line, and maybe we get a little bit better. Let's get a lot better, and let's give New Mexicans the greatest care right next door, not in another state, and sometimes not even necessarily all the way in Albuquerque, right in Las Vegas. Let's make it so women can deliver their babies there, that you can get great care. When something goes wrong, there's a great institution in your community that could take care of you. And let me just I have a minute to say Of course.

A couple small towns that are doing amazing things in health care. University of Iowa Hospitals and Clinics, where I trained, town of 77,000 people, has one of the best hospitals in the entire country. Amazing. Tiny little town, terrible weather, not nearly as pretty as Santa Fe or some of our other great towns, Las Cruces, even Albuquerque. And so these are things that that's certainly a small place.

Small state, 3,000,000 people. And then the behemoth that you have to talk about when you talk about small towns and great health care, the Mayo Clinic. The Mayo Clinic, town of depends on how big of an area you define as the town, but certainly around 200,000 people. So we're in the range of Rio Rancho and Las Cruces and some of our bigger cities. But still, this is the world renowned Mayo Clinic, the top hospital in the country.

It's not in New York City, it's not in San Francisco, it's not in LA, it's in Rochester, Minnesota, which is freezing cold right now. We're a little cold here, not that And so if it doesn't have to do with the size of town you're in, and that started with a humble beginnings, just a family called the males, a dad, and two sons who are doctors. So, you know, we may have a humble beginning here, but certainly that should not define our future, and our size cannot either. And so that's why I take some time to say, let's step back from this conversation, and let's just aim for greatness from the get go, and let's demand that of our legislators, let's demand that of our institutions. We want greatness.

Absolutely. And I look at that as comparable to the conversations that are happening right now along education. We are striving for better than fiftieth, and we should be doing that for our health care system as well. Like, if we're talking about education, we should be talking about health care just the same because ideally, you would hope that the pipeline of students in New Mexico would become doctors and they have a place to stay here at home in New Mexico instead of being forced out to other states, like you said, to practice. I I think anyone who is like us wants to stay at home.

We want to be close to our parents. We you know, we're very family oriented, and we want to foster an environment where, you know, folks can stay close to home. You don't have to go to another state. You don't have to go to Texas. You don't have to go to Houston to MD Anderson, like you said.

You don't have to go to Rochester, to the Mayo Clinic to have a great career opportunity. You can do it right here at home, and we're going to create that pipeline for you. So and the expectation should always be the greatest. So with that, I want to take it back to 2021 Sure. And House Bill 75.

What happened there?

So I think that what you're saying there in terms of allowing our kids to stay here, medicine is a relationship business, and it just is. And I believe you get the highest level care when you're being cared for by somebody who genuinely has an interest in you. And when you have a homegrown kid and they know your grandpa and your grandma and it's like a family reunion when they show up in the room and it happens to be your doctor. That is a beautiful situation because you talk about somebody who's vested in you as a person. So then to ask you, so why would a doctor who graduated from Mora or Las Vegas not want to go back or stay in the state at least to practice?

Certainly there's plenty of patients to be seen. You could start a practice and be flooded with patients. It's a great scenario from that standpoint, so it's obviously something different than just market dynamics that are keeping people from practicing, from coming in large numbers into New Mexico in terms of doctors. And that is the medical malpractice situation. So there's other things that obviously contribute to it.

It could be education Partly alive, crime, I mean. These things are brought up often. And sometimes they're brought up to confound and confuse the situation. But the truth of the matter is we've lost a lot of doctors since 2021. In 2021, then Speaker Egoff put forward a bill with Damon Eli, and it was a bill to dramatically rewrite the Medical Malpractice Act.

It was House Bill 75. So you can remember back in January 2021, the country was closed down. New Mexico was closed down. This was a legislative session held on Zoom because we were afraid of what was going to happen. Our hospitals were flooded.

Our ICUs were full. We were afraid of mass deaths from COVID. And we took this opportunity when the state was on its back heels, when doctors had no ability to fight anything other than a pandemic, which is the worst in over one hundred years, and we rewrote the Medical Malpractice Act, which grossly made it in favor of trial attorneys. And no surprise that the people who rewrote it, the legislators, are trial attorneys with massive conflict of interests, who then left the legislature to profit off of this law. Yeah.

And it's pretty clear. When you look at the graphs, 2021, the bill passes. The number of suits in this state skyrockets. The value of those suits skyrocket immediately. It puts us at three times the national average in terms of suits settled, three times the national average in terms of the value of those suits.

In fact, the value of our suits are the highest in the country. The number of suits are the highest in the country. And so if you're looking for a job, you don't want to go to somewhere where you're very likely to be sued. Right. And being sued in this case has no correlation with the level of care, because the level of care stayed the same, but the number of suits increased when so happened a law changed.

And so you have to go back and adjust this law. It's important to point out that doctors still do care and want patients who are hurt by the medical system to have representation. And there's a form of doing that through the patient compensation fund, where they can get ongoing health care, where they can be made whole. That's not even part of the issue. This law, though, however, swayed this so far towards the side of the point 01% of patients.

I mean, one patient was awarded so much money this past year in New Mexico, it was the same amount of money it would take to provide all of the health care for Rio Rancho, New Mexico. Wow. One patient. Wow. That's statistics.

And so there's no extra pot of money for where those huge settlements come from. That is bankrupting institutions. And when you bankrupt an institution, you can give up any hope of being number one.

Yeah. Yeah. And I mean, we've seen it with a lawsuit in New Mexico that nearly bankrupt a hospital in rural New Mexico. I mean, what does that do for the rest of the folks that live in that community? And I think we've had this conversation before.

You know, medical malpractice laws are necessary for bad actors. We know that there are bad actors. But unfortunately, the current laws right now, the the burden to prove is really minimal. And I'd love for you to walk us through that. But Sure.

That's just something that really sticks out with me is that this isn't about going after bad actors. This is just about we're gonna make some money here, and we're just gonna sue for just about everything. And we'll put up a a graph that you've shared with us on the rise in claims since 2021 when house bill 75 passed and the amount of claims that went up and the amount of lawsuits. So thank you very much for providing that. And we'll get into a little bit of that, but let's go back to the the burden of proof.

But the burden of proof is probably, from what I've seen, the least of most states across our country to be able to file a lawsuit.

So part of the rewriting of this act for House Bill 75, it did change the cap amounts of what could be settled. It made them huge for hospitals, dollars 6,000,000. There could be multipliers in there. It just really escalated things tremendously from where we had been. The big issue, though, when you're talking a burden of proof where I'd like to get us focused because this is a complex issue, and doctors have had to study it for years and learn not only the legislative process, the legal process, and how to figure it out.

But the big issue was how punitive damages have changed. So let's educate folks on what a punitive damage is. So if you had a medical malpractice suit, there's a compensatory damage of just saying there was medical malpractice, and this is what your health care costs are going to be, and this is how we're going to make you whole. A punitive damage, then, is different than that. A punitive damage is saying, you intentionally

Harmed this person.

Harmed this person, and so we are going to punish you now, the doctor or the hospital, for doing this because there was some intentionality. It was just gross and terrible. Should be exceedingly rare for that to happen because doctors rarely, if ever, go into a hospital saying, I'm going to really mess you up in surgery today intentionally. That is not how this happens. Yet in New Mexico, 95% of the suits that are being filed have punitive damages associated with them.

Wow. So the neat thing to point out that's different about a punitive damage is it's not part of the insurance. Every doctor has to have malpractice insurance. If you did anything without malpractice insurance, it would be foolish. The malpractice insurance typically has like a 1,000,000 per case cap on it.

And that's kind of the general number for everybody inside what's called the patient compensation fund and outside the patient compensation fund. That's just sort of the general insurance cap that's had. But once you allege punitive damages, that's different. There's no insurance for punitive damages. Punitive damages are your personal money.

And so they're targeting your assets in your business, your personal assets, like your home and cars, and those sort of things become a problem. And so the reason why on that graph you see that escalation in 2021 when things shoot up is because the number of suits that were settled dramatically increased. They should not have increased that quickly, because it takes four or five years to settle a suit. The reason they all settled in 2021, got a new law, boom, huge settlements happening, is because they were able to hold punitive damages over somebody in order to get compensatory damage. So you get the quick million dollar check, and they say, if you settle with us, we won't go after your home and your business and your kid's college fund and all of that sort of stuff.

And so obviously, it's a very effective way to make institutions pay. It's a very quick dollar, and it needs to stop because it's really unfair. Suits that have really no merit are being settled because of that, because of the And threat of a punitive so that's why I think it's really important that we educate folks on what punitive damages are. Because come legislative session, they're going to be talking about insurances and caps and all this sort of stuff. The real fear is behind punitive damages.

And when doctors say they want it to be safe to practice in New Mexico, that's what they mean. And sometimes, in medicine, as we've seen in all the TV shows and as you can imagine, and maybe some of your loved ones were in this unfortunate situation, but you can show up to a place, to a hospital, in dire needs, and very complex decisions are made really quickly. And you want to empower doctors to make those decisions in your best interest, in things that might save your life, things that might make you more functional, give you a little bit of an edge. That's great medicine. If your doctor is saying, no, that's kind of a little too edgy, I could get sued and lose everything, that's no longer a safe environment to provide the best possible care.

Right. And so New Mexicans deserve better. New Mexicans deserve to be number one at something, at some point. And why not medicine? The number one economic driver in the country.

It's a $5,000,000,000,000 national business. Why not excel in medicine at this state? Why not make this a destination for great health care? Certainly you'd rather spend a winter in Albuquerque or Las Cruces or Roswell than Rochester if you were going through treatment. So I think we have a lot to work forward to.

In terms of punitive damages, some of the nitty gritty, if I Yeah, please do. So a couple of things is we've had one of the lowest burdens of proof in the country. We want to raise that. It's sort of like you know, for a murder conviction, you hear them talk about beyond You a reasonable see that on all the TV You

have to prove that this person no had intention to

doubt. No doubt in your mind. We'd like a step lower than that, which is clear and convincing, which is, you know, that you're pretty sure that this happened, which is very reasonable. It's a middle of the road. Most states have that.

Very few states have ours, which is preponderance of doubt, which is the lowest barrier. We'd like to strengthen the language so that it really says that there was intentional malice, harm, intent to cause harm. There's words in ours like reckless, some of the suits are cited, patient rights, things that just don't belong in there that allow for interpretation in these ballooning, what are called nuclear suits, where you get into the tens of millions of dollars, and should have never it should have never been allowed. But we need to strengthen our language. And finally, we need a cap.

We need a cap on punitive damages so that there's some reassurances that we're not going to, as you pointed out, bankrupt our rural hospitals. Even our big hospitals in Albuquerque are not immune from going bankrupt, and also our individual providers. It just has to be kept so that there's sort of a measured response to these things. And there's a moral injury that's going to take some time to get over and get fixed. But if we can show our doctors that we're legislatively going to fix these problems to protect them, to protect the institutions that our communities rely on, you can't have a great town without a great hospital.

It just is essential. The two go hand in hand. And I think just demanding from our legislators that that is the bar. Asking trial attorneys about how to fix health care, getting their permission to fix health care is like asking the cartels permission to fix crime. There's no need to do it.

You don't need to go there. We know where the fixes are. We know how other states have done this. We know how to get positive results. Let's do that, and let's change our talking points from, oh, just the next measured increment to give up a little bit of the pie, and let's just do what's right for New Mexicans and their communities.

Absolutely. And and on that note, as we talk about legislators who are trial attorneys, two of the most notorious trial attorneys in our state legislature, specifically our state senate, I've built a little bit of frustration as I've seen some of the interim committee hearings, on the medical malpractice issue, and and one was most recent where we had a legislator ultimately tell a doctor and a think tank that was working on compiling all the data to show where New Mexico ranks and ultimately said, your data's a lie. Like, you are lying. And that to me and we have the graphs here that you've shared with us that we're gonna share with our folks. But ultimately, this legislator would be telling you, doctor Reubel, you're lying.

Your data is wrong. Us trial attorneys know better. Like, you all are harming patients. And that's ultimately what she said is that everyone is just making this up that, you know, doctors aren't leaving New Mexico because of medical malpractice and everything that the data has shown has been a big lie. And to me, that's frustrating because ultimately, you're slapping in the face the people who are coming to you that are the experts like yourself who are practicing and telling them, oh, no.

It's our medical malpractice laws that are driving doctors out of our state. And, you know, are there other reasons for doctors leaving potentially? But one big one is that, like, in typical New Mexico fashion, we're anti business. We're we're anti entrepreneurship. We're, you know, anti folks making a living and being successful.

And ultimately, we're going to attack you for doing that. But that's just how does that feel? Like, when you hear legislators who have interest from, you know, some of the trial attorneys or being backed by trial attorneys say that the data's a lie. I mean, that's got to be frustrating, right, to hear that and say, no, I'm telling you, as a physician, as a doctor, here's what's happening on the ground.

Well, the reason I've put together graphs like that, that graph is from the National Practitioner Database. That's from CMS. That's as good as the data gets. It's a .gov address. It's not an individual that had nefarious reasons and put it together.

It's just data right out the bank. And if you're savvy enough, you can get in there and calculate it yourself. That's what I would encourage people to do, go in and calculate it themselves. The other daunting number is between 2019 and 2024, New Mexico went negative in doctors. We lost two forty five practicing doctors, which is terrible.

Although there's a health shortage, they say this is a national problem, not a New Mexico problem, there is a physician shortage nationally, but nationally every state added doctors except for New Mexico. We lost doctors. And all of this happens to correlate with a 2021 bill, you know, I think sooner or later you have to face the music. And, you know, the senator who's saying that, she is a trial attorney. She's my senator in my district.

She can be a ferocious debater, which is good for her. But, you know, we need to face the music. Mhmm. And, you know, it's sort of like education in New Mexico. I've heard the same thing.

Oh, those statistics are not meaningful because, you know, that we don't like how they measure something or another.

Yeah. Got to be flawed because we don't like it.

Well, you know, that's not the way you do it, you know? Like, you take a test, if you get an F compared to everybody else, it's a comparator. And these are comparators, and let's just part of fixing a problem is you've first got to be willing to talk about it. And facing the music on the problem is saying, we have an actual problem here. It's okay to have put together a law that didn't work, first off.

If the 2020 law one law, House Bill 75, is so terrible and it's wrecking health care in New Mexico, why not just admit it and say, we put this bill together, it didn't work, we're going to rethink this and change some things. That's fine. That's you couldn't expect a 100% hit rate on every single bill, but I think the fact that we're still trying to talk around it is problematic. What's even more problematic is the people who are talking around it are either employed or have been employed by trial attorneys or are trial attorneys. And you know, I think we have to get smart, and New Mexico voters have to get smart when they see this.

And this is partially why people like me, doctors, are out doing the Chili Wire podcast. We're trying to talk about it and be reasonable, and I think that that's what medicine ultimately is in a community, is you have folks who are trusted by the community, who are very professional, have the community's well-being at stake. And I think that that's what we're trying to do is just reeducate the public. And the truth of the matter is, if you have somebody who wants to deny data, who wants to talk around experts, who wants to continually vote in ways that hurt 99.9% of New Mexico in terms of their health care, their safety, their ability to get great jobs, and build a strong future Mexico, does that person really need to be in our legislature?

Yeah. I ask you that. Yeah. Just like every bill has unintended consequences, elections have consequences, and sometimes this is what you get. And I think your your spot on voters need to start becoming more aware of what their legislator is doing and what the legislature in its entirety is doing.

But there's some positive things happening, and there's a pathway and there's some solutions. And I'd love for you to walk us through that, of some of the stuff that you're working on and some of the things that are happening around our communities, that are creating a pathway and potentially an upcoming solution to some of the crisis that we're seeing.

Yeah, so I think basically it's meant that doctors like myself have had to brush up and learn a lot about the political process. You've been deeply involved in, and you'll know more than I ever will. But we've had to learn about this. I think in New Mexico, we have two factions, right? You've got Democrats and Republicans.

And I've started to look at New Mexicans in the sense of sports fans. Yeah. So I'm a big Lobo fan and season tickets to the basketball games, and I love sports. I love taking my family there. And sometimes it's hard to be a Lobo fan because we don't always win, you know?

And you'd like to see more wins some years than we get, and you don't always agree with the coaching. But no matter what, you know you're going to put on the Lobo Lobo cherry rad, and you're going to go and support, and that's what you do. Politics was never meant to be that way. You were never supposed to put on a Republican or a Democrat jersey and just vote that way endlessly. I know my home community does that, but that has been our downfall.

Because as long as you're doing that, we're in trouble. That's why we have to start tearing this stuff apart by issues and looking at individual issues and informing voters. So part of it is that voters have been really misinformed for a long time, because the progressive Democratic machine is incredibly powerful, and they know how to market, and they have a lot of media. And so come election time, everybody who's running is pro health, anti crime, going to rebuild education, so why not stick with the home team, right?

Right.

And that's just not true. And so obviously, if you're not getting good results, have to take a look at it, particularly through data, we've been doing. So part of what you say, when you first started, you said there's been some good from this. Well, how is this good? We've lost doctors.

We've almost bankrupted at least one hospital, and doctors are leaving, saying they just don't want part of that environment. The part of the good that has come from this is in 2021, we woke up a sleeping giant. And this giant was a house of medicine. Doctors who had been just content to go to work and see patients and stay out of all of this have had to wake up for their own safety, for the safety of their family, for their financial futures, and for their ability to continue to practice in New Mexico. And you've seen this unification of medicine and hospitals and hundreds of doctors showing up to the legislature.

All of this stuff is new in New Mexico. And when you talk about this incredibly powerful lobbying arm of the trial attorneys, to have an arm that's growing to be powerful, which is the House of Medicine and doctors and just advocating for health care and advocating for patients and helping to grow and strengthen our hospitals and our communities, that is something that can potentially pay dividends to New Mexicans for decades, for generations. Because if we really strengthen health care, we start legislating, if every legislative decision had two goals. One, is it going to make you and your family more healthy? And two, is it going to make it easier for you to get health care in your hometown?

If those two things were part of the decision making tree for about all of our legislation, goodness gracious, things would get a lot better. And so I think that that's the good. So certainly, we're focusing on medical malpractice. That's the first hurdle. That's problem number one, number two, and number three.

And so we can't focus on anything else. It's taking all of the air out of the room right now. But when we get that fixed, goodness gracious, we get to start fixing some of the other stuff that's going to be really fun. And when we fix some of the other stuff in terms of insurances and access and different things that we can do, things are really going to get pretty nice here. So I'm optimistic in the next five to ten years that New Mexico is going to be an incredible place to be healthy in.

Absolutely.

And that is going to be really exciting. And in order to do that, we're going to have to get involved legislatively. We're going to have to work hard to form a grassroots community amongst voters. We're going to have to have doctors talking to patients about some of this stuff, which has been sort of taboo. It can't be taboo because we need to ensure that they understand where we're coming from and how we can take the best care of them, our patients and our fellow community members.

And so part of what we've done in order to do that is we've had to build the same tools that the other side has. And those tools are the ability to lobby legislators, the ability to communicate with patients and voters, inform, and also raise money, because we've had these things, media campaigns And take that's something that we've never had that level of organization to do. But if one side's running commercials and you're not

You're going to lose every time.

Yeah. And that's been the math so far. And so if you're a basketball team and the other team doesn't show up, it's a guaranteed win. And that's been the calculus so far in New Mexico, and obviously, the state has suffered. And so in part of our efforts, what we've created is an organization called Citizens for a Healthy New Mexico.

Citizens for a Healthy New Mexico is a group of doctors. It's a group of just extraordinary New Mexicans who have learned the ropes through over the last five years and said, we've got to do better. We need to build the toolset to allow us to represent ourselves, to get the legislative outcomes that we're going to want to make New Mexicans healthy, to hold our legislators accountable, to help inform the public on legislative races where we think it's important. And with those same two goals that I set, is every piece of legislation going to make us healthier? Is it going to make it easier for us to get care at home?

And I think that this is easily this state's ninetyten issue. This has nothing to do with being a Democrat or a Republican. This is just part of being a New Mexican. And New Mexicans are not divided on this. And I do believe that when we educate them, when we tell them what we need in order to build these institutions to recruit doctors to be able to get OBGYNs to move into Las Vegas, New Mexico, to Taos, to Roswell, to Rehoboth and Gallup.

Right now, we have these deserts where women can't even deliver babies. You know?

Yeah. Alta Vista in Las Vegas got rid of their OBGYN services.

Well, part of it is you can't recruit in it. And these are great towns to live in. I do believe that docs love to be there because it's just great living, and the communities are awesome. But let's make it possible for these institutions to recruit these doctors in a meaningful way. And in order to do that, we have to make them safe.

And that's what Citizens for Health in New Mexico has been and begun to do, is just get out and talk to New Mexicans, to unite the House of Medicine, to influence the legislative process. Because ultimately, I ask you this question: What is the most powerful office in a democracy?

The people.

Yes. Absolutely. It's citizens. And I think for too long, we've been sitting on the sidelines. New Mexicans have been disenfranchised because we never feel like we get the Ws that we want and that we deserve legislatively, and we're tired of hearing about being 50 in this and forty ninth in this, and it builds up to where you become disenfranchised and disengaged and removed from the process.

The problem is is that's led to things being snowballed and getting worse at a faster rate. So I have tremendous faith in the community and the citizenry of New Mexico because New Mexicans are just this resilient, hardworking, awesome group of people that are great to sit down and just chat with. Yeah. You won't have better conversation, find more hospitality, and just people who are genuinely willing to help you. That's like the heart and soul of the New Mexico I know.

It's the chili wire.

Yeah. It's the chili wire. When you put the legislative process back in the hands of the people, I do believe that New Mexico is bound to have some significant, very, very positive changes in how we're governed and and how those who govern are reporting back to the people, because those chains have been broken for too long. There's no chilly wire no wired communication between those two. And so I commend you for your staff here, for your great work that you're doing in trying to inform New Mexicans because that's ultimately getting back to the voters.

And I think it's the the highest call to our state and serving our state right now, which is why I'm so involved with it.

Yeah. And we greatly appreciate that. And I paid doctor Roy Ball a lot of money to throw a shout out to the Chili Wire. So thank you for that, doc. Now, I'm broke, so appreciate it.

But no, you're you're exactly right. The the Chili Wire is rooted in that we want to inform New Mexicans because, and we don't hold punches here at the Chili Wire. I'm I'm gonna say this very confidently that a lot of our legislators have done a disservice to their constituents. And they've misinformed them just like the trial attorney senator that represents you has misinformed constituents that you are neighbors with, by telling them that that is a lie. That that is false.

That is not what's happening. You're gaslighting your own constituents and misinforming them. And ultimately, you're blinding them. But, you know, we're having these conversations on the Chili Wire to counter that and say, hey, here's what's going on. Here's doctor Roybal, an actual physician who's on the ground and can tell you what is happening.

And I I love hearing about Citizens for a Healthy New Mexico because I think that is so imperative to fighting back now against the behemoth of the trial attorneys and, you know, showing that, hey. You're not the only ones running the roundhouse anymore. We're coming in as well, and we're gonna defend ourselves. And, you know, it it's unfortunate because now we're taking doctors out of their daily duties of serving patients and having to get into political fights. That's not what you all signed up for.

But it is great that you are getting involved in the process. And so I, I'm really excited. We're gonna put up a QR code here on our podcast so you all can learn more about Citizens for a Healthy New Mexico. And I'm assuming, y'all take donors as well. So if folks wanna chip in, please do, and, let let's fight this battle together.

There's important disclosures, so please read them when you when you when you go on there. But But it is. I think it is going to take all of us in order to turn things around. And we can no longer afford to have anybody sidelined. And if you feel sidelined because you feel like you're unheard and unimportant to the process, you're wrong.

Come join us. We need you as much as anybody else, and I'm speaking to everybody out there, in that we want to advocate for you, we want to advocate with you, and change New Mexico. And I think that that, yes, I love being in clinic and seeing patients and doing surgeries. It's the love of my life. But this advocacy part has been pretty fun, too, getting to talk to people one on one and trying to influence the future of New Mexico.

There's an important line in the Hippocratic Oath. The Hippocratic Oath is this ancient oath from medicine, and it has all this stuff in it. But it does challenge doctors to improve the health of their patients by any means necessary. And I think this is just absolutely necessary at this to take on advocacy, to try to change these laws, to try to improve the overall health outcomes of every New Mexican. And I think New Mexicans are so far very much on board with this, and it's going to change a lot in this state.

Absolutely. And I completely agree. The message is best received from the folks that are actually experiencing the problem. And so, you know, Abe going to the roundhouse, cool. Thanks, Abe, for letting us know.

But doctor Roy Ball, you know, other doctors saying, hey. There's an issue here. I'm dealing with it. It impacts me personally and and professionally. And that message just is so much stronger coming from someone like you and all the others who have now rallied behind you in this mission to advocate.

And I think, with that oath, I think this falls along those lines is that you are looking out for the health of everyone, every patient, and that is every patient in New Mexico to ensure that they have access to high quality health care.

And I think that's the thing. We want everybody to have highest quality health And I think that that's just really exciting to me. And the thing that you point out in terms of, you know, has data and charts these days, but I think there's sort of inside each and every one of us a little truth detector, you know? And if there's somebody telling you, no, no, no, no, don't look over there, that's not true, but they're making a lot of money off of the current statutes, harder to believe them. And I think that inside, New Mexicans are experiencing the shortage of doctors.

As I said, you can go give a talk in any community and say, How many of you have lost your primary care? And a lot of hands are going up, and that's concerning. And so I don't think they need as much convincing as we think.

Yeah, living it.

What they've needed is leadership. What they've needed is a group of leaders to band together to create things like Citizens for a Healthy New Mexico. Other ones you'll hear about are Patient Led New Mexico, Patient Primeto Primeto, yeah. In Las Cruces. There's just incredible organizations.

But this is what it looks like, these grassroot organizations just saying, follow me, and let's change this. Let's band together. And that's super exciting. I think that's the pinnacle of being a great New Mexican, being a great American, is when you see a change that needs to happen and working together for that in your community, totally cool.

Yeah. Regardless of political affiliation. I love the analogy that you used of the Lobos, but, you know, we are not and should not be identified as Republican, Democrat, but New Mexican and what is best for New Mexico, moving forward and just advocacy. You know, let's get together. Let's unite.

I've said the same thing about education is that we've politicized education beyond belief, and we're doing that now with our health care. And it shouldn't be red or blue. I mean, it should just be what is best for New Mexico moving forward.

And when you're voting, who's going to make it most likely that you get the results in your hometown that you deserve? And when I see patients in clinic, I see a lot of patients, you know. We'll see 60 patients in the clinic today. We're here during our lunch But you know, you don't ever walk into a room and know if someone's a Democrat or a Republican. And when you don't know that and you just have conversations with New Mexicans, they are not divided.

New Mexicans are not divided on any of

this Yeah, we are more alike than we are different. We

are 100% near 100% and there's a few outliers. But in general, when you have a conversation with folks on this, we're 100% in agreement. And so all we need to do is start voting like that. And whoever is gonna give us the results, and if you get that job and that vote of confidence, then there's an expectation, and the expectation is greatness. And we are not gonna settle for anything less than that.

I love it. I'm pretty sure you were listening to a lot of old Michael Jordan strive for greatness material right before this because now I'm inspired, and I hope we've inspired our audience. And as doctor Roybal mentioned, he's given up his lunch hour to join us here at the Chili Wire, and we're very grateful. And, doc, I I wanna wrap it up here so we're mindful of your time, but I just wanna tell you how appreciative we are for you sharing what's happening across New Mexico and the work that you're leading along with other doctors to make a change for the better for our state. And before we wrap up, I want to open it up to you to make any other comments that you may have on your mind.

And I also got to ask because we're the Chili Wire, red or green.

You know, this is this is a Northern New Mexico boy, and I don't know if this will be interesting whether Abe agrees with me or not. Northern New Mexico, in my opinion, is all red.

All red.

You can't go to Northern New Mexico. The red chili in Northern New Mexico is extraordinary.

I agree. Chimayo red chili is hands down my favorite.

And you cannot get it anywhere else in the world. And you get the abuelitas, chili, and tortillas in some home in a small town in Northern New Mexico, that is Michelin four star. It just cannot be replicated. And so I am 100% red.

Alright. Yeah. I it's it's rare on the show that we get a 100% red. Most people are Christmas or green. I will say mine is green.

I I love green Chile. But every now and then, I do love red. And when I'm in a red chili mood, it's usually Christmas. I'm like, give me best of both worlds. I I will say that I've learned from people who say, You can't mix the two flavors.

Red is very different than green, and you're ruining the palate if you're eating both at the same time. And I'm like, Look, I enjoy both

of I'm not that sophisticated.

Same. I'm like, Alright. Hey, I'm no James Beard award winners, so I will trust you, but I'll tell you they both taste great.

Well, we're very fortunate to have it, and New Mexico cuisine is just one of the things that, you know, New Mexico is a unique Absolutely. It is. But New Mexico is a beautiful place. There's not a prettier state in the country. There's not a better population of people that just care about each other and wanna do what's right and and just have incredible values and hospitality.

And, you know, those people deserve the best. It is worth fighting for. It's worth getting up for. It's worth having difficult conversations because of that. But I think at the end of the day, there's going to be just this great community coming together.

And I think if we can look back on talks like this and say this was all part of the process in getting New Mexicans the care they deserve, the economic outcomes they deserve, the educations they deserve, then doggone it, we'll do whatever it takes.

I love it. And I'm inspired, and I don't think we can finish off on a better note. So with that, Doctor. Ruibaugh, thank you so much for coming on the Chile Wire. Thank you everyone.

If you haven't subscribed, please do hit that follow button. Find us on all social media platforms and listen in to this important conversation. And Doctor. Roybal, hope you have a Merry Christmas and Happy Holidays, and thank you so much again from the Chile Wire.

Thank you. Looking forward to it.

Thank you. And that's it for this week's Chile Wire, y'all. We'll see you next time.