Walking down the main hall of the Baylor Scott & White Community Care – Fort Worth clinic on 8th Avenue, Karla Alvarado made her way to her office space. 

Inside the clinic, the medical receptionist checked in patients and directed them to seats in the waiting room. There wasn’t much noise in the clinic on this early summer day. Several of Alvarado’s colleagues were on the phone — making their rounds of patient calls. 

Alvarado jump-started her computer and checked her to-do list. It was time to call her first patient of the day. 

Alvarado serves as a community health worker at the Fort Worth clinic, where she assesses the needs of low-income patients in Tarrant County. She has been at Baylor Scott & White Health since 2011. 

Her job duties include helping patients with financial assistance, translation of completed forms, meal provision, appointment scheduling and connection with transportation to a health care facility near their homes. She is also responsible for following up with patients days, weeks, months and even years after an initial hospital visit. 

For Alvarado, serving as a community health worker isn’t just a job — it’s a key part of her life. 

“We serve our patients with shared languages and culture so they can relate to someone who looks like them when they go into a medical office,” Alvarado said. “Speaking with physicians, providers and nurses can sometimes seem scary, because they are a medical authority.” 

Alvarado dialed her first patient’s number and waited for an answer. She was about to meet with a Spanish-speaking patient admitted at Baylor Scott & White All Saints Medical Center – Fort Worth who was scheduled for a follow-up at the clinic soon. 

“We want to see when she’s going to be discharged to schedule her,” Alvarado said.

Immediately, the patient answered the phone. Alvarado introduced herself, and asked the patient in Spanish, “How are you this morning?” 

“I’m OK, thank God,” the patient responded in Spanish. 

Alvarado pulled up the patient’s medical record on her office computer and spent the next few minutes asking the patient questions about their hospital visit. The patient was experiencing repeated bouts of physical pain and was concerned with their well-being. 

The patient informed Alvarado they would be discharged that day. Alvarado sighed in relief and informed them they would need to come to the community clinic next week for a visit with the facility’s physician, Dr. Nathan Smith. The patient agreed. 

With no other updates, Alvarado bid the patient farewell and ended the call. Once documentation of the visit was complete, she looked at her schedule and prepared for the next visit. 

Alvarado called two more patients that morning — the number of visits in a day can vary. 

There are some days Alvarado has to walk across the street to Baylor Scott & White’s Fort Worth hospital to meet a patient in person. Either way, a patient will always meet her face to face at some point, Alvarado said. 

“I want them to see a face, because when they come again, I want them to see the same person and say, ‘Karla saw me at the hospital,’” she said. 

The work Alvarado does on a daily basis isn’t new to her. It’s a job she ties back to her childhood. 

Alvarado was born in Mexico, but immigrated to the U.S. when she was young and grew up in El Paso. As a bilingual child, she used to walk to school to not only register herself, but other neighborhood children whose parents didn’t read or comprehend English. 

“I would fill out all this paperwork for all the neighbors, because filling out forms is not fun,” she said. “Soon it became helping neighbors with translating letters. I was scheduling appointments. I’ve been doing this (work) all of my life.” 

Alvarado laughed, remembering her mother’s reaction to finding out she had gotten a job as a community care navigator at Baylor Scott & White. Her mother thought it was a scam, she said. 

“It seems too good to be true. What do you mean you’re gonna get paid for it now?” Alvarado recalled her mother asking her.

Maira Loera, chronic disease community health worker at the Fort Worth clinic, has worked alongside Alvarado for over 10 years. She’s seen firsthand the “great asset” Alvarado has been for the health system’s patients. 

“She’s always looking for opportunities to improve our patients and for us to work together in different roles, but always with the same goal,” Loera said. 

Even though Alvarado loves her job, community health work can be difficult. It’s common for patients to deny or avoid further assistance because of pride, she said. 

“Sometimes patients feel that they should be able to fix this,” she said. “As humans, it’s embarrassing to sometimes ask for help. I have had patients that call me a year later.” 

Patient interactions can also take a toll on community health workers’ mental health, since it’s a draining job, Alvarado said. 

“You carry your patients with you,” she said. “You try to help everybody and almost carry the guilt when you can’t help that one person. Self-care is so important. That’s something that we talk about in our team all the time. ‘If you feel overwhelmed today, call me.’” 

Challenging work conditions put over 20 million U.S. health care workers at risk for mental health issues. Mental health concerns among health workers include stress, burnout, depression, anxiety, substance abuse disorder and suicidal behavior, according to the Centers for Disease Control and Prevention. 

Alvarado always strives to take care of her mental health by spending time with her family and watching her favorite sport: basketball. 

Despite the challenges, she is motivated by the love she has for helping underserved Fort Worth communities. She doesn’t see herself doing anything else. 

“I do think that people who are working in community clinics are a different type of person, because we work extra hard and go the extra mile,” she said. “This is the only way we can get our community better. It gives us a bigger platform to help.” 

David Moreno is the health reporter for the Fort Worth Report. His position is supported by a grant from Texas Health Resources. Contact him at david.moreno@fortworthreport.org or @davidmreports.

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