Health Care Heroes: Medford physician uses video visits to keep contact with patients

Dr. Nat Fondell works with many low-income patients and specializes in addiction treatment

By: - January 5, 2022 6:00 am
Rhonda Capello shows her doctor, Dr. Nat Fondell, her next prosthetic legs on her phone.

Rhonda Capello shows Dr. Nat Fondell a photo of her new prosthetic legs. On Medicaid, she’s battled addiction and is among the hundreds of thousands in underserved communities in Oregon. (La Clinica)

When the pandemic hit in early 2020, Dr. Nat Fondell switched to video visits with his patients.

Many were reluctant to make office visits over fears of catching Covid-19. But Fondell had another reason for using video. 

Just treated with chemotherapy for cancer, he was immunocompromised.

Video visits had advantages, too. Fondell used it to reach patients, like Rhonda Capello, who lives in Medford and might have skipped seeing a doctor in-person in the past. Diabetes chewed up her feet and made walking painful. She’s also homeless and doesn’t have a car.

“It saved my life to have those video visits,” Capello said. “I wouldn’t have been able to see him otherwise.”

Editor’s note: This is part of an occasional series highlighting health care professionals who work behind the scenes or go beyond their job to keep Oregonians healthy.
Fondell, who works at La Clinica Birch Grove Health Center in Medford, is among many physicians in Oregon who switched to phone or video visits starting in early 2020. Some struggled with the technology, but Fondell found it helped him keep closer contact with some patients. He saw their environment in video chats and could easily discern whether they needed in-home services. 

“You get a better sense of how they’re doing,” Fondell said.

Many of his patients struggle with addiction.

At 16, Capello started using methamphetamine. In 2003, when she was 26, she was convicted of possessing a controlled substance and was sentenced to probation. That year she was also  diagnosed with Hodgkin’s lymphoma and quit using meth, she said.

She later served 10 months in prison for a felony conviction related to fraud. When she came out in 2019, she met Fondell. 

“Dr. Fondell treated me like a human being and not a criminal,” said Capello, now 44. 

He wasn’t like other doctors who had dismissed her as a drug addict or declined to treat all of her health issues, she said.

She’s had successive health problems since childhood. Inspired by an uncle who was an award-winning weight lifter, she trained to power lift as a child and by 9 was competing in championships. At 14, she injured her back in a competition.

“I couldn’t walk for a year,” Capello said. “I had to have back surgery.”

It saved my life to have those video visits. I wouldn’t have been able to see him otherwise.

– Rhonda Capello

She’s also had foot and face surgeries, the latter caused by antibiotic resistant infections. In February, she relapsed, the first time in more than 17 years. 

When she saw him in person, she told Fondell everything. She loved the video visits but sometimes the connection was bad.

“I was able to tell him things about myself that are hard to talk about to just anybody,” Capello said. “When you tell a doctor those things, you worry about being judged and shamed. But he wasn’t like that at all.”

She credits him with keeping her on track.

Fondell said the video visits, through an free medical app called Doxy, make it possible to connect with patients anywhere. 

The app is now widely used by providers, and though doctors’ offices have now opened back up, telehealth remains popular. 

“Telemedicine is still in higher use than it was before the pandemic — meaning telemedicine is here to stay,” Stephanie Tripp, marketing director of the Oregon Medical Association, said in an email. “The passage of HB 2508 in the 2021 legislative session allows clinicians to be reimbursed at the same rate as an in-office visit. The financial certainty of this allows investment in technology to better serve patients across the state.”

Fondell said it makes it easier for patients to see their provider.

“I’ve talked to patients who were at work and I’ve talked to patients shopping,” Fondell said.People have even called while on vacation. We couldn’t do that before. It’s made us so much more flexible.”

First job after residency

Fondell, 36, grew up in Alaska and rural Minnesota. He earned a bachelor’s degree in history and journalism at North Park University in Chicago and wanted to be a reporter. But he couldn’t find a job, so he took a position at a hospital moving patients in beds and wheelchairs. That inspired him to earn a medical degree at the University of Minnesota in Minneapolis. 

During a three-year residency at a clinic in Minneapolis, Fondell was trained in addiction medicine. Doctors do three to seven years of on-the-job training to complete their education. 

Fondell wanted to be a family physician with a focus on addiction. Birch Grove offered both. He was hired at the end of 2019, and he and his wife decided to stay in the area because they consider it a good place to raise their children – they now have four – and enjoy the easy access to the mountains and coast.

Fondell also loves his mix of clients, which includes many low-income patients on Medicaid like Capello, people struggling with addiction and transgender patients.

“It’s wonderful to have a job to be able to do the work you really want to do and care for the patients that you are interested in advocating for and protecting,” Fondell said.

He first treated transgender patients in Minnesota.

“There’s a big transgender community there,” Fondell said. “I fell in love with that work.”

About 5% of his patients at Birch Grove are transgender. 

Birch Grove’s staff works for La Clinica, which has a group of several federally subsidized health centers in the Medford area. One of its priorities is equity.

“There is also continual work at all levels of our organization to grow our understanding of equity, diversity and inclusion so that patients of all backgrounds and orientations may feel welcome and supported in our clinics,” said Dr. Justin Adams, La Clinica’s chief medical officer.

Adams called Fondell an “exceptional” physician.

I look at myself as a safe place for them to come with all of their issues.

– Dr. Nat Fondell, provider at La Clinica Birch Grove Health Center in Medford

“His interpersonal skills are well tuned to the collaborative-care environment at Birch Grove and he is especially skilled at connecting with patients, supporting them through growth and change,” Adams said. “He also has a remarkable intellect paired with an ability to explain medical concepts in a way that patients can understand.”  

Almost all of Fondell’s transgender patients are on hormone therapy and many also have other health problems. “I have a patient on hormone therapy who is also doing dialysis,” Fondell said. “One of my colleagues has a patient who’s on hormone therapy and has liver failure.”

The clinic’s physicians help such patients maintain their therapy in these situations while also providing primary care. The office maintains a list of specialists who are sensitive to their needs, and hangs diversity flags in the office to make them feel welcomed.

“We get so many comments about them from patients,” Fondell said. “Two patients even broke down in tears. They said ‘I never walked into a clinic where I felt so accepted.’”

Fondell thinks of Birch Grove as their sanctuary.

“I look at myself as a safe place for them to come with all of their issues,” Fondell said.

He doesn’t just address their medical needs either. His team helped Capello find housing.

“I’m in a hotel right now,” Capello said. “Dr. Fondell helped me get the funding.”

In March, she had to have her legs amputated from the knees down. Fondell showed up at the hospital, but not as her doctor – as a friend. The staff at Birch Grove helped her get her $30,000 prosthetics paid for through Jackson Care Connect, the Medicaid coordinated care organization in Jackson County. CCOs act as insurers for Medicaid patients.

She’s used them so much that she now needs a new pair, something that Fondell’s team is helping with.

She sometimes worries that he’s overextended. He and his wife now have a new baby.

“He feels and cares so much,” Capello said. “I love that man. I love his heart.”

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Lynne Terry
Lynne Terry

Lynne Terry has more than 30 years of journalism experience, including a recent stint as editor of The Lund Report, a highly regarded health news site. She reported on health and food safety in her 18 years at The Oregonian, was a senior producer at Oregon Public Broadcasting and Paris correspondent for National Public Radio for nine years. She has won state, regional and national awards, including a National Headliner Award for a long-term care facility story and a top award from the National Association of Health Care Journalists for an investigation into government failures to protect the public from repeated salmonella outbreaks. She loves to cook and entertain, speaks French and is learning Portuguese.

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