By Haley Amick MPH, CHES

Metro Health’s ¡Por Vida! Program

Expands to Promote San Antonio’s Healthiest Food Service Establishments

By Haley Amick, MPH, CHES

How it Started

In 2009, the ¡Por Vida! program was established when the San Antonio Metropolitan Health District (Metro Health) and the San Antonio Restaurant Association partnered and explored ways to work together to improve the health of the community. The collaboration quickly grew into what was called the Healthy Restaurants Coalition and included public health professionals, local restaurateurs, registered dietitians, local chefs, marketing professionals, educators and many others working to improve the health of our community. ¡Por Vida! meals follow strict nutrition criteria defined by registered dietitians, which include limiting calories, saturated fat, sodium and added sugars but are still loaded with great taste. If a customer or resident sees the ¡Por Vida! logo, then they know the meal is healthy. ¡Por Vida! is now housed within Metro Health and currently has 22 participating businesses that include restaurants, caterers, food trucks, worksites and school cafeterias.

Expansion in 2022

Metro Health recognizes there are more ways the food and culinary industry promotes health than just offering healthy menu items. Community feedback collected from some of San Antonio’s highest needs zip codes has shown there is a need for healthy food options when dining outside the home. When local restaurants and stakeholders were surveyed about the ¡Por Vida! program, the feedback pointed to the importance of shifting our focus from what is “healthy” by simply offering nutritious menu options to a “whole health” or holistic approach. Metro Health’s Community Nutrition Program used this feedback to develop an expanded version of the ¡Por Vida! program, internally dubbed “Por Vida 2.0.”

In 2022, Metro Health will launch this expanded ¡Por Vida! program as a tiered system that recognizes food service establishments not only for providing healthy menu items, but also for receiving high sanitarian scores, being tobacco-free, practicing environmentally friendly practices and giving back to the community.

The expanded ¡Por Vida! criteria incorporate sustainability, community investment, local food systems, managing food waste, building up local businesses, providing resources to restaurant workers, donating food to food banks and promoting culinary mentorships. The new nutrition criteria support local food policies, such as menu labeling and ensuring kids’ menus do not offer sodas as default beverages. Metro Health will also hire three new Community Health Workers dedicated to nutrition programs, who will work to ensure food service establishments in the South, East and West regions of San Antonio have the resources and technical assistance needed to join and thrive in the ¡Por Vida! program.

The ¡Por Vida! expansion addresses several social determinants of health, including access to healthy food and drink, clean air, education/mentorships/job opportunities and better work benefits. This program helps to increase access to healthy meal options in the community, drives the community to food establishments that promote a healthy environment and supports businesses as they work to create an even healthier San Antonio.

Partners in the Culinary Industry

Metro Health has partnered with key organizations and initiatives in San Antonio to further promote ¡Por Vida! restaurants that go above and beyond to obtain gold certification. ¡Por Vida! goldtiered restaurants will also receive special recognition as being affiliated with the San Antonio UNESCO Creative City of Gastronomy designation. In 2020, ¡Por Vida! and Culinaria partnered to create the “¡Por Vida! Healthy Trail” which highlighted 10 local restaurants that promote tasty and healthy menu options while also giving back to the community and environment. Unfortunately, many of the partners on this trail have closed temporarily or permanently due to the COVID-19 pandemic. However, the ¡Por Vida! Healthy Trail will be re-established and feature 10 of the new ¡Por Vida! gold-tiered partners. The goal of this program is to embrace and sustain the local community and culture by fostering a healthy environment through the rich, unique food and culinary industry in San Antonio.

What to Look for in Early 2022

Metro Health’s expanded ¡Por Vida! Program will recognize local restaurants for creating healthy environments through good nutrition, sanitation, sustainability and community development. Restaurants, food trucks and caterers can score bronze, silver or gold medals for the work they do in these categories, which ultimately will provide residents healthy food options and healthy environments to dine in across the city. (The accompanying infographic outlines the criteria for restaurants earning bronze, silver and gold recognition).

Bronze Level ¡Por Vida! partners meet the original ¡Por Vida! criteria. They offer at least one healthy menu item (as outlined by the original Por Vida standards) and maintain high sanitarian scores.

Silver Level ¡Por Vida! partners meet the original ¡Por Vida! criteria by offering at least one healthy menu item and maintaining high sanitarian scores, and also do advanced work in nutrition in addition to either sustainability or community giveback.

Gold Level ¡Por Vida! partners meet the original ¡Por Vida! criteria by offering at least one healthy menu item and maintaining the highest sanitarian score possible, and also do advanced work in nutrition in addition to both sustainability and community giveback.

Keep your eye out for the new ¡Por Vida! program, which is set to launch in early 2022! This program will offer full flavor and the convenience of dining out without sacrificing good nutrition and health. Our motto is: “When you choose ¡Por Vida!, you make a better choice ‘For Life’!”

Haley Amick, MPH, CHES is the Community Nutrition Program Coordinator for Metro Health’s ¡Por Vida! program. To learn more about ¡Por Vida! and to see a list of participating restaurants, visit www.porvidasa.com or contact porvida @sanantonio.gov.

A Team-Centered Approach in Detecting Breast Cancer

By Ramon S. Cancino, MD, MBA, MS, FAAFP

In 2021, breast cancer became the most common global cancer, accounting for 12% of all new cancer cases worldwide.1 In the United States, breast cancer is the second leading cause of cancer death in women. The chance a woman will die from breast cancer is about 1 in 39 (about 2.6%). Breast cancer can often be caught early through regular mammograms. In fact, timely breast cancer screening and increased awareness are among the factors contributing to decreasing cancer death rates nationally.2 As part of UT Health San Antonio Regional Physician Network (RPN) accountable care organization’s focus on wellness care, the RPN team partnered with San Antonio primary care physicians to develop patient-centered strategies to improve breast cancer screening rates.

The physician-led effort started with discussions with primary care physicians in the RPN network. Members discussed current cancer screening workflows, successes and challenges. One common challenge was knowing which patients were still due for mammograms in the first place. For example, while many female patients reported having completed their mammograms, the PCP was not always aware that it was completed. RPN has developed sophisticated analytics capabilities, including aggregating and analyzing real-time, practice-level and claimsbased data. To provide a comprehensive analysis, the RPN platform is also able to combine automated data feeds with manually abstracted data. Using CMS data on paid Medicare claims of RPN-attributed patients, the RPN team was able to develop a report to identify patients whose mammograms were completed. The data allowed individual PCPs to get a clearer picture of which patients still needed to have breast cancer screenings completed.

Another challenge was the lack of time and, in some cases, staff to call patients and help schedule mammograms. Even though

the RPN team was able to provide the data necessary to help practices identify and close breast cancer screening gaps, it was difficult for physicians or their staff to carve out time to outreach to patients and imaging centers in scheduling mammograms and retrieving records. In partnership with more than 30 primary care practices in the San Antonio region, the RPN team reviewed and analyzed patient-level and claims data. Using this data, for those practices who requested the support, the RPN team provided targeted patient outreach to those patients still needing mammograms. This outreach was done using scripts and workflows that each individual practice helped develop. By developing these partnerships with RPN physicians and our community’s patients, many more patients received evidencebased breast cancer screening. An example of how our team members support patients involved a hesitant patient. An RPN team member identified a female patient was due for a mammogram and hesitant to get one. In response, the RPN team member stayed in touch with the patient, developed a rapport and worked with the patient’s PCP to help that patient learn the importance of regular breast cancer screening. With permission from the patient and the patient’s PCP, the RPN team member traveled to meet the patient at her breast cancer screening appointment to support her before and after the mammogram. The mammogram detected an early breast cancer; and, in the end, the woman was successfully treated for cancer. The team member’s ability to provide wraparound care helped the patient receive the screening that caught cancer sooner. In addition to providing accurate data, outreaching to patients and helping provide shared-decision making support, the RPN team also supports practices by adding the exact date of the last mammogram to the records of many RPN physicians. By adding this data to the records, RPN PCPs feel confident that the breast cancer screening records they have are accurate. Therefore, RPN physicians can order necessary preventive care screenings without being concerned that they are ordering redundant testing. This simple intervention contributed to increasing breast cancer screening rate of four RPN practices by 100%.

Taken as a whole, these breast cancer screening interventions helped raise the RPN’s breast cancer screening rate in 2020 by 17% compared to 2019 and increased the screening rate of 80% of RPN practices. While merely numbers on a page, these improvements reflect real women who received timely breast cancer screening! The COVID-19 pandemic has resulted in many elective procedures being put on hold, and this has led to a substantial decline in cancer screening.3 Locally, health care facilities are providing cancer screening during the pandemic with many safety precautions in place. Please continue to encourage patients to receive regular breast cancer screening. Prevention and early detection are essential to reducing cancer-related deaths. References 1. Breast cancer overtakes lung as most common cancer-WHO. Reuters. https://www.reuters.com/article/healthcancer-int-idUSKBN2A219B. Published

February 2, 2021. Accessed November 6, 2021. 2. How Common Is Breast Cancer? | Breast

Cancer Statistics. Accessed November 6, 2021. https://www.cancer.org/cancer/ breast-cancer/about/how-common-isbreast-cancer.html 3. Cancino RS, Su Z, Mesa R, Tomlinson

GE, Wang J. The Impact of COVID-19 on Cancer Screening: Challenges and

Opportunities. JMIR Cancer. 2020;6(2): e21697. doi:10.2196/21697

Ramon S. Cancino, MD, MBA, MS, FAAFP is Senior Medical Director and Medical Management Director of the Primary Care Center of UT Health Physicians. He is a member of the Bexar County Medical Society.

100% Large Practice Groups Membership Highlight

By HealthTexas Medical Group

HealthTexas Medical Group is a group of local primary care physicians who care about the health and well-being of the communities of the San Antonio region. HealthTexas was founded in 1994 by four local physicians. These physicians recognized the need for primary care doctors to play a more significant role in a patient’s overall health and wellness. Founder, Dr. Richard Reyna retired as President & CEO of the medical group in 2018. Founder, Dr. Rowland Reyna is still a practicing physician within the medical group.

HealthTexas believes a strong primary care provider is essential in helping patients navigate their medical care most successfully. Actively connecting a patient’s primary care visit, specialist, hospitalizations and ER care ensures a patient’s global care is focused upon rather than spread piecemeal throughout the health care system.

The HealthTexas doctors’ recipe for success lies in the fact that each physician takes a hands-on approach to caring for patients. HealthTexas coordinates all aspects of care for their patients. They partner with a select group of quality specialists. This coordination of care occurs not only when the patients are ill, but also throughout all phases of their lives and all aspects of their health care, with a focus on preventative care as a priority for patients. This personal approach is what differentiates HealthTexas doctors from others and why patients choose HealthTexas for their primary care.

The group focuses on primary care, preventive needs and chronic conditions. When outside care is required, they assist patients in navigating increasingly complex health care choices. They also partner with specialists who pay attention to needs that matter to their patients like character, on-call services, personal touch, quality and outcomes.

All HealthTexas physicians are board-certified in their specialty of internal or family medicine. The group has been recognized for the following awards: • Best Doctors in America® • Texas Super Doctors® (as listed by Texas Monthly Magazine) • Top Doctors in San Antonio® (as listed in SA Scene Magazine) • Top Doctors in America® (as listed by Castle Connolly in U.S.

News & World Report) • Patient’s Choice Award • Accredited Diabetes Education Program • National Committee for Quality Assurance (NCQA) • Best Places to Work® (San Antonio Business Journal) - 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2018 2019, 2020 • Top Work Places® (Express News) - 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021 • Top Work Places® (Express News) Training Award – 2009 • Top Work Places® (Express News) Manager Award – 2010 • Bexar County Medical Society (BCMS) o Previous President - Dr. Gabriel Ortiz (Blanco Clinic) o Previous President - Dr. Manuel M. Quinones, Jr (Helotes Clinic) • Texas Medical Board, Appointee by Governor Greg Abbott, Dr.

Manuel Quiñones

HealthTexas is a patient-centered, physician-owned and physicianled organization. The President and CEO of HealthTexas Medical Group is Dr. Kristi Clark. The HealthTexas Physician Board governs the providers and clinical operations of the Medical Group and is chaired by Dr. Manuel Quiñones. The HealthTexas Corporate Board governs the operations of the Management Company of HealthTexas and is chaired by Dr. Rowland Reyna.

To learn more, please visit HealthTexas Medical Group’s social media:

Website: HealthTexas.org Facebook:HealthTexas Medical Group LinkedIn:HealthTexas Medical Group Twitter: @HealthTX Instagram:healthtexas YouTube:HealthTexas Medical Group

Quality of care is their cornerstone, and because of that, they have many processes in place to ensure quality stays at the helm of patient care. They have established several committees that convene regularly to discuss priority matters: • Patient Care Committee (PCC) – ensures providers receive operational updates, current EMR training, review of policies and procedures as well as review of quality dashboards on a weekly basis. • Quality/Peer Review Committee – ensures each provider is achieving high quality and managing the needs of patients at the local clinic level. • Complex Care Committee – manages the outpatient needs of the most complex and vulnerable patients. • Business Development Committee – reviews potential new business opportunities for the organization. • HTP/HTC Compliance Committee – ensures that HealthTexas is compliant with regulatory requirements. • Recruitment Committee – recruits providers to HealthTexas Medical Group. • The HealthTexas Experience Committee – focuses on improving the HealthTexas Experience for patients by standardizing customer service from clinic to clinic. • Electronic Medical Record (EMR) Committee – focuses on maximizing the strengths of EMR systems to improve quality of care and streamline provider workflow.

Charting Paths Through the Fog

Reviewing “High Conflict” by Amanda Ripley

By David Alex Schulz, CHP

Bellicose argument has become a hallmark of the pandemic, and it can’t help but influence the physician-patient relationship. Journalist Amanda Ripley explores causes and solutions to our social belligerence in “High Conflict - Why We Get Trapped and How We Get Out” (August 2021; Simon & Schuster). Beginning with the legal arena’s progress from a solely antagonistic model to include mediation, Ripley traces paths to peace in case studies from the Hatfield-McCoy feud and the gang wars of South Chicago to Colombia’s civil war. The reader finds parallel pitfalls and opportunities for harmony, regardless of location or cause. “You might be reading this and thinking, I’m not part of a gang or a blood feud. Not yet anyway. What does this have to do with political polarization? Or the fight I had with my brother last year at Christmas?” Patient noncompliance has always been a concern, but mistaken beliefs in possibly dangerous and inappropriate therapies have scaledup with COVID-19. “High Conflict” isn’t a toolkit of persuasion techniques. It is an invitation to join the author on a journey that illuminates the reader’s own social interactions and helps them develop their own strategy to cool roiling waters.

Ripley’s specialized vocabulary, defined in the introduction, hints at the common keys she found in conflict resolution. It’s a lexicon built on distinguishing the good, productive friction “that can be serious and intense but leads somewhere useful and does not collapse into dehumanization” from bad, high conflict “that becomes self-perpetuating and all-consuming, in which almost everyone ends up worse off. Typically an us-versus-them conflict.”

One essential listening technique for conflict-resolution discussed at length is called “looping for understanding.” A non-passive technique “in which the person listening reflects back what the person talking seems to have said—and checks to see if the summary was right.”

Purposeful listening is both a silver bullet and a vastly neglected skill. “Most people don’t know how to listen,” Ripley continues. “We jump to conclusions. We think we understand when we don’t. We tee up our next point, before the other person has finished talking. Basically, it means to listen in ways people can see. Show them you’re listening; don’t tell them you are. Most of us do not feel heard much of the time.”

Ripley’s case-in-point is peculiarly relevant to our readership (and earns our only footnote): “On average, doctors interrupt patients after only eleven seconds of listening to them explain what ails them. When doctors don’t interrupt, patients stop talking on their own just six seconds later. That’s all the time they needed to explain themselves: just seventeen seconds. But almost none of them got it. But patients, if they feel understood, leave the hospital more satisfied and more likely to follow their doctor’s orders.” *

Ripley doesn’t simply observe: her analyses are based on first-hand experience, save the Hatfield-McCoy feud. Taking professional mediation workshops from the field’s leading pioneer; touring South Chicago with a reformed gangbanger and his lifelong lethal adversary; visiting with members of FARC in Colombia, “a place with decades of experience in trying to get people out of conflict at scale.” She finds, “to help people out of conflict at scale, you must clear a path,” which in Colombia’s case, runs through a soccer field.

The book’s most relatable and compelling narrative is reserved for its final third, and it’s a doozy: building a path between members of a liberal New York Jewish congregation, and a Michigan community of conservative Christian correction officers. The discoveries each com-

munity makes during reciprocal field trips, hosted in the homes of new-found friends, begin with erasing the anxiety of leaving a comfort zone, becoming strangers in a strange land. Once paranoia is cleansed, the atmosphere becomes one of delightful exploration, intellectual and experiential, of lifestyles found to be both exotic and familiar. Where Michiganders find the Upper West Side much friendlier and less threatening than expected, the Manhattanites’ visit to a Michigan gun range proves uncomfortably more fun and satisfying than expected. This achievement of mutual understanding breathes vitality and dimension into another glossary term: the Fourth Way.

“The Fourth way,” explains Ripley “is a way to go through conflict that’s more satisfying than running away, fighting, or staying silent, the three usual paths. It involves leaning into the conflict.”

The rabbi had previously found the “Fourth Way” to lead his congregation through contentious issues such as intermarriage and the Israeli-Palestinian conflict. Then he decided to tackle an even more challenging breach: politically polarized Americans. The congregation accomplished their goal, finding common ground and agreement in the meetings; neither side will look at each other in stereotype again.

But closing the schism took journeys to each other’s “world.” Hopefully, the paths we chart out of the current pandemic tribalism, with its allegiance to possible medical fallacies, won’t necessitate field trips.

* eleven seconds: Singh Ospina, N., Phillips, K.A., Rodriguez-Gutierrez, R., et al. “Eliciting the Patient’s Agenda—Secondary Analysis of Recorded Clinical Encounters.” Journal of General Internal Medicine 34 (2019). more likely to follow their doctor’s orders: Kim, Sung Soo, Stan Kaplowitz, and Mark V. Johnston. “The Effects of Physician Empathy on Patient Satisfaction and Compliance.” Evaluation & the Health Professions 27, no. 3 (September 2004).

All quotes and images from “High Conflict - Why We Get Trapped and How We Get Out” by Amanda Ripley, Simon & Schuster © 2021.

David Alex Schulz, CHP is a community member of the BCMS Publications Committee.

Artistic Expression in Medicine

By Caroline Zhu, Cynthia Jiang, Sijil Patel and Richard Marlow Taylor, MD

Flight, Colored pencil drawing By Caroline Zhu

As Emily Dickinson once personified hope as a bird, this portrait done in the Arcimboldo style brings together birds of the Greek Olympian Gods.

Caroline Zhu is a medical student at the Long School of Medicine, UT Health San Antonio, Class of 2022. Wings of Hope, Watercolor painting By Cynthia Jiang This is a watercolor painting of a bird that was always outside my window. I started painting while studying for Step 1 as a form of stress relief this past April during COVID-19.

Cynthia Jiang is a medical student at the Long School of Medicine, UT Health San Antonio, Class of 2022.

Stardust, Mixed media on drawing board By Sijil Patel This piece is gesso, color pencil and assorted mixed media on drawing board. It was inspired by the song “Fix You” by Coldplay, which has helped me during difficult times. It serves as a reminder that even when we're faced with what may seem to be insurmountable challenges (such as those that come with being a female student-doctor pursuing medicine during a pandemic), we can continue to compassionately pursue our goals through grit and perseverance!

Sijil Patel is a medical student at the Long School of Medicine, UT Health San Antonio, Class of 2022.

The Psychiatric Evaluation of Dog, Acrylic on canvas By Richard Marlow Taylor, MD A: Pico appears well-groomed but upon closer inspection, malodorous from rolling around in the mud and certainly has not bathed in several days. His nails certainly need clipping. There is increased kinetic activity observed in frequent tail wags. Appears puppy-like despite documented geriatric age. Frequently observed to interact with internal stimuli – or merely snapping at flies. Speech is indiscernible but delivered at increased volume with punctuated emphasis on “woof” when another dog walks by. M: Stated mood “woof” is congruent with attentive affect with unconstricted range at times appearing perplexed, at other times inquisitive. S: Ready to move at a moment’s notice, able to sit, shake, fetch and roll over upon command. I: Clearly well above average based on ability to successfully beg for scraps with varied tactics and covert forays into the trash. T: Consistently goal-directed but with obviously paranoid thought content, notable for overtly homicidal thoughts toward squirrels and opossums who may or may not invade his yard. Endorsing grandiose thoughts that he owns the couch. Judgment is quite poor as evidenced by his breakneck sprints toward bicycles and heavy machinery. Insight is questionable, as he almost certainly believes himself to not be a dog.

Richard Marlow Taylor is a resident in the Department of Psychiatry at the UT Health Long School of Medicine. He is a resident member of the Bexar County Medical Society.

2022 BCMS Installation of Officers

Rajeev Suri, MD 2022 BCMS President

Brent W. Sanderlin, DO Vice President

Ezequiel Silva, III, MD Treasurer

Alice Gong, MD Secretary

John Joseph Nava, MD President-Elect Rodolfo “Rudy” Molina, MD Immediate Past President

Vincent Paul Fonseca, MD Board of Directors Second Term 2020-2022

Lubna Naeem, MD Board of Directors First Term 2021-2023

Lyssa Ochoa, MD Board of Directors First Term 2020-2022

Jennifer R. Rushton, MD Board of Directors First Term 2022-2024

Raul Santoscoy, DO Board of Directors First Term 2022-2024

John Shepherd, MD Board of Directors First Term 2020-2022

Amar Sunkari, MD Board of Directors First Term 2021-2023

Lauren Tarbox Board of Directors First Term 2022-2024

Woodson “Scott” Jones, MD Appointed to fill Board of Directors First Term 2021-2023 Col. Timothy Lawrence Switaj, MD Board of Directors Military Representative

Jayesh B. Shah, MD Board of Directors TMA Board of Trustees, Representative

Ramon S. Cancino, MD Board of Directors Medical School Representative

Lori Kels, MD Board of Directors Medical School Representative

Ronald Rodriguez, MD Board of Directors Medical School Representative

2022 BCMS Installation of Officers (continued)

Carlos Alberto Rosende, MD Board of Directors Medical School Representative

Taylor Frantz President BCMS Alliance Representative

Manuel M. Quinones, Jr., MD Board of Ethics, Chair Melody Newsom BCMS CEO/Executive Director Board of Directors Liaison

George F. “Rick” Evans, Jr. General Counsel

Save the Date

2022 Joint Installation of Officers

Dr. Rajeev Suri, BCMS President Taylor Frantz, Alliance President Saturday, January 15, 2022 7:00 pm Virtual Event Meeting Details and Link Available on BCMS website on 1/07/2022

2022 BCMS Alliance Installation of Officers

Taylor Frantz President

Cheryl PierceSzender President-Elect/ Treasurer

Jenny Case President-Elect

Michelle Richardson 1st Vice President Membership Team

Heather Davila 1st Vice President Membership Team Ryan Ramos 2nd Vice President Newsletter/ Communication

Jazmin Gibbons 3rd Vice President Programs/ Social Team

Stephanie Stewart 3rd Vice President Programs/ Social Team

Amy Mahadevan 4th Vice President Comminity Outreach Team

Celinda Guerra 4th Vice President Community Outreach Team Virginia Profenna Treasurer-Elect

Victoria Kohler-Webb Secretary

Nichole Eckmann Immediate Past President

Danielle Henkes Presidential Advisor

Lori Boies Presidential Advisor

Please ask your practice manager to use the Physicians Purchasing Directory as a reference when services or products are needed.

ACCOUNTING FIRMS

Sol Schwartz & Associates P.C. (HHH Gold Sponsor) Sol Schwartz & Associates is the premier accounting firm for San Antonio-area medical practices and specializes in helping physicians and their management teams maximize their financial effectiveness. Jim Rice, CPA 210-384-8000, ext. 112 jprice@ssacpa.com www.ssacpa.com “Dedicated to working with physicians and physician groups.”

ACCOUNTING SOFTWARE

Express Information Systems (HHH Gold Sponsor) With over 29 years’ experience, we understand that real-time visibility into your financial data is critical. Our browser-based healthcare accounting solutions provide accurate, multi-dimensional reporting that helps you accommodate further growth and drive your practice forward. Rana Camargo Senior Account Manager 210-771-7903 ranac@expressinfo.com www.expressinfo.com “Leaders in Healthcare Software & Consulting”

ATTORNEYS

Kreager Mitchell (HHH Gold Sponsor) At Kreager Mitchell, our healthcare practice works with physicians to offer the best representation possible in providing industry specific solutions. From business transactions to physician contracts, our team can help you in making the right decision for your practice. Michael L. Kreager 210-283-6227 mkreager@kreagermitchell.com Bruce M. Mitchell 210-283-6228 bmitchell@kreagermitchell.com www.kreagermitchell.com “Client-centered legal counsel with integrity and inspired solutions” ASSETT WEALTH MANAGEMENT

Bertuzzi-Torres Wealth Management Group (HHH Gold Sponsor) We specialize in simplifying your personal and professional life. We are dedicated wealth managers who offer diverse financial solutions for discerning healthcare professionals, including asset protection, lending and estate planning. Mike Bertuzzi First Vice President Senior Financial Advisor 210-278-3828 Michael_bertuzzi@ml.com Ruth Torres Financial Advisor 210-278-3828 Ruth.torres@ml.com http://fa.ml.com/bertuzzi-torres

BANKING

BankMD (HHH Gold Sponsor) Our Mission is your Success. We are the ONLY Physician-Focused Bank in the Country Moses Luevano, President 512-547-6065 mdl@bankmd.com Chris McCorkle Director of Healthcare Banking 210-253-0550 cm@bankmd.com www.BankMD.com “Specialized, Simple, Reliable”

Broadway Bank (HHH Gold Sponsor) Healthcare banking experts with a private banking team committed to supporting the medical community. Shawn P. Hughes, JD Senior Vice President, Private Banking 210-283-5759 shughes@broadway.bank www.broadwaybank.com “We’re here for good.”

The Bank of San Antonio (HHH Gold Sponsor) We specialize in insurance and banking products for physician groups and individual physicians. Our local insurance professionals are some of the few agents in the state who specialize in medical malpractice and all lines of insurance for the medical community. Brandi Vitier, 210-807-5581 brandi.vitier@thebankofsa.com www.thebankofsa.com

Synergy Federal Credit Union (HH Silver Sponsor) Looking for low loan rates for mortgages and vehicles? We've got them for you. We provide a full suite of digital and traditional financial products, designed to help Physicians get the banking services they need. Synergy FCU Member Services 210-750-8333 info@synergyfcu.org www.synergyfcu.org “Once a member, always a member. Join today!”

BUSINESS CONSULTING

Medical Financial Group (★★★ Gold Sponsor) Healthcare & Financial Professionals providing core solutions to Physicians from one proven source. CEO is Jesse Gonzales, CPA, MBA Controller & past CFO of (2) Fortune 500 companies, Past Board President of Communicare Health Systems. Jesse Gonzales, CEO CPA, MBA 210-846-9415 information@medicalfgtx.com Linda Noltemeier-Jones Director of Operations 210-557-9044 lindanj@medicalfgtx.com www.medicalfgtx.com “Let’s start with Free Evaluation and Consultation from our Team of Professionals”

CREDENTIALS VERIFICATION ORGANIZATION

Bexar Credentials Verification, Inc. (HHHH 10K Platinum Sponsor) Bexar Credentials Verification Inc. provides primary source verification of credentials data that meets The Joint Commission (TJC) and the National Committee for Quality Assurance (NCQA) standards for health care entities. Betty Fernandez Director of Operations 210-582-6355 Betty.Fernandez@bexarcv.com www.BexarCV.com “Proudly serving the medical community since 1998”

FINANCIAL ADVISORS

Oakwell Private Wealth Management (HHH Gold Sponsor) Oakwell Private Wealth Management is an independent financial advisory firm with a proven track record of providing tailored financial planning and wealth management services to those within the medical community. Brian T. Boswell, CFP®, QKA Senior Private Wealth Advisor 512-649-8113 SERVICE@OAKWELLPWM.COM www.oakwellpwm.com “More Than Just Your Advisor, We're Your Wealth Management Partner”

Elizabeth Olney with Edward Jones (HH Silver Sponsor) We learn your individual needs so we can develop a strategy to help you achieve your financial goals. Join the nearly 7 million investors who know. Contact me to develop an investment strategy that makes sense for you. Elizabeth Olney, Financial Advisor 210-858-5880 Elizabeth.olney@edwardjones.com www.edwardjones.com/elizabeth-olney "Making Sense of Investing"

FINANCIAL SERVICES

Bertuzzi-Torres Wealth Management Group ( Gold Sponsor) We specialize in simplifying your personal and professional life. We are dedicated wealth managers who offer diverse financial solutions for discerning healthcare professionals, including asset protection, lending & estate planning. Mike Bertuzzi First Vice President Senior Financial Advisor 210-278-3828 Michael_bertuzzi@ml.com Ruth Torres Financial Advisor 210-278-3828 Ruth.torres@ml.com http://fa.ml.com/bertuzzi-torres

Aspect Wealth Management (HHH Gold Sponsor) We believe wealth is more than money, which is why we improve and simplify the lives of our clients, granting them greater satisfaction, confidence and freedom to achieve more in life. Jeffrey Allison 210-268-1530 jallison@aspectwealth.com www.aspectwealth.com “Get what you deserve … maximize your Social Security benefit!”

SWBC (HHH Gold Sponsor) SWBC for Personal and Practice: Physician programs for wealth management and homebuying. For You Practice: HR administration, payroll, employee benefits, insurance, and exit strategies. SWBC’s services supporting Physicians and the Medical Society. Michael Leos Community Relations Manager Cell: 201-279-2442 Office: 210-376-3318 mleos@swbc.com swbc.com

HEALTHCARE BANKING

BankMD (HHH Gold Sponsor) Our Mission is your Success. We are the ONLY Physician-Focused Bank in the Country Moses Luevano, President 512-547-6065 mdl@bankmd.com Chris McCorkle Director of Healthcare Banking 210-253-0550 cm@bankmd.com www.BankMD.com “Specialized, Simple, Reliable”

First Citizens Bank (HHH Gold Sponsor) We’re a family bank — led for three generations by the same family-but first and foremost a relationship bank. We get to know you. We want to understand you and help you with your banking. Stephanie Dick Commercial Banker 210-744-4396 stephanie.dick@firstcitizens.com Danette Castaneda Business Banking Specialist 512-797-5129 Danette.castaneda@firstcitizens.com https://commercial.firstcitizens.co m/tx/austin/stephanie-dick “People Bank with People” “Your Practice, Our Promise”

Amegy Bank of Texas (HH Silver Sponsor) We believe that any great relationship starts with five core values: Attention, Accountability, Appreciation, Adaptability and Attainability. We work hard and together with our clients to accomplish great things. Jeanne Bennett EVP | Private Banking Manager 210-343-4556 Jeanne.bennett@amegybank.com Karen Leckie Senior Vice President | Private Banking 210-343-4558 karen.leckie@amegybank.com Robert Lindley Senior Vice President | Private Banking 210-343-4526 robert.lindley@amegybank.com Denise C. Smith Vice President | Private Banking 210-343-4502 Denise.C.Smith@amegybank.com www.amegybank.com “Community banking partnership”

HEALTHCARE TECHNOLOGY SOLUTIONS SUPPLIER

Nitric Oxide innovations LLC, (★★★ Gold Sponsor) (NOi) develops nitric oxide-based therapeutics that prevent and treat human disease. Our patented nitric oxide delivery platform includes drug therapies for COVID 19, heart disease, Pulmonary hypertension and topical wound care. info@NitricOxideInnovations.com 512-773-9097 www.NitricOxideInnovations.com

HOSPITALS/ HEALTHCARE FACILITIES

UT Health San Antonio MD Anderson Cancer Center, (HHH Gold Sponsor) UT Health San Antonio MD Anderson Cancer Center, is the only NCI-designated Cancer Center in South Texas. Our physicians and scientists are dedicated to finding better ways to prevent, diagnose and treat cancer through lifechanging discoveries that lead to more treatment options. Laura Kouba Manager, Physician Relations 210-265-7662 NorrisKouba@uthscsa.edu Lauren Smith, Manager, Marketing & Communications 210-450-0026 SmithL9@uthscsa.edu Cancer.uthscsa.edu Appointments: 210-450-1000 UT Health San Antonio MD Anderson Cancer Center 7979 Wurzbach Road San Antonio, TX 78229

INFORMATION AND TECHNOLOGIES

Express Information Systems (HHH Gold Sponsor) With over 29 years’ experience, we understand that real-time visibility into your financial data is critical. Our browser-based healthcare accounting solutions provide accurate, multi-dimensional reporting that helps you accommodate further growth and drive your practice forward. Rana Camargo Senior Account Manager 210-771-7903 ranac@expressinfo.com www.expressinfo.com “Leaders in Healthcare Software & Consulting”

INSURANCE

TMA Insurance Trust (HHHH 10K Platinum Sponsor) Created and endorsed by the Texas Medical Association (TMA), the TMA Insurance Trust helps physicians, their families and their employees get the insurance coverage they need. Wendell England 512-370-1746 wengland@tmait.org James Prescott 512-370-1776 jprescott@tmait.org www.tmait.org “We offer BCMS members a free insurance portfolio review.”

Humana (HHH Gold Sponsor) Humana is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. Jon Buss: 512-338-6167 Jbuss1@humana.com Shamayne Kotfas: 512-338-6103 skotfas@humana.com www.humana.com

INSURANCE/MEDICAL MALPRACTICE

Texas Medical Liability Trust (HHHH 10K Platinum Sponsor) With more than 20,000 health care professionals in its care, Texas Medical Liability Trust (TMLT) provides malpractice insurance and related products to physicians. Our purpose is to make a positive impact on the quality of health care for patients by educating, protecting, and defending physicians. Patty Spann 512-425-5932 patty-spann@tmlt.org www.tmlt.org Recommended partner of the Bexar County Medical Society

The Bank of San Antonio Insurance Group, Inc. (HHH Gold Sponsor) We specialize in insurance and banking products for physician groups and individual physicians. Our local insurance professionals are some of the few agents in the state who specialize in medical malpractice and all lines of insurance for the medical community. Katy Brooks, CIC 210-807-5593 katy.brooks@bosainsurance.com www.thebankofsa.com “Serving the medical community.”

MedPro Group (HH Silver Sponsor) Rated A++ by A.M. Best, MedPro Group has been offering customized insurance, claims and risk solutions to the healthcare community since 1899. Visit MedPro to learn more. Kirsten Baze 512-658-0262 Kirsten.Baze@medpro.com www.medpro.com

ProAssurance (HH Silver Sponsor) ProAssurance professional liability insurance defends healthcare providers facing malpractice claims and provides fair treatment for our insureds. ProAssurance Group’s rating is AM Best A (Excellent). Mike Rosenthal Senior Vice President, Business Development 800-282-6242 MikeRosenthal@ProAssurance.com www.ProAssurance.com

continued from page 37 INTERNET TELECOMMUNICATIONS

Unite Private Networks (HHH Gold Sponsor) Unite Private Networks (UPN) has offered fiber optic networks since 1998. Lit services or dark fiber –our expertise allows us to deliver customized solutions and a rewarding customer experience. Clayton Brown - Regional Vice President of Sales –San Antonio 210-693-8025 clayton.brown@upnfiber.com Aron Sweet – Account Director 210-788-9515 aron.sweet@upnfiber.com Jim Dorman – Account Director 210-428-1206 jim.dorman@upnfiber.com Tammy Carosello – Account Director 210-868-0420 tammy.carosello@upnfiber.com www.uniteprivatenetworks.com “UPN is very proud of our 98% customer retention rate”

INVESTMENT ADVISORY REAL ESTATE

Alamo Capital Advisors LLC (★★★★ 10K Platinum Sponsor) Focused on sourcing, capitalizing, and executing investment and development opportunities for our investment partners and providing thoughtful solutions to our advisory clients. Current projects include new developments, acquisitions & sales, lease representation and financial restructuring (equity, debt, and partnership updates). Jon Wiegand Principal 210-241-2036 jw@alamocapitaladvisors.com www.alamocapitaladvisors.com

MEDICAL BILLING AND COLLECTIONS SERVICES

Medical Financial Group (★★★ Gold Sponsor) Healthcare and Financial Professionals providing core solutions to Physicians from one proven source. CEO is Jesse Gonzales, CPA, MBA Controller and past CFO of (2) Fortune 500 companies, Past Board President of Communicare Health Systems. Jesse Gonzales, CEO CPA, MBA 210-846-9415 information@medicalfgtx.com Linda Noltemeier-Jones Director of Operations 210-557-9044 lindanj@medicalfgtx.com www.medicalfgtx.com “Let’s start with Free Evaluation and Consultation from our Team of Professionals”

PCS Revenue Cycle Management (HHH Gold Sponsor) We are a HIPAA compliant fullservice medical billing company specializing in medical billing, credentialing, and consulting to physicians and mid-level providers in private practice. Deion Whorton Sr. CEO/Founder 210-937-4089 inquiries@pcsrcm.com www.pcsrcm.com “We help physician streamline and maximize their reimbursement by 30%.”

Commercial & Medical Credit Services (HH Silver Sponsor) A bonded and fully insured San Antonio-based collection agency. Henry Miranda 210-340-9515 hcmiranda@sbcglobal.net www.cmcs-sa.com “Make us the solution for your account receivables.”

MEDICAL PAYMENT SYSTEMS/CARD PROCESSING

First Citizens Bank (★★★ Gold Sponsor) We’re a family bank — led for three generations by the same family-but first and foremost a relationship bank. We get to know you. We want to understand you and help you with your banking. Stephanie Dick Commercial Banker 210-744-4396 stephanie.dick@firstcitizens.com Danette Castaneda Business Banking Specialist 512-797-5129 Danette.castaneda@firstcitizens.com https://commercial.firstcitizens.co m/tx/austin/stephanie-dick “People Bank with People” “Your Practice, Our Promise” MEDICAL SUPPLIES AND EQUIPMENT

Henry Schein Medical (HH Silver Sponsor) From alcohol pads and bandages to EKGs and ultrasounds, we are the largest worldwide distributor of medical supplies, equipment, vaccines and pharmaceuticals serving office-based practitioners in 20 countries. Recognized as one of the world’s most ethical companies by Ethisphere. Tom Rosol 210-413-8079 tom.rosol@henryschein.com www.henryschein.com “BCMS members receive GPO discounts of 15 to 50 percent.”

MOLECULAR DIAGNOSTICS LABORATORY

iGenomeDx ( Gold Sponsor) Most trusted molecular testing laboratory in San Antonio providing FAST, ACCURATE and COMPREHENSIVE precision diagnostics for Genetics and Infectious Diseases. Dr. Niti Vanee Co-founder & CEO 210-257-6973 nvanee@iGenomeDx.com Dr. Pramod Mishra Co-founder, COO & CSO 210-381-3829 pmishra@iGenomeDx.com www.iGenomeDx.com “My DNA My Medicine, Pharmacogenomics”

MORTGAGES

SWBC MORTGAGE - THE TOBER TEAM (HHH Gold Sponsor) SWBC for Personal and Practice: Physician programs for wealth management and homebuying. For You Practice: HR administration, payroll, employee benefits, insurance, and exit strategies. SWBC’s services supporting Physicians and the Medical Society. Jon Tober Sr. Loan Officer Office: 210-317-7431 NMLS# 212945 Jon.tober@swbc.com https://www.swbcmortgage.com /jon-tober PROFESSIONAL ORGANIZATIONS

The Health Cell (HH Silver Sponsor) “Our Focus is People” Our mission is to support the people who propel the healthcare and bioscience industry in San Antonio. Industry, academia, military, nonprofit, R&D, healthcare delivery, professional services and more! President, Kevin Barber 210-308-7907 (Direct) kbarber@bdo.com Valerie Rogler, Program Coordinator 210-904-5404 Valerie@thehealthcell.org www.thehealthcell.org “Where San Antonio’s Healthcare Leaders Meet”

San Antonio Medical Group Management Association (SAMGMA) (HH Silver Sponsor) SAMGMA is a professional nonprofit association with a mission to provide educational programs and networking opportunities to medical practice managers and support charitable fundraising. Alan Winkler, President info4@samgma.org www.samgma.org

REAL ESTATE SERVICES COMMERCIAL

Alamo Capital Advisors LLC (★★★★ 10K Platinum Sponsor) Focused on sourcing, capitalizing, and executing investment and development opportunities for our investment partners and providing thoughtful solutions to our advisory clients. Current projects include new developments, acquisitions & sales, lease representation and financial restructuring (equity, debt, and partnership updates). Jon Wiegand Principal 210-241-2036 jw@alamocapitaladvisors.com www.alamocapitaladvisors.com

CARR Realty (HH Silver Sponsor) CARR is a leading provider of commercial real estate for tenants and buyers. Our team of healthcare real estate experts assist with start-ups, renewals, , relocations, additional offices, purchases and practice transitions. Brad Wilson Agent 201-573-6146 Brad.Wilson@carr.us Jeremy Burroughs Agent 405-410-8923 Jeremy.Burroughs@carr.us www.carr.us “Maximize Your Profitability Through Real Estate”

Foresite Real Estate, Inc. (HH Silver Sponsor) Foresite is a full-service commercial real estate firm that assists with site selection, acquisitions, lease negotiations, landlord representation, and property management. Bill Coats 210-816-2734 bcoats@foresitecre.com https://foresitecre.com “Contact us today for a free evaluation of your current lease”

RETIREMENT PLANNING

Oakwell Private Wealth Management (HHH Gold Sponsor) Oakwell Private Wealth Management is an independent financial advisory firm with a proven track record of providing tailored financial planning and wealth management services to those within the medical community. Brian T. Boswell, CFP®, QKA Senior Private Wealth Advisor 512-649-8113 SERVICE@OAKWELLPWM.COM www.oakwellpwm.com “More Than Just Your Advisor, We're Your Wealth Management Partner”

STAFFING SERVICES

Favorite Healthcare Staffing (HHHH 10K Platinum Sponsor) Serving the Texas healthcare community since 1981, Favorite Healthcare Staffing is proud to be the exclusive provider of staffing services for the BCMS. In addition to traditional staffing solutions, Favorite offers a comprehensive range of staffing services to help members improve cost control, increase efficiency and protect their revenue cycle. Cindy M. Vidrine Director of Operations- Texas 210-918-8737 cvidrine@favoritestaffing.com “Favorite Healthcare Staffing offers preferred pricing for BCMS members.”

Join our Circle of Friends Program

The sooner you start, the sooner you can engage with our 5700 plus membership in Bexar and all contiguous counties. For questions regarding Circle of Friends Sponsorship, please contact:

Development Director, August Trevino august.trevino@bcms.org or 210-301-4366

2022 Mercedes AMG GT53

By Stephen Schutz, MD

The Mercedes AMG GT coupe is a serious Porsche 911 rival that’s 90% sports car and 10% luxury conveyance (I’ve reviewed it previously). The sedan version of the AMG GT, on the other hand, is a different animal. Based on the E-class sedan, the four-door AMG GT is definitely an automotive athlete, but a stretched AMG GT coupe it is not.

It looks like that though. The aggressive AMG GT grille and angry headlights seem like they could be the same (they’re not), and the flowing profile and tapered rear end say “high performance” almost as much as the coupe’s styling does.

Nevertheless, the AMG GT sedan is also seriously handsome with an elegant exterior that would merit a valet parking spot in front of any hot restaurant. Its competitors, the BMW 8-series Gran Coupe and Porsche Panamera, provide similar driving experiences, but neither is anywhere near as good-looking as this car.

The good looks extend to the cabin, where everything looks and feels top shelf. Surprisingly, the objects that draw your eye the most inside the AMG GT sedan aren’t the seats, gauges or center console, although they’re all nice, but the HVAC vents. Round, aluminum and very visible, those vents add attractive jewelry-esque elements to Mercedes’ interiors.

Good for Mercedes. In the 1980s, Bruno Sacco’s restrained but modern interiors were easily the class of the luxury automotive space. Since that high water mark, however, Mercedes seemingly lost their way when it came to automotive interior design.

Who took over that leadership position? 30 years ago, Lexus had the best interiors, 20 years ago it was Audi, 10 years ago, still Audi, and now it’s Mercedes. Who will it be 10 years from now? Maybe Lucid.

Internal combustion engine (ICE) development is nearing an end as all automotive manufacturers pivot to battery electric vehicles, and the powerplants available in the Mercedes AMG GT sedans may be the ICE high water mark. The GT53 I tested features a 3-liter inline six-cylinder engine that integrates a turbocharger, electric supercharger and an electric motor to maximize power.

The electric motor and supercharger provide instant oomph before the turbo kicks in, which is when the GT53’s 429HP gets real. My test car was seriously fast—zero to 60 mph in 4.1 seconds fast, actually—and it was amazing to experience how all of that powerplant tech combined with a nine-speed automatic transmission moves this relatively large sedan forward.

A detuned GT43 is available in addition to the GT53, but the OTT GT63 and GT63S models are the ones you want. Powered by a monster 4.0-liter V8, the max AMG GT sedans combine dry-sump oiling, direct injection and two turbochargers to crank out 577HP in the GT63 and 630HP in the GT63S. Sounds great, doesn’t it? Regrettably, due to supply chain snafus and other challenges, Mercedes will be importing very few if any V8-powered cars and SUVs for a lot of the 2022 model year. I’m a fan of Mercedes’ new inline six-cylinder engines, but there’s nothing like a V8.

Driving the AMG GT53 is a treat and a reminder that, regardless of a modern luxury crossover or SUV’s utilitarian advantages, and there are many, in no way will any of those types of vehicles go down the road as well as a sports sedan. The AMG GT53 attacks high-speed sweeping corners with confidence and competence, and just gobbles up interstates. It’s so good when you’re in a hurry, in fact, that I’m amazed that it’s based on the relatively pedestrian E-class. Trudging around town in the AMG GT sedan is nothing special, but that’s true for almost any vehicle.

As always with a Mercedes, options, which are many, can quickly inflate the price of an AMG GT53 from its base of $108,000 to close to $150,000 or even more if you get overly exuberant.

It’s worth noting that Mercedes, like all automotive manufacturers, is directing almost all of its R&D capital towards electrification, which means that delicious ICE sedans like the AMG GT53 won’t be around forever. I suspect that the venerable S-class will be the last Mercedes to give up its engine for an electric motor, and it makes sense that niche gasoline-powered sedans such as the AMG GT and CLS will go away sooner. Too bad, these are peak times for luxury ICE sedans, especially those from Germany, and, sadly, they’re not long for this world.

The AMG GT sedan is a terrific driver’s car that can do it all, from taking four friends to dinner in comfort to ferrying you quickly and safely to the hospital at 2 a.m. It’s not cheap, but nothing this good ever is. Get it while you can.

As always, call Phil Hornbeak, the Auto Program Manager at BCMS (210-301-4367), for your best deal on any new car or truck brand. Phil can also connect you to preferred financing and lease rates.

Stephen Schutz, MD, is a board-certified gastroenterologist who lived in San Antonio in the 1990s when he was stationed here in the US Air Force. He has been writing auto reviews for San Antonio Medicine since 1995.

11911 IH 10 West San Antonio, TX 78230 Coby Allen 210-696-2232

Kahlig Auto Group

Bluebonnet Chrysler Dodge Ram 547 S. Seguin Ave. New Braunfels, TX 78130 Matthew C. Fraser 830-606-3463

Land Rover San Antonio 13660 IH 10 West San Antonio, TX Cameron Tang 210-561-4900

Kahlig Auto Group

North Park Mazda 9333 San Pedro San Antonio, TX 78216 John Kahlig 210-253-3300

Kahlig Auto Group

North Park Subaru 9807 San Pedro San Antonio, TX 78216 Raymond Rangel 210-308-0200

Audi Dominion 21105 West IH 10 San Antonio, TX 78257 Rick Cavender 210-681-3399

Northside Ford 12300 San Pedro San Antonio, TX Marty Martinez 210-477-3472

Kahlig Auto Group

North Park Lexus 611 Lockhill Selma San Antonio, TX Tripp Bridges 210-308-8900

Mercedes Benz of Boerne 31445 IH 10 West Boerne, TX James Godkin 830-981-6000

Kahlig Auto Group

North Park Subaru at Dominion 21415 IH 10 West San Antonio, TX 78257 Phil Larson 877-356-0476

Northside Chevrolet 9400 San Pedro Ave. San Antonio, TX 78216 Charles Williams 210-912-5087 Chuck Nash Chevrolet Buick GMC 3209 North Interstate 35 San Marcos, TX William Boyd 210-859-2719

Northside Honda 9100 San Pedro Ave. San Antonio, TX 78216 Paul Hopkins 210-988-9644

Kahlig Auto Group

North Park Lexus at Dominion 25131 IH 10 W Dominion San Antonio, TX James Cole 210-816-6000

14610 IH 10 West San Marcos, TX 78249 Mark Hennigan 832-428-9507

Kahlig Auto Group

North Park Lincoln 9207 San Pedro San Antonio, TX Sandy Small 210-341-8841

Mercedes Benz of San Antonio 9600 San Pedro San Antonio, TX Al Cavazos Jr. 210-366-9600

Cavender Toyota 5730 NW Loop 410 San Antonio, TX Gary Holdgraf 210-862-9769

9455 IH 10 West San Antonio, TX 78230 Douglas Cox 210-764-6945

Kahlig Auto Group

North Park Toyota 10703 Southwest Loop 410 San Antonio, TX 78211 Justin Boone 210-635-5000