Dr. Javier Iturbe doesn't scold immigrant parents who give bean juice to their month-old babies. Even though nutritional guidelines in the United States say infants shouldn't eat solids until four to six months after birth , Iturbe knows that his patients from Mexico and Central America often get different advice from their relatives.

Instead of admonishing them to stop feeding their babies anything other than breast milk or formula, he suggests that they start slowly with solids, while avoiding foods that heighten the risk of an allergic reaction (such as strawberries, shellfish and nuts) or an infection (such as undercooked eggs).

He isn't a stickler for the minor stuff. "In other cultures, traditionally they do chamomile tea when (the babies) are a couple weeks old, and there's really nothing wrong with something like that," he said.

Here, at Camino Entrada Pediatrics in Santa Fe, physicians respect what families do to help their children heal and thrive, but they also educate families about myths and present alternatives.

"Instead of blowing them off and saying, 'You don't know what you're talking about' or 'You're ignorant,' we honor and respect their feelings and their traditions — and at the same time give another side and ultimately let them choose," Dr. Michael Patterson said. "That way they're taking part, and the care of their child is not just dictated by us."

When Iturbe treats chronically ill patients, he knows it's best to ask parents if they are giving herbal or folk remedies to their child. "I'm from Mexico and I grew up that way," he said.

Iturbe said he has a sense of what might be toxic and which home remedies are probably harmless, even though they aren't scientifically proven as effective treatments.

"If you have a kid with leukemia and they want to try herbal medications or whatever, if you tell them no, they're still going to do it, hide it. So it's better sometimes to combine those things," he said. "The other thing is to let them know to be careful of certain things that can be toxic."

Best of all, both doctors can explain the child's diagnosis and course of treatment in Spanish. That alone eliminates a lot of confusion because, as Iturbe explains, even patients who are fluent in English can get tripped up by medical terminology.

This depth of cultural understanding has given the new clinic, which Christus St. Vincent Regional Medical Center opened two summers ago near Airport Road, a robust following. About 50 percent to 90 percent of its patients are Spanish speaking, (the percentage varies depending on which doctor you ask).

The clinic has a sweeping regional appeal as well. Given its close proximity to N.M. 599 and Interstate 25, Camino Entrada Pediatrics draws patients from Rio Rancho to Raton and from Pecos, Pojoaque, Peñasco, Chama and beyond.

"The demand is huge," clinic manager Elvera Simoni said.

So huge, in fact, that the caseload has become overwhelming. Every day, the clinic turns away 20 to 40 people, Simoni said.

"We double and triple book appointments, and we try to do what we can," Patterson said. "People get upset, and they can't get in."

A handwritten sign on the door reminds patients that appointments are required; this is not a walk-in clinic or an urgent-care facility. Camino Entrada Pediatrics is accepting new patients; however, for children over 2 years old, the wait for an appointment can be two to three months long, Simoni said.

Together, Patterson and Iturbe serve more than 1,000 patients a month. To help ease the load, the hospital recently hired a pediatric nurse practitioner who is shared with Arroyo Chamiso, the hospital's other pediatric clinic.

"He has been a godsend," Patterson said. The nurse practitioner speaks native Alaskan and African tribal languages, but not Spanish.

Ideally, the clinic needs more doctors, nurses, medical assistants and clerical staff.

"If we had a couple more people here, this would be a top-notch place," Patterson said.

Infants make up the bulk of Camino Entrada's clientele. The doctors do much more than wellness visits, however. Some seriously ill children whose families need bilingual services get referred to their practice.

"It's not just your basic bread-and-butter diaper rash and colds. We have a lot of chronic kids," Patterson said. "That's what's nice about being here — we can provide a service. The specialists are in Albuquerque. They can see them for the special care, but we still get to follow them and take care of them (in Santa Fe)."

Heart disease, heart transplants, liver transplants, muscular dystrophy, multiple sclerosis, developmental disabilities — these are the kinds of complicated cases doctors at Camino Entrada handle.

"We have one child who came in this morning who was here for four hours getting an IV infusion of a special immune globulin," Patterson said.

While Camino Entrada Pediatrics promotes cultural sensitivity, its physicians still adhere to American Academy of Pediatrics guidelines for disease prevention and treatment. The New Mexico Immunization Coalition, which includes the state Health Department and first lady Barbara Richardson, gave the clinic an award this year for having 92 percent of its patients immunized.

Historically, the hospital operated one pediatric clinic in town, Arroyo Chamiso on South Galisteo Street. As housing developments sprang up on Santa Fe's south side, the hospital decided it was time to venture out, too.

"It's the poor area of town, so they were actually more underserved," Iturbe said.

Through Lovelace Health System, Iturbe and Patterson had an established, independent practice across from the hospital, but a lot of their Medicaid patients lived on the south side of town, so when the hospital decided to build a new pediatric clinic, they got on board with it.

"The growth is going this way," Iturbe said.

Besides running Camino Entrada, the pediatricians also work shifts at the hospital.

Based on a Lovelace survey five years ago, Santa Fe needed 14 full-time pediatricians to provide hospital coverage as well as see patients in clinics, according to Iturbe. Since that survey, the city's population of newborns has spiked. And yet today, by Iturbe's count, the city has only five full-time pediatricians.

"So, in general, I think that there's really a lot of need for pediatric care here," Iturbe said.

Camino Entrada Pediatrics has a spacious waiting room. Photographs of wildlife add character to the freshly painted walls, but the room lacks children's books, toys and a play area for toddlers. It has four kid-sized chairs.

Roughly 80 percent of the new clinic's patients have low incomes and rely on Medicaid to cover their medical bills.

"We always joke — we say we're the other La Familia Medical Center — the pediatric version," Patterson said, referring to Santa Fe's community health center that serves people of all ages. "A lot of our patients switch from La Familia to us."

Camino Entrada Pediatrics, which accepts patients from birth to age 18, is open from
8 a.m. to 5 p.m. Monday through Friday. Families who need medical advice after hours can contact an answering service, which serves both pediatric clinics, and ask to speak to the pediatrician on call. Someone is available 24 hours a day, seven days a week.

Camino Entrada Pediatrics shares a building with two other businesses.

In general, Santa Fe has no specialists who cater to children, other than Pediatrix Cardiology Associates of New Mexico. This medical group runs clinics all over the state. In Santa Fe, it had an office at the medical-dental building adjacent to Christus St. Vincent Regional Medical Center, but after it lost that lease, it began working out of Camino Entrada Pediatrics three months ago, said medical director
Dr. Steven Yabek.

Every Friday, children from as far away as Taos and Los Alamos come for treatment. Without this service, they would have to drive to Albuquerque.

Open MRI of Santa Fe is across the hallway from Camino Entrada Pediatrics. It has the only open-air imaging unit in Northern New Mexico, according to marketing manager Mike Ellis. For people who are obese or claustrophobic, the typical MRI machine with a cylinder tube can be problematic. The Airis Elite takes that confinement away. What's more, for parents who want to hold their child's hand during the diagnostic procedure, the Airis Elite makes that possible, Ellis said.

The 10,000-square-foot medical building has room for more services. St. Vincent envisioned opening an urgent-care clinic there, but those plans are on hold as the hospital re-evaluates its direction, said spokesman Arturo Delgado. In April, New Mexico's oldest hospital merged with Texas-based Christus Health, a Catholic enterprise. The priority right now, Delgado said, is physician recruitment throughout the hospital system.

Patterson thinks an urgent-care clinic could do well at this location.

"You build it and they will come, especially if the care that they provide is good," he said.