Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Transforming Pediatric Care in Rural Georgia with Marc Welsh & Dr. Jean Sumner

Transcript

Transforming Pediatric Care in Rural Georgia with Marc Welsh & Dr. Jean Sumner · Becker’s Healthcare -- Pediatric Leadership Podcast

• 0:00
  Welcome to the Becker's Healthcare Podcast. I'm Chris
• 0:02
  Sosa, your host. And I'm thrilled to be
• 0:04
  joined today by Mark Welsh, who is vice
• 0:06
  president of children's advocacy for children's health care
• 0:08
  of Atlanta, and doctor Jean Sumner, who is
• 0:11
  dean of the Mercer University School of Medicine.
• 0:13
  Mark and doctor Sumner, thank you so much
• 0:15
  for joining us today. Thank you. Glad to
• 0:16
  be here. Thank you for having us.
• 0:19
  Excellent. Thank you, guys. We are, of course,
• 0:21
  here to talk about your kids' alliance for
• 0:23
  better care program. I'm so excited to learn
• 0:25
  about that. But off the top, could you
• 0:28
  just please introduce yourselves and tell us a
• 0:29
  bit about your backgrounds? Doctor Sumner, why don't
• 0:31
  you go first?
• 0:33
  Well, I'm Jean Sumner. I'm a internist by
• 0:35
  training. I'm the dean at Mercy University School
• 0:38
  of Medicine, and I'm approaching my tenth year.
• 0:40
  I've spent most of my life practicing in
• 0:43
  rural Georgia, some of the poorest counties in
• 0:45
  the state.
• 0:46
  And the school is driven by its mission,
• 0:48
  which is helping alleviate
• 0:50
  health disparities in in rural Georgia.
• 0:54
  And, Mark, how about you? I'm Mark Welsh.
• 0:56
  I'm the, as you've mentioned, the vice president
• 0:58
  of child advocacy here at Children's. I've been
• 0:59
  with the organization
• 1:01
  for eight years, and our work here focuses
• 1:03
  on how do we impact the community. My
• 1:05
  team does both prevention work in the community,
• 1:08
  but also
• 1:09
  is so proud to do work like this
• 1:10
  rural health initiative. I am a
• 1:12
  epidemiologist by training, but I spent most of
• 1:14
  my career
• 1:15
  leading large, public health focused programs.
• 1:19
  Fantastic. Alright. As you we've mentioned, we're here
• 1:21
  to talk about a wonderful program that you
• 1:23
  have combined forces,
• 1:25
  to launch into the health care sphere, so
• 1:28
  to speak.
• 1:29
  Doctor Salmer, I wanna start with you. So
• 1:31
  could you paint a picture of what health
• 1:33
  care for kids looks like in rural communities,
• 1:35
  and also what inspired you to work to
• 1:37
  address this lack of access?
• 1:39
  Well, thank you, Chris, for the opportunity to
• 1:41
  talk about something that we're passionate about. Health
• 1:43
  care in rural Georgia for children is probably
• 1:46
  the most underserved area of care. There are
• 1:49
  120
• 1:50
  of the 159
• 1:51
  counties in our state that are considered rural
• 1:54
  by Georgia's definition, which is 50,000
• 1:56
  or less.
• 1:57
  Of the 120 counties,
• 1:59
  65 do not have a pediatrician.
• 2:02
  And and of the ones that do, many
• 2:04
  have one pediatrician.
• 2:07
  So
• 2:08
  I believe that the most underserved area of
• 2:10
  medicine
• 2:11
  is care for children. Now there are great
• 2:14
  family medicine docs who fill in and take
• 2:16
  care of kids as well.
• 2:18
  But having a pediatrician
• 2:19
  that's accessible,
• 2:21
  I think, in many ways offers things
• 2:23
  that improve the care of children across the
• 2:26
  state.
• 2:27
  We we're fortunate to live in a great
• 2:29
  state, and our legislators have been very focused
• 2:31
  on trying to improve care. And Georgia has
• 2:34
  invested a great deal of resources into rural
• 2:36
  health,
• 2:37
  But making the health status better,
• 2:40
  has not happened. I do believe that we're
• 2:43
  very honored to have an alliance with Children's
• 2:45
  Healthcare of Atlanta and that this program is
• 2:47
  laying the foundation
• 2:49
  for a program that could use be used
• 2:51
  as a model nationally
• 2:52
  to make a difference in these communities.
• 2:56
  It's a worthwhile program to say the very
• 2:58
  least, and I'm sure both your organizations are
• 3:00
  very proud of the work you're doing and
• 3:01
  will continue to do.
• 3:04
  For one of you, let whoever wants to
• 3:06
  take this question tackle it. I'm just looking
• 3:08
  for an overview of the collaboration between both
• 3:10
  your organizations.
• 3:12
  Yeah. I mean, I can I I can
• 3:14
  take a the first go, and I'm sure
• 3:15
  doctor Sumner will jump in and fill in
• 3:17
  what I missed? You know, for us at
• 3:19
  Children's, we, in any given year, will serve
• 3:22
  kids from all a 159
• 3:23
  counties across the state.
• 3:25
  The 120 rural counties that doctor Sumner mentioned,
• 3:28
  we know have unique needs and and that
• 3:30
  those families
• 3:32
  are doing amazing things to raise kids, but
• 3:34
  face unique challenges in ensuring those kids get
• 3:36
  cared. And so when we set about this
• 3:38
  project, we really looked at, okay, how do
• 3:40
  we ensure that we are not only thinking
• 3:43
  about what will best impact those kids, but
• 3:45
  that we engaged with a partner, engaged with
• 3:48
  an organization that would allow us to really
• 3:51
  understand the needs of rural communities. And that's
• 3:53
  why we began this work with with the
• 3:55
  Mercer School of Medicine and the Rural Health
• 3:56
  Innovation Center because these are folks who live
• 3:58
  in rural communicate communities and dedicate every single
• 4:01
  day to serving,
• 4:03
  communities across our state. And so we set
• 4:06
  about really trying to better understand how to
• 4:08
  meet those needs. And from an initial meeting
• 4:10
  that doctor Sumner organized with
• 4:12
  pediatricians from the communities and hospitals, we landed
• 4:15
  on four core areas of focus.
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  The first is really helping rural hospitals be
• 4:21
  better able to meet the needs of kids
• 4:23
  in their communities.
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  These are wonderful facilities that are doing amazing
• 4:26
  work to serve their communities, but they're primarily
• 4:28
  serving adults. And in many of these cases,
• 4:31
  they weren't really ready and prepared to respond
• 4:33
  to the needs of kids. And so we
• 4:35
  set about understanding how do we best support
• 4:37
  them, best meet those needs, and and ensure
• 4:39
  that they have what they need to meet
• 4:41
  the needs of that kid that may walk
• 4:42
  through their doors.
• 4:44
  The second was really supporting pediatricians. And so
• 4:46
  we heard from a wonderful group of pediatricians
• 4:48
  who said, hey. We are we are doing
• 4:51
  great things for our community, but often, we're
• 4:53
  out here on an island. We're on our
• 4:55
  own. I I we they don't have
• 4:57
  a partner down the hall who they can
• 4:59
  go and say, hey. Come and take a
• 5:00
  look at this case.
• 5:02
  So they really wanted to not only create
• 5:04
  that connection amongst each other, but have that
• 5:06
  ongoing support through telehealth and through opportunities for
• 5:09
  ongoing learning from the experts in children's.
• 5:12
  So there was an opportunity to facilitate that.
• 5:15
  The third area of behavioral and mental health,
• 5:17
  we know that that's a challenge across the
• 5:19
  nation, certainly a a challenge in Metro Atlanta.
• 5:22
  But in our rural communities in particular, that
• 5:25
  challenge is amplified
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  by not only, the the continuation of stigma
• 5:30
  around mental health, but also a lack of
• 5:31
  access to care. And so we wanted to
• 5:33
  think about how do we best work with
• 5:35
  schools to not only do screening, but more
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  importantly, as doctor Sumner always stress stresses,
• 5:40
  connecting kids to care. It's not about just
• 5:42
  screening and identifying and leaving. You have to
• 5:45
  close the loop and connect to care. So
• 5:47
  really thinking about models that allow us to
• 5:48
  do that. And the last area is probably
• 5:51
  the area that I continue to be the
• 5:52
  most proud of, and that is thinking about
• 5:55
  sustainable way ways to build the health care
• 5:58
  workforce across the state. Doctor Sumner mentioned the
• 6:01
  number of counties that are without a pediatrician
• 6:03
  throughout our state. And so we set about,
• 6:06
  through through the guidance of the Mercer School
• 6:08
  of Medicine to say, what would it look
• 6:09
  like to offer scholarships
• 6:11
  to med students who in turn commit to
• 6:14
  serving rural communities post their training? And so
• 6:16
  we are excited to have 27 young people
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  who made that commitment. There's they have scholarships
• 6:21
  that'll cover their full med school tuition, and
• 6:24
  they'll come into four years of serving in
• 6:25
  a in a rural community post that training.
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  In addition, we said, hey. That's that's working.
• 6:31
  That's amazing. What would it look like to
• 6:33
  do that on the side of mental health?
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  And so we've we've begun that same program
• 6:38
  for marriage and family therapists who are also
• 6:40
  making a commitment to serving in rural communities.
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  So thinking about these sustainable models to build
• 6:44
  the workforce in rural Georgia.
• 6:47
  Yeah. And that commitment to collaboration, Mark, that
• 6:50
  you just
• 6:51
  outlined so eloquently, I'm glad it's alive and
• 6:53
  well, and not only with your organizations, but
• 6:56
  as I speak to other health care leaders,
• 6:57
  it's alive there as well, which is terrific.
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  And now, doctor Summer, I wanna give you
• 7:01
  an opportunity to
• 7:03
  to have the floor and discuss just what
• 7:05
  Mercer's role looks like in this program and
• 7:07
  this effort.
• 7:08
  Chris Mercer was created back in the eighties
• 7:11
  to be a medical school that trained physicians
• 7:14
  and health care professionals for rural Georgia.
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  Everything we do here from our research to
• 7:19
  our selection of students
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  is focused on making Georgia healthy
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  and finding sustainable solutions to rural health. I
• 7:27
  don't know if anything we do that has
• 7:29
  been more impactful than this effort.
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  Because to in order to impact a rural
• 7:34
  community, rural communities are often looked at as
• 7:38
  unsophisticated,
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  as not educated,
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  as
• 7:42
  not caring about their families or not caring
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  about their community, and nothing could be further
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  from the truth. They're actually resilient.
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  There may be less levels of education,
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  but people care about their families and they
• 7:55
  want to do well. But there's so many
• 7:57
  obstacles to care
• 7:59
  in these communities. They've been left out of
• 8:01
  the loop. They have to drive many miles
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  for care.
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  They're often
• 8:07
  implied
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  to be not
• 8:09
  motivated to care for themselves,
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  when actually it's so hard to access care
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  that often they give up.
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  What we do is build long term trust
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  with these communities.
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  When Mercer comes, we don't go away,
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  and we listen to the community, and we
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  learn what the issues are.
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  You will find that every rural community in
• 8:29
  Georgia is different. It has strengths, and it
• 8:32
  has weaknesses.
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  But it always has, you will find, a
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  group of people
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  who will work together
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  to engage their community
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  and to rise to the challenge of of
• 8:43
  changing the health in that community.
• 8:45
  So trust
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  is is very important in health care, but
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  it's required if you're gonna impact the health
• 8:52
  of a rural system.
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  You can't be a mobile doctor. The scholarships
• 8:56
  that Mark mentioned, these students are by
• 9:01
  contract or required to live and work in
• 9:03
  those rural communities. They don't commute.
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  But our students,
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  Mercy is a little different that we only
• 9:09
  accept Georgians and we preferentially accept rural students.
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  So if you look across the country,
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  about 5% or less of students in MD
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  programs came from a small town. And at
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  Mercer, we're between 4050%,
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  and we continue to rise. And 70% of
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  our students come from outside of Metropolitan Atlanta.
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  We will always take Atlanta students,
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  but we look for young people who love
• 9:33
  where they grew up, who wanna go home,
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  and we find a path for them.
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  And so, they're very motivated to get the
• 9:40
  skills. I personally think to be an independent
• 9:43
  practitioner in a small town, you need stronger
• 9:45
  skills
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  because you can call a code or need
• 9:48
  help. And as Mark said, there's nobody there
• 9:50
  to help you. So you need to build
• 9:51
  a team around you,
• 9:53
  and you need to be really good at
• 9:55
  what you do.
• 9:56
  But we we impact those by doing what
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  we say,
• 10:01
  not giving up, listening,
• 10:03
  understanding the needs of the community,
• 10:06
  and providing the resources they need and also
• 10:08
  the training they need to use those resources.
• 10:11
  And we build the coalition. I think the
• 10:13
  coalition between these counties is so important. It
• 10:16
  the counties geographically are large, and you may
• 10:19
  be in Coffee County and not realize there's
• 10:21
  that there's a pediatrician
• 10:23
  two counties over that you could pick up
• 10:25
  the phone or chat with with a telehealth
• 10:27
  unit or share a case.
• 10:29
  So we build that coalition and best practices
• 10:32
  come out of that coalition.
• 10:34
  And so it's really been exciting to work.
• 10:37
  You know, I was had an interview one
• 10:40
  time, and the the woman who was interviewing
• 10:42
  me said, when you when this is over,
• 10:44
  they'll just go back to their bad ways.
• 10:47
  And I said, you've never lived in a
• 10:48
  county. In a small town, you know everybody.
• 10:52
  You know you know who smokes secretly. You
• 10:54
  know who drives too fast. You know who,
• 10:57
  does other things. But you care about you
• 11:00
  you it's a diverse group of people who
• 11:02
  need each other, and they care about each
• 11:05
  other.
• 11:05
  And so you're the doctor, and you know
• 11:08
  that patient. You're the nurse in that ER.
• 11:10
  Your children probably go to play softball with
• 11:13
  with the other kids. They go to school
• 11:15
  with other kids. You know, the mothers, the
• 11:18
  grandmamas, the great grandmothers.
• 11:20
  So you want to be the best you
• 11:22
  can be, and you want them to have
• 11:24
  confidence
• 11:25
  in your institution.
• 11:26
  When when you have a major emergency in
• 11:29
  a child,
• 11:30
  you have a short time frame to get
• 11:32
  that child to a center. You have to
• 11:33
  stabilize them, and and that is one of
• 11:36
  our goals, being able to stabilize critical emergencies.
• 11:39
  But there are also so many things that
• 11:41
  could stay home
• 11:42
  and be treated well.
• 11:44
  And we've set up through this initiative
• 11:47
  the ability for these hospitals to regain their
• 11:49
  found foundational values in pediatrics and the skills
• 11:53
  they need to to care for that child
• 11:55
  at home and then refer if appropriate. But
• 11:58
  many of the cases can be kept at
• 11:59
  home. A family that has to go to
• 12:01
  Atlanta or go 60, a 100 miles for
• 12:04
  care, that means days off from work. It
• 12:07
  means gas they don't have. It means,
• 12:10
  you know, missing school. And so if we
• 12:12
  can provide care at home with guidance and
• 12:15
  with building a inner world team that can
• 12:18
  help each other
• 12:19
  or maybe sending them to the next county
• 12:21
  instead of sending them a 100 miles away,
• 12:24
  That helps the family.
• 12:26
  Children do better in school and are just
• 12:29
  healthier and more happy with what their lives
• 12:31
  are like. And so we help families achieve
• 12:34
  the care they need, and we hope we
• 12:36
  change that culture.
• 12:38
  Doctor Summer, thank you for signing
• 12:41
  a very powerful spotlight on on all the
• 12:43
  issues that are affecting
• 12:46
  rural communities and rural children in particular. I
• 12:49
  mean, I love how you
• 12:51
  illuminated the connectivity that
• 12:54
  exists in all these communities and how important
• 12:57
  that is and how resilient they are. And
• 13:00
  I'm so glad that you two have found
• 13:02
  each other,
• 13:03
  you know, not only, you know, you yourselves
• 13:06
  as colleagues, but as organizations.
• 13:08
  On that note, Mark,
• 13:10
  you've given us
• 13:12
  a lot of details, wonderful details on how
• 13:15
  Children's Healthcare of Atlanta plays a role in
• 13:18
  this. What else
• 13:20
  do you want our audience to know about
• 13:21
  how your organization is involved with this effort?
• 13:25
  Well, I mean, I think one of the
• 13:26
  things I I I want folks to know
• 13:27
  is is really to shine a light on
• 13:29
  all of the wisdom that doctor Sumner just
• 13:31
  shared, and I I use the word wisdom
• 13:33
  on purpose.
• 13:34
  I think it's easy to sit in a
• 13:37
  big city and say, I know best. I
• 13:39
  know what is best for this community.
• 13:41
  We're the experts. We know. We we'll never
• 13:44
  have that wisdom and the lived experience of
• 13:46
  what it means to live in one of
• 13:48
  these one of our rural communities, to understand
• 13:51
  that interconnectedness,
• 13:52
  to understand
• 13:53
  the importance of trust and building trust. And
• 13:56
  so I think the biggest thing for us
• 13:57
  here at Children's
• 13:58
  has been to be willing to have the
• 14:01
  humility to come and say, hey. Teach us.
• 14:03
  Help us understand where we can make the
• 14:05
  biggest impact.
• 14:06
  And from that perspective, we've we've done really
• 14:09
  two core things. We've said we will invest
• 14:11
  in this initiative
• 14:12
  financially, and we will invest in terms of
• 14:14
  the pediatric expertise that sits at children's.
• 14:17
  But we will look to, our collaborators at
• 14:20
  Mercer to say, how do we best impact
• 14:22
  the communities,
• 14:23
  that we wanna serve and that you all
• 14:25
  are are so interconnected with? And I think
• 14:28
  that that's important. As as others listen to
• 14:30
  this this podcast and as other health systems
• 14:33
  think about how they can do more, it
• 14:35
  is important that you connect with folks who
• 14:37
  are in the communities you're trying to serve.
• 14:39
  I think it's vital to hear those voices,
• 14:41
  to understand those needs.
• 14:43
  And then from there, think about how you
• 14:45
  can best make an impact.
• 14:47
  Looking ahead,
• 14:49
  certainly, this is a program that I understand
• 14:51
  is in its third year, which is terrific
• 14:53
  that it's come this far. So looking ahead
• 14:55
  three to five years, even beyond that, doctor
• 14:57
  Sumner, Mark, what what do you see this
• 14:59
  program looking like in that time?
• 15:01
  Children's has committed to ten years of this
• 15:04
  program.
• 15:05
  And, you know, we hope that we we
• 15:08
  use the resources that are available to us
• 15:10
  to help these communities,
• 15:12
  and we use their expertise to guide these
• 15:15
  communities.
• 15:16
  I hope this is a a lifelong commitment.
• 15:19
  I I think that you will see that
• 15:21
  mothers
• 15:22
  and daddies care about their children,
• 15:25
  and healthy children become healthy young people become
• 15:28
  healthy adults.
• 15:30
  And children's health transforms the family.
• 15:33
  And so
• 15:35
  Georgia needs rural Georgia.
• 15:37
  Rural Georgia is a wealth of industry in
• 15:41
  terms of mining and farming and food and
• 15:44
  timber and
• 15:45
  but industry
• 15:46
  won't come
• 15:48
  to communities where there is no health care,
• 15:50
  particularly health care for children.
• 15:52
  Children who are well do better in school.
• 15:54
  They have more opportunity.
• 15:57
  And so we believe that not only are
• 15:59
  we transforming the health of children, and we'll
• 16:02
  continue to work diligently to do that. We're
• 16:05
  transforming economically
• 16:06
  some of these communities
• 16:08
  that give the opportunity for industry to come
• 16:11
  in or businesses and have good health care
• 16:13
  and have expertise in children. I have to
• 16:16
  say that that Children's Healthcare of Atlanta is
• 16:18
  a treasure, and they do things that nobody
• 16:20
  else
• 16:21
  does. They didn't have to do this,
• 16:23
  but we are so honored to be in
• 16:25
  a in alliance with them and to have
• 16:28
  this association that allows us to go into
• 16:31
  these communities
• 16:33
  and transform them,
• 16:35
  with the help of the local people. And
• 16:36
  and and don't underestimate
• 16:39
  the value of those local communities that are
• 16:41
  110%
• 16:44
  engaged. It's the the communities where we've been,
• 16:47
  we where we are, and we never leave
• 16:49
  over the 10 every even though we had
• 16:51
  the, you know, the third year, we stay
• 16:53
  very close and visit with the first and
• 16:55
  second years. We don't abandon them. But we're
• 16:58
  building this family of
• 17:00
  network that we will stay in touch with
• 17:02
  and continue to bring them the the best
• 17:04
  that we can bring them. We have continuing
• 17:06
  education every month. It's free.
• 17:08
  We have,
• 17:09
  specialty clinics where if a child in Worth
• 17:13
  County needs a nephrologist,
• 17:15
  there's a clinic where that child can
• 17:17
  be in Sylvester, see the nephrologist in Augusta,
• 17:21
  and never have to take a day out
• 17:23
  of school or a day mama didn't have
• 17:25
  to take a day out of work.
• 17:27
  So there's so many things to this project
• 17:28
  that grow, and then we learn every day
• 17:30
  new things that we could do and new
• 17:33
  approaches that we could have. And a lot
• 17:35
  of that comes from suggestions from the community.
• 17:37
  What do you think about this? And, so
• 17:40
  we listen intensely, and then we try to
• 17:42
  address those needs.
• 17:44
  So it's it's exciting. I I've spent my
• 17:47
  whole life in rural health,
• 17:49
  and I don't know
• 17:51
  anything more exciting to me than this project.
• 17:53
  We're committed to transforming
• 17:56
  the care of children in our state. And
• 17:58
  I think, also,
• 18:00
  our we ask our young people to live
• 18:02
  and work in rural communities, but these children's
• 18:05
  scholars,
• 18:07
  both the marriage and family therapist
• 18:09
  and the pediatric scholars, I'm I'm always interested
• 18:13
  when I interview them. These young people seem
• 18:15
  to know they wanted to be a pediatrician
• 18:17
  when they came to medical school. They all
• 18:18
  recount
• 18:19
  interactions
• 18:21
  with their doctor or their pediatrician,
• 18:23
  but now that pediatrician's not there.
• 18:26
  He went away.
• 18:27
  So we're we're giving hope again to those
• 18:30
  communities
• 18:31
  and having a workforce that
• 18:33
  that will be sustainable,
• 18:35
  we hope.
• 18:36
  Mark, anything you would like to add to
• 18:38
  that? I think doctor Sumner covered it really
• 18:40
  well. I think the the the biggest thing
• 18:42
  for me as I look ahead to the
• 18:43
  next five years is
• 18:46
  that we will continue to innovate and look
• 18:48
  for new ways to make an impact and
• 18:50
  learn. The the way that this has been
• 18:52
  developed and the way that it is set
• 18:54
  up is exactly what doctor Sumner expressed. It's
• 18:56
  an opportunity for us to continue to hear
• 18:58
  and learn from the communities that we serve.
• 19:00
  There's already been that example. We started with
• 19:02
  the, pediatric scholars, and we said, hey. Well,
• 19:05
  you know, why not why not think about
• 19:07
  how we can impact mental health and and
• 19:09
  began with the MFTs?
• 19:11
  Those are the types of things that I
• 19:12
  think will continue to happen, innovation to meet
• 19:15
  the needs in these communities.
• 19:16
  And, also, I think, you know, a lot
• 19:18
  about the growth that will happen in these
• 19:20
  communities. I think about the kids that will
• 19:22
  be exposed to a pediatrician because of the
• 19:24
  work that we're doing, that they themselves will
• 19:26
  decide that they want a career as a
• 19:28
  pediatrician,
• 19:29
  because of the exposure that they're getting. And
• 19:31
  I think those are the transformative things as
• 19:33
  we look five, ten years down the line.
• 19:35
  And I think we'll begin to see the
• 19:37
  real impact of this program. I, for one,
• 19:39
  can't wait to see where this program goes.
• 19:41
  Jean, doctor Sumner, Mark, thank you so much
• 19:43
  for being part of this. Your passion for
• 19:46
  this program definitely shines through, and that is
• 19:48
  not to be underestimated
• 19:49
  in any respect. So thank you again for
• 19:51
  being on the podcast and sharing what this
• 19:53
  program is all about. And, honestly, we can't
• 19:55
  wait till our paths cross again.
• 19:58
  Thanks, Chris. Thanks, Chris. We appreciate your interest.