This Week in Mac Sports: 9/15

UVA-trained Doctor Opens Direct Primary Care Clinic In Charlottesville

CHARLOTTESVILLE, Va. (WVIR) - A new patient-centered health clinic is open in the Charlottesville area.

Doctor Denise Annie Way, a UVA-trained doctor, branched out from the insurance-driven healthcare system to provide affordable care to those in need.

"My family and I immediately fell in love with the community, the wonderful diversity here and also the natural beauty," Dr. Way said.

Dr. Way's new practice, Skyline Family Medicine, is doing business differently by not leaning on health insurance coverage.

"In a sense, this is sort of concierge medicine but for the common man because it's not only beautiful, but it's also affordable," Dr. Way said.

Direct primary care is very different from an insurance-driven approach. It's more like a subscription service that has patients pay a flat monthly fee.

"There are no copays, there's no hidden fees, there's reduced pricing on labs, reduced pricing on imaging," said Dr. Way. "The patients that sign up for direct primary care experience less ER visits, shorter stays in the hospital. They don't need specialty care as much and overall the cost of health care for them is less."

Dr. Way says patients also have faster access to their doctors.

"They can call them, they can email them, they can text them, they can do tele video visits with them at any time of day," she said. "It is really health care as it should be."

Do you have a story idea? Send us your news tip here.

Copyright 2023 WVIR. All rights reserved.

OBGYN Deserts Grow In South Georgia

ALBANY, Ga. (WALB) - Happening right now in South Georgia, expectant moms are spending 30 minutes to an hour driving to an OBGYN's office due to labor and delivery closures in hospitals and medical malpractice suits against providers.

"My labor and delivery is closing down and it's like last minute and I need to know where I'm gonna have my baby," said expectant mom, Angel Glass.

Glass is just one of many moms left without O.B. Care after her Donalsonville hospital announced they were closing their labor and delivery unit.

Related Facebook post

Shared from Facebook

"Donalsonville Labor and Delivery is closing. So that's going to have another influx of patients that had a critical care access center that they no longer have within Donalsonville, so now, those patients are going to look for other providers," board-certified OBGYN Sheena Favors said.

An administrator for Donalsonville Hospital said the decision to close their unit was strictly financial. These types of closures are nothing new in South Georgia. Most of the counties surrounding larger medical centers have closed their O.B. And delivery services too. This creates a strain on the major facilities that are still open.

"As a mom, you know, you want the best. So, I'm thinking well I want to go to Dothan or Albany. You know, you hear wonderful things and to be constantly turned away, the more the panic sets in," Glass said.

Glass plans to transfer to Bainbridge for her prenatal care and delivery. In fact, most of the patients from Donalsonville will do the same. Memorial Hospital & Manor in Bainbridge says they are planning to hire Donalsonville's O.B. And some staff members to prepare for the influx of patients.

"The fact is, rural healthcare is a challenge to keep the services going. We're fortunate to have three OBGYNs and a nurse practitioner in our office. The goal would with another influx of these patients would probably be to hire Dr. Lenz, so that would be four physicians," said Jim Lambert, CEO of MHM.

© Provided by Albany (GA) WALB This map depicts Labor and Delivery closures in red, and current facilities in black.

As more O.B. Facilities shut their doors, the distance between places offering this care grows larger. That can be a barrier for women needing prenatal care, especially those with income, transportation, or insurance limitations.

"Access to care is a crisis across the country. Certainly, Georgia has its fair share of lack of OBGYNS. I believe there's, you know, eight or nine counties in Georgia with no licensed physicians, and at last count, 75 counties with no obstetrician/gynecologist, and that's a real problem. So, these patients don't have access to care. And as you can imagine, not having prenatal care can lead to many different issues. It certainly makes any obstetric emergency more likely," said D.O. Joanne Kakaty-Monzo, PCOM's Department of Obstetrics and Gynecology Academic Chair.

When these emergencies occur, the O.B. Provider can face legal action from their patients.

"O.B. Is one of the highest litigious fields in the specialty of medicine, we typically always rank in the top four for medical malpractice costs, so that your insurances a lot higher than most of your other specialties. And it is well known that OBs get sued on average more often than a lot of the other medical specialties," said Randall Sisam, D.O. And Director of Primary Skills at PCOM.

But there are things that medical centers can do when it comes to helping O.B.S avoid lawsuits and to recruiting more O.B.S.

One is participating in O.B. Emergency training like PCOM offers.

"It allows us to use both high-fidelity simulators and also test trainers to first be able to recognize that this is potentially a problem in O.B. Emergency, and then also to practice some of the maneuvers that would be needed to lead to resolution," said Brian Mann, Chief of Simulation Operations at PCOM.

I submitted open records requests to all of the major medical centers in our region. None currently offer any type of litigation protections for O.B.S that have the rights to deliver at their facilities. However, some, like Phoebe and South Georgia Medical Center, have O.B.S on staff to specifically help with emergencies, freeing up outside providers from that legal risk. This also helps with work-life balance.

"I think instituting these laborists and or hospitalist programs will help. Sometimes hospitals will bring in locum tenens, which are temporary positions that cover that practice if physicians need to have a vacation. My first practice in obstetrics was in Southwest Georgia, where the state help reduce the burden of my student loans for every year that I stayed in that practice in that area. I think that's a way that they can offer incentives to O.B. To come out and get their loans paid off," Randall Sisam, D.O. And director of primary skills at PCOM, said.

When it comes to recruiting more O.B.S to this area, the solutions we've already explored might not be enough. That's where other incentives and programs come in.

"The importance of having actual programs targeted to rural medicine. So we see that a lot with family medicine and other specialties. I don't really see that a lot, specifically for obstetrics and gynecology," Justice Dove, a second-year D.O. Student at PCOM, said.

There is still hope that these changes will bring out the next generation of providers and start growth in what's considered an OBGYN desert in South Georgia.

Bainbridge Memorial Hospital and Manor hope to help women in those rural areas get prenatal care with office visits in Blakely and Donalsonville. The transition will begin in July 2023.

New West Side Primary Care Clinic Promises To Expand Access To Uninsured Residents

When Jermaine Harris got sick growing up, there was no walk to see a familiar family doctor in Austin. Instead, the family had to take the CTA well beyond the neighborhood, to Rush Medical Center.

"We have to seek out these things outside our community," Harris said. "Growing up on the West Side, it was always on us to leave."

That's why he returned to the neighborhood to celebrate the debut of a primary care clinic, which he helped open, and which promises to cut the gap in care for West Siders.

"Here's a health care site you can walk to," Harris said, standing outside the clinic, at Corcoran Place and Menard Avenue, for its grand opening earlier this. Month. "That's the way of the future. … Smaller community spaces are how we're going to transform communities."

The Thresholds Health clinic at Corcoran Place and Menard Avenue in Austin. The clinic is the first from Thresholds Health, the health care arm of the social services agency that has helped Chicagoans struggling with homelessness and substance abuse since the late '70s. The clinic, on the ground floor of the agency's Austin apartment building, was available to building residents since last fall and opened to the general public in mid-March. Patients without insurance are accepted on a sliding scale basis.

Anthony Vazquez/Sun-Times

Harris is a founding board member of the clinic, called Thresholds Health, and was among a crowd of staff, local residents and city officials, including Commissioner Dr. Allison Arwady of Chicago's Department of Public Health, celebrating on April 11.

The clinic, which opened to the general public in mid-March, is the first from Thresholds Health. That's the health care arm of the Thresholds housing and social services agency that has helped Chicagoans struggling with homelessness and substance abuse since the late 1970s.

The 1,900-square-foot clinic is on the ground floor of the agency's Austin apartment building. Residents of the building have been able to get care there since September. 

Leaders decided to open it to the general public because of the wider need in the community. They expect to see 200 patients per week at the clinic, open weekdays, 9 a.M. To 7 p.M., no appointment necessary.

They plan to treat patients regardless of their insurance status, said CEO Ed Murphy, adding that Thresholds is applying to be designated as a "look-alike" federally qualified health center, which would help them get federal funds to pay for that care.

Either way, they won't turn anyone away.

"We're going to see people whether they can have insurance or not," said Murphy, the former CEO of a health center Downstate. "In this community, primary care is needed."

The advent of federally-qualified health centers, and the look-alikes, has transformed care for uninsured or underinsured people nationwide.

There are about 200 such health centers in Chicago, according to the most recent federal Health Resources and Services Administration data. Most are on the South and West sides. Thresholds' clinic would be sixth in the 60644 ZIP code, which covers south Austin.

Arwady said she came to the clinic to show her support for Thresholds receiving the designation.

The clinic is the "backbone of how we provide health care for everybody in the city of Chicago," Arwady said.

"Our primary goal is closing the life expectancy gap," she added, referring to the notorious lifespan chasm between Black and white Chicagoans.

In Austin, where 76% of residents are Black, the life expectancy is almost 11 years shy of Loop residents, only 7% of whom are Black.

"The biggest reason for that gap is chronic diseases — heart disease, smoking-related illness — and a lot of that has to do with root causes such as healthy food, but it's really critical people get primary care."

Chicago Department of Public Health Commissioner Dr. Allison Arwady speaks outside the Thresholds Health clinic at Corcoran Place and Menard Avenue in Austin. Arwady said she came to show her support for the clinic, which will provide care for patients regardless of insurance status.

Opening federally-qualified clinics has greatly improved health outcomes for Chicago neighborhoods in the past, Arwady said, noting how Esperanza Health's five centers have helped Southwest Siders, especially during the pandemic when the city partnered with Esperanza and other federally-qualified centers to deliver vaccines and care.

For example, after vaccines were rolled out in 2021, the COVID death rate among neighborhoods with Esperanza clinics, such as Little Village and Brighton Park, was significantly lower than in surrounding neighborhoods on the South and West sides, according to the Chicago Health Atlas.

The Austin clinic will help decrease the gap there, but even according to Thresholds' own studies — which found there are around 40,000 uninsured or underinsured Austin residents — more needs to be done. 

The area experiences higher rates of hypertension, lung cancer and diabetes-related hospitalizations, according to the health atlas, and the rate of insured residents is almost five times that of the Near North Side. 

Many of those uninsured patients end up at Loretto Hospital. 

Camille Lilly, the hospital's chief external affairs officer and a state representative, was among those at Thresholds for the opening. She said the hospital wanted to show its support for the clinic, as it will lower the number of uninsured patients coming to the hospital for non-emergency services. 

Uninsured people often go to the ER instead of private clinics specifically because they don't have insurance.

"These people don't have access to health care," Lilly said, "and their lives are turned upside down because of it."

Michael Loria is a staff reporter at the Chicago Sun-Times via Report for America, a not-for-profit journalism program that aims to bolster the paper's coverage of communities on the South Side and West Side.

---