Dr. Charles Howell, a pediatric surgeon from Children’s Hospital of Georgia in Augusta, interacts with Brantley Williams, 5, at the Phoebe Pediatric Specialty Clinic on Arlington Lane. Howell is among a group of physicians from the Augusta area who come down to the clinic periodically as a way to improve access to pediatric specialties in Southwest Georgia. (Staff Photo: Jennifer Parks)
ALBANY — With a presence in pediatric specialties lacking, there are many children in Southwest Georgia who are often not getting the standard of care they need when a regular pediatrician might not be enough.
To help close the gap in access to care, a pediatric specialties clinic is operating on Arlington Lane across from Phoebe North. There, several physicians — primarily from the Georgia Regents Health System based in Augusta — come in once a month, or every other month, for roughly half a day representing various specialties which many area families do not have access to.
At the clinic, children from as far away as the other end of south Georgia have access to specialists in areas including cardiology, orthopedics, surgery, neurology and oncology and hematology.
Dr. Charles Howell, chief of pediatric surgery at Children’s Hospital of Georgia, represents the surgical component of the physicians who make the trip to Albany for the clinic.
“There were a lot of babies in the Phoebe (Putney Memorial Hospital) NICU (neonatal intensive care unit) who were needing surgery and being transported to Augusta,” he said. “With the follow ups, there were issues with folks having so far to go. They (now) make one trip to Augusta (for the surgery), and do the follow-ups here once a month.
“As it’s gotten going, there are other practitioners who come down as well. We have folks (patients) from as far away as Waycross, Moultrie and Tifton. I come in once a month, and I fit in as many as possible.”
Juanita Golden is one such parent who has benefited from the clinic’s presence since her daughter, Laura Golden, now 15, began having neurological problems. Laura’s issues began five years ago when she started having seizures in school, and the family said doctor she had been seeing was not doing much other than adjusting her medication dosages — and the family felt lost because they didn’t have anywhere else to go.
Last summer, she was connected to the clinic.
“The more dosage he (the other doctor) gave … it got better for awhile and then she went down,” Golden said. “I heard about Dr. (Bernard) Maria, and the first day (Laura) she came in, I felt so much better. He listened to my concerns.
“He actually listened to what I said. It made a world of difference.”
Eventually, a magnetic resonance imaging scan was ordered — confirming that Laura was suffering from epilepsy. She is currently undergoing testing to see if she will be able to have surgery. If things go according to plan, the teen will have the surgery in Augusta and come back into the Albany clinic for follow-up visits.
Meanwhile, Laura has been coming into the clinic every two months to do a check-up, and access to a specialist has given both mother and daughter peace of mind.
“(Maria) has more answers and knows what he is talking about,” the 15-year-old said. “(The old doctor was) in there for three minutes and he walked back out. He (Maria) stays in there longer and he tells us what he thinks.”
Circumstances are looking brighter now for the Goldens.
“(This clinic) is a good thing,” the mother said. “You don’t know until you need it (that the specialties are not here). (Without this resource), I would probably have to take her to the emergency room because it had gotten so bad.”
Maria, the medical director of Children’s Hospital of Georgia and chair of pediatrics at Georgia Regents Medical Center, said he first saw the need when he entered the state from South Carolina five years ago and discovered just how desperate some of rural areas of Georgia are when it comes to access to pediatric care.
“One of the things that struck me was that there are so many parts of the state that are underserved, (particularly) in pediatric sub-specialties,” the pediatric neurologist said. “There are 50-60 counties (in Georgia) without a pediatrician, and 50-60 without an obstetrician. We looked at Albany as the first way to raise the bar.
“Families were being transferred a great deal because the expertise is not there (and the clinic is part of an effort to improve that). Except for (in) large metro areas, you are not going to find certain specialties.”
The absence of pediatric specialties, Maria said, has resulted in roughly 300,000 children in the southern part of Georgia with families who are traveling a minimum of two hours for anything beyond standard primary care. With the clinic, he said, complicated procedures still need to be done at the Children’s facilities in Augusta — but the follow-up care can be done closer to home.
“Being transferred a long distance is inconvenient, but the convenience is (that care following that) will be done locally,” he said.
Maria is among those coming down to the clinic once a month, during which time he sees 20-30 children in half a day — many of whom are new patients.
“Families are happy to get the specialty care without putting gas in the car,” he said. “The average expense (for these families) is $1,000 a more a year out of pocket without the clinic. That $1,000, every bit of it, those families need.”
In Maria’s practice, a lot of what he sees at the Albany clinic are cases similar to Laura Golden — children having unexplained seizures with very little avenues to get the optimal treatment they require.
“The pediatricians do a good job, but they don’t have the expertise on what medications to use, how to use them and what tests to order,” he said.
The children often come into the clinic via a referral, whether it be from their regular pediatrician or from the doctors treating them in the hospital. Maria said officials are currently piloting a telemedicine component, and that recruitment efforts are being kicked into gear to get some pediatric specialists into the Albany area full-time through the medical school presence that has already been established in the area.
In the meantime, plans call for more specialties to be added, including gastroenterology and infectious disease.
There’s no question that a full-time presence is needed.
“The kids are so much sicker (in Southwest Georgia) here than they are in Augusta,” Maria said. “Some have had neurological issues for some time, seizures for some time or on the wrong medications. It’s life-changing. I had one patient who was 6 years old who would collapse instantly, and (the child) had six family members with the same thing. I put her on a medication that has helped eliminate (her symptoms).
“I think of that moment in terms of quality of life. There is a convenience factor, and they have access to something they have had to travel four hours one way for. We’ve taken that (the distance barrier) away, and I’m proud of that … It’s not like they wouldn’t be referred, but when (families) are struggling to put something on the table, are you going to put $80 in the car and drive to Augusta?”
Cary Burcham, director of children’s services at Phoebe Putney Memorial Hospital, said the agreement was signed with Georgia Regents University over a year ago. The clinic was not initially utilized to the degree it is now, but has since begun providing new specialties.
Since he came on board at Phoebe in June of last year, Burcham said he has seen a growth in the patient base of 20 percent at the clinic.
“The agreement with Georgia Regents University is part of a strategic initiative to establish a women’s and children’s center,” he said. “The mission for a pediatrics standpoint is to meet the needs of children.
” … (In terms of continuity of care) if they are seen in Augusta or here, they have good continuity of care, so all of the follow up visits are here.”
It’s considered a vital resource, Burcham said, because the specialties would simply not exist in Albany without it, and the hope is that it will continue to grow as the plans to convert Phoebe North into a women’s and children’s center are played out.
“The vision is, as we build the women’s and children’s hospital, we will have even more comprehensive pediatric care,” Burcham said. ” … We will outgrow the clinic space we have now, and we will incorporate the space into the hospital.
“As we increase our pediatric presence, it will be a draw for specialists. The kids are here, but what might not be here is a specialized hospital just for kids.”
With the reality that children, even if they get referred, sometimes still don’t get the specialized care they need due to financial barriers involved, it is not uncommon for these children to end up in the emergency room rather than their families develop a relationship with a specialist.
“It is always a benefit if the problem can be addressed sooner rather than later,” Burcham said. “Because of barriers, it’s a challenge (to find the money), and its a challenge with this (current) climate to take time off work and school.”