Sunday Gazette-Mail from Charleston, West Virginia on August 10, 1975 · Page 68
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August 10, 1975

Sunday Gazette-Mail from Charleston, West Virginia · Page 68

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Charleston, West Virginia
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Sunday, August 10, 1975
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Page 68
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Modern Medicine (continued) ray, the lab, and the audiometer." The doctors refer patients who need specialized care to medical specialists and hospitals in surrounding counties. Health Center personnel often arrange transportation and find funds for treatment. "The two-doctor system is a cornerstone of the clinic's success," according to Dr. Hansbarger. "Two physicians are monitoring each other, talking, discussing, seeing each other's patients. It is analogous to the reviews and meetings of a hospital. We can cover for each other and attend meetings. Also the fatigue factor is somewhat relieved." In that year Monroe county joined with eight other West Virginia counties to form the Southern West Virginia Regional Health Council, or "OH-9" (Operation Health - Nine Counties). The Council was funded two years later by the Appalachian Regional Development Act to set up "demonstration health projects." The buildings and mobile units out of which the Monroe Health Center operates today were built and purchased through Appalachian Regional Commission funds, matched locally. Monroe county businessmen and political leaders, such as Billy Joe -McGuire and Stanley Broyles, directors of Monroe's two funeral homes, and Haskel Shumate, then county clerk, worked on various aspects of the Health Center program. By 1972, Monroe had a contract with OH4 to hold different types of monthly clinics in the An elaborate radio and telephone communications system links doctors, ambulance, police and nearby hospitals, after office hours the doctors take turns being "on call." lJFCa vi i«v«*..»j »......».- «. -County residents who need medical county, but the doctors traveled out help at odd hours call a toll-free from Bluefield as no doctor in Mqn- number to reach a central dispatcher in Bluefield, 50 miles away. The dispatcher alerts the doctor, who returns the call of the person in trouble, and if necessary meets him at the clinic for treatment or makes a house call. Both Dr. Gelderman and Dr. Hansbarger live on farms, but even up at the barn or out in the hayfield, the doctor on duty keeps within reach of the dispatcher by portable two-way radio unit. "We have 24-hour coverage, 365 days a year," said Dr. Hansbarger. ^'This is really what it is all about." '"Qver in the aluminum trailer, Dr. Mark Kilcollin drips pink liquid wax onto a set of plaster teeth with spacers. He is the only dentist hi Monroe county. There is work for another dentist, he believes, but not the money to make the practice . ,, _ , _ ,, _ ,, , worthwhile io most people. The^ sliding fee scale," said Mrs. Neel, "vendorship" of the state'subsi- noting that the sliding fee scale is dized Childhood and Youth dental . . . . . . . . . -^ . program makes up 60% of his patients. He spends the rest of his time in private practice, but does not participate in the sliding fee scale that the clinic uses. Originally from Charleston, he graduated in roe County had the time to be the clinician. Claybourn Campbell, a dairy farmer and head of the Monroe Health Council oversaw the up- again, down-again negotiations with the National Health Service Corps that finally resulted in two doctors being assigned to Monroe in the fall of 1972. Financial solvency is a perennial headache for the Monroe Health Center. The clinic runs a deficit, explained Shirley Neel, depending a great deal on a system of "third party reimbursement," by which funds come from state, federal, and local levels through medicare, welfare, and various state-subsidized health programs for women and children. "We ate reaching but in every way now to get funds to keep our 1974 from the West Virginia University School of Dentistry. He has been "interested in public health dentistry for a long time." This, he believes is "one of the better programs, though there are still problems." Five years ago Monroe County was truly a medically deprived rural area. There were two overworked doctors and no dentist for 11,000 people. Hospitals were an hour to two hours away, and no ambulances with trained medical personnel existed to move emergency cases. Medical statistics showed that Monroe residents paid a toll in Ulness and death fair higher than the national average. But several concerned citizens had long before begun the search for ways and means of coping with the problems. James Frazier of Union remembers that as superintendent of schools he began in 1966 to work on ways of bringing mobile units into the county to get dental care for school children. the key to affordable hea.ld care lor the many Monroe County people who are not on welfare, but who work at low-paying or seasonal jobs. "A lot of people, they just don't have the money," agrees James Frazier, who once went as far as Washington to testify before congress on the medical needs of this area. Federal funding is periodic, Frazier emphasized. "One year, two years, then you have to start begging and looking around again." The governor has taken an interest in the continuance of various parts of the program, however, according to Frazier, and "The county court comes to our rescue when we really get down and out." One of the ways the Monroe Health Center tries to extend services while holding down the budget is the innovative use of paramedical personnel many of them trained at nearby hospitals under contract to the Southern West Virginia Regional Health Council. The ambulance drivers begirt as Emergency Medical Technicians, but several of them have now increased their training to the level of paramedic. "I can run EKG's give shots and W's," said Bill Tingler, formerly a security guard at The Greenbrier, Dr. Mark Kilcollin and assistant Gail Dunbar attend young patient in trailer designed for comprehensive dentistry. ledge about disease processes now. Now I can do physical examination and evaluation of patients with chronic diseases and evaluate those with acute problems too." A nurse practitioner cannot authorize medication and must work under a doctor's supervision. Though her new training opens many opportunities to her, Nancy Mullins wants to stay at the Monroe Health Center, where she feels her continuing presence will "lead to better total patient care." . · the success of the Monroe Health Center has implications far beyond the borders of Monroe County or even West Virginia, according toTDr. N. Allen Dyer, director of the Southern West Virginial Health Council. "The delivery of adequate health care in rural America is emerging as the number one health care problem of this country," he believes. "Sixty-three million Americans lack access to a modern comprehensive health care system." At this time, Dr. Dyer thinks, the nine-county area serves as the demonstration health project that it was set up to be. People come from other states to Ibis area and marvel. They tell me, 'We're just starting to talk about something like this in California or in Maine.' It is as if someone said, ·West Virginia, you go ahead and develop a model for the rest of the country.'" Dr. Dyer considers the Monroe Health Center to be a model community program within a model regional program. "Monroe county's program is as comprehensive as it is because all the ingredients--money, community interest, and manpower -came together at fee right time. But this is a quality unique to Southern West Virginia. A determination to get together and work things out. To have the guts to really push it and stick with it until you've got it." Technician Jane S outhern works in diagnostic lab. now a paramedic. His training emphasized cardio-pulmonary resuscitation, a skill very much.needed' in a community of many elderly people prone to heart attack. As well as working with the emergency, transport system, Bill Tingler and the rest of the 5-man crew teach first aid to community groups and run blood pressure clinics. A highly unusual example of a paramedical person on the Monroe Health Center staff is Mrs. Nancy Mullins. She is one of two family nurse practitioners now working in the state. Mrs. Mullins returned at the end of June from a 5% month training course in Charlottesville, Va. "There were ten people in my class," commented Mrs. Mullins. "Five of them were married women with children. Just think. That many husbands were willing to cooperate." Her 10-year old son stayed in Monroe County with his father and grandmother while his mother took, the course. The National Health Service Corps sponsored Mrs. Mullins, paying her tuition in return for her agreement to practice at least 14 months at the Monroe Health Center. Why did she want to become a nurse practitioner? I felt I was capable of doing more than I was allowed to do as an RN. I have some added skills and know- August 10,1975, Sunday Gazette-Mail

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