HLM: Is sending subspecialists into the field a good use of limited resources?
Rhodes: That's true to a degree. You may need to bring the patients into the tertiary care center for the testing and expertise. But the patients I see in these outreach clinics I may be able to see three times before they need to come to Morgantown.
Once every one or two years I may have to bring a patient here, but I can see that patient every six months in their community. I can think of patients I haven't had to bring to Morgantown in five years. I can go and see the patient as a subspecialist. The family medicine guy is good at taking care of the patient in between.
But they get a little uncomfortable if they are watching the kid with the artificial heart valve. They may have the experience of 20 adults with that problem but what do you say to a 12 year old who has an artificial heart value in terms of his physical activities? There are certain things we can take to the community that are not necessarily things that they need to come to the tertiary care hospital for.
HLM: Are you urging other subspecialists to do outreach work?
Rhodes: I think so, very much. I personally prefer going to the communities because I love it. I love going out and seeing the patients in their home communities. I pride myself in knowing where almost every patient of mine is from. If I have not been to where they are from I will drive there sometime to find out.
There are always resources issues. If you only have one neurologist in your practice it is a little harder to say 'go do a clinic once a week somewhere else.' But it is a great public service. It helps the patients. It helps with compliance. It is very rewarding. I am old enough to realize that what I used to think I was doing for the patient I am really doing for myself.
It is always easy to hide under the guise of 'this is for patient care,' but I can tell you the best days of the month for me are when I am in my truck driving to one of these clinics.