DOCTOR’S DAY March 30
We need our doctors and healthcare staff more than ever.
YOU ARE APPRECIATED!
March 27, 2021 A special supplement to The Alexander City Outlook & The Dadeville Record
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Doctors’ Day 2021
Thursday, March 27, 2021
‘It’s all about the relationships’
General practice doctors say they take pride in ability to care for their extended family By CLIFF WILLIAMS Staff Writer
T
Submitted / Tallapoosa Publishers
Dr. Edward Roberts and Dr. Tate Hinkle of Russell Medical’s Total Healthcare say being a rural doctor is ‘all about the relationships.’
elevision shows often glamourize the medical specialities. They show a cardiologist performing open heart surgery or a neurosurgeon removing part of a skull. While those are needed medical specialities, much care can be given by family practitioners in a rural setting. For the doctors at Total Healthcare, they take pride in knowing they can help most patients with most of their ailments, but for them, practicing medicine is only the beginning of what keeps them in a rural setting. It’s the relationships that bring them the biggest reward. Dr. Tate Hinkle sees patients at Russell Medical’s Total Healthcare in Alexander City and Russell Medical’s Medical Park Family Care in Dadeville. Family medicine in a rural setting is very appealing to Hinkle. “The reason it still interests me is one the need is always there,” Hinkle said. “Two, the people are just incredibly nice. We become part of their family; we get to know them; we get to know their families; they get to know our families. “I end up seeing entire families. I have got one family where I see the grandparents, the parents and four of the grandchildren. I see eight members of the family.” Those relationships help Hinkle with medical care of the family. “Being able to have those relationships when one of them comes in, I know the whole family,” Hinkle said. “I know the dynamic of the family. You don’t get that in an urban setting. That is a big aspect of why I did family medicine. That to me is highlighted in rural areas because the family unit is such a big part of rural Alabama. Being able to be a part of taking care of a whole family is really important to us.” Relationships with patients and their families is also critical for Total Healthcare’s Dr. Robert Edwards. “Getting to know families, not only the patient but their families and their roles in the community, interacting with those folks on a personal level, I enjoy it,” Edwards said. “It’s really rewarding to see folks doing well and knowing you had a role in that.” Edwards said he couldn’t see himself in any other medical area than a family practice in a rural setting. “I was born to do this; I’m a people person,” Edwards said. “True increases in long term health is done in this setting. You go to the ER, it is to get you upright again. The same with the hospital. “In this setting we are able to help folks with problems they have medically that make big time changes in their lives. Being a part of that, helping someone lose weight, helping someone get their diabetes under control so it is not an issue, it’s extremely rewarding. It is awesome to see your patients do well. You get feedback on a daily basis and it is a great thing.” Hinkle knew early on he wanted to go into medicine but wasn’t sure exactly what he wanted to do. Hinkle shadowed different doctors in high school and college. “When I finally shadowed my first family doctor, it was like a light switch went off,” Hinkle said. “I saw him as somebody who had formed these relationships. He had been some patients’ doctor for more than 30 years. He knew what was going on with them before he walked into the door. He knew why they were there. Half the visit was how is your daughter who is now in college or going on to medical school. “I don’t do this but he delivered babies. Some of those people he
delivered the patient that is now sitting in front of him, now 30, and having a child. That kind of a relationship with people when you get to help them and treat them when they are at some of their best and worst times of their lives and being able to help walk them through those times and be there for when they need you but also see their successes, that is some of the best things ever.” Hinkle doesn’t cross his arms and send a patient on to some random specialist. Hinkle wants to put all of his training to use but is not afraid to let another medical provider assist. “We pride ourselves on being able to handle 90 to 95% of what everybody else does,” Hinkle said. “What I try to do when I send them to somebody else, they are ready to do whatever they need to do. I can’t operate on people but I can do everything I can to get them ready for Dr. Swenson — x rays and test. When they go to see her, all she has got to do is yea you need surgery lets go do it.” Hinkle wants to get to the bottom of a patient’s issue to the best of his ability even when he does refer a patient to a specialist. “I want to make sure I’m sending patients where they need to go too,” Hinkle said. “That is part of my job is to figure out exactly where they need to go instead of somebody else trying to figure out what is going on. I like being a detective and figuring out what is going on. “It also helps out if I have done most of the workup, I know when the patient comes back what is going on. I have got more knowledge of what is going on.” Hinkle made sure his efforts in medical school and beyond prepared him to serve the vast majority of patients coming through the doors of the clinic. “One of the things when I was going through residency, I made sure I went to a program and made sure I got experience in doing everything,” Hinkle said. “I was trained to deliver babies. I delivered 80 babies in residency. I don’t do it anymore. If someone walked in the door delivering a baby, I could do it. We still like to be able to handle pretty much everything that walks through the door. I tell patients I’m your first stop for whatever you have. If I can’t take care of it or don’t know what is going on, I will find someone who can. But I’m going to try my best to figure it out to begin with.” Seeing incremental medical improvements keeps Edwards motivated. “To me I like the ability to be able to care for all sorts of medical issues and really take care of most of them,” Edwards said. “I guess the most rewarding thing for me as a primary care guy in a rural area is making a difference in the long term outcome whether it be improving their diabetes or heart patients to help with their issues. Taking people with multiple comorbidities and being able to help them not have to go to the hospital all the time, decreasing their morbidity from disease.” Hinkle likes he gets to see the full picture of treatment of his patients. “I noticed with a patient from a big city that moved here, talk about how their primary care doctor had her going to five or six different specialists,” Hinkle said. “It is all stuff we take care of on a daily basis. She was going to one for her blood pressure, another doctor for her diabetes and another doctor for this. I was like, ‘I do all that.’ We can offer that for the most part for our patients right here. They don’t have to go elsewhere. Obviously if we feel like there are See RURAL • Page 3
Doctors’ Day 2021
Thursday, March 27, 2021
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Doctors’ heroism shines in pandemic D
octors have always played a crucial role in our lives, taking care of us when we are at our most vulnerable as well as helping to steer us in the right directions when it comes to healthy lifestyles. But never has the importance of doctors ever been as clear and present as we have seen in the past year. Last Doctors Day, we were just about two weeks into the
beginning of the Covid-19 pandemic. Routine elective procedures had to be pushed off, doctors were—and still are—working around the clock with an unprecedented influx of patients needing attention. In a time of fear and uncertainty, doctors have been our stabilizing force. Doctors have been key to continuing the general health and wellbeing of patients
to ensure people feel safe. Now they are the ones JACOB delivering our vaccines, our hope for the end of this seemHOLMES ingly unending pandemic. News I never liked going to the Editor doctor’s office, and I absolutely hate being in hospitals, but while also balancing their own it’s impossible not to respect risk from the novel coronavithe work doctors and nurses rus. They have also been key do every day to provide care figures in arming us with the to us and our loved ones. information we need to stay The truth is, doctors have safe, breaking through barriers been heroes all along, but the
Rural
pandemic has finally put their heroism on full display. This Doctors Day, they deserve all of our thanks and praise as we look to the light at the end of the tunnel. Once the pandemic ends, we cannot forget all that they have done and how much we have to be thankful for. Let us always remember to honor these heroes, even if we do prefer to stay out of their offices.
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instances where they need to go see a specialist, we still do that.” Even when they send a patient to a specialist, patients still seek Edwards’ and Hinkle’s advice. “A lot of times when a patient goes to a specialist and recommends something, a lot of times the patient will come back to me and say, ‘They recommended this. What do you think about it? You are my family doctor. What do you think I should do?” Hinkle said. “I send them to someone who can do something I can’t do but the patient has trust in us because of our relationships that they want to know what our opinion is on everything before they go do something.” Neither Edwards nor Hinkle would trade a rural setting for the big city.
“I grew up in a rural town; I grew up in Lanett,” Hinkle said. “It was primarily manufacturing, very much like Alexander City with Russell, it was West Point Stevens. “One set of my grandparents had a farm. I grew up in that life. I saw in rural Alabama how it would be good to be a good primary care doctor that could take care of a lot of different stuff.” Edwards rural upbringing has family roots. “I kind of knew I was going into rural healthcare when I entered med school because I was raised in a rural community,” Edwards said. “I married a wife that was raised in a rural community. That kind of pointed me to a rural area.”
Edwards’ wife was influential in him coming to Russell Medical. The decision means Edwards can care for his patients all across the system. “My first visit here during the interviews before any offers were made, I walked out with my wife and she said, ‘You would be happy here,’” Edwards said. “She was right. I can interact with the hospital. I can interact with patients in the hospital. I can go care for them while they are in the hospital.” Edwards said the relationships of medical providers and the fact Russell Medical is a member of the UAB Health System means great care for all patients in a rural setting. “I just really enjoy my small town; I just really enjoy my small hospital,”
Edwards said. “What is really unique is the breadth and youth of specialists that we are getting from UAB is huge. I can pick up the phone and get a patient in front of whoever is needed immediately. We can have a good conversation about patient care and all of us be onboard. There is no turf stuff. There is no competition between sub-specialists. It is just a fluid environment here. Edwards just loves trying to make the area better and enjoying the rural setting and the relationships it affords. Hinkle is the same. “I enjoy the slower pace of life of a rural area,” Hinkle said. “I enjoy the relationships. That is why I do what I do. If I had to boil it down to one thing it is the relationships.”
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Doctors’ Day 2021
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Thursday, March 27, 2021
Orthodontist shows, not tells, using science fiction-like X-ray technology By SIRI HEDREEN Multimedia Reporter
Some might be baffled to hear from an orthodontist that braces will help their child pay attention in class. That’s where Alexander City orthodontist Dr. Bill Harrell pulls up on his computer a 3D image of the patient’s head, made translucent to show their teeth and jawbone, and explain how the patient’s small jaw is set back, narrowing their airway and making it difficult to breathe while sleeping. When children’s sleep is affected, they have trouble paying attention in class. To get those 3D images, Harrell uses his Cone Beam CT scanner, the first of its kind in Alabama when his practice got it in 2005. After the Cone Beam CT scans a picture of the patient’s teeth, Harrell uses a 3D photogrammetry system to get a 3D scan of the patient’s head and facial features. “Now that with the 3D face, I’m the first practice in the United States to have both of those together,” he said. Harrell, also an assistant associate professor at University of Alabama, is standards committee chair for the Cone Beam CT technology. Earlier this week, the committee announced it would start offering dental and medical accreditation programs for doctors interested in using the imaging technology, an important step in making the Cone Beam CT ubiquitous nationwide. Harrell said the accreditation is optional See HARRELL • Page 5
Siri Hedreen / Tallapoosa Publishers
Top: Dr. Bill Harrell shows off his Cone Beam CT scanner, the first of its kind in Alabama. Above: Dr. Harrell shows a Cone Beam CT scan of his grandson.
Doctors’ Day 2021
Thursday, March 27, 2021
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Doctors serve patients in extraordinary pandemic circumstances By JACOB HOLMES News Editor
“What (Covid-19) did is it made us think outside the box and how to take care of Doctors already fulfill a the patients’ medical needs heroic role, but the Covid-19 and their emotional needs,” pandemic has put them front Thompson said. “On Mother’s and center. Day, one nurse went out and This Doctors’ Day comes bought balloons and flowers almost a year to the day from for every Covid-19 patient that the start of the pandemic in the was a mom. U.S. “One person at the hospital Elmore Community was in charge of FaceTiming, Hospital hospitalist Dr. setting up times to go in with Melissa Thompson said it has patients and FaceTime; at a been a hard but rewarding least there was communication journey for doctors in the year there. We had birthday parties since. outside of windows. One time “We admitted our first on a Sunday, we probably had COVID patient March 29, 35 people outside the window 2020,” Thompson said. “We of this patient.” Thompson admitted seven patients from Because of how long a local nursing home. Over “Immediately, nobody patients were hospitalized, the course of the next four could visit,” Thompson said. the physicians really became months, we took care of “No family members or familiar with them. more than 100 nursing home friends could come to see “The average length of patients. Nursing homes were their patients. Our sweet little stay was between 21 and 28 very hard-hit and didn’t have patients hadn’t seen any family days, so we really knew these a plan to quarantine patients; for almost a month and then patients,” Thompson said. they had to find places to keep were transferred to an unfamil- “That scene you always see patients.” iar hospital. That was really on TV with patients being Elmore Community Hospital hard, not only on them, but wheeled out with people lining had been preparing for weeks also on the staff. We knew how the halls, that’s really what it prior. After taking care of sad and depressed they were.” was like.” the nursing home patients, With the challenges of the During all of this, the doctors Thompson said they didn’t have pandemic, nurses and doctors were scrambling to find out the a strong community impact took extra measures to help latest information on a virus from the virus until the fall. patients. that had little research to go on.
“The biggest challenge was that we did not know what we were working with, where the recommended treatment changed three times and there was no central place to really get information,” Thompson said. “What’s the best way to treat them? With steroids? Or is that harmful? We were truly learning as we went along. There was no FDA-approved anything so you were truly doing what was best for the patient without harm, so it was very challenging.” With no ICU, Thompson said the hospital felt the strain and pressure of having nowhere to send patients whose conditions worsened. “Some people within a 12-hour period of time would be on a ventilator,” Thompson said. “We did not have an ICU or pulmonologist. We had a plan but were very lucky we didn’t have to put anyone on a ventilator. I called almost every hospital in the state one day for a patient that was getting worse and there were almost none available at all and that was really scary.” Now that more and more people are being vaccinated, Thompson said doctors are
Harrell but will make it easier for patients’ scans to get covered by health insurance. “(Doctors) don’t have to get it done; it’s kind of a voluntary thing,” he said. “But if you take one of those images it’s not like you’ve got to fight with the insurance company anymore, because it’s all done the way the insurance company wants to do it.” In order to explain the technology better, Harrell first contrasted it with an ordinary CT scan. “You go to a hospital, you get a CT scan. They lay you down and the thing runs around you like this,” he said, moving his hand in a circular motion. “Every time it makes it’s (rotation) it takes a little slice of you, like slices of bread. It’s just taking an image, moving a little bit more, taking an image.”
starting to see hope for the end of the pandemic. “You feel like you can take a big breath now,” Thompson said, “knowing people are getting vaccinated and the severity seems to not be as bad now as in the very beginning. It speaks to the administration for Ivy Creek; they had our vaccine orders in and freezers bought right at the very beginning so we were able to start vaccinating people faster. We have a batch of vaccine that comes in and already have that number of people scheduled to come in. As more vaccine companies are approved, the vaccine availability grows exponentially.” The doctor community has also been invaluable, Thompson said. “The doctor community is a pretty small community in that everybody tries to help everyone else and this was really shown during this pandemic,” Thompson said. “I would talk to a pulmonologist at Baptist South or call Jackson (Hospital) and talk to an infectious disease expert. I’ve been a doctor about 20 years and have never seen this level of collaboration.”
continued from Page 4 Just as slices of bread form a loaf, the CT scan combines hundreds of 2D X-rays to form a 3D full-body scan. Harrell’s Cone Beam CT scanner, however, takes 300 to 400 X-rays taken from different angles around the face, which the computer then combines into one 3D image. The scan takes less than 10 seconds. When viewing the scan on the computer screen, “It’s just like a skull — it’s a full-rendered view,” Harrell said. “If you looked at each X-ray, it just looks like an X-ray. But the computer knows all these distances and where the faces sits so it knows how the anatomy moves, and it can plot the anatomy.” Layered over the skull is a realistic 3D image of the patient’s face, which Harrell says is not just for aesthetic
reasons. “The shape of the bones and all that and the way the bones and teeth are all oriented affects the face,” he said. “If you have a small, gimpy lower jaw, your jaw’s going to be sitting back.” In addition to being an orthodontist, Harrell practices dental sleep medicine, two fields that go hand-in-hand. As an example, Harrell pulled up an X-ray of one of his small-jawed patients and clicked on her airway, which the computer measured. “She’s 12 years old and it’s supposed to be 120 mm2,” he said. “Instead it’s 79 mm2. If you think about the lower jaw sitting back, if it’s sitting back what’s it doing is it’s going in the airway.” A narrow airway can cause sleep apnea and other breathing problems,
Harrell said. For adult patients, he prescribes headgear which temporarily moves their jaw forward while they sleep at night. For kids, however, whose jaws are still growing, braces can help guide the jaw’s growth away from their airway. “I can grow the jaw that way so it’s a permanent resolution to it,” he said. “As I’m making room for the teeth, I’m making room for the tongue, and guess what, I’m making the airway bigger.” All of this Harrell is able to explain with the aid of an interactive, 3D image. “If you look at that you say ‘Well yeah, OK, I can understand that,’” he said. “’I can see how crowded they are. I can tell my child’s got a small airway,’ or something like that.”
IT’S TIME FOR OUTDOOR FUN, IS YOUR HEART HEALTHY? It’s time for outdoor fun, and you don’t want to miss a single moment in the sun. Make sure your heart is healthy and ready for the season with an appointment at the UAB Heart & Vascular Clinic at Russell Medical. Kevin Sublett, MD, is board-certified in cardiovascular care and offers the latest in prevention, testing, and treatment for keeping your heart healthy. Our clinic is backed by the knowledge and expertise of UAB Medicine, including: • • • •
Advanced ultrasound testing Nuclear medicine imaging in fully accredited labs Management of cardiac rhythm disorders Interventional cardiology care
Doctors’ Day Tuesday, March 30
We salute the doctors and healthcare teams whose tireless dedication to our communities have saved countless lives and provided much-needed comfort in this time of dire need.
HEART & VASCULAR CLINIC AT RUSSELL MEDICAL Make an appointment today by calling (256) 234-2644. 3368 Highway 280, Suite 130 • Alexander City, AL 35010 uabmedicine.org/HeartRussell
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Doctors’ Day 2021
Thursday, March 27, 2021