Welcome to the Becker's Healthcare Podcast. I'm Chris
Sosa, your host. And I'm thrilled to be
joined today by Mark Welsh, who is vice
president of children's advocacy for children's health care
of Atlanta, and doctor Jean Sumner, who is
dean of the Mercer University School of Medicine.
Mark and doctor Sumner, thank you so much
for joining us today. Thank you. Glad to
be here. Thank you for having us.
Excellent. Thank you, guys. We are, of course,
here to talk about your kids' alliance for
better care program. I'm so excited to learn
about that. But off the top, could you
just please introduce yourselves and tell us a
bit about your backgrounds? Doctor Sumner, why don't
you go first?
Well, I'm Jean Sumner. I'm a internist by
training. I'm the dean at Mercy University School
of Medicine, and I'm approaching my tenth year.
I've spent most of my life practicing in
rural Georgia, some of the poorest counties in
the state.
And the school is driven by its mission,
which is helping alleviate
health disparities in in rural Georgia.
And, Mark, how about you? I'm Mark Welsh.
I'm the, as you've mentioned, the vice president
of child advocacy here at Children's. I've been
with the organization
for eight years, and our work here focuses
on how do we impact the community. My
team does both prevention work in the community,
but also
is so proud to do work like this
rural health initiative. I am a
epidemiologist by training, but I spent most of
my career
leading large, public health focused programs.
Fantastic. Alright. As you we've mentioned, we're here
to talk about a wonderful program that you
have combined forces,
to launch into the health care sphere, so
to speak.
Doctor Salmer, I wanna start with you. So
could you paint a picture of what health
care for kids looks like in rural communities,
and also what inspired you to work to
address this lack of access?
Well, thank you, Chris, for the opportunity to
talk about something that we're passionate about. Health
care in rural Georgia for children is probably
the most underserved area of care. There are
120
of the 159
counties in our state that are considered rural
by Georgia's definition, which is 50,000
or less.
Of the 120 counties,
65 do not have a pediatrician.
And and of the ones that do, many
have one pediatrician.
So
I believe that the most underserved area of
medicine
is care for children. Now there are great
family medicine docs who fill in and take
care of kids as well.
But having a pediatrician
that's accessible,
I think, in many ways offers things
that improve the care of children across the
state.
We we're fortunate to live in a great
state, and our legislators have been very focused
on trying to improve care. And Georgia has
invested a great deal of resources into rural
health,
But making the health status better,
has not happened. I do believe that we're
very honored to have an alliance with Children's
Healthcare of Atlanta and that this program is
laying the foundation
for a program that could use be used
as a model nationally
to make a difference in these communities.
It's a worthwhile program to say the very
least, and I'm sure both your organizations are
very proud of the work you're doing and
will continue to do.
For one of you, let whoever wants to
take this question tackle it. I'm just looking
for an overview of the collaboration between both
your organizations.
Yeah. I mean, I can I I can
take a the first go, and I'm sure
doctor Sumner will jump in and fill in
what I missed? You know, for us at
Children's, we, in any given year, will serve
kids from all a 159
counties across the state.
The 120 rural counties that doctor Sumner mentioned,
we know have unique needs and and that
those families
are doing amazing things to raise kids, but
face unique challenges in ensuring those kids get
cared. And so when we set about this
project, we really looked at, okay, how do
we ensure that we are not only thinking
about what will best impact those kids, but
that we engaged with a partner, engaged with
an organization that would allow us to really
understand the needs of rural communities. And that's
why we began this work with with the
Mercer School of Medicine and the Rural Health
Innovation Center because these are folks who live
in rural communicate communities and dedicate every single
day to serving,
communities across our state. And so we set
about really trying to better understand how to
meet those needs. And from an initial meeting
that doctor Sumner organized with
pediatricians from the communities and hospitals, we landed
on four core areas of focus.
The first is really helping rural hospitals be
better able to meet the needs of kids
in their communities.
These are wonderful facilities that are doing amazing
work to serve their communities, but they're primarily
serving adults. And in many of these cases,
they weren't really ready and prepared to respond
to the needs of kids. And so we
set about understanding how do we best support
them, best meet those needs, and and ensure
that they have what they need to meet
the needs of that kid that may walk
through their doors.
The second was really supporting pediatricians. And so
we heard from a wonderful group of pediatricians
who said, hey. We are we are doing
great things for our community, but often, we're
out here on an island. We're on our
own. I I we they don't have
a partner down the hall who they can
go and say, hey. Come and take a
look at this case.
So they really wanted to not only create
that connection amongst each other, but have that
ongoing support through telehealth and through opportunities for
ongoing learning from the experts in children's.
So there was an opportunity to facilitate that.
The third area of behavioral and mental health,
we know that that's a challenge across the
nation, certainly a a challenge in Metro Atlanta.
But in our rural communities in particular, that
challenge is amplified
by not only, the the continuation of stigma
around mental health, but also a lack of
access to care. And so we wanted to
think about how do we best work with
schools to not only do screening, but more
importantly, as doctor Sumner always stress stresses,
connecting kids to care. It's not about just
screening and identifying and leaving. You have to
close the loop and connect to care. So
really thinking about models that allow us to
do that. And the last area is probably
the area that I continue to be the
most proud of, and that is thinking about
sustainable way ways to build the health care
workforce across the state. Doctor Sumner mentioned the
number of counties that are without a pediatrician
throughout our state. And so we set about,
through through the guidance of the Mercer School
of Medicine to say, what would it look
like to offer scholarships
to med students who in turn commit to
serving rural communities post their training? And so
we are excited to have 27 young people
who made that commitment. There's they have scholarships
that'll cover their full med school tuition, and
they'll come into four years of serving in
a in a rural community post that training.
In addition, we said, hey. That's that's working.
That's amazing. What would it look like to
do that on the side of mental health?
And so we've we've begun that same program
for marriage and family therapists who are also
making a commitment to serving in rural communities.
So thinking about these sustainable models to build
the workforce in rural Georgia.
Yeah. And that commitment to collaboration, Mark, that
you just
outlined so eloquently, I'm glad it's alive and
well, and not only with your organizations, but
as I speak to other health care leaders,
it's alive there as well, which is terrific.
And now, doctor Summer, I wanna give you
an opportunity to
to have the floor and discuss just what
Mercer's role looks like in this program and
this effort.
Chris Mercer was created back in the eighties
to be a medical school that trained physicians
and health care professionals for rural Georgia.
Everything we do here from our research to
our selection of students
is focused on making Georgia healthy
and finding sustainable solutions to rural health. I
don't know if anything we do that has
been more impactful than this effort.
Because to in order to impact a rural
community, rural communities are often looked at as
unsophisticated,
as not educated,
as
not caring about their families or not caring
about their community, and nothing could be further
from the truth. They're actually resilient.
There may be less levels of education,
but people care about their families and they
want to do well. But there's so many
obstacles to care
in these communities. They've been left out of
the loop. They have to drive many miles
for care.
They're often
implied
to be not
motivated to care for themselves,
when actually it's so hard to access care
that often they give up.
What we do is build long term trust
with these communities.
When Mercer comes, we don't go away,
and we listen to the community, and we
learn what the issues are.
You will find that every rural community in
Georgia is different. It has strengths, and it
has weaknesses.
But it always has, you will find, a
group of people
who will work together
to engage their community
and to rise to the challenge of of
changing the health in that community.
So trust
is is very important in health care, but
it's required if you're gonna impact the health
of a rural system.
You can't be a mobile doctor. The scholarships
that Mark mentioned, these students are by
contract or required to live and work in
those rural communities. They don't commute.
But our students,
Mercy is a little different that we only
accept Georgians and we preferentially accept rural students.
So if you look across the country,
about 5% or less of students in MD
programs came from a small town. And at
Mercer, we're between 4050%,
and we continue to rise. And 70% of
our students come from outside of Metropolitan Atlanta.
We will always take Atlanta students,
but we look for young people who love
where they grew up, who wanna go home,
and we find a path for them.
And so, they're very motivated to get the
skills. I personally think to be an independent
practitioner in a small town, you need stronger
skills
because you can call a code or need
help. And as Mark said, there's nobody there
to help you. So you need to build
a team around you,
and you need to be really good at
what you do.
But we we impact those by doing what
we say,
not giving up, listening,
understanding the needs of the community,
and providing the resources they need and also
the training they need to use those resources.
And we build the coalition. I think the
coalition between these counties is so important. It
the counties geographically are large, and you may
be in Coffee County and not realize there's
that there's a pediatrician
two counties over that you could pick up
the phone or chat with with a telehealth
unit or share a case.
So we build that coalition and best practices
come out of that coalition.
And so it's really been exciting to work.
You know, I was had an interview one
time, and the the woman who was interviewing
me said, when you when this is over,
they'll just go back to their bad ways.
And I said, you've never lived in a
county. In a small town, you know everybody.
You know you know who smokes secretly. You
know who drives too fast. You know who,
does other things. But you care about you
you it's a diverse group of people who
need each other, and they care about each
other.
And so you're the doctor, and you know
that patient. You're the nurse in that ER.
Your children probably go to play softball with
with the other kids. They go to school
with other kids. You know, the mothers, the
grandmamas, the great grandmothers.
So you want to be the best you
can be, and you want them to have
confidence
in your institution.
When when you have a major emergency in
a child,
you have a short time frame to get
that child to a center. You have to
stabilize them, and and that is one of
our goals, being able to stabilize critical emergencies.
But there are also so many things that
could stay home
and be treated well.
And we've set up through this initiative
the ability for these hospitals to regain their
found foundational values in pediatrics and the skills
they need to to care for that child
at home and then refer if appropriate. But
many of the cases can be kept at
home. A family that has to go to
Atlanta or go 60, a 100 miles for
care, that means days off from work. It
means gas they don't have. It means,
you know, missing school. And so if we
can provide care at home with guidance and
with building a inner world team that can
help each other
or maybe sending them to the next county
instead of sending them a 100 miles away,
That helps the family.
Children do better in school and are just
healthier and more happy with what their lives
are like. And so we help families achieve
the care they need, and we hope we
change that culture.
Doctor Summer, thank you for signing
a very powerful spotlight on on all the
issues that are affecting
rural communities and rural children in particular. I
mean, I love how you
illuminated the connectivity that
exists in all these communities and how important
that is and how resilient they are. And
I'm so glad that you two have found
each other,
you know, not only, you know, you yourselves
as colleagues, but as organizations.
On that note, Mark,
you've given us
a lot of details, wonderful details on how
Children's Healthcare of Atlanta plays a role in
this. What else
do you want our audience to know about
how your organization is involved with this effort?
Well, I mean, I think one of the
things I I I want folks to know
is is really to shine a light on
all of the wisdom that doctor Sumner just
shared, and I I use the word wisdom
on purpose.
I think it's easy to sit in a
big city and say, I know best. I
know what is best for this community.
We're the experts. We know. We we'll never
have that wisdom and the lived experience of
what it means to live in one of
these one of our rural communities, to understand
that interconnectedness,
to understand
the importance of trust and building trust. And
so I think the biggest thing for us
here at Children's
has been to be willing to have the
humility to come and say, hey. Teach us.
Help us understand where we can make the
biggest impact.
And from that perspective, we've we've done really
two core things. We've said we will invest
in this initiative
financially, and we will invest in terms of
the pediatric expertise that sits at children's.
But we will look to, our collaborators at
Mercer to say, how do we best impact
the communities,
that we wanna serve and that you all
are are so interconnected with? And I think
that that's important. As as others listen to
this this podcast and as other health systems
think about how they can do more, it
is important that you connect with folks who
are in the communities you're trying to serve.
I think it's vital to hear those voices,
to understand those needs.
And then from there, think about how you
can best make an impact.
Looking ahead,
certainly, this is a program that I understand
is in its third year, which is terrific
that it's come this far. So looking ahead
three to five years, even beyond that, doctor
Sumner, Mark, what what do you see this
program looking like in that time?
Children's has committed to ten years of this
program.
And, you know, we hope that we we
use the resources that are available to us
to help these communities,
and we use their expertise to guide these
communities.
I hope this is a a lifelong commitment.
I I think that you will see that
mothers
and daddies care about their children,
and healthy children become healthy young people become
healthy adults.
And children's health transforms the family.
And so
Georgia needs rural Georgia.
Rural Georgia is a wealth of industry in
terms of mining and farming and food and
timber and
but industry
won't come
to communities where there is no health care,
particularly health care for children.
Children who are well do better in school.
They have more opportunity.
And so we believe that not only are
we transforming the health of children, and we'll
continue to work diligently to do that. We're
transforming economically
some of these communities
that give the opportunity for industry to come
in or businesses and have good health care
and have expertise in children. I have to
say that that Children's Healthcare of Atlanta is
a treasure, and they do things that nobody
else
does. They didn't have to do this,
but we are so honored to be in
a in alliance with them and to have
this association that allows us to go into
these communities
and transform them,
with the help of the local people. And
and and don't underestimate
the value of those local communities that are
110%
engaged. It's the the communities where we've been,
we where we are, and we never leave
over the 10 every even though we had
the, you know, the third year, we stay
very close and visit with the first and
second years. We don't abandon them. But we're
building this family of
network that we will stay in touch with
and continue to bring them the the best
that we can bring them. We have continuing
education every month. It's free.
We have,
specialty clinics where if a child in Worth
County needs a nephrologist,
there's a clinic where that child can
be in Sylvester, see the nephrologist in Augusta,
and never have to take a day out
of school or a day mama didn't have
to take a day out of work.
So there's so many things to this project
that grow, and then we learn every day
new things that we could do and new
approaches that we could have. And a lot
of that comes from suggestions from the community.
What do you think about this? And, so
we listen intensely, and then we try to
address those needs.
So it's it's exciting. I I've spent my
whole life in rural health,
and I don't know
anything more exciting to me than this project.
We're committed to transforming
the care of children in our state. And
I think, also,
our we ask our young people to live
and work in rural communities, but these children's
scholars,
both the marriage and family therapist
and the pediatric scholars, I'm I'm always interested
when I interview them. These young people seem
to know they wanted to be a pediatrician
when they came to medical school. They all
recount
interactions
with their doctor or their pediatrician,
but now that pediatrician's not there.
He went away.
So we're we're giving hope again to those
communities
and having a workforce that
that will be sustainable,
we hope.
Mark, anything you would like to add to
that? I think doctor Sumner covered it really
well. I think the the the biggest thing
for me as I look ahead to the
next five years is
that we will continue to innovate and look
for new ways to make an impact and
learn. The the way that this has been
developed and the way that it is set
up is exactly what doctor Sumner expressed. It's
an opportunity for us to continue to hear
and learn from the communities that we serve.
There's already been that example. We started with
the, pediatric scholars, and we said, hey. Well,
you know, why not why not think about
how we can impact mental health and and
began with the MFTs?
Those are the types of things that I
think will continue to happen, innovation to meet
the needs in these communities.
And, also, I think, you know, a lot
about the growth that will happen in these
communities. I think about the kids that will
be exposed to a pediatrician because of the
work that we're doing, that they themselves will
decide that they want a career as a
pediatrician,
because of the exposure that they're getting. And
I think those are the transformative things as
we look five, ten years down the line.
And I think we'll begin to see the
real impact of this program. I, for one,
can't wait to see where this program goes.
Jean, doctor Sumner, Mark, thank you so much
for being part of this. Your passion for
this program definitely shines through, and that is
not to be underestimated
in any respect. So thank you again for
being on the podcast and sharing what this
program is all about. And, honestly, we can't
wait till our paths cross again.
Thanks, Chris. Thanks, Chris. We appreciate your interest.