Medics Reach Out to Regional Patients
By Douglas J. Gillert
American Forces Press Service
SHEPPARD AIR FORCE BASE, Texas, Jan. 9, 1997 For Army Dr. (Capt.) John Johnson, TRICARE Region VI medical outreach allows him to see the kinds of ailments he'll take care of when he completes his residency.
For Air Force Dr. (Lt. Col.) Charles Morton, the program extends his developmental pediatrics practice at Wilford Hall Medical Center, Lackland Air Force Base, Texas, to six more bases and hundreds more patients.
And for Air Force Dr. (Maj.) Frank Shelton, Sheppard Hospital pediatrics chief, the program means his patients get the care they need.
For two years, teams of Wilford Hall specialists have made day trips by Air Force C-21 aircraft to each Region VI military base in Texas, Oklahoma and Louisiana. They deliver the kind of care patients used to have to travel to San Antonio to get -- or pay high prices for in their local communities. "Some of my patients would not travel to Wilford Hall, 350 miles away," Shelton said, "so they might not get medical care they really do need."
In fiscal 1996, Wilford Hall conducted 179 medical outreach missions. The missions saved patients the expense and time of traveling to Wilford Hall for treatment. They also saved Region VI medical facilities more than $286,000.
Until the outreach program began, older retirees had to make the trip, because only Wilford Hall, a large, well-staffed teaching hospital, could and would care for them. Most smaller hospitals and clinics, including Sheppard, aren't staffed to treat all retirees. Medicare-eligible beneficiaries, in particular, usually go elsewhere for treatment.
"We have a lot of folks who travel [to Wilford Hall] on a regular basis," noted Air Force cardiologist Dr. (Lt. Col.) Brad Personius. "On outreach trips, I get to see many of them for follow-up evaluations" -- a savings to patients and a boost in the level of care he can provide them, he added.
Specialists, including doctors in residency, visit Army, Navy and Air Force bases in Region VI every other month. Besides developmental pediatrics and cardiology, their specialties include orthopedics, obstetrics and gynecology, podiatry, dermatology and pediatric neurology. But virtually any subspecialty could participate if there's a need, Morton said.
Among the patients Morton, Johnson and first-year resident Army Dr. (Capt.) Tonya Kratovil saw during a recent trip was a young girl with an undiagnosed syndrome affecting her attention span, vision and learning ability. They'd also proctor a standardized intelligence test for a 13-year-old boy with a suspected learning disability.
The day before, Morton examined a fifth grader with severe dyslexia at Fort Hood, Texas. "The boy's parents are having problems getting the kind of care he needs from the school district," Morton said. "Part of my visit was to advise them how to get those services."
Along with evaluating, treating and counseling patients, the visiting doctors advise local doctors on treatment regimens and frequently discuss difficult cases with them by telephone, Morton said. "The quality of care in my specialty has risen significantly because the doctors are now much more comfortable treating different problems," he said.
Morton recalled the first outreach mission, to Altus Air Force Base, Okla., in February 1995. "There was freezing rain and we were barely able to land," he said. "Even so, the wing commander -- a brigadier general -- came out to the plane to meet us. It was like a holiday at Altus. We saw patients most of the day, then delivered lectures to the medical staff. It was a great day for us and for everyone there."