Tag: Other Stories

Local medical community rises to meet the challenge

Story by Scottie Vickery
Photos by Graham Hadley
Submitted photos

Long before COVID-19 found its way to St. Clair County, medical professionals in the area were preparing for its arrival. They had been monitoring the progression of the virus, which began in December 2019 in Wuhan, China, even before it first made its way to the United States in January.

Alabama got its first reported case on March 13, and the virus hit St. Clair County four days later. By mid-July, the state’s numbers had risen to well over 58,000 cases with nearly 1,200 deaths. At that time, St. Clair County had nearly 700 cases and four deaths.

“The biggest thing in the beginning was dealing with the panic and uncertainty,” said Dr. Michael Dupre’, who led the coronavirus response efforts for Northside Medical Associates. “When you use a word like pandemic, it gets people’s attention.”

The virus brought challenges that medical personnel had not faced before, and local healthcare officials raced to implement new procedures, alleviate concerns and remove obstacles for their staffs. At the same time, they had to treat existing patients while trying to diagnose and care for those with COVID-19.

Rapidly changing information was an initial challenge since much was still unknown. Lisa Nichols, administrator of St. Vincent’s St. Clair, said that by the time guidelines from sources such as the Centers for Disease Control and the Alabama Department of Public Health were communicated with the staff, new information and guidelines had been released.

“There were a lot of changes,” she said. “Our staff works in 12-hours shifts, and by the time we got information out to everyone, it had changed again. Our team was very resilient and did an excellent job of going with the flow.”

The immediate concern was keeping patients and medical personnel safe, according to Nichols, Dupre’ and Dr. Barry Collins of Pell City Internal and Family Medicine (PCIFM).

“This was like nothing I’ve ever experienced before,” Collins said. “To be honest, I was afraid when all this hit, the fear would deplete our staff. They hung in there fearlessly, though, because they knew they were essential to the community.”

Dupre’ said staff members were initially concerned that they would contract the virus and take it home to family members who were at risk for complications, such as aging parents or an immunocompromised child. Employees with chronic health issues or family members who were at-risk were reassigned to other areas where it was safer. The level of anxiety was unlike anything I’d ever seen before,” he said, “There were fears, but our duty and commitment to our community did not change one bit.”

Implementing safeguards

Once initial fears were addressed, the focus was on treating patients – those with COVID-19 and those without – while preventing the spread of the virus. The first step was to identify potential coronavirus cases before patients encountered anyone else.

“We have so many entry points to the facility, so we changed the way you come into our hospital,” Nichols said, adding that separate entrances and parking lots were designated for patients and associates. Door screeners at each entrance checked everyone for fever and symptoms of the virus, including cough or shortness of breath. Anyone who is identified as having symptoms of the virus is directed into a separate waiting area while waiting for the triage nurse.

At PCIFM, patients were initially screened over the telephone when they called to make appointments, and staff members conducted temperature screenings and checked oxygen levels and symptoms at the door. Anyone who was a potential positive, based on either check, was directed to the practice’s drive-thru testing lane. “We were able to do COVID testing without having the patient leave the car,” Collins said.

Northside patients were screened at the door of all four locations – Pell City, Moody, Springville and Trussville – and only one entrance and exit was used at each office, Dupre’ said. At the Pell City campus, the building housing the ACCEL Urgent Care Center was designated for respiratory illnesses and COVID-19 testing and treatment. Anyone with symptoms of the virus, or those who had been exposed, were directed there.

In addition, hospital and medical office personnel all over the county implemented additional cleaning processes to cut down on the spread of the virus. “We’re constantly changing scrubs and masks and rotating stethoscopes,” said Dr. Jason Thompson, a cardiologist with Birmingham Heart Clinic, which has an office at Northside’s Pell City campus. “Exam rooms are being sanitized between every visit, and it’s not just changing the paper on the table. We’re wiping walls down with Clorox and wiping the table down with Clorox.”

The virus brought additional hurdles, as well. Schools and day care centers closed, leaving medical personnel scrambling for child care. Northside and PCIFM set up day care programs at their offices so their employees could continue to focus on caring for the community.

“We called it Camp Northside,” Dupre’ said of the child care program that operated for three months. “If our employees didn’t have anyone to take care of their kids, we took care of them here,” he said.

Collins said their day care program was largely operated by family members of staff as well as volunteers. “The community really rallied around that idea,” he said. “They were donating lunches and teaching materials for the children.”

Hard decisions

There were other dilemmas, as well. “Probably one of the hardest things we had to do was go to a no-visitors policy,” Nichols said. At first, patients at the hospital were limited to two visitors, but as guidelines continued to change, it went down to one within a few days. Not long after, no visitors were allowed, except for end-of-life situations and patients that required caregivers.

“We struggled with how to get people information about their loved ones. We encouraged patients to connect with their families via social media,” Nichols said, adding that the hospital purchased tablets for patients without smartphones. They also implemented a process to ensure that the nursing staff contacted one family member or caregiver to provide updates, as long as the patient gave permission.

Even though that added more work for a nursing staff that was already stretched, the team didn’t balk at that or any other additional duties, according to Shiloh Swiney, director of nursing for the hospital. “They all chipped in and said, ‘We’re going to get this done. We’re going to get these patients taken care of,’” she said. “We have a strong nursing group, and the morale has been very high.”

The suspension of elective dental and medical procedures caused additional concerns. “Initially, we rescheduled all elective procedures and did Telehealth visits for routine checks of less acute patients,” Collins said. “Not everyone had access to the internet and some patients weren’t tech savvy and weren’t comfortable with talking on camera. We had to educate our patients.”

While some of Thompson’s patient appointments could be handled virtually, other cardiac patients needed to continue to be seen in person. In order to limit exposure in waiting rooms, Thompson said that his office asked those patients to come alone unless a caregiver was truly necessary. That sometimes limited the information he received.

“I’ve got some patients who, if their wives didn’t come with them, I wouldn’t know anything,” Thompson said. “The wife is who would tell me if he had been short of breath. Now, a lot of times I’ll pick up the phone, call the wife and put her on speaker. That’s how I’ve brought them back in the exam room without crowding the waiting room.”

Patients with chronic conditions who were concerned about catching the virus often delayed seeking treatment, which led to other problems. “Our ER volume was almost cut in half,” Nichols said. “Some of the patients we’re seeing now are sicker because they waited too long to get the care they need. We want everyone to know that we are a safe place, and we are absolutely taking steps to keep everyone safe.” High-touch areas are being cleaned many times throughout the day, and some chairs in waiting rooms are blocked off to ensure patients have plenty of room between them, she said.

Thompson, especially, saw the effects that fear and suspending elective procedures, like having a stent inserted, had on his patients. In some cases, patients had strokes that could have been prevented, or they lost heart function after a heart attack that might possibly have been restored if they had sought help faster.

“I’ve had patients who sat on their chest pains for fear of the ER,” he said. “With a heart attack, time is muscle. If we can get to you within 12 hours of chest pain, we can salvage heart muscle.” Although his patients’ cardiovascular disease makes them high risk for coronavirus complications, their heart issues still need to be addressed. “We have to be careful, but we cannot ignore their underlying disease,” Thompson said.

A community rallies together

Long before Gov. Kay Ivey issued a statewide mask order in mid-July, all patients and staff at St. Vincent’s, Northside, PCIFM and the Birmingham Heart Clinic were required to wear masks, which were provided for patients who didn’t have them. When supplies were low in the early days of the pandemic, employees at Northside got busy.

“Our staff made thousands and thousands of masks,” Dupre’ said. “We had hundreds of patients at home making masks with their own fabric and their own money. We’ve always thought the world of our patients, but so many went above and beyond.”

Patients weren’t the only ones offering support. Dupre’, Collins and Nichols all said they were overwhelmed by the love shown by the community as a whole. Individuals, churches and businesses from all over the county provided meals; offered masks, hand sanitizer and cleaning products; and prayed.

Several nights, Swiney said, individuals and church groups gathered in the back parking lot of the 40-bed hospital to pray. “There are so many people out there who wanted to help, and to know they were praying for each one of us here was amazing,” she said.

“The community was absolutely awesome,” Collins said, adding that donated meals meant the staff didn’t have to leave the building and could focus on the crisis at hand. “It reminds you about what is great about the human spirit,” Dupre’ added.

Moving forward

Early efforts to flatten the curve helped because, even though people continued to get sick, the cases were spread out over a period of weeks, so the hospital was not overwhelmed. “Fortunately for St. Clair County, we’re rural enough to spread out,” Dupre’ said. “That’s really helped, and we haven’t had the impact other counties have had.”

Early on, Dupre’ said, Northside looked at designating one of the buildings at the Pell City campus to house overflow patients from the hospital, if necessary. “Thank God it was never that bad,” he said.

It could still reach that point, however, if people relax too much. Alabama saw a resurgence in cases in late June and early July after the state began reopening, and Collins said he worries about the looming flu season. Although flu season is typically considered to be October to March or April, it’s not uncommon to see cases in September.

“There’s been a real spike in (COVID) cases, and now we’re almost back to square one,” Collins said. “The only way we can get this virus to go away is to starve the virus from the host.”

That’s why it’s critical that everyone continues to social distance, wash hands frequently, avoid group gatherings and wear face coverings to prevent the spread. “Wearing a mask can really protect the people you interact with,” Nichols said. “A lot of asymptomatic people are testing positive, even though they have no symptoms. If they’re wearing masks, the likelihood of spreading the virus is reduced.”

Dupre’ said masks are especially crucial for high-risk patients. “We know the masks work,” he said. “We’ve had staff here who have swabbed thousands and thousands of patients, and we haven’t had one catch COVID,” he said in early July. He added that people need to continue to isolate themselves if they are sick and wash hands frequently, especially when they have come in contact with surfaces outside their homes.

Although Thompson said masks have meant that he has had to dramatically slow down his speech so older patients who are hard of hearing can understand him, he agrees that wearing them and taking other precautions is imperative. “We have to take this seriously,” he said. “I think it has become apparent to us that this is not going away tomorrow. We will continue to deal with this for a year or more.”

He added that, while the growing death toll from the virus is tragic, it’s not the only tragedy of this pandemic. Thompson has seen widowed patients suffer depression after being isolated from friends and family for months on end. People haven’t been able to gather for funerals, which has had a negative effect on the grieving process. Couples looking forward to starting their lives together have had to postpone weddings.

“All of this is part of the human tragedy we’re all living through,” he said. “We are social animals, and it’s interesting how you begin to crave that interaction with family and friends. I’m not pretending this is going to be easy, but it can be done.”

Collins said he is hopeful that the newfound awareness among the public about how germs are transmitted will have lasting benefits even after COVID-19 goes away. “Right now, this virus is a curse, but if it changes behavior, it may mean a decrease in other communicable diseases, such as the flu,” he said. “It may be somewhat of a silver lining beyond this nightmare.”

Broad focus meeting
patient’s needs

Story by Eryn Ellard

Photos by Graham Hadley

Submitted photos

It is no secret by now: 2020 has been met with great adversity and trial as a pandemic gripped the world.

Healthcare workers across the country and here at home have been working tirelessly to keep their skill sets sharp and to keep the community healthy during the COVID-19 pandemic.

Northside Medical is home to St. Clair County’s largest outpatient health care facility, serving over 5,000 patients throughout its six locations, and its innovations in the delivery of health care are widely known.

One of those innovations comes in the form of a six-member team inside Northside’s Health & Wellness department that stresses not only the importance of receiving proper medical attention when you are ill but also when you are healthy in order to stay healthy.

Working directly with each provider, the department serves as a convenient central hub for patients and provides the foundation to stay healthy – from flu shots to cancer screenings, wellness visits for women, depression screenings and everything in between.

The department was established as a part of the Northside team three years ago as the need for preventative health was on the rise. The idea, says Executive Director Dianna McCain, is to keep health care cost effective but also to do everything you possibly can to keep from being hospitalized.

“By the time a patient needs to be admitted to the hospital, it is almost a guarantee that they will also need to be treated for something completely different than for what they had to come for in the first place,” McCain said. “We want to do everything in our power to keep hospitalizations to a minimum.”

Nurse practitioners also can be found making house calls through the department. If a patient is unable to acquire transportation or cannot physically come into the facility for a visit, a member of the wellness team will come to them.

McCain said most lab work and X-rays can be done at the home. The visits have proven to be a great tool, not only during a pandemic, but also to several patients who would not otherwise receive care. Because individual providers don’t have the time to assess individual patient’s more in-depth needs, McCain says her department has been very successful in identifying these patients and serving them.

“We have seen instances when a diabetic patient’s blood sugar isn’t being maintained properly through medication and diet,” McCain said. “We can just touch base and see if we can come see them at home. Many times, it can be just as simple as a patient not drawing their insulin up correctly.”

In addition to running patient queries to call and schedule routine immunizations and screenings, McCain says the department has been able to extend monetary assistance when a need arises. McCain and her staff often work directly with other local organizations like the St. Clair County Coalition, The Christian Love Pantry, as well as several area churches to provide groceries, medication assistance and utility bill relief to some patients.

“It can be very bad if, for example, a diabetic doesn’t have adequate power or food available to them,” McCain said. We have been able to visit our patients at home, see what they need and even provide them with the right food they need to stay well.”

Northside patient and county native Andrea Nobles says she is beyond grateful for all the measures Northside Health & Wellness has done for her.

“When you get to be my age, things start coming up with your health,” Nobles said. “It is very assuring to know that I am not just a number but a person whose concerns are also my doctor’s concerns,” Nobles said. “I have lived here all my life, and I actually enjoy going to the doctor’s office now that we have Northside. We look out for each other.”

The majority of Alabamians who receive private health insurance can also qualify for incentives and breaks in premiums when they are proactive about their health. By receiving annual wellness checks and screenings, weight management, help with smoking cessation and women’s health screenings, for example, patients often see a discount in their monthly premiums and other incentives, like gift cards and entertainment vouchers.

“Health care costs are astronomical when you get into hospitalizations,” McCain said. “Ninety percent of costs come when a person goes to the hospital. We want to do everything in our power to keep a patient out of there, no matter what.”

PCIFM, Bedsole Eye Care, ATI Physical Therapy, Comfort Care Hospice expand to new facilities

Story by Leigh Pritchett

Photos by Graham Hadley

Submitted photos

Pell City is experiencing quite a boost in its growing medical community thanks to the expansions of Pell City Internal and Family Medicine, ATI Physical Therapy and Comfort Care Hospice expanding into new facilities.

Pell City Internal and Family Medicine

Dec. 26, 2019, was a second Christmas Day for Pell City Internal and Family Medicine: That was when the practice opened its new, freestanding clinic next to South Park Center.

The new construction has consolidated PCIFM’s main office in Physicians Plaza at St. Vincent’s St. Clair Hospital and its satellite office in South Park Center into one location.

Together, the two previous clinics totaled 15,000 square feet and had 23 examination rooms. The new building boasts 20,000 square feet, close to 40 examination rooms, a procedure room, laboratory and plenty of space for specialty care physicians.

“We have room for expansion,” said Dr. Barry Collins, a physician and partner in PCIFM. Some areas used for other purposes can easily convert to additional exam rooms if needed, he said.

PCIFM, which was established in 2012, provides primary, after-hours, women’s and pediatric care.

When its physician partners decided to construct a new building, they took note of the increase in retail and population in the southern part of the city.

This location placed the clinic in a rapid-growth sector of the city and in proximity to people in Vincent and Harpersville (both in neighboring Shelby County). Yet, it is still close to the hospital and Interstate 20, Collins said.

Because of the building’s “linear” design, all medical services are on one floor, which not only lessens the amount of walking for a patient, but also streamlines patient flow, Collins said.

This improves ease of care and speed of care, said Collins and Dr. Ilinca Prisacaru, also a partner.

Even the design of the parking lot limits the walking distance for patients, said Dr. Rick Jotani, partner and chief executive officer. “It’s a little more convenient for our folks.”

The array of on-site diagnostics, imaging and other services now available at PCIFM reduces the need for patients to commute to the hospital to receive them, Prisacaru said.

Having so many services at one location promotes cohesiveness and continuity of care, added Collins.

PCIFM – which was already offering space to several specialists before the new building was constructed – now has room for even more sub-specialties.

Currently, two cardiologists, two general surgeons, an orthopedic surgeon and two gastroenterologists see patients at the PCIFM facility. Jotani and Collins said the practice is “actively recruiting” specialists in dermatology and audiology as well.

Jotani also noted that physical therapy is available on campus through ATI Physical Therapy.

The partners said adding another physician to PCIFM’s primary and after-hours care may happen within the next 18 months. “As the community expands, so should our services,” said Collins.

Prisacaru and Jotani pointed out that the conference room allows on-site diabetes classes to be held on a regular basis. Led by a nurse practitioner, the classes are kept small for participants to receive personalized attention.

The spaciousness of the facility meant there was even room for daycare for employees’ children during the COVID-19 shutdown.

Ten to 15 children each day stayed in a designated area of the building while their parents attended to patients, Jotani said, adding that the community brought food and other items for the employees’ children.

“The community supported us immensely,” Collins said of those weeks of working when many essential services in the city were closed.

Another asset of the new building is a designated aesthetics suite. There, Jotani Aesthetics offers non-surgical cosmetic measures.

Since December 2019, PCIFM has seen a definite increase in patient load, Prisacaru said. One contributing factor is the addition of Saturday clinic hours, Collins said. Previously, the clinic was open Sunday through Friday.

Clinic hours are 8 a.m. to 7 p.m. Monday through Thursday, 8 a.m. to 5 p.m. Friday, 9 a.m. to 2 p.m. Saturday, and 1-5 p.m. Sunday. Two practitioners are always on duty during office hours.

Collins said visibility – being next to a retail center – has likewise contributed to an increase in patients. “Folks know we’re here,” Jotani said.

To meet increasing demand, another nurse practitioner was hired, as were more clinical and laboratory staff, Collins said. Jotani and Prisacaru estimated that employment has increased 10 to 12 percent since the building opened.

James W. Bedsole, O.D. Eye Care

In August, James W. Bedsole, O.D. moves to a modern building, designed for Eye Care, situated just in front of South Park Center. Dr. Bedsole’s practice will relocate from downtown Pell City to 2020 Martin Street South.

Dr. Bedsole said that, of all the properties he considered for relocation, this particular location was the very best.

He provides primary eye care, vision correction and treatment of eye diseases, as well as pre-operative and post-operative care.

The new building, state-of-the-art, will allow greater comfort and efficiency for patient care. The new location is convenient – located in front of the South Park Shopping Center that includes Publix – and it’s more accessible.

The brick-and-mortar buildings are important for patient care, but even more important are people, Bedsole said, noting that he has a great staff who works hard and really cares for their patients. 

The new building is an asset in continuing to deliver exceptional patient care.

ATI Physical Therapy

Situated at the Hardwick Road end of PCIFM’s building is the Pell City location of ATI Physical Therapy.

Based in Illinois, ATI operates stand-alone physical therapy sites, as well as units on high school and college campuses, said Chris Baker, director of physical therapy at ATI in Pell City. The Pell City site opened Feb. 17.

Encompassing more than 2,800 square feet, the local ATI provides physical therapy for a wide range of needs and specializes in therapy for orthopedic and cervical spine issues, Baker said.

Monday through Friday, ATI offers one-to-one care, using new equipment and a variety of treatments. Appointments are available 7 a.m. to 7 p.m.

The growth occurring in Pell City schools and in southern St. Clair County made this location particularly attractive to ATI, Baker said. Even though the location opened shortly before the COVID-19 shutdown, Pell City’s ATI has experienced a steady increase in clientele.

Future plans include hiring additional physical therapists, Baker said.

“We have been very blessed with the patients we have seen so far,” Baker said. “Pell City has been good to us. We look forward to growing with the community.”

Comfort Care Hospice

Comfort Care Hospice opened its Pell City office May 1 in South Park Center.

“The growth around here is just awesome,” said Clay Spencer, administrator and a registered nurse with Comfort Care Hospice. “I have wanted to come over here so long. … I can’t tell you how happy we are to be here.”

Spencer said the office relocated to Pell City to be more central to its coverage area, which includes St. Clair, Clay and Talladega counties.

The 10-plus employees at the Pell City location include nurses, aides, a social worker, a chaplain and office staff. The physicians are Dr. Rick Jotani of Pell City, who is medical director, and Dr. Jarod Speer of Childersburg.

Spencer said Comfort Care Hospice also has a corps of volunteers who call patients and offer short-term respite for caregivers.

Hospice care, Spencer explained, is for patients with terminal diagnoses. “Our goal is to keep them home and keep them comfortable,” she said.

With hospice care, patients receive medical attention right at home. Nurses are available around the clock and also visit at least twice each week with patients. Aides make several visits each week in patient homes, as well.

The hospice mission allows patients, along with family members, to make their own decisions about care, Spencer said. “(Hospice) does elongate how much time they do have before they make that transition.”

Dr. Greg Tankersley, the chaplain, gives spiritual and emotional support to patients and families during the time of hospice care. After a patient passes, he offers grief support to family members for 13 months.

“We stay in touch with our families,” Spencer said.