Another Piece in the Health Care Puzzle

Marshall Nelson was having his right shoulder recently after having had surgery a couple of months ago.

Instead of driving to Marianna or Bay County or Tallahassee to receive orthopedic care, Nelson drove only as far as the Gulf County Health Department facility in Port St. Joe.

Nelson is one of the beneficiaries of the ripples caused by the construction of the new Sacred Heart Hospital here, benefiting from a collaboration which is providing any color in the growing health care spectrum in the county.

Through a partnership among the Health Department, Sacred Heart and Tallahassee Orthopedic Clinic, patients in need of orthopedic care are but a short drive away from a path to healing.

And not just for those with insurance or of means, but folks who lack health insurance, are covered by Medicaid or who fall under the umbrella of indigent care.

"We've had a good partnership," said Doug Kent, executive director of the county Health Department. "It's provided specialty care in the community and that has always been one of our goals."

That goal became attainable through a series of conversations among the parties involved and the personal relationship and skills of Rick Williams, who works for TOC, lives in the area and helps provide orthopedic care to young athletes around the county.

TOC has long had a partnership with the Gulf County School Board to provide care for athletes injured during the course of any given week. Though budgetary constraints have prevented a broad contracted partnership, Williams and the team behind him have a special affinity for the county and its young people.

"The needs for student athletes are increasing, but the school system budgets are decreasing," Williams said as he prepared to put a cast on a patient. "We are trying to forge these collaborations to fill a real need.

"To meet what the county really needs, resources need to be increased. So we are trying to forge these collaborations to increase those resources."

Enter Sacred Heart. The health provider is currently constructing a hospital near the Gulf/Franklin Center that is scheduled to open late next year or early in 2010.

As part of its entry into Gulf County, Sacred Heart established a radiology department at the Health Department, where X-rays and scans can be taken and electronically sent to Pensacola or Destin for reading.

A diagnosis can be just a short wait away.

Those diagnostics were put in place as TOC was in discussions with Sacred Heart about becoming the orthopedic provider at the hospital.

"I knew I had the blessings of Sacred Heart which was important," said Martin Shipman, CEO of TOC, of the partnership with the Health Department. "We're excited about it. The hospital is going up and we have a verbal agreement to be the orthopedic presence at the hospital.

"We have quality people doing the diagnostics, which is important to orthopedics. (Superintendent of School) Tim Wilder has also been very supportive, but Doug (Kent) was excited about us working out of the Health Department. That is a hand-and-glove sort of deal."

Another part of the deal that appealed to Kent was the willingness of Shipman and his company to handle the under-insured, Medicaid and indigent clients, an important aspect of the partnership since currently most orthopedic groups in the area have cut back on Medicaid patients and do not greet the uninsured with open arms.

TOC sends a physician's assistant, Mike Nuccio, down from Marianna to see patients twice a month. He's been coming since January and word of mouth has built the practice, he said.

"We've done more than a dozen surgeries and a couple of joint replacements," Nuccio said, noting that surgeries are done either through the Marianna TOC satellite or in Tallahassee. "We enjoy coming down here because the people are so nice.

"The first month or so I wondered if this would work but now the day is full every time we come down here."

On this particular Thursday morning, there were 14 patients to be seen, Nuccio said.

Kent added, "They stay slammed when they come twice a month. They are willing to increase the number of visits as the patients increase."

"The last couple of months have been crazy," Shipman said. "That's word of mouth and Rick Williams knowing the community. The workload is steadily growing. So far we've been pleased with the growth.

"Rick Williams has been with us 18 years and has done a great job in the rural areas. Port St. Joe is very special to him and he thought there were some opportunities for collaboration."

The partnership could not have worked out better for a patient such as Nelson, who was diagnosed with a rotator cuff injury that turned out to be a bone spur on the shoulder. Mere weeks after surgery, he was showing off his range of motion to Nuccio.

"This is perfect for me," Nelson said. "I run out here and I am away from work a few minutes instead of hours. The treatment is excellent."

While TOC continues to work with Sacred Heart on bringing additional specialists to the hospital, something that excited Shipman, Williams and Nuccio continue their care.

Maybe it is just twice a month for Nuccio, but for Williams, who roams athletic sidelines at more games than he could count, it is more than that.

"This is a personal agenda for me," Williams said. "If it works with Sacred Heart and TOC and the Health Department - that is where it's at for me."