Editor’s note: National Rural Health Day is Nov. 21, 2019. Throughout the month, we are sharing stories to highlight the challenges and good work being done to improve health care in rural America. This article originally appeared in the March/April 2019 issue of the Sandhill ConNEXTion.
In December, CareSouth Carolina received the 2018 Jimmy Newsom Signature Award from the Darlington County School District for its efforts in providing dental care to students and educating them on the importance of proper dental health.
For CareSouth, one of the area’s largest health care providers, entering local schools in Darlington, Chesterfield, Marlboro, Dillon and Lee counties to provide dental, medical, and mental health education and care is a significant development in improving health care in the region.
“If we can catch them young, maybe we can develop a relationship with them and keep them in healthy habits,” says CareSouth Carolina’s Kelli Cross, who works in the CareSouth Cheraw Center. “Maybe we can change the mindset that we as adults only have to go to a physician when we’re sick.”
In Cross’ mind, CareSouth’s mobile medical services for adults and students in the area are the most important part of a multifaceted health care business in the mostly rural region. The backbone of the mobile program is a 40-foot mobile medical unit, which is equipped with two medical exam rooms. It can reach local communities when it is hosted by schools, businesses, churches and other organizations.
CareSouth’s mobile program called ROADS — an acronym for Reaching Out and Delivering Services — delivers those services to local communities outside the proximity of the company’s 13 medical offices and pharmacies. Of those facilities, CareSouth operates four in Marlboro County — the Bennettsville Center, Bennettsville Pediatric Center, Bennettsville Women’s Center and the McColl Center. The Cheraw Center and the Society Hill Center, which opened a pharmacy in December, sit just over the county line.
“We have a lot of school-based services, including a massive dental aprogram and medical program,” CareSouth Carolina CEO Ann Lewis says. “Going into schools, we can provide health and wellness visits for kids and even provide mental health counselors where they’re needed.”
Lewis says CareSouth received a grant from the Doris Duke Charitable Foundation to expand the dental program this past year.
“We can’t continue to think about health care within just four walls,” Lewis says. “Health care is in the whole community, not in our four walls. It’s all of them. That’s what we’ve got to learn how to do — address the whole community.”
The challenges facing CareSouth are not unlike those facing doctors in traditionally underserved rural areas in other eras, but Lewis says technological advances and other more local changes could make a difference.
“We can’t afford to put a doctor on every corner, so we have to look at good options,” she says, noting a USDA grant received by CareSouth to expand its telemedicine program. “The new telemedicine options are really, in my opinion, game-changers.”
With high-speed internet available in rural areas, doctors and specialists are able to at least virtually see patients when they consult with local physicians or physicians assistants.
Putting together a proper telemedicine program in underserved areas can help treat patients more efficiently and accurately. “So much of our time and money is often spent accessing services through an ER for, say, an upper-respiratory condition when, really and truly, you ought to be able to stay at home and have a remedy through telemedicine — one that works just as effectively and a lot more efficiently,” Lewis says.
CareSouth is also looking at other ways of using technology in its practices. Patients who choose to can receive text messages to help with medicine regimens and to help them monitor conditions such as high blood pressure or blood sugar.
No Cellphone? No Problem
“We’ll give them a cell-phone if they don’t have one,” Lewis says. “We also have monitoring equipment that comes home with the patient. Sometimes conditions need to be checked two or three times a day, and the monitor connects to our offices. We can see the results multiple times a day to see what’s going on with that patient, and sometimes you need that because some of these conditions are so complex.”
Lewis says she is also looking at a program that would put iPads or similar tablets in the hands of homebound patients who need them to help monitor their conditions. “A lot of people say an iPad is too expensive, but it’s not,” she says. “Want to see expensive? Look at a bill for a visit to the emergency room.”
The South Carolina state legislature also made a move in 2018 that is already helping CareSouth and other health care providers by expanding the legal capabilities of nurse practitioners. In the state, nurse practitioners outnumber family practice doctors by just over 2,000, but there is still a shortage of both. Under the new regulations, nurse practitioners can now prescribe Schedule II medications, which include certain painkillers and other drugs. They are also now allowed to put patients in hospice care.
CareSouth now employs three nurse practitioners in Cheraw. “That’s a huge change for us,” Cross says. “A good change.”
CareSouth Carolina Locations – Marlboro County area
999 Cheraw St. | 843-479-2341
Bennettsville Pediatric Center
210 W. Main St. | 843-479-1200
Bennettsville Women’s Center
1076 Marlboro Way | Suite 1
715 S. Doctors Drive | Suite E
225 S. Main St. | 843-523-5751
Society Hill Center
737 S. Main St. | 843-378-4501