Rheumatology Outreach Clinics

September 15, 2016

Image with caption: Alan Erickson, MD

Alan Erickson, MD

There is a nationwide shortage of rheumatologists. That is a known fact according to Alan Erickson, MD, an associate professor in the Division of Rheumatology and Immunology.

Dr. Erickson and Marcus Snow, MD, an assistant professor in the Division of Rheumatology and Immunology, both conduct outreach clinics in rheumatology. Dr. Erickson conducts two outreach clinics per month, one at West Point, Neb. and the other is at Fall City, Neb. Dr. Snow also conducts two outreach clinics per month, both at Columbus, Neb.

"This is a way to provide rheumatology care in underserved areas," Dr. Erickson said. "Rheumatology is a hands-on specialty. We must be able to do a physical exam."

Most people in rural communities prefer to stay in their rural communities for care when possible, Dr. Erickson said.  He believes it is important to be aware of the services critical care hospitals in small rural communities provide.  Dr. Erickson uses the resources at those facilities.

"The reality is that if all of their patients go elsewhere for medical care, hospitals close," he said.  "For me, the goals are simple, provide state-of-the-art medicine for citizens in rural areas, to allow their medical community to thrive and provide medical care."

Drs. Erickson and Snow have both conducted some educational programs in the outreach communities, as well.  Dr. Erickson also attends staff meetings at West Point every month since it is on his clinic day.  He has become an active member there and part of the medical team. He hopes he can be called on as a trusted resource for complicated and challenging cases. And, he believes it is important to the local providers and patients to feel that this is a long-term relationship.

Marcus Snow, MD

Marcus Snow, MD

Dr. Snow's Columbus clinic is different in that they rent space from the hospital.  A Nebraska Medicine nurse goes with him. They remote into EPIC from a laptop.  He said he doesn't usually notice a difference unless something is effecting the entire UNMC EPIC system.

When patients have questions, they call Omaha, he said. Dr. Snow and his team can handle everything just like they handle his patients at Village Pointe.

"We want to keep people where they want to be seen," Dr. Snow said.  "We incorporate into their medical community, not the other way around."

Dr. Snow said he likes going to Columbus.  It is a nice change of pace.  He likes seeing a different part of the state, and the patients are appreciative.

Dr. Snow's best tip for any practitioners thinking of starting outreach clinics would be to not "reinvent the wheel." When he started to go to Columbus with Nebraska Medicine, he talked to Dr. Leslie Eiland, assistant professor, Division of Diabetes, Endocrinology and Metabolism, who has conducted outreach clinics for a couple of years. She and her support team had set up some things Dr. Snow was able to use.

"I think there are inroads that have already been established that you can, a lot of the time, use their expertise to quickly get things established that may take longer otherwise," Dr. Snow said. "If we are looking to expand outreach, we could gain a lot by having a coordinated approach."

He thinks that will happen with time.

Dr. Erickson said there are two doctors at Creighton who also conduct outreach rheumatology clinics. He believes between the two universities we do a good job of covering a big chunk of Eastern Nebraska and a little of Western Iowa.  The next step, he believes, will be to think of ways to provide care to Western Nebraska. 

Although government regulations and different electronic medical record systems do pose a challenge, Dr. Erickson thinks the biggest challenge is overcoming the distance.