Adam Ewing photo
The "heroes" theme for this year's Top Doctors issue recognizes the higher calling that many physicians feel to serve people in need. We look at how three people are responding to that calling. And they are in good company. Almost 900 physicians in the area provide free specialty care for the uninsured through Access Now, a program run by the Richmond Academy of Medicine. Many others volunteer at the region's free clinics, and still more travel to countries such as Haiti, where health care needs are even greater.
"Most doctors get into medicine because they want to help people," says Dr. Thomas M. Hubbard of Ashland Medical Center. A fellow Hanover County physician, Dr. M. Lee Blackburn Jr., suggested through the survey that we recognize Hubbard for his role in establishing Hanover Interfaith Free Clinics, a network that provides medical care for three hours a week at five churches in the county. (Blackburn is among the physicians who volunteer at the clinics.) "We've never had a fundraiser," Hubbard says. "People hear about us and say, ‘What can I do to help?' " His wife, Susan, runs the clinics as executive director. The Hubbards also happen to be the parents of Richard Hubbard, a medical student who is one of the three "heroes" highlighted in this issue for his work helping the poor in Bangladesh.
Survey responses also called our attention to work by two other physicians who are included in the Top Doctors list: Dr. J. James Zocco, who has performed free heart surgeries for children in Jamaica and Grenada through the World Pediatric Project, and Dr. Alan J. Burke, who, through the same organization, travels with a team of volunteers at least once a year to repair cleft palates and facial deformities in Belize. Names of other "Top Docs" also appear as volunteers in the organization's annual reports.
Three other physicians on our list received humanitarian awards in March from HCA Virginia hospitals for "extraordinary concern for the welfare and happiness of patients, co-workers and their communities." They are Dr. James A. Shield Jr., Dr. Minh Bui and Dr. Lowrey Holthaus. A fourth award recipient, Dr. Dan Jannuzzi, is not on this year's Top Docs list, but he's been widely praised for his work on behalf of the uninsured as medical director of CrossOver Ministries. (He was also a special honoree in our 2008 Top Docs package.)
In conducting our 2011 survey, we asked local physicians to tell us whom they would recommend in 53 categories. We also asked for nominations to recognize health care workers in five special-honors categories: floor nurse, operating-room nurse, nurse practitioner, physician assistant and volunteer. Some of them are featured in this issue.
We sent letters to more than 3,700 doctors, alerting them to our online survey. From that list of licensed practitioners obtained from the Virginia Department of Health Professions, 530 responded to the survey, for a response rate of just over 14 percent. A confidential panel of well-established physicians also reviewed the list and gave input; however, Richmond magazine's editors made the final decisions. —Tina Eshleman
Always Room For One More
Gynecologist ‘never hesitates to say yes' to seeing uninsured patients
The motivation behind Dr. Sumac Diaz's involvement in Access Now is simple. "I joined medicine to help people," the gynecologist says. Access Now depends on the generosity of specialists such as Diaz for follow-up consultations with uninsured clients, who are treated at 19 regional free clinics, health departments and federally qualified health centers. Of the more than 2,000 referrals Access Now (accessnow.ramdocs.org) arranges each year, about half are for gynecologists.
Because Diaz can conduct examinations in Spanish, Access Now does not need to arrange for an interpreter during her appointments. "And when patients understand what's going on, they are more compliant and more comfortable with a gynecological exam," Diaz says.
Her obstetrics, gynecology and family practice — Complete Care Center for Women — is next to CJW Medical Center's Chippenham Hospital, in an area with a large immigrant population. In fact, HCA Chippenham officials recruited her in 2004. At the time, Diaz, a native of Michigan, was completing her residency program in family practice and OB/GYN at Riverside Regional Medical Center in Newport News.
She has agreed to see up to 10 uninsured patients a month referred through Access Now — far more than any other affiliated doctor. "And she never hesitates to say yes to just one more," says Marilyn Nicol, manager of the 3-year-old program.
A frequent reason for gynecological referrals is follow-up when Pap smears indicate cervical cell abnormalities that may be pre-cancerous. Cervical cancer can be prevented through proper care and simple treatment.
"She's an excellent physician who's very open to helping women in need with gynecological issues," says Dr. Dan Jannuzzi, medical director of the CrossOver Ministries' three Richmond-area health centers. "She's a humanitarian. I don't think the community here understands the level of charity work done," adds Jannuzzi, who serves on the Access Now board of directors. "Many physicians have felt this higher calling, which really is a professional obligation."
Diaz has seen 169 patients referred by Access Now since its official launch in January 2008 — 70 of them just last year. "She's a saint," Nicol says. "She performs an important service." —Marilyn J. Shaw
A Personal Calling
Medical student earns national accolades for helping the poor in Bangladesh
As a college undergraduate a few short years ago, Richard Hubbard says, "I thought for a while I wanted to become an economist in international development, but decided they spend a lot of time talking about problems instead of dealing with problems." Now a second-year medical student, the Hanover County native is dedicating part of his frenetic life to helping the impoverished in Bangladesh.
"[Hubbard's] dedication to humanitarianism is unparalleled," says Dr. Isaac K. "Ike" Wood, a senior associate dean at the VCU School of Medicine. "It is unheard of that a young man, facing the rigors of undergraduate medical education and medical school, still has created the time to fund raise, volunteer and build a hospital and educational setting at an international level."
Wood nominated Hubbard for the Medical Society of Virginia Foundation's 2010 Salute to Service Award for medical students or residents. In February, Hubbard followed that honor with a 2011 Leadership Award from the American Medical Association Foundation, given to just 24 medical students nationwide.
The recognition helps the Basic Needs Program (bangladeshbasicneeds.org), which Hubbard co-founded in 2007, improve life for street families without a breadwinning father. Last year, Basic Needs opened a village school near the capital of Dhaka for 35 students, and this year admitted 25 more. The building contains four classrooms, a medical clinic and a room to house orphans. Hubbard, 24, is working with VCU School of Medicine faculty to promote independent student research projects in Bangladesh that would involve health care work.
He first visited Dhaka to perform public health research as an undergraduate student at the University of the South in Tennessee. In the streets, he encountered a severely malnourished 12- to 18-month-old child. At 7 pounds, she was too weak to blink or cry. Hubbard took her to a malnutrition ward, paid for her care and learned how her fatherless family struggled to survive.
That led him to found the Basic Needs Program, which assists the desperately poor in and around Dhaka with housing, clothing, food, education and medical care. Through lectures, news stories and groups inspired by Hubbard's acts, Basic Needs has collected about $75,000.
"People ask me why I started Basic Needs. It was given to me," says Hubbard. "It makes me a more rich and fulfilled person by showing me what's important and what's not important at all."
In July, after taking the imposing Step 1 medical board examination, Hubbard will revisit Bangladesh. —MJS
A Great Need
Psychiatrist treats patients with few options for mental health care
For Dr. Christopher Kogut, providing mental health care at the Fan Free Clinic means "fulfilling a need that is not served through normal channels." Kogut had volunteered at community clinics as a medical student, and after becoming a psychiatrist, he says, "I wanted to get back to it."
The clinic relies on volunteers to fulfill its mission of providing medical treatment to people in the Richmond area with limited access to care. Kogut, a former Fairfax County resident who joined the faculty at the VCU School of Medicine two years ago, is one of two psychiatrists whose expertise in medication management is invaluable at the clinic. He has volunteered there two evenings a month for more than a year.
Kogut, also a master's-level social worker, sees a huge need for mental health care. "One-quarter of people will experience depression at some point in their life," he says.
Medication can treat depression caused by biological factors. Depression also can be brought on by all kinds of stressors, among them "not having insurance, or working but not being paid well enough to get care," Kogut says.
An estimated 70 percent to 80 percent of patients served by free clinics experience depression, says Karen Legato, executive director of the Fan Free Clinic (fan freeclinic.org). That means perhaps 1,800 of the 2,400 medical patients the clinic expects to serve this year (with patient visits estimated at 7,000) could benefit from mental health services.
"We have more than 600 clients with HIV that we service who have chronic illness, are isolated and face all the other life barriers that come with that," Legato says.
HIV patients were Kogut's special interest during a post-residency fellowship at VCU in consultation-liaison psychiatry, which treats people with medical as well as psychological illnesses. "I enjoy working with them to provide comprehensive care," he says.
"There are so few places you can send people for mental health services who don't have access," Legato says. "We literally have only one other psychiatrist. Without them, we'd have to put the whole thing on hold. We couldn't do what we do without people like Chris Kogut. Patients adore him. If we could clone him, that would be ideal."
One of a dozen volunteer counselors at the Fan Free Clinic, Victoria Menzies, says she relies on clinical notes for continuity of care. "Because Dr. Kogut volunteers there, I'm comfortable volunteering there."
Kogut says the clinic makes volunteering easy to do. "I have this neat opportunity to work for an organization I have a lot of respect for, while serving a need by providing access to care." —MJS