- [Narrator] Support for this program is provided by the Weldon F. Osborne Foundation, the Schillhahn-Husky Foundation and viewers like you.

Thank you.

- On today's show, (upbeat music) we'll learn more about two impactful non-profits in our area.

One offers hope to families affected by birth defects.

The other provides medical services for uninsured patients.

We are stronger together, Chattanooga, so stay with us to learn more.

(upbeat music) Welcome to Chattanooga: Stronger Together.

I'm Barbara Marter.

In 1963, the Walter E. Boehm Birth Defects Center was established by Dr. Walter Boehm, a Chattanooga neural surgeon, who recognized a need to treat children born with birth defects.

Today, the nonprofit organization located at Children's Hospital on Erlanger's Campus offers medical, financial, and social services to families across the region.

Elizabeth Myers is executive director, and we are pleased to have her with us today.

Elizabeth, thank you for joining us today.

So tell me a little bit about the Walter E. Boehm Medical Center, and what is it that you do there?

- Like you mentioned, the center was founded in 1963 by a local neurosurgeon, Walter Boehm, who saw that there was a great need for treating patients with birth defects of the brain and spine in a very focused, organized, and coordinated way so that we were providing care throughout their lifetime from birth to death.

And that we were also supporting their families, and their entire caregiving systems.

- So I had read somewhere that we are now working with a third generation of the Boehm family?

- That's correct.

So as of today, third generation neurosurgeon, who volunteers weekly in our medical clinic, Dr. Peter Boehm Jr. is now directing the center.

So the center's mission is to make a difference in the lives of people born with birth defects.

And we implement this by providing a medical case management program that addresses not just the medical care, but also financial assistance and psychosocial assistance.

So Dr. Peter Boehm Jr. volunteers once a week to see our patients in some clinical space donated by Children's Hospital at Erlanger, and we see about 10 to 12 patients on a weekly basis, regardless of insurance.

- Wow.

That's amazing.

- Yeah.

It's great.

- So when you talk about the birth defects, evidently there's just a couple of birth defects that you focus mainly on.

Can you talk about that?

- Yeah, so we are specifically treating patients with neural tube defects and those are birth defects of the brain and spinal column.

The two primary birth defects we're seeing in our center right now are spina bifida, which is caused by a malformation on the spine where it doesn't close properly during birth.

And also hydrocephalus, which is a big word, but it really just means water on the brain.

And it happens with about 90% of patients that have spina bifida, but it also occurs as a result of premature birth and trauma that's happening during birth.

- Hmm, wow.

So, not every spina bifida has the hydrocephalus, (laughs) but every hydrocephalus is part of the spina bifida.

Is that correct?

- Well, actually hydrocephalus can be caused by various factors.

One of them is when a patient has spina bifida, or is diagnosed with something congenitally.

Also during birth, you can develop hydrocephalus if there's a brain bleed or other sort of trauma.

And what we're seeing in today's world, and what the center is treating primarily is hydrocephalus because babies are being born at a younger age, and they're surviving.

And what we are doing is we will eventually meet with the patient once they're stabilized in the NICU, and we will monitor the growth of the water on the brain.

And typically what happens is Dr. Boehm will go in, and eventually have to insert what we call a shunt.

I actually brought one with me today.

It's really kind of fascinating.

So a shunt is really about the size of an iPhone charger, and what it does is it goes inside to the ventricles of the brain and then underneath the skin, and generally the tubing coils into the stomach, and it drains the fluid out of the brain.

Our medical case management program in the medical clinic that we provide weekly for our patients is primarily monitoring to make sure that this device is not malfunctioning.

It's a man-made device.

It could get clogged with particles in the cerebral spinal fluid.

It can get kinked up as a patient goes through a growth spurt, and sometimes their tubing gets too tight.

And they'll develop an infection or it's painful.

So we are getting imaging, x-rays, MRIs of the head, the stomach, and monitoring very closely.

So depending on how old the patient is, will determine how often they come to the clinic to make sure nothing is going on.

- Okay, so a patient that has the stint in there, might come, what, every six months, or they're on a rotation plan, aren't they?

- That's correct.

- Okay.

- So if a baby is born with this and we're following them, it's very similar to how you go to your pediatrician.

Initially every two weeks and then a month out, six months, and then annually.

And we follow a very similar schedule.

What happens is if something, if a patient requires surgery, which most patients do, we will then change the plan.

The care plan will then start over and say, we're gonna see you two weeks post-op, and make sure there's no infection, or no further complications.

- So how many surgeries would a baby child have during this whole period?

I mean, how long does the shunt last?

Is it up to a certain age?

- That's a really good question.

And it varies.

- Okay.

- It varies by the brand of shunt.

But what we have found is that some patients can have 46 surgeries by the time they're 18, and that's 46 invasive brain surgeries, which is very scary for families.

We can also have some of our older patients who had a different kind of shunt, called a Hakim shunt.

They are in their forties and fifties, and we're just now seeing them start to have shunt malfunctions.

So it really varies, but we do have patients that have multiple invasive surgeries.

And we are here for the patients, and their families to support them through that scary time.

So.

- So, these mature adults that are in their forties and fifties, that have these shunts.

These are shunts that they received when they were born.

- Correct.

- So they've had them in their head all of this time.

- That's correct.

- That's amazing.

- It is amazing.

- I would never in my wildest dreams have thought that you would have to live with something like that because your body doesn't have the capability of expunging that liquid, or moisture, or water from the brain, and it needs the shunt to do it.

- Typically, yes.

Now, we will follow children until three years of age.

If they have been diagnosed with hydrocephalus.

If it looks like the body is able to naturally absorb it, we won't do any medical or surgical intervention, but typically a shunt will need to be installed.

And we don't typically take them out because that's more traumatic than leaving it in.

We do have some patients who the body will reject the shunt if it's in the stomach cavity.

And so we'll go in and the doctors will put a separate shunt in, and it'll drain out into the heart cavity.

Just depending on each- Each patient's body is very different.

So we've seen all sorts of situations with shunts, but typically they don't come out.

- So tell me a little bit about, explain a little bit in more detail, spina bifida to me.

- Sure.

Spinal bifida requires a different medical intervention.

It's located somewhere on the spine, anywhere on the spinal canal.

And it's an opening on the spine that either is fully open or covered with skin.

And our doctors go in at birth and they close it up.

Many of our patients with spina bifida are unable to walk.

So they are in wheelchairs or they have walkers, and the center helps cover some of those costs because they're very expensive.

We have other patients like my friend, Martin, who has spina bifida, but is able to ambulate.

And that's because his opening was in a different spot, higher up on his spine.

Martin is one of our success stories.

I love to talk about him just because he's had so many different things going on.

He not only has hydrocephalus, but he does have spina bifida.

And even though he is able to ambulate, he does have trouble.

And so there are a lot of orthopedic issues that come along with our patients with spina bifida, and part of what the bone center does is coordinate the medical care to other subspecialties in the community.

They'll need physical therapy.

A lot of times they'll need speech therapy, and occupational therapy because they are immobile in certain ways.

Martin successfully completed the bone center program, actually graduating from high school, and just now graduating from nursing school.

And I believe he just got engaged.

So we keep in touch, yes.

- That is such a wonderful success story.

- Yes, it is.

It's wonderful.

- And I bet when you do have success stories like that, you do celebrate them.

- Oh, we totally do.

- You don't see that many of them, but when you do, I bet they are very special.

- They are.

Martin, he's gone on to really advocate for patients.

He became part of our program when he was still in high school and would volunteer in the clinic, and just give advice on talking to patients that needed similar surgeries that he had already had.

And he would just kind of walk them through it.

And it was good to hear from a patient's perspective.

- Well, I'm glad that you mentioned volunteers because is there an opportunity for our viewers to volunteer?

I know it's very specialized what you do, but are there opportunities to volunteer?

- There are.

We have a couple of opportunities and ways to get involved.

Throughout the year, we have a lot of fundraising events, and we love to have anyone in the community come help with those.

They are all throughout the year.

And more information about that can be found on our website at www.boehmbdc.com.

Also on there is information about becoming part of the volunteen program, which is a summer program for teenagers or high schoolers.

And you do have to go through the Erlanger's training program, but it's a great way to do an internship, and to get inside the hospital and back behind the scenes and meet the patients.

And also learn more about what we do.

- Great.

Thank you so much for coming in today, Elizabeth.

Up next, we'll have Joel Henderson, executive director of Volunteers in Medicine.

Stay tuned.

(upbeat music) We want to know how you serve your community.

Send us photos or videos of you or your family volunteering.

And we might feature it on a future episode.

Email stronger@wtcitv.org, or use the #StrongerWTCI on social media.

Welcome back.

I'm here with Joel Henderson, executive director of Volunteers in Medicine.

Volunteers in Medicine is a primary care clinic staffed by volunteer providers, including medical physicians and nurses.

They provide free medical services to financially eligible adults who are uninsured.

Joel, thank you for being with us today.

So for our viewers, kind of tell me what is Volunteers in Medicine and how did it get started?

- Sure, and thank you so much for this opportunity to share our story.

Volunteers in Medicine here in Chattanooga began 16 years ago from intentional community leaders, physicians, churches, came together based on a need, Matthew 25: serving those in the greatest of need.

And that's what we do to provide medical care for the uninsured.

- That sounds great.

So when it says volunteers in medicine, I assume those are your providers that are volunteers?

Your doctors, nurses, and things like that.

Kind of elaborate on that, please.

- Sure, so our model was built completely on volunteers and a very small staff, which we still have.

There's five of us who were on staff, over 85 volunteers.

The model originally was semi retired and retired providers, but that model has changed now where we have younger folks who are working in local hospitals and clinics similar to ours.

And then they give their time at our clinic to provide the care for our patients.

- So who's the doctor that's over there now?

- Sure, so I have to give, when I think of our medical director, I always think about Dr. Bob Bowers.

He was at the original table, the visioning process.

And then last year, Dr. Mitchell Mutter stepped into the role as medical director.

So the torch never hit the floor.

Those two champions have been working side-by-side.

Dr. Bowers still see patients almost every Monday in our clinic, and then Dr.

Mutter both, once again, as volunteers continues to be our medical director lead.

- Oh, that's amazing.

So let's talk about what services do you provide?

- Sure, so when you think of primary care, and hopefully many of the folks who are watching this have insurance coverage.

Think about those folks who possibly haven't seen physicians in many years because they don't have a medical home or primary care physician.

So it's that preventive.

Unless you're very, very sick.

I think about diabetes is one of the top folks that come to us diagnosis.

And once they get that balanced, that's that health maintenance.

I use that as one example.

So health maintenance is a part of primary care, acute care, preventative, and those types of services.

- Now let's say if I was a diabetic, and I came in and you determined I was a diabetic, what about my insulin or any of the medicines that I would need.

How do you go about doing providing those?

- Sure, and that's very much thought through.

So you come in there, you're not sure what's wrong.

You find out you have diabetes, now what?

We're very blessed to have a prescription assistance program where we help those individuals on that continuity of care, get that health maintenance that they need for their medications.

- And so what if I come in and you really find that I have something very serious.

Is there a referral to other providers that would step up and do pro bono?

Or how does that work?

- Absolutely, and we partner, I call them our cousins, with many community partners in the health industry.

But Project Access through the medical study in Chattanooga, a daily communication with those folks for that exact reason.

If folks come to us for primary care, and we needed a specialist, we refer them for specialty care.

We also partner with them and Memorial Hospital for labs.

We get our full labs done as a patient in our facility.

X-ray services.

I mean, you name it.

Full service at our clinic.

- Wow.

So I noticed that you do health education too?

- We do.

When you think about that, that preventative, holistic, that quality of life.

That's so important with once you've been diagnosed.

I keep going back to diabetes.

Now, what does that mean for the rest of your life?

And how to have that education.

And we provide that for folks.

- Oh, that's great.

And the other one was physical therapy, I think I read about.

- Sure, and right now during COVID, the physical therapy is not done as much.

Our goal is to get that line back up.

We're getting so close.

COVID has been many challenges for many organizations, and definitely in healthcare.

- What does physical therapy look like though?

- Sure, so if folks are coming in, that's part of, depending on what their diagnosis is.

Of how they're kind of being that preventive healthcare.

- So what are your hours of operation and the days?

I don't think you're open for the full week, are you?

- Sure, so once again going back to COVID.

We are currently operating Monday through Wednesday, nine to four.

And since our doors opened, I don't think I touched on that, but we have seen over 75,000 patients.

So right now we're continuing to do the best we can to see those patients that are coming to us with that volunteer model.

- You have such a passion in your voice, and talking about Volunteers in Medicine.

And you haven't really been there that long as the executive director.

What brought you over to Volunteers in Medicine?

- Sure, so coming once again, as from a volunteer, I come from the Project Access.

I've referred earlier side.

Many years volunteering and having a special passion, and working with now at Volunteers in Medicine.

For those folks who I see, my parents were small business owners.

And I see how people can struggle if good working folks who may not have healthcare insurance for themselves, you have one crisis that hits you.

You think that you have things that are balanced, and you can be financially devastated.

That's a real cost.

You can go in, it's one thing folks may not realize, you go into a hospital setting, and you walk out with thousands of dollars.

That's the reality of the cost of healthcare.

Did that help?

- It does because you talk about those insured versus those uninsured.

I'm thankfully insured, Medicare.

But in 2015, I had a major heart attack, and I've got two stints in my heart.

I walked out after 24 hours owing over $58,000.

I mean, that was the bill.

- Sure.

- Thankfully insurance took care of it.

But I can't imagine those people that are uninsured, that what do they do?

Where do they go?

How do they get the help?

So do you know how many uninsured we have in the community?

- Well, I look at that and I go back to the need that we have.

Having seen over 75,000 patients since we opened our doors, that need continues to obviously be there.

And the folks that we're continuing to see weekly that come into the clinic.

If I can touch on that to make it very impactful, what those costs are that you were also talking about earlier.

- Yeah.

- So we're talking with Volunteers in Medicine, those clinic rates would have been over $25 million for those 75,000 patients.

And for if they'd gone into like an emergency room department setting, it'd been over $110 million.

Those are real costs.

Now those costs obviously are deferred to us.

We make it work.

But those costs for our clinic, that would be $7 million for those 75,000 patient visits.

And I think that, I know those are numbers, but it really helps to kind of people understand the ripple effect of the cost of medicine.

Now, as I referred to earlier, once patients go through our eligibility criteria, they never receive a bill.

All the care they receive is absolutely free.

- Joel, share with me and our audience.

So what is the age group of your clients that come in?

- We serve adult, which is age 19 to 64.

And we also help with transitions.

So if you're turning 65, we don't throw you on the street.

We help you transition into that referral of what is next for the remainder of your quality of life.

- And so at 65, they could actually sign up for Medicare if they've had employment in the past, correct?

- And other programs that we help them with with our screening process and our case managers.

- Okay.

That's great.

And then also, how wide is your network, your counties that you serve?

Do you see your clients coming in?

- That's a great question.

We are located over by the East State Mall area, right by the public library.

However, we see, being so close to the state line.

We help folks from Georgia, we help folks from boundary counties, and they're not turned away.

We continue to provide the best care to be their medical home for primary care.

It does get a little challenging, but we're working through that together.

When we talked earlier about needing that referral for specialty care.

The need is great in our community, but at least we can provide the primary care services right here based in Hamilton County.

- So from last year, and then this year, have you seen an increase in the number of calls coming in because of homelessness, or people losing their jobs, or losing their insurance coverage?

Have you seen an increase in the number of calls coming in asking, "Can you help?

What services do you provide?"

- Absolutely.

The need is definitely there.

We have the capacity.

There's confusion in our community about are we continuing to see new patients?

Absolutely.

We are open.

We are accepting new patients.

The need is there.

But being a volunteer based organization, that's where it gets a little interesting.

Going back to once again with COVID.

Trying to make sure we have enough of those providers, which is what, hopefully talk about volunteer opportunities, we have those.

With the patients that are coming in, and getting scheduled and seen for their care.

- So you really do need a lot of volunteers, and they don't necessarily to have a special skill or anything.

They could actually come in and maybe do some office work, or maybe sit with and talk to an older patient.

Maybe calm them down or help with some paperwork.

Some areas like that, that they could volunteer in?

- Absolutely, besides many times people think, "Oh, well, I'm not a physician or a nurse practitioner."

Or what have you.

But we have areas in the office for, especially with getting back to that new normal, for greeters.

We have screenings we need help with, for folks par the eligibility criteria process.

Also just the day to day in an office.

Those are all things we run very lean with good stewardship dollars, being a faith partner in our community, a health ministry partner.

We're making sure that we have a place, also a prayer.

We're open to churches.

We're interfaith for churches to be a part of that engagement, besides passing the offering plate.

And we appreciate that support, but being engaged in having that time for prayer.

That's very important.

- So in this last few seconds that we have to wrap up, how can people reach out to Volunteers in Medicine.

Your website?

How can they find out about volunteer opportunities?

- Well, there's a ton of information and resources on vim-chatt.org, and that's our website.

And they'll receive all the information, including the address, the phone number, all that's on there, if they can just go there.

And we'll try to help them in their path for that next quality of life.

- Joel, thank you so much for coming in today and sharing with us and our viewers, all that Volunteers in Medicine does.

And I do encourage people that if they have a heart, and are passionate and want to start volunteering.

To check your website out and to reach out to you guys, and just come and sit with somebody, and just help them with some paperwork, or just pray with them or just be a friend with them.

So thank you so much for coming in today.

- Thank you.

- And thank you for spending some time with us today.

We hope that Chattanooga: Stronger Together serves as a trusted source of information for viewers like you, who are looking to make a difference in our community.

So let us know what you think.

Email us at stronger@wtcitv.org, or use the #StrongerWTCI on social media.

I'm Barbara Marter.

We'll see you next time.

(upbeat music) - [Narrator] Get access to even more of the shows you love with WTCI Passport on the PBS video app.

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Thank you.