Category: Project Access Tarrant County

Growing into the future

by Kathryn Narumiya

This piece was originally published in the January/February 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

Isn’t it great when a business has more clients than they know what to do with? Of course! It’s a problem most business owners would beg for unless they are providing critical medical services to those in need. 

At Project Access Tarrant County, we are honored to have the opportunity to provide surgical treatments to our client base. While PATC can always use more volunteer general surgeons, gynecologists, and orthopedists, lack of volunteers is not the main issue. Many of you have eagerly and graciously given of your time and expertise to these patients. We are all grateful for your time and efforts. 

Unfortunately, the number of patients far exceeds the volume that Tarrant County hospital partners can provide on a charity basis.  For us, having clients on long wait lists or undergoing emergency surgery because PATC is unable to coordinate their surgeries is heartbreaking. We don’t want these outcomes to become normalized or acceptable. 

In 2020, we began working toward reducing our wait times. While progress has been slow, we have made significant strides in this direction. After considerable research into alternative services offered by peer organizations across the country, we have identified an opportunity to strengthen the number of patients we can serve through an additional lane to our current panel of services. To be clear, Project Access Tarrant County as it currently exists is not going away.

Introducing – Access Surgery Partnership. 
Based on Surgery on Sunday, a medical nonprofit organization in Lexington, Kentucky (www.surgeryonsunday.org), Access Surgery Partnership will host surgery days in a separately leased surgery center on a periodic basis on a day when the facility would traditionally be closed. The surgery center partner(s) will receive compensation for use of the facility. The surgery center staff will be comprised of teams of volunteer surgeons, nurses, and ancillary staff, both medical and non-medical.  The united surgery center staff will perform multiple outpatient surgeries and procedures in one day, effectively eliminating long surgery wait times. 

The traditional PATC model will still exist as we realize that not all procedures are appropriate for an outpatient setting, and not all physician volunteers will participate in the new model. We will still need our current hospital partners in order to serve our client base. 

We are not doing this alone. We are building a strong foundation for this new service line by collaborating with Brittain-Kalish Group and Dynamic Development Strategies to complete a proforma, business plan, timeline of milestones, and a long-term development plan. Several funders have shown interest in backing this initiative, and we are continuing to cultivate and update those parties as we progress. In fact, the Sid Richardson Foundation has singlehandedly funded the “discovery phase” of this project as we research and plan. 

A lot of work remains to be done with various challenges to overcome. Our primary and most imperative challenge is finding a surgery center partner. Additional challenges include recruiting volunteer medical non-physician staff and obtaining our own surgery center license. 

 This is where you come in. We need your help!

1. CONNECTIONS to Leaders!

    o Do you know leadership at a Tarrant County surgery center? 

 Please make an introduction to PATC!

2. Staff VOLUNTEERS! Talk to your medical staff about volunteering. 

3. STEP UP YOURSELF! If you have not been able to volunteer previously due to conflicts, this new model may be more conducive to your schedule.

      o Contact me and we can discuss options!

As other opportunities to help arise, we will let you know about them. We will also keep you apprised of our progress towards making Access Surgery Partnership a reality. With the Tarrant County Medical Society membership, we know we are well on our way. 

A patient’s perspective

by Daisy Ortiz with Kathryn Narumiya

This article was originally published in the September/October issue of the Tarrant County Physician. You can read find the full magazine here.

I will remember Project Access forever because not only did it save me, but it also helped my family.

I am twenty-eight years old. I have been married for seven years and I have a son and a daughter. Five years ago, I was diagnosed with rheumatoid arthritis. Doctors were shocked. They had never seen a patient my age with such severe rheumatoid arthritis. 

My condition has affected everything. It has been the cause of my depression. I felt like giving up on life. I could not be a mom or a wife. My husband would always see me sick and in pain. I could not take my kids to the park. My son would ask me to kick a ball with him, but I could not do simple things. 

It has been a major setback in my life. Since being diagnosed, I have had to quit three jobs because of my arthritis, especially in my knees.

This year has been hard because my pain has increased so much. It has been hard on me physically, emotionally, and mentally. One day, the pain was so unbearable that I went to the emergency room. After many tests, I was told that I needed an orthopedic surgeon. I knew that it was going to cost so much money. My husband told me that he did not care if he had to give up his whole paycheck for me to go to the doctor but that I was going to get the care I needed. That was when I started seeing Dr. David Brigati at Texas Bone and Joint. He immediately saw how bad my condition was and he told me he did not care what he had to do, that he was going to help me. He contacted Kathryn and that is when Project Access started helping me. 

Dr. Brigati performed my double knee replacement at Baylor Surgicare. My life has changed so much since the surgery. I am 70-80 percent better. I can walk and get around on my own now, which is a huge accomplishment for me. I can finally drive and get in my car. I have been able to take myself to the grocery store. This past Sunday, my family and I went to the zoo. It was a big milestone for us because I was able to walk and go up and down the stairs. My husband kept asking me if I was okay because he couldn’t believe how much I was able to walk at the zoo. 

Project Access also connected me to Baylor Community Care Clinic, where I have been seeing a therapist, and that has helped my mental health so much. The fact that I am now able to move freely and be more independent has helped me mentally. I feel so much better knowing that my family is not so concerned about me because they know I am improving day by day. 

I will remember Project Access forever because not only did it save me but it also helped my family.

I have been connected to a rheumatologist, and I plan on starting treatment soon. Eventually I hope to go back to work because I can finally walk. 

I want Dr. Brigati to know that I am forever grateful for him. He listened to me, understood me, and validated me. He did not just help me. He helped my husband, my kids, and my whole family. He helped me come back to life. I just want to say “thank you.” I do not have words to describe my appreciation. We need more doctors like him. 

For a long time, I dealt with so much pain that was contributed to my depression. It has been very hard for me to get healthcare. I just wanted to stop trying. I did not know there are resources out there that are willing to help. It’s amazing to me that there are organizations that want to help others. I have seen how much the surgery and physical therapy costs and I am so fortunate to not have to pay for these services. I am so grateful that PATC was able to help me. Diana and Kathryn were so helpful, and I am grateful for their patience. They have been a huge blessing in my life. I will remember this forever because not only did it save me, but it helped my family.

Moving Forward

By Kathryn Narumiya

This article was originally published in the July/August issue of the Tarrant County Physician. You can read find the full magazine here.

After nearly a decade under the leadership of Dr. Jim Cox (and during a pandemic, no less), Dr. Stuart Pickell joined Project Access Tarrant County as the new medical director. He reviewed his first patient chart in December 2020 and made the transition seamless. 

Dr. Pickell has long been involved in Tarrant County’s charitable network. He volunteered at Beautiful Feet (Christian Community Health Clinic) for over fifteen years and became involved with an informal gathering of clinic leadership, led by then-TCMS CEO Robin Sloane. In these meetings, attendees shared challenges and possible solutions regarding their patients’ barriers to care. Dr. Pickell says, “Access to specialists and surgeons was always at the top of the list.” As a member of the TCMS Board of Advisors and the current TCMS vice president, Dr. Pickell has stayed apprised and supportive of PATC’s activities over the past decade.

We are blessed with many gifted and generous physicians willing to donate their time and expertise to care for patients in need.  Our next hurdle is to build and expand collaborative relationships with the entities we need to allow those physicians to do just that. David Capper, MD, long-time PATC board member, says, “Stuart Pickell carries forth from the superb foundation of medical direction and immense respectability established by Dr Cox. He also enriches the position with practical insights that benefit both patients and clinicians.”

While he was not surprised, Dr. Pickell was pleased to learn the number of physicians who volunteer with PATC. Because of his history of volunteering in a primary care clinic setting, he was well aware of the barriers clinics face with accessing specialty care. He also knew that many specialists want to give back but do not feel they have a mechanism to utilize their area of expertise. This connection, Dr. Pickell believes, is where PATC shines. “By creating networks of charity clinics, specialists, and surgeons, supporting personnel and outpatient facilities specialists and surgeons can treat as many patients as they want in their own clinics on their own time.  It’s a win-win.”

Dr. Pickell recognizes the challenge that PATC faces in trying to provide care to as many patients as possible. “Leveraging the strength of many team members with unique skill sets and gifts, we can realize better outcomes for patients,” Dr. Pickell says. “Medical systems, which are the community’s greatest tangible resource for healthcare, value collaboration as well, but most of their energy is spent within their systems.  They may share common goals and understand the community value of bridging silos, but they continue to function independently, competing rather than cooperating with the other systems.” Dr. Pickell sees this as a critical area of growth to sustain PATC. 

When asked what his vision for PATC’s future is, Dr. Pickell says, “There are several priorities that I believe will help PATC continue to be strong and expand.  The first is financial sustainability.  Even though we offer charity care, there are still costs.  We seek to minimize these, but they are an ever-present reality.  The second is to expand networks – build a stronger team of partners willing to donate time, equipment, and facilities.  Finally, we need to expand the specialty services we can offer.  We already do well at this, but there is always room for improvement, and we still have needs in some specialties.”

“Fundamentally, my long-term vision is that Project Access Tarrant County would become a model for providing healthcare services to the underserved.  We need to expand on the excellent foundation that has been laid by Dr. Cox and his team and expand our network so that patients who need specialty services will be able to access them.”

Dr. Pickell is a welcome addition to PATC leadership. “I am a strong advocate for teamwork in healthcare, for collaboration, and for cooperation,” he says. “Project Access is about improving the healthcare of our most vulnerable residents through collaboration.  It seeks to create bridges between the silos in health care – the hospital systems, the physicians, the all-important ancillary staff – to improve the health of those who otherwise would be unable to afford it.  Project Access seeks the common ground of shared values, those things that unite us in our human condition.   This may be aspirational, but it is an aspiration worth striving for.”