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VA clinic evolving, growing
Veterans like telehealth, but welcome onsite doctor
043015 VA CLINIC 01
U.S. Army veteran David McDaniel, 56, is attended to by Statesboro VA Clinic registered nurse Lara Birdsong while participating in a telehealth checkup with Dr. Kumud Smith at the VA in Augusta. - photo by SCOTT BRYANT/staff

Open two years and two months as a “telehealth” clinic, the Statesboro VA Clinic on Northside Drive is now transitioning to have a full-time doctor see veterans in person for primary care.
David McDaniel’s recent checkup on his 56th birthday illustrates how the clinic has worked until now.
First, there was a check-in at the window in the waiting room, as at any doctor’s office. Next, Lara Birdsong, RN, who knows McDaniel well from past visits, greeted him warmly.
When it was time to see and be seen by the doctor, McDaniel sat on an exam cot in front of an equipment cart where a high-resolution camera with a special zoom lens gazed back at him from atop a video monitor.
From her office at the Charlie Norwood VA Medical Center in Augusta, Dr. Kumud Smith appeared, smiling, on one of the two screens.
“So, I saw you back in November,” she said. “I see you’ve had a couple of things happen since then.”
McDaniel has some chronic health issues, including diabetes and high blood pressure controlled with medication. Now a truck driver whose home is in Sylvania, he served in the Army seven years as a cook, at Fort Stewart and Fort Knox and a NATO base in the Netherlands before his discharge in the mid-1980s.
Face-to-face but never closer than the screen, the doctor asked him how often he takes his medicines and discussed information from a blood test done prior to the visit. She also congratulated him on his recent loss of 15 pounds.
The doctor laughed when McDaniel joked about how hard he was working while on vacation.
Birdsong, meanwhile, held the stethoscope to McDaniel’s chest and back, allowing Dr. Smith to listen to her patient’s heart and lungs.
Like several other veterans interviewed for this story, McDaniel said he likes Dr. Kumud Smith’s friendly manner and the way the clinic has worked for the past two years. But the veterans don’t object to the clinic getting a full-time doctor.
“They should have one,” McDaniel said. “Even though this is nice and I like it, seeing the actual doctor in face and hand you know where you’re both coming from, and the visual and touch is a lot better.”

A small clinic
Until now, the Statesboro clinic’s in-house staff has consisted of two registered nurses, one licensed practical nurse, an administrative person at the front desk and a contract security officer. The clinic shares the leased professional building with an unrelated private medical practice.
Besides Dr. Kumud Smith, Statesboro VA Clinic patients are seen remotely, over the telemedicine setup, by a family nurse practitioner, Lorena Giron.
Contacted for the clinic’s second anniversary, officials at the VA Medical Center in Augusta revealed that the Statesboro clinic would be undergoing a transition.
The Charlie Norwood VA Medical Center is one of the 152 medical centers operated by the U.S. Department of Veterans Affairs, popularly known as “the VA.” The VA also has about 1,400 other health facilities, listed at
The Statesboro clinic is one of three that the Charlie Norwood Center oversees outside Augusta. The clinics in Aiken, S.C., and Athens, Ga., were already full Community-Based Outpatient Clinics, or CBOCs.

Transitioning now
Christened as a telehealth clinic in March 2013, the Statesboro clinic had to build a patient base before officials judged it eligible for a full-time doctor.
But now, another Dr. Smith well known in the area, Dr. Emory Smith, has been hired by the VA to see patients at the clinic in person five days a week, said Dr. Charles Green, associate chief of staff for ambulatory care for the Augusta medical center and its clinics.
Green, along with Zenobia Boyd, business manager for the three clinics, and Pete Scovill, the medical center’s public affairs officer, visited the Statesboro clinic the day of McDaniel’s checkup.
About 1,000 veterans, Boyd said, regularly use the clinic’s services.
“We’ve got a thousand enrolled, and we see about eight to 10 a day, and that doesn’t include those who might just walk in and need care,” she said.
This week, Scovill confirmed that Dr. Emory Smith is scheduled to begin at the clinic Monday.
The change opens the clinic up to some veterans who were considered too seriously ill to receive primary care by telehealth.
“We will have a highly qualified internal medicine physician on-site here who will be able to assume the care of those more complicated patients and thus, I think, centralize care more toward Statesboro,” Green said.

Expected to grow
Green expects other veterans, now driving longer distances to see doctors at VA facilities such as a clinic in Hinesville, to try the clinic here.
“I think some of those patients will likely want their care up here in Statesboro, and then I think secondly, because of the veteran population that’s here, we’re going to see a rapid growth in this clinic,” he said.
He predicted that soon it will need more medical providers.
Meanwhile, Dr. Kumud Smith and Lorena Giron, FNP, are being reassigned to provide primary care in Augusta.
Statesboro’s telemedicine setup still will be used as backup for primary care, such as when the on-site doctor takes vacation, Green said.
The telehealth connection will continue in regular use for veterans who receive mental health services from a psychologist. A weight loss program also will continue to be offered via telehealth.
For now, the Statesboro clinic still is not a full Community-Based Outpatient Clinic, but has become more than a telehealth clinic.
“We fall into that ‘other’ category until we meet a certain number of primary-care and mental health visits,” Green said. “Then that starts the paperwork back up to give it the CBOC designation.”

Veterans fought for it
VFW Post 10825 and American Legion Dexter Allen Post 90 campaigned for the clinic for several years and won it with the help of U.S. Rep. John Barrow, the Democrat unseated by new Rep. Rick Allen, a Republican, in November’s election.
The Statesboro area veterans raised petitions and held meetings, but the request through VA channels stalled until Barrow intervened, recalled VFW Post 10825 Commander Jerry McCarthy.
“And we can honestly say if it wasn’t for his efforts we wouldn’t have gotten it,” McCarthy said.
He brought several Bulloch County veterans together at a coffee shop for an interview about the clinic’s anniversary.
Besides McCarthy, 73, who served as a jet mechanic supporting surveillance flights over Cuba and Vietnam in the early 1960s, the others were Marvin Grimm, 68, awarded the Purple Heart for a shrapnel wound received as a Navy medical corpsman in Vietnam; Mooney Prosser, 90, who fought as a Marine in the Pacific in World War II; and Mike Cox, 58, Army veteran of the 1991 Desert Storm campaign and Somalia.
All have used the clinic and said they like it, especially for the driving it saves to Augusta, about 80 miles each way.
“All of my experiences with the clinic have been absolutely the best,” said Prosser, who added that seeing a doctor on a screen hadn’t made much difference.
“She does a great job,” he said.
Cox described one visit in which the connection did not work at first and had to be rebooted twice. “Other than that, I like it,” he said. “I like the fact it’s here.” He called the staff friendly and knowledgeable.

Set own appointments
But Cox, who is trying to have his disability rating upgraded because of severe arthritis, also described his experience of getting an appointment for an exam. It took four months to receive a mailing with the appointment, which then was about two months later, he said.
“I’d like to see the clinic be able to set up their own schedule and make their own appointments without having to go through Augusta,” McCarthy said. “That would shorten up the time quite a bit.”
However, Boyd said the Statesboro clinic takes direct calls from veterans seeking appointments. She and Scovill said that with only one person to answer the phone, some calls may roll over to Augusta.
The clinic also receives some veterans with acute problems as walk-ins, but Green emphasized that appointments are much preferred.
Just walking in, he said, “takes away from the veteran who already has an appointment, and it’s really not fair to them.”
Al Hackle may be reached at (912) 489-9458.

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