Editor's Corner

Blending advantages of academic and community practices

by Tommy Leonard, Jr., M.D.
Associate Professor of Pediatrics–Neonatology
Medical Director of Nurseries, Twelve Oaks Medical Center–Sharpstown

The Neonatology Section of Baylor College of Medicine (BCM) and Texas Children’s Hospital has undertaken a joint venture at four community hospitals. This enterprise is designed to improve the immediate care of sick newborns, to facilitate stabilization and transportation to a higher level of care for the sickest infants, and to create another venue to educate third and fourth-year medical students in the health care of newborns.

BCM neonatologists and pediatricians at these community hospitals are full-time faculty members of the Baylor College of Medicine Department of Pediatrics and Section of Neonatology. Their responsibility is to identify the medical needs, including having appropriately trained nurses and proper equipment available, and to assure creation of the optimum environment to achieve timely stabilization and care of ill newborns.

If a critically ill newborn infant requires a higher level of care, preparations and advance communications are paramount. Once stabilization is achieved, a route of evacuation should already be in place. The beauty of our system is the constant communications that exist with colleagues at Texas Children’s in the Texas Medical Center and their knowledge of the community hospitals’ medical capabilities. Thus, the quality and level of support provided is enhanced. Because of the advance administrative preparation, a Texas Children’s transport team activates within 30 minutes of first contact. Such smooth coordination occurs only in an environment where lines of communication were established before the urgent need for support arises.

Baylor College of Medicine, Texas Children’s Hospital, and other institutions involved in the community hospitals neonatology program have had the foresight to include an education component in this collaboration. Thus, our youngest physicians can appreciate the constraints and challenges that exist for community hospitals in providing first-class medical care and in creating institutions that are fiscally responsible.

The BCM community hospital physicians also have rotations at the Baylor-affiliated hospitals in the Texas Medical Center, providing the unique confluence of the private practice mentality with the research and education focus of academic medicine.