There aren’t many doctors left in Bamberg. Those that remain are clustered around the old hospital. Since it closed four years ago, patients have had fewer options for care. Which means the doctors who stayed, like Danette McAlhaney are busy.
“There is seldom a time here when we are slow,” she said. ”We just stay busy all the time.”
When McAlhaney isn’t treating people herself, they are still coming to her office to have appointments with other doctors, who are hours away, through a television screen.
“It’s like skyping,” she explains. “They are there and you are here and you can see them and talk to them and they can see you and talk to you.”
McAlhaney offers the telehealth appointments because it is good for her patients, but it also because brings in some money. Each time a patient uses her office to connect she gets a fee of around $15.
“Let’s face it, I don’t get electricity for free and my staff doesn’t come to work for free,” she said. “I have to be aware of the bottom line.”
McAlhaney will also be the doctor on the other side of the screen if a kid at one of the public schools in Bamberg County gets sick. As a provider South Carolina Medicaid will reimburse her as if the patient was in her exam room. Between July 2015 and 2016 SC Medicaid reports it paid $1.17 million to providers who saw more than 4,000 different patients through telehealth appointments.
Kathy Schwarting with Palmetto Care Connections is looking to grow that number. The state telehealth network started in 2010 helps doctors, like McAlhaney, get services and equipment.
“We are based in Bamberg strategically because we focus on rural areas and improving access to care,” she said. “We felt we needed to be in the communities we are talking about.”
Private practices are increasingly using telehealth services. The Medical University of of South Carolina reports it has done 10 times as many virtual appointments last fiscal year as when it started the program in 2012. The bulk of those are with psychiatrists and nutritionists.
“No specialist is going to come to Bamberg. We are lucky to get primary care,” Schwarting said, “Telehealth is a means to bring care to patients where they are.”
Another rural town, 90 miles northeast, is in the same situation. Kingstree has few specialists and the only hospital in town recently closed as a result of water damage. It was flooded during October 2015 when heavy rains soaked most of the state. The town has a temporary modular emergency room and a temporary hospital is under construction.
Some doctors in Kingstree have also turned to computer to connect their patients. Gaye Douglas is the telehealth coordinator for Hope Health, a network of practices with multiple locations in the Pee Dee region.
She said the virtual appointments still make up a small portion of the practice’s business, but it’s proving to be convenient for patients.
“In the past two weeks we saved two families trips to Charleston because we did follow up visits without them having to travel,” Douglas said.
MUSC estimates telehealth connections with private practices have saved people from traveling more than 34,000 miles between April and June 2016. Douglas said while the system can be beneficial for doctors and patients in rural parts of South Carolina, she warns it augments in person care, it doesn’t replace it.