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The DO | Patient Care | In the Field

Hero Next Door: With whole patient in mind, W.Va. DO seeks to reinvent a city

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C. Donovan Beckett, DO, helps construct an arbor for the new Williamson, W.Va., community garden. As the chairman of the Williamson Redevelopment Authority, Dr. Beckett has overseen several city-enriching projects.

This article is part of a series, The Hero Next Door, on osteopathic physicians who are quietly transforming health care in their communities and beyond.

Deep in the foothills of the Appalachian Mountains lies Mingo County, W.Va. Many of the county’s roughly 26,000 residents struggle with both their health and their livelihoods.

The county has the second-highest hypertension rate in the state at almost 42% and the fourth-highest obesity rate at 37%, according to the state Health and Human Services Department. But those who live there are often preoccupied with more pressing issues than their health. In 2012, the county’s poverty rate was more than 23%.

In the heart of coal-mining country, many of the county’s dwellers lost their jobs following mine closures and cutbacks. The area is struggling to find a new identity, to diversify beyond a coal-based economy.

Enter C. Donovan Beckett, DO. Born and raised in Williamson, W.Va., the Mingo County seat, Dr. Beckett left the area for medical school and returned 10 years ago. After establishing a private family medicine practice, he saw firsthand the residents’ struggles and wanted to make Williamson a healthier, more developed city.

In 2005, he became the chairman of the Williamson Redevelopment Authority (WRA). Under his leadership, the organization has overseen downtown revitalization, the creation of a community garden and a farmers market, monthly 5K runs and a lunch walk program.

Anne Warum Lambright, a commissioner with the WRA, says Dr. Beckett’s drive stems from a desire to help his patients on a deeper level.

Sanger

“[Dr. Beckett] has really gone above and beyond as a private physician to try to help people who don’t have health insurance.”
Sanger

“Dr. Beckett is looking at the future of families in Williamson,” she says. “He doesn’t just think in terms of their physical health. He’s also concerned about their emotional and economical health. He looks beyond his day-to-day patient work.”

The new programs are starting to transform the city, Dr. Beckett says.

“We live in an area where you didn’t see a lot of physical activity,” he says. “But now I see people running everywhere—on the sidewalks, on the side of the four-lane highway that goes through Williamson. The programs have really encouraged a lot of activity.”

People who felt their health was the least of their concerns have started getting fit because of Dr. Beckett, says Robin Sanger, a nurse practitioner with Dr. Beckett’s practice.

“Dr. Beckett brings a lot of ideas to to the community, such as the farmers market and the community garden,” she says. “People are often thinking more about their job loss and how they’re going to put food on the table, but he has them also considering their exercise, their diet and eating the right kinds of foods for their health.”

Osteopathic roots

Dr. Beckett’s thirst for revitalization and community health in his hometown is rooted in his osteopathic background. He graduated from the West Virginia School of Osteopathic Medicine in Lewisburg in 2000, where the concept of treating the whole patient became one of his core values.

“Holistic medicine is what osteopathic physicians do,” he says. “And when you want to transform a community, you have to consider not only the physical structures but also the types of food available and the types of economic development available. We want to create a sustainable economy as well as sustainable lifestyles. This is a holistic approach to community development.”

Dr. Beckett’s interest in city improvement was sparked in 2004 when he bought a few apartment buildings in downtown Williamson. He leased space to local businesses on the buildings’ lower floors such as a coffee shop, a restaurant and a tour group, which helped rejuvenate the city center. This made him wonder what else could be done to revive the area. He joined the WRA, and the organization applied for and received a $370,000 transportation revitalization grant from the state, which was used to upgrade downtown sidewalks, crosswalks and the city entranceway.

Afterward, Dr. Beckett thought more about what the residents of Williamson and Mingo County truly needed. He examined their demographics.

“We had such high rates of obesity and hypertension that my focus started to change,” he says. “I thought that if we were going to improve all these physical structures, we needed to try to improve our physical well-being as well.”

Much of Mingo County is a “food desert,” Dr. Beckett notes. The county has only has one grocery store, and it’s 30 miles outside of Williamson. To increase access to fresh fruits and vegetables in the city, the WRA developed a farmers market and a community garden.

The weekly farmers market, where residents sell tomatoes, corn, zucchini and more, earned roughly $65,000 last year, Dr. Beckett says, so it not only helps residents get healthful food but also enables them to earn money. Some people sell the food they grow in the community garden at the farmers market. The WRA began renting plots at its new community garden on the east end of town for $2 per season last year, Dr. Beckett says.

“The community garden creates a full-circle scenario,” he says. “Folks get out of their apartment, get physical activity, eat better and also develop entrepreneurial spirit as well.”

To encourage even more physical activity, the WRA’s diabetes coalition began sponsoring a lunch walk program and monthly 5K runs. Both programs started relatively recently but have generated much interest in the community, Dr. Beckett says.

“We’ve been doing 5K runs for a year and a half. The first one had fewer than 25 participants,” he says. “And we just had one on Saturday night in downtown Williamson that had 384 participants. They’ve grown so much.”

The lunch walk program grew beyond Dr. Beckett’s expectations as well. In the program, teams of coworkers in tens from local companies and businesses wear pedometers and calculate their steps as a team. They then track their progress on a U.S. map—some teams have walked from West Virginia to California and halfway back across the country, Dr. Beckett says.

Helping patients

Dr. Beckett also tackles community improvement in his work as a physician. His practice, Comprehensive Health Solutions, began operating a free clinic on Fridays two years ago, though Dr. Beckett now takes free patients and those who pay on a sliding scale throughout the week. And the city of Williamson, at Dr. Beckett’s suggestion, is applying to operate a federally qualified health clinic to help serve more of the area’s Medicaid and Medicare patients who are having trouble finding a physician.

With Dr. Beckett’s persistence, the practice’s free clinic has made a dramatic difference in the lives of uninsured patients, says Robin Sanger, a nurse practitioner with the practice.

“In addition to seeing patients for free, Dr. Beckett helps people who can’t afford to have their bloodwork done get their labs at a very reduced cost,” she says. “Then we are able to tell whether their thyroid is off, what their glucose is, and what their cholesterol is. He has really gone above and beyond as a private physician to try to help people who don’t have health insurance.”

Nearly 13% of the residents of Mingo County have diabetes, a stark jump from the national average of 8.3%, according to the American Diabetes Association and the West Virginia Health and Human Services Department. Dr. Beckett has helped enact two initiatives to control and prevent the disease and educate residents—a Diabetes Education Center (DEC) at Williamson Memorial Hospital and the WRA’s Mingo County Diabetes Coalition. Started in 2009, the DEC runs a class physicians can refer their patients to. In the classes, patients work with diabetic educators, nurse practitioners and nutritionists to learn how to better manage the disease and adopt healthier eating and exercise habits.

More than 400 patients have matriculated through the DEC, Dr. Beckett says, and patients show an average drop of 2.1% of their hemoglobin A1c. A sustained A1c drop of 2.1% can significantly reduce one’s chance of suffering from diabetes-related stroke, renal failure and amputations. So these efforts greatly reduce health care costs as well, he notes.

And even more patients are poised to control their diabetes through the work of the Mingo County Diabetes Coalition, which formed in 2011 and focuses on diabetes education and prevention efforts.

In 2012, the coalition received a three-year, $2.2 million grant from the Centers for Medicaid & Medicare Services as well as a $40,000 grant from a pharmaceutical company. The organization is using the money to hire patient navigators to visit diabetic patients at home to evaluate their medications, show them how to use medications and insulin and counsel them on lifestyle changes.

“The weekly interaction that we have with the patients keeps them on track,” says Vicki Hatfield, a nurse practitioner and the coalition’s lead researcher. “We’re seeing people learn to eat better. They’re seeing the benefits of exercise. They’re seeing how their medications work better.”

As an example of how the program helps patients, Dr. Beckett cites one of his own. A nurse at his practice had shown this patient how to use insulin, but her blood sugar was still very high when she returned to the office. Dr. Beckett suspected that the patient needed further help using insulin, so he sent a patient navigator to the woman’s home.

“The navigator saw that when the patient was injecting the insulin, she was leaving the hub on the needle,” Dr. Beckett says. “So when she would try to inject the insulin, it was spraying out on her stomach. The navigator was able to identify the problem and properly instruct the patient on how she should be using the insulin. And now she’s perfectly controlled.”

The CMS grant covers three years of diabetes education and programs, Hatfield notes, and early results suggest the program will provide a significant improvement in diabetes management across the county.

Results are also on Dr. Beckett’s mind—with the rapid expansion of many of the community health programs he helped enact, he hopes to see measurable reductions in the county’s sky-high heart disease, obesity and diabetes rates.

“Our goal when we set out with all these programs was to eventually look at the data and see the needle move in the opposite direction,” he says. “That’s when we’ll have some satisfaction from seeing the fruits of our labor in terms of putting all these groups together to try to have a healthy impact on the area.”

But Dr. Beckett’s colleagues say his work has already noticeably changed Williamson and Mingo County.

“Williamson was a pretty depressed town until Dr. Beckett and some others came here and got these projects started,” says Lambright. “Dr. Beckett has changed people’s attitudes.”

rraymond@osteopathic.org

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