Doctor Boosts Small Town's Health Care Access

Access to health care is often a tremendous problem for people who live in rural areas, especially the poor. Few get needed treatment for chronic illnesses. Now, a doctor in Georgia has created a specialty health care center with a clever economic set-up.

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If you live outside a city or a big town, you already know it's hard to find a doctor despite the real need. Listen to these figures. About a third of adults in rural areas in poor to fair health, nearly half with at least one major chronic illness. Now a doctor in Georgia has an idea.

Joshua Levs reports.

JOSHUA LEVS: When 62-year-old Willy Ellington(ph) in Eatonton, Georgia was diagnosed with prostate cancer a few years ago, he had to travel two hours each way to Atlanta for daily radiation treatments. And for him, like other poor people in similar situations, it meant a serious expense.

Mr. WILLY ELLINGTON (Eatonton, Georgia): We're talking 15 to $20 here a trip. I think about eight or nine week's debt.

LEVS: Now Ellington sees a urologist right near his house. Dr. Bob Cowles, creator of the Cowles Clinic that provides all sorts of specialty services. Cowles sees it as a case of supply and demand.

Dr. BOB COWLES (Creator, Cowles Clinic): Eighty-eight percent of the people who lived here got in their car and drove over an hour and a half to get their health care. Well, that's a need.

LEVS: The need is similar in other rural areas and there are reasons it's working here in Greensboro, Georgia along Lake Oconee. Cowles used to come out here with his family on weekends, taking a break from their busy life in Atlanta. He noticed that the area has a large wealthy population, perhaps big enough to support a clinic that would also serve the poor. It was his lifelong dream. It would mean starting off with his own urology practice here.

Dr. COWLES: If I didn't come out here and show people, doctors specifically, that they could make a good living out here, there's no way I could've referred them. So I was the guinea pig. I was the guy that had to jump off the cliff and go tell them, look, I did it, so can you.

LEVS: It worked. His first week, he saw 14 patients. He now sees more than a dozen an hour, though he pays himself less than he made his first year out of residency nearly 20 years ago. He has built a staff of 42 doctors, partly by letting them be part owners of the clinic, a sprawling campus on what was once just a dirt road.

Dr. COWLES: Two, three, four, five, six - we have six buildings right now, and one will be finished in two months and then we'll have five more buildings.

LEVS: Each building is like a villa that focuses on a different specialty. There's a cancer center, gynecological surgery, pain management - all with state-of-the-art equipment like a CAT scan machine shaped like a doughnut that Cowles says is the most technologically advanced one available.

Dr. COWLES: This is as good as it gets anywhere in the world, right out here in rural America.

LEVS: The clinic can afford this equipment because it's bringing in enough patients to use it.

Dr. COWLES: When you bring a large number of different specialties together you can maximize and get 100 percent utilization of all your technology.

LEVS: Cowles says the clinic is breaking even, even though it takes indigent patients with no health insurance. He says last year he, alone, gave away more than $200,000 in free health care. Bud Sanders is chairman of the board of commissioners for Greene County, one of three counties the clinic serves.

Mr. BUD SANDERS (Chairman, Board of Commissioners, Greene County, Georgia): It's a strong selling point to bring people into the county.

LEVS: So you see this as an economic boost?

Mr. SANDERS: Absolutely. And I think that what Dr. Cowles is creating here is can be used as model throughout the nation.

LEVS: To help boost it's coffers, the Cowles Clinic is capitalizing on Lake Oconee's popularity as a getaway for golfers. It's offering executive health services, as in full body screenings for people who make a vacation out of the experience.

For NPR News, I'm Joshua Levs.

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