Pediatric Health Care: Challenges in the Mississippi Delta
By: Philip L. Levin, MD
Delta residents enjoy catfish farms, football games, hunting and the famous Blues Trail. The rural life can be relaxing, yet has the drawback of low availability of medical care, including pediatric services. The lack of physicians working in this low-income part of the country is central to this challenge.
As an example, the Delta Health Center (DHC) is the oldest rural federally qualified health center in the United States. Located in Mound Bayou, Mississippi, the DHC recently opened a brand new 26,000-square-foot facility to provide care to medically underserved families. Yet, for almost a year, the DHC has been advertising for a physician and is unable to fill the position.
The father and son physician team of Mack and Sidney Carlton Gorton have run the Gorton Rural Health Clinic in Belzoni since 1973. Dr. Mack Gorton, now 75 years old, still practices full time. He was joined in the medical practice by his son in 2004. In a town with a population of 2,000 and a county reach of about 8,000, for many years they provided the only health care in Humphreys County.
“Everybody here knows everyone else,” Dr. Sidney Carlton Gorton said. “I’ve treated patients, their children, their children’s children, and then the great grandchildren as well.”
The duo provides internal medicine and pediatric care, from newborns to the elderly. The only hospital in the county closed five years ago, so now their clinic, and a neighboring Carmichael federal clinic, provide the only available medical services.
“We used to be able to treat heart failure, cellulitis and pneumonias,” Dr. Gorton explained. “Now all those patients must be shipped out of county, usually the 45 miles to Greenwood.”
Their clinic population runs about half pediatrics and half adult. The main issues for children include asthma, vaccine needs, and, in the winter, a lot of flu cases. For adults, a high level of obesity brings in hypertensives, diabetics and cardiovascular complications. The clinic has basic lab facilities, x-ray, and on two days per week, there’s a visiting ultrasound technician.
One of the difficulties in providing medical care in a small clinic such as the Gorton is keeping up with medical technology. The electronic medical record (EMR), which large facilities have instituted with the aid of a legion of technical professionals to back them up, can’t economically be installed in such a small venue. The Gortons record their vital signs and send prescriptions electronically, although the rest of their charting is on paper.
“We don’t need the electronics,” Dr. Gorton told me. “I can look back from when my father saw someone in the 1970s and get as much information as I would from EMRs.”
I asked about the future of his clinic, and medical care in his county in general.
“It’s hard to find someone to come here,” Dr. Gorton told me. “We have to recruit those who grew up in the area.”
The clinic also includes a nurse practitioner and a physician assistant, both native to the Delta. When asked whether there might be a third generation of Gortons to join the clinic, Dr. Gorton said his 14-year-old daughter loves to help out.
Pediatric care in the Mississippi Delta is dependent on the devoted practitioners who recognize the love of a small-town community. Although statistics suggest a great need to provide resources to improve the care, those on the front lines love what they do, and their patients love them back.
Some Pediatric Healthcare Facts:
• According to the CDC, in 2015 Mississippi ranked number one in the nation for infant mortality at 0.93%, with the national average of 0.59%.
• According to the Mississippi Department of Health, five of the counties with the highest infant mortality rates are in the Delta: Tunica, Coahoma, Sunflower, Leflore and Humphreys, with all over 1.4%.
• The CDC also reports that Mississippi ranks first in the nation (2015) in percent of births to unmarried mothers, cesarean delivery rate, and low birthweight rate, while it’s tied for second at preterm birth rate.
Philip L. Levin, MD is a Coast-based physician and writer. He is the author of numerous award-winning stories and poems, many nonfiction articles, and eight published books, including two children’s books.