Texas PASS winning small-town doctors

By Kristen Holland Shear / September 2010

It may be more than 90 miles from Dr. Kimberly Burlingham’s East Texas practice to Dallas, but the pediatrician says the distance is irrelevant thanks to an innovative program based at UT Southwestern.

The program — called Texas Pediatric Access to Subspecialists, or Texas PASS — links primary care providers such as Dr. Burlingham with pediatric faculty subspecialists at UT Southwestern. Now a year old, the program recently expanded its offerings and unveiled a new website (http://txpass.org) where pediatric primary care providers can learn more about the program.

           Dr. George Lister

Dr. Burlingham, who opened her practice in rural Winnsboro about 20 years ago, said Texas PASS has enabled her to consult quickly with child psychiatrists as well as pediatric endocrinologists, oncologists and infectious disease specialists about patient —often before patients leave her office.

“I don’t have enough good things to say about PASS. It’s been a blessing,” said Dr. Burlingham, one of two pediatricians in her community. “I know of one subspecialist here, and he happens to be my husband. He’s a general surgeon.”

Jeanne Nightingale, clinical nurse administrator in pediatrics and one of two program coordinators for Texas PASS, said the program is a great resource for providers who occasionally have patients with medical problems that require discussion with a specialist.

The free service offers primary-care providers in 74 counties round-the-clock telephone access to pediatric subspecialists at UT Southwestern and Children’s Medical Center Dallas. Eight subspecialties are currently offered: cardiology, child psychiatry, endocrinology, gastroenterology, hematology/oncology, infectious disease, nephrology and neurology.

“Child psychiatry is the most requested subspecialty, but our endocrinology, which we started offering last December, and infectious disease physicians are close behind,” Ms. Nightingale said, adding that 90 providers across North and Northeast Texas have already used the service.

Dr. George Lister, chairman of pediatrics, developed the program in conjunction with Dr. Carol Podolsky, assistant professor of pediatrics and medical director of the network, as well as Ms. Nightingale and Nicole Santiago, program coordinators.

The program, supported by the Texas Health and Human Services Commission, aims to improve access to pediatric subspecialty services for Medicaid-enrolled children and to provide rapid, expert consultation with pediatric subspecialists for primary care providers. Access to these subspecialists can be difficult due to a shortage of specialists nationwide, according to recent reports in The New York Times, Wall Street Journal and Boston Globe.

Dr. Lister said the need for this type of service is greater than ever as the number of children enrolled in Medicaid continues to increase.

“Texas has the largest number of uninsured or underinsured children in the nation and also faces a huge shortage of pediatric subspecialists,” he said. “Anything we can do to help families and improve patient care is a positive step forward.”

Ms. Santiago said the feedback from participants has been very favorable.

“The providers who have used the service really love it,” she said. “The patients get better care, and the providers calling in feel supported by the subspecialists here at UT Southwestern. Everyone benefits.”

Dr. Burlingham agreed, saying, “I’ve been in practice out here a long time and a lot of programs have come and gone, but I can’t think of any one that’s made me feel as supported as Texas PASS. Sometimes as a pediatrician you just want a little help, a little support – PASS provides that. I’ve been thrilled with the program.”

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Dr. Lister holds the Robert L. Moore Chair in Pediatrics.