Total Healthcare, Urgent Care facility holds ribbon cutting (copy)

Mayor Jim Nabors, center, cuts the ribbon to Total Healthcare as doctors Adams, Hinkle, Edwards, and Vines look on. (Cliff Williams / The Outlook)

Television shows often glamourize the medical specialities. They show a cardiologist performing open heart surgery or a neurosurgeon removing part of a skull.

While those are needed medical specialities, much care can be given by family practitioners in a rural setting. For the doctors at Total Healthcare, they take pride in knowing they can help most patients with most of their ailments, but for them, practicing medicine is only the beginning of what keeps them in a rural setting. It’s the relationships that bring them the biggest reward.

Dr. Tate Hinkle sees patients at Russell Medical’s Total Healthcare in Alexander City and Russell Medical’s Medical Park Family Care in Dadeville. Family medicine in a rural setting is very appealing to Hinkle.

“The reason it still interests me is one the need is always there,” Hinkle said. “Two, the people are just incredibly nice. We become part of their family; we get to know them; we get to know their families; they get to know our families.

“I end up seeing entire families. I have got one family where I see the grandparents, the parents and four of the grandchildren. I see eight members of the family.”

Those relationships help Hinkle with medical care of the family.

“Being able to have those relationships when one of them comes in, I know the whole family,” Hinkle said. “I know the dynamic of the family. You don’t get that in an urban setting. That is a big aspect of why I did family medicine. That to me is highlighted in rural areas because the family unit is such a big part of rural Alabama. Being able to be a part of taking care of a whole family is really important to us.”

Relationships with patients and their families is also critical for Total Healthcare’s Dr. Robert Edwards.

“Getting to know families, not only the patient but their families and their roles in the community, interacting with those folks on a personal level, I enjoy it,” Edwards said. “It’s really rewarding to see folks doing well and knowing you had a role in that.”

Edwards said he couldn’t see himself in any other medical area than a family practice in a rural setting.

“I was born to do this; I’m a people person,” Edwards said. “True increases in long term health is done in this setting. You go to the ER, it is to get you upright again. The same with the hospital. “In this setting we are able to help folks with problems they have medically that make big time changes in their lives. Being a part of that, helping someone lose weight, helping someone get their diabetes under control so it is not an issue, it’s extremely rewarding. It is awesome to see your patients do well. You get feedback on a daily basis and it is a great thing.”

Hinkle knew early on he wanted to go into medicine but wasn’t sure exactly what he wanted to do. Hinkle shadowed different doctors in high school and college.

“When I finally shadowed my first family doctor, it was like a light switch went off,” Hinkle said. “I saw him as somebody who had formed these relationships. He had been some patients’ doctor for more than 30 years. He knew what was going on with them before he walked into the door. He knew why they were there. Half the visit was how is your daughter who is now in college or going on to medical school.

“I don’t do this but he delivered babies. Some of those people he delivered the patient that is now sitting in front of him, now 30, and having a child. That kind of a relationship with people when you get to help them and treat them when they are at some of their best and worst times of their lives and being able to help walk them through those times and be there for when they need you but also see their successes, that is some of the best things ever.”

Hinkle doesn’t cross his arms and send a patient on to some random specialist. Hinkle wants to put all of his training to use, but is not afraid to let another medical provider assist.

“We pride ourselves on being able to handle 90 to 95% of what everybody else does,” Hinkle said. “What I try to do when I send them to somebody else, they are ready to do whatever they need to do. I can’t operate people but I can do everything I can to get them ready for Dr. Swenson — x rays and test. When they go to see her, all she has got to do is yea you need surgery lets go do it.”

Hinkle wants to get to the bottom of a patient’s issue to the best of his ability even when he does refer a patient to a specialist.

“I want to make sure I’m sending patients where they need to go too,” Hinkle said. “That is part of my job is to figure out exactly where they need to go instead of somebody else trying to figure out what is going on. I like being a detective and figuring out what is going on.

“It also helps out if I have done most of the workup, I know when the patient comes back what is going on. I have got more knowledge of what is going on.”

Hinkle made sure his efforts in medical school and beyond prepared him to serve the vast majority of patients coming through the doors of the clinic.

“One of the things when I was going through residency, I made sure I went to a program and made sure I got experience in doing everything,” Hinkle said. “I was trained to deliver babies. I delivered 80 babies in residency. I don’t do it anymore. If someone walked in the door delivering a baby, I could do it. We still like to be able to handle pretty much everything that walks through the door. I tell patients I’m your first stop for whatever you have. If I can't take care of it or don’t know what is going on, I will find someone who can. But I’m going to try my best to figure it out to begin with.”

Seeing incremental medical improvements keeps Edwards motivated.

“To me I like the ability to be able to care for all sorts of medical issues and really take care of most of them,” Edwards said. “I guess the most rewarding thing for me as a primary care guy in a rural area is making a difference in the long term outcome whether it be improving their diabetes or heart patients to help with their issues. Taking people with multiple comorbidities and being able to help them not have to go to the hospital all the time, decreasing their morbidity from disease.”

Hinkle likes he gets to see the full picture of treatment of his patients.

“I noticed with a patient from a big city that moved here, talk about how their primary care doctor had her going to five or six different specialists,” Hinkle said. “It is all stuff we take care of on a daily basis. She was going to one for her blood pressure, another doctor for her diabetes and another doctor for this. I was like, ‘I do all that.’ We can offer that for the most part for our patients right here. They don’t have to go elsewhere. Obviously if we feel like there are instances where they need to go see a specialist, we still do that.”

Even when they send a patient to a specialist, patients still seek Edwards’ and Hinkle’s advice.

“A lot of times when a patient goes to a specialist and recommends something, a lot of times the patient will come back to me and say, ‘They recommended this. What do you think about it? You are my family doctor. What do you think I should do?” Hinkle said. “I send them to someone who can do something I can’t do but the patient has trust in us because of our relationships that they want to know what our opinion is on everything before they go do something.”

Neither Edwards or Hinkle would trade a rural setting for the big city.

“I grew up in a rural town; I grew up in Lanett,” Hinkle said. “It was primarily manufacturing, very much like Alexander City with Russell, it was West Point Stevens.

“One set of my grandparents had a farm. I grew up in that life. I saw in rural Alabama how it would be good to be a good primary care doctor that could take care of a lot of different stuff.”

Edwards rural upbringing has family roots.

“I kind of knew I was going into rural healthcare when I entered med school because I was raised in a rural community,” Edwards said. “I married a wife that was raised in a rural community. That kind of pointed me to a rural area.”

Edwards’ wife was influential in him coming to Russell Medical. The decision means Edwards can care for his patients all across the system.

“My first visit here during the interviews before any offers were made, I walked out with my wife and she said, ‘You would be happy here,’” Edwards said. “She was right. I can interact with the hospital. I can interact with patients in the hospital. I can go care for them while they are in the hospital.”

Edwards said the relationships of medical providers and the fact Russell Medical is a member of the UAB Health System means great care for all patients in a rural setting.

“I just really enjoy my small town; I just really enjoy my small hospital,” Edwards said. “What is really unique is the breadth and youth of specialists that we are getting from UAB is huge. I can pick up the phone and get a patient in front of whoever is needed immediately. We can have a good conversation about patient care and all of us be onboard. There is no turf stuff. There is no competition between sub-specialists. It is just a fluid environment here.

Edwards just loves trying to make the area better and enjoying the rural setting and the relationships it affords. Hinkle is the same.

“I enjoy the slower pace of life of a rural area,” Hinkle said. “I enjoy the relationships. That is why I do what I do. If I had to boil it down to one thing it is the relationships.”

Cliff Williams is a staff writer for Tallapoosa Publishers.