N.C. Children's Hospital Opens Pediatric Subspecialty Clinic in Wake County

Imagine being a child and hearing words such as gastroenterologist, pulmonologist or endocrinologist. Worse yet, imagine being a parent facing a wait of weeks or months for your child to see a pediatric subspecialist.

A shortage of pediatric subspecialists is a nationwide problem. North Carolina ranks particularly low, with 75 percent fewer pediatric subspecialists per child than the national average. As a result, children with specialized health needs struggle to get appointments and frequently have to travel great distances for care.

Children with chronic medical conditions can develop complications while they wait; delays in specialty care can ultimately result in extended hospital stays. At times, parents are even left with no choice but to seek care at an emergency room.

Fortunately, a collaborative effort in the medical community has resulted in improved access to subspecialty pediatric care in Wake County. Children with highly specialized health needs can now receive care at the N.C. Children's Specialty Clinic. Located on the UNC Rex Healthcare campus in Raleigh, the new multidisciplinary outpatient clinic is operated by N.C. Children's Hospital, a part of UNC Hospitals in Chapel Hill.

Just What the Doctor Ordered

The child-friendly satellite clinic, which opened November 2008, is supported through a grant from the John Rex Endowment. The increased capacity and expanded reach created through this new location represents something unique in addressing both the need in Wake County and the statewide shortage of pediatric subspecialists.

"Anything we can do to expedite the care and treatment of children who need it is a step in the right direction," said Dr. Alan Stiles, chief physician at N.C. Children's Hospital and chair of pediatrics at the UNC School of Medicine.

Stiles is a principal investigator for Improving Pediatric Access through Collaborative Care (IMPACC), a program that works to lessen the toll that the shortage takes on families. He began planning the Wake County clinic more than three years ago. To find out which specialties were most needed, he and colleagues surveyed all pediatricians in Wake, Johnston and Harnett counties who had referred a child to the Children's Hospital's outpatient clinic in the last two years.

Prior to opening the new clinic in Raleigh, approximately one-third of patients receiving subspecialty care at N.C. Children's Hospital were traveling to Chapel Hill from Wake and its surrounding counties.

With 50 percent added clinical capacity and a location more convenient for many families, specialists should be able to see more children on any given day with reduced wait times. Additionally, appointments should be easier to make, and children in Wake County can receive care closer to home.

The satellite clinic, on Lake Boone Trail next to Rex Birthing Center, is designed to eliminate transportation hassles that are a barrier for some families. The clinic provides free patient parking next door, and the clinic sits at the intersection of two bus lines. "We want to be sure we're not excluding any group from care, and we want to expand our opportunity to take care of patients who need care but aren't getting it," said Stiles.

"The new family-friendly location is impressive," said Kevin Cain, president and CEO of the John Rex Endowment. "By supporting improved access to care locally and enabling more families to receive specialty care within Wake County, the new resource has a ripple effect on capacity issues in outlying areas. We applaud Dr. Stiles for his willingness to listen, identify needs and work collaboratively to create solutions to improve the health of children."

Extra Special Care

The N.C. Children's Specialty Clinic in Raleigh has 17 exam rooms and 3 procedure rooms and is equipped with Wake County's only pediatric pulmonary function test lab. The satellite location offers services in a child-friendly environment complete with murals and extra special touches to make families more comfortable.

Services currently include pulmonology; endocrinology; gastroenterology; genetics and metabolism; behavior and development; hematology and sickle cell disease; pre-operative consults and post-surgery appointments. A diagnostic referral service also helps patients who present challenges that don't easily fit into a single subspecialty.

As an extension of N.C. Children's Hospital's pediatric outpatient clinic at UNC Hospitals in Chapel Hill, the clinic's physicians are faculty of the UNC School of Medicine. They represent more than a half-dozen pediatric subspecialties, with more being added in the coming months. Their clinical care is complemented by ancillary services such as nutrition, psychology, social work and respiratory therapy. The team also includes a full-time Spanish translator.

Future plans include a gradual expansion of services, including allergy and nephrology clinic. A rheumatology clinic is also planned for the near future. In one to two years, the clinic will offer infusion services for administration of immune modulating drugs or other therapeutics for gastrointestinal or rheumatoid conditions.

Any referred patient can visit the new clinic, but it should be especially convenient for patients who live in Wake County and surrounding areas. Learn more about the services at the N.C. Children's Specialty Clinic in Raleigh or call (919) 783-7809 for referral information.