Health care forum covers COVID, mental health, staffing, other topics

For the Enquirer

Increasing COVID cases, rising requests for mental health help and the need for more primary care doctors were among the topics covered Thursday during the 2024 State of Health Care Forum in Decatur.

More than 225 people, including more than 90 students studying medicalrelated fields at Decatur City, Morgan County and Hartselle City schools, attended the annual event at DoubleTree by Hilton Hotel. The Decatur-Morgan Chamber of Commerce hosted the forum.

Four health care professionals served as panelists at the event – Dr. Tyler Goldbach, specialist in emergency medicine; Dr. Graeme McFarland, vascular surgeon; Dr. Rishi Patel, an expert in hematology and oncology; and Dr. Allison Warren, an authority in obstetrics and gynecology. Decatur-Morgan Hospital CEO Kelli Powers served as moderator.

Powers said there has been a recent rise in COVID cases seen at the hospital.

“We have gone from no patients to 12 patients, and it is back down now but it ebbs and flows,’ she said. She asked Goldbach what he is seeing in the emergency room.

“We are definitely seeing an uptick in COVID cases,” Goldbach said. “Anecdotally, I would not say these are serious cases of COVID. I think it is basically becoming more and more like the flu. I have seen more recently flu cases that were much worse.” But it is still a health care concern in the community, and Powers said it will continue to be treated like any other infectious illness, with specific treatments and proper protection to prevent spread of the virus. She asked the doctors if they were seeing any COVID-related side effects in patients.

McFarland said early in the COVID epidemic doctors saw blood clots on a daily basis, including deep vein clots and aortic clots, but they are seeing fewer of these cases. It is still a worry but it seems to be stabilizing, he said.

Powers said there were recently two pregnant women with COVID on the labor and delivery floor.

“So, with pregnancy, as with a lot of different things, COVID tends to be a little worse because pregnancy itself is an immunocompromised state,” Warren said. “So, in pregnancy a lot of times when a person gets COVID, depending on what point they are at in their pregnancy, they may have a higher chance of developing preeclampsia and that becoming a much worse case of preeclampsia or a higher case of going into preterm labor.” She added they have not been seeing that as much with the more recent COVID variants compared to early on in the COVID epidemic, but they still do see it from time to time.

Outcomes were fine, she said. Babies tend not to be that affected by COVID, even when they get it after birth. They are more likely to be affected by low birth weight and other issues related to preeclampsia and preterm labor than by COVID itself.

Mental health The panel also discussed mental health issues they confront at the hospital.

“It’s unfortunately a big issue in the ER,’ Goldbach said. “And not just in the ER, this is a nationwide issue. We have a lot of mental health patients coming to the ER. Thankfully, we have Decatur (Morgan) West to help us a great deal with screening – helping us determine if they need to go to an inpatient facility or whether they need to go home with outpatient resources.” Patel said his wife is finishing up her training in therapy and will be providing mental health counseling for cancer patients.

“One of the problems we have had at Clearview (Cancer Center) is getting people the proper counseling,” Patel said. “They need it especially after a diagnosis of terminal cancer.” He said there is a nationwide shortage of mental health providers.

Warren said she did not realize until she started her practice how much mental health counseling would be needed in her obstetrics practice, “which is a lot.” That is because she is dealing with woman who are “premenstrual, post-menopausal and pregnant hor-monal,” she said.

Staffing Powers said the hospital system is focused on adding more family practice primary care doctors next year. Two are expected in the next six to eight months. She said the medical profession saw a lot of people leave during and after COVID and some others simply left due to being retirement age. More primary care doctors and medical personnel are needed to replenish those who have left. They would like to create an eightperson primary care office somewhere in Morgan County to serve the community, she said.

“We are not alone,” Powers said. “There is a huge need across the whole United States. We’re all fighting for the same doctors. So, you will see us add nurse practitioners all the time to try and complement that.” Powers, who has been president since August 2020, summarized some of the work Decatur-Morgan Hospital does as part of Huntsville Hospital Health System. It has more than 1,800 employees over five campuses and 18 outpatient clinics that serve Morgan County and the surrounding areas. It spends more than $100 million on annual payroll.

“We give over $5 million a year in charity medical care so we are your community not-for-profit health care here in Morgan County and we take care of a lot of individuals who do not have health insurance or means to even get to the hospital,” Powers said. “So, it’s a great thing for the community.”