MUSC plans more specialty care in Orangeburg

The Medical University of South Carolina entered into a 99-year lease for $1 a year with the hospital in 2023. The partnership was deemed necessary to help the RMC, which was consistently operating with significant deficits, but that’s not the end of the story for MUSC President Dr. David Cole.

“Since 2019, we’re in eight of the most rural and underserved counties today in South Carolina longitudinally and with purpose. … When we come into these different communities, we look toward partnership first. We look for where there’s an opportunity that can be a win-win. As a basic premise, our goal is … local care,” Cole said.

“We have assets that can help elevate others in the process. That’s sort of a conceptual reason for the growth,” he said.

As the health care system of MUSC, MUSC Health has a mission to deliver the highest-quality and safest patient care while educating and training health care providers and leaders to serve the people of South Carolina and beyond.

“As the Medical University of South Carolina, we have a missional obligation for the entire state. We don’t need to own hospitals in every county, but we deliver care in every county. … We can’t solve it all on our own. We don’t need to own the world. So, therefore, partnership is a primary principle,” Cole said.

“Meet people where they are, elevate the best local care and put patients at the center of what your decisions are. That’s how we work,” the president said.

Dr. Patrick Cawley, chief executive officer of the MUSC Health System, said the MUSC is committed to bringing specialties to the Orangeburg community and surrounding areas. Cancer specialists, cardiologists and vascular surgeons are among them.

“We want people to get care as close to home as possible. So we’re full-on committed. … We have a full plan of bringing a variety of different specialties. At the top of the list is more cancer specialists,” he said.

“We’re trying to improve with more surgical oncologists, even bring surgical oncologists here from Charleston or Columbia part-time if we need to. We’ve recruited a new radiation oncologist. We’re going to add radiation therapy here. We just recruited another medical oncologist. We’re going to add medical oncology here. So that’s big,” Cawley said.

Cardiology services also will be added within the community.

“That’s cardiologists, vascular surgeons, anybody that works on the heart system. Then the third area is primary care. Those just happen to be the top three priorities, but we’re trying to bring more OB (obstetrician care),” Cawley said.

“The hospital’s lost OB services, or significantly decreased, and people are a long way to have their babies. That needs to stop. Women need to have their babies in this county. There needs to be more pediatric care in this county. So we’re committed there, as well,” he said.

Orangeburg County is home to only one neurologist even while the Alzheimer’s Association’s 2024 Alzheimer’s Disease Facts and Figures report ranked Orangeburg County eighth highest in the country out of 3,142 counties in Alzheimer’s prevalence at 15.2% of those 65 and older.

Cawley said MUSC is also targeting that issue with the continued expansion of the South Carolina Alzheimer’s Network, or SCAN.

“SCAN is going to primarily support our primary care doctors with whatever they need to take care of patients with dementia, not just Alzheimer’s. There’s many kinds of dementia,” he said.

Cawley continued, “That may be things like bringing specialty neurology, or helping them interpret images, or helping them make a determination. Is this patient somebody that’s eligible for some of these new medications that are on the market? There’s more of those coming. … Anything that’s needed, including helping with social work, helping with care coordination, or connecting with community services. That’s how we envision the SCAN network working.”

Cawley said SCAN was up and running statewide in the past year.

“We anticipate that just continuing to expand over the next several years. That’s an area of focus for us. Because of the aging population, because of the number of people moving into South Carolina, we’re going to be seeing record amounts of dementia. Unless some miracle cure comes along, we’re going to be seeing a record number, and that’s important for us,” he said.

Cole said, “We have a fractured system with resources that are not well connected for an individual in, you know, Bamberg, or for, you know, a family member. So how do we get better connectivity? How do we maximize the effectiveness of the doctors that are present? How do we maximize the rare earth thing called the neurologist in terms of when and how they’re needed?”

He continued, “The world’s not solved by telehealth, but that’s definitely a tool that’s in the middle of this. So those are the questions we’re asking. We’re not saying, ‘Oh, it’s solved,’ but let’s maximize how and what we can do in terms of connectivity. …

“Right now, often primary-care doctors don’t have the connectivity, or maybe the background. So they refer to neurology, which is a six-month referral. How do we enable primary-care doctors to take on those dementias where they live better, with better resources? That’s the concept, but we are very much leaning in that space.”

Cawley said more neurologists would be trained, but that even that would not sufficiently address the problem with the deficiencies in care for people with Alzheimer’s and other dementia.

“So we’ve got to rethink how we use somebody like a neurologist … and how we get that neurologist to take care of large numbers of population through primary care docs. So that’s how that’s envisioned, and we’ll work that out,” he said.

Cole said, “This didn’t just sort of come out of the blue. Our neurologist actually spent two years going across the state sort of doing a surface scan and talking to primary care in communities to understand what’s out there and then try to envision what might work, or what could actually happen.”

Cawley said the completion of the mission to deliver the best local health care continues and will take time.

“We feel very, very good about where Orangeburg is headed. Job’s not done. We find it takes about three years to get into a very stable situation just based upon other hospitals that we’ve acquired. We’re just a little more than a year in,” he said, noting that the delivery of care supersedes a patient’s ability to pay, which may particularly harder in poor, rural communities.  

“We’re not afraid to go into rural communities. We will go into rural communities In fact, we’re completely embracing rural health because we think it needs to be done differently. There’s people in those communities and, if we do it differently, we can help those people survive,” Cawley said.