Still about the patients, pioneering dialysis-access surgeon says

The 73-year-old is now glad he chose a fulfilling career in the medical field, where he has had the chance to transform the lives of countless patients.

The internationally renown vascular access specialist who grew up on a farm outside Sumter reflects on his establishment of a Dialysis Access Institute at the Regional Medical Center in 2011 to serve patients with end-stage renal disease.

The RMC marked the DAI’s 10th anniversary on March 21.

“My feeling was I wanted to be one of two things. For one reason or another, I said, ‘Maybe surgery would be fun,’ and have not regretted that. That’s a pivotal choice … that worked out just fine,” Ross said.

The Regional Medical Center’s Dialysis Access Institute is continuing to provide premier training to international physicians in the latest vascular-access procedures while staying committed to patient care as the only full-time, dedicated access center in existence.

‘It was all

about the patient’

Ross said it all started back in 1979 in Bamberg, where he was a surgeon at the now-defunct Bamberg County Hospital.

“At that particular point and time, I was down there only a couple few months when Dr. Mohammad Nassri, who’s still a kidney doctor in Orangeburg, sent me a patient to have dialysis access. You can’t be dialyzed unless you have some kind of access to get the blood out,” Ross said.

He continued, “So he sent the patient down to me. No one had ever done this kind of surgery very much. It’s still brand new. So we did the patient, and the patient did well. He started sending more and more patients.”

Ross said his philosophy of care had always been patient-centered.

“It was always about the patient. … As time went on, there were numbers of patients coming from all over South Carolina to Bamberg: Charleston, Columbia, Greenville, Spartanburg. Then some started coming from Florida, Georgia and all over. We were taking a true special interest in doing this kind of surgery. Believe me, this was not planned. It just happened,” he said.

Ross continued, “We started to develop new operations, and we started thinking about this quite a bit differently because since I do not have any partners, I got to see the things that did well, and I got to see the things that didn’t do as well. Patterns started to form.”

Ross said clinical trials started in the late 1990s, including studies on how to use new devices.

“We started the training program back in that period of time, where many of the companies that had different devices wanted to have them demonstrated to physicians. So physicians were coming from all over the United States to Bamberg,” he said.

Ross finds that amazing since “Bamberg supposedly was the fourth poorest county in the United States.”

“The practice kept growing with so much of this particular type of surgery. I guess it was maybe around 2010 that the Bamberg hospital and Allendale and Barnwell wanted to form a tri-county hospital down there,” Ross said, noting the plan did not ever come to fruition.

“I was told that the Bamberg hospital was going to close because they needed those beds for this new tri-county hospital. So I decided, ‘Well, what are we going to do? We have this tremendous amount of patients, and these patients need to be taken care of,” he said.

The process of finding a place for what would be the DAI began.

Health care more

than health business

Ross said Charleston and Columbia were among the places he could have established a DAI.

“All of these places said that they had interest in bringing the practice with me because the patients would hopefully come wherever I went, but Orangeburg hospital was an interesting situation. My wife actually talked to the hospital administrator, who in those days was Tom Dandridge. Tom said, ‘Gosh, we would love to have you come over here,’” the surgeon said.

“I said, ‘Well, we will be happy to come over, but we need a building. We need to have a staff. We need to have a true dialysis-access institute, something that has never been done before.’ So the board and administration got together and realized, ‘My gosh, this could be something that would be good for the Orangeburg hospital, but certainly for all these patients that are around,” Ross said.

“I think it was March of 2011 we did our first cases under the guise of Dialysis Access Institute. Of course, we had to get a Certificate of Need and get the building built and all those kinds of things. I think it was October of 2013 that we did our first cases over at DAI. It’s been going great ever since. The hospital has been wonderful. We still had the training programs, we still had clinical trials going, and we had patients that come from all over the Southeast now to Orangeburg,” he said.

Ross said he could not have accomplished a thing without a dedicated team of medical professionals.

“”It’s always going to be about ‘we.’ Without the nurses and the techs and the other people that are necessary to make this work – this is truly a large institution – nothing happens. The purpose was just like it started in 1979 – its’ all about the patients,” he said.

Ross said caring for patients must not be superseded by business interests.

“We’re still in health care, not as much as health business. A lot of times in health care it has transitioned sometimes – and maybe by necessity – to health business. We still want to take care of the patients no matter what,” he said.

Ross continued, “That philosophy that started 40 years ago or more is still the same philosophy that we’re trying to function with even though it has changed in a lot of places. We’re still trying to deal with the patient first. That’s how it got started and hopefully that philosophy is going to extend us right into the future as it should.”

With the number of patients needing dialysis growing tremendously, the need for vascular-access surgery is not going away anytime soon, he said.

“I have been told there’s nothing in the medical community increasing faster than dialysis, and a lot of that is because of diabetes, of course,” Ross said, noting that the DAI’s completion is a worthy accomplishment for all involved.

“This is becoming in certain places in the United States a template that is trying to be reproduced. We’ve got the building, we’ve got the physicians, we’ve got place, we’ve got the personnel,” Ross said, noting that the future of dialysis-access care is bright.

“Well, we know the number of patients that are going to require dialysis is increasing rapidly. You can’t have dialysis unless you have dialysis access. The need for this kind of surgery to be done is going to do nothing but increase.

“If we can keep our patient-first philosophy and take care of them as best as we know how, be compassionate when taking care of this patient population, the future of the Dialysis Access Institute will only increase the volume and, hopefully, the training effect,” he said.

The DAI has welcomed numerous physicians, nurses and technologists from around the globe for training in the procedures/operations performed at the DAI each year.

The DAI is accredited by the American Society of Diagnostic and Interventional Nephrology, or ASDIN. Physicians from throughout the world train onsite and via live streaming video as they pursue ASDIN certification, or to enhance their knowledge and skills in vascular access.

“That are over 60 different operations that we do. It depends on the patient’s age, their blood vessels, a whole bunch of stuff. Hopefully it has helped us by looking at the entire patient,” Ross said, noting that the partnership between RMC and the DAI has been fruitful.

“The hospital has tremendous facilities over there and wonderful doctors, but I think because of the uniqueness of what we do, it kind of makes patients that would come from Charleston, Columbia, Greenville, Augusta and Savannah come here, which then brings in a population of patients to RMC that they would not normally have,” he said.

Ross, the DAI’s former medical director, said that position is now held by Dr. Mark London, who he said is like a son to him.

“I trained him. He and I go way back, and I decided that I needed to pass that baton. But we talk almost every single day about things,” said Ross, who still comes to the DAI once a week – and sometimes more – to perform surgeries and other duties.

“It’s just whenever they need me. I look forward to doing that. I still enjoy the patients. I enjoy the technical aspects of doing operations, always have. You don’t give up things that you still enjoy as long as you can do those things well,” he said. “I am 73 years old. I get up at 4:30 every morning and am wide open. Nothing’s changed yet.”