Pediatric Cardiologist Mary Mehta, MD, is the Chief Medical Officer at Nemours Children’s Health, Pensacola. For more than 20 years she has served the communities of the Florida panhandle and southern Alabama. It’s a vast swath of land that draws visitors from around the world to its beautiful white sand beaches. It’s also a hurricane-prone area dotted with rural communities and military bases. Dr. Mehta discusses the unique challenges and opportunities that exist to ensure families can access the care and services they need for their children, when and where they need them.
Hear more from Dr. Mehta on Champions for Children’s Health Episode 58.
Thanks for tuning in today! Please visit NemoursWellBeyond.org to catch all our episodes and sign up for our monthly newsletter. You can also use the voicemail feature on the website to leave a message with your episode ideas or questions — you just might be featured on an upcoming episode of the show.
Carol Vassar, producer
Guest: Mary Mehta, MD, Vice President and Chief Medical Officer
Nemours Children’s Health, Pensacola
Subscribe, review or let your voice be heard at NemoursWellBeyond.org.
Well Beyond Medicine Episode 26, Transcript
Carol Vassar, podcast host/producer (00:00):
Welcome to Well Beyond Medicine, the Nemours Children’s Health Podcast. Each week we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar, and now that you are here, let’s go.
(00:27):
MUSIC:
Well Beyond Medicine!
With me today is Dr. Mary Mehta. Dr. Mehta is the Chief Medical Officer at Nemours Children’s Health, Pensacola. So yes, we are in Pensacola. Dr. Mehta is a pediatric cardiologist by training and experience with an expertise in prenatal diagnosis. Now you’ve been in medicine for over 30 years at this point. You’ve been with Nemours for 20 years, and we featured your story on the podcast Champions for Children in October 2020, which was episode 58. We’ll put a link in the show notes. I want to pick up the conversation from there, Dr. Mehta. First and foremost, welcome.
Dr. Mary Mehta, Nemours Children’s Health (01:07):
Thank you. I’m so glad to be here.
Carol Vassar, podcast host/producer (01:10):
When last we spoke, the world was less than a year into COVID-19. We didn’t really have a chance to talk much about how COVID-19 was affecting the practice here. So I want to talk about that. I want to talk about the changes you’ve seen in the way medicine is being practiced now as a result of the pandemic experience. What has changed in those years?
Dr. Mary Mehta, Nemours Children’s Health (01:36):
Well, certainly, that was a very trying time back in ’20 and into 2021 because we were having patients and families that did not want to come in for their appointment, even though we were trying to assure them that we had the precautions in place for them to come in. Even with the masking and those kinds of things, families just didn’t want to come at times. We tried to do telemedicine, which we were for some success, and as we went through the pandemic, I think people, at least in our region of the country, were less and less interested in doing that.
(02:10):
They wanted to be able to come and see the doctor.
Carol Vassar, podcast host/producer (03:37):
As we are just outside the waiting room for Nemours’ Specialty here in Pensacola, I am seeing and hearing a lot of patients and families coming in and out. Has that also increased? Are things back to “normal”?
Dr. Mary Mehta, Nemours Children’s Health (03:53):
We are not back to completely where we were pre-COVID, but very close to it. We are seeing more and more referrals from farther and farther away. I think our willingness to be adaptable to the situation really helps families know that we’re here for the long term and are here to help them through whatever needs they may have, and we have definitely seen a recovery in our referrals from pediatricians.
Carol Vassar, podcast host/producer (04:18):
Let’s talk about the rural nature of the Panhandle. You have Pensacola, which is fairly well populated, but you also cover all of Northwest Florida, and you go into parts of Southern Alabama. A lot of that area is rural. Talk about the barriers that your patients face, their families face, and you face in providing them with the specialty care that they’re looking for. How do you see those barriers? What are those barriers? How are they overcome?
Dr. Mary Mehta, Nemours Children’s Health (04:48):
That is so, so very true. Internet connectivity and constant connectivity is a major problem for a lot of our families in the rural community. We face that two different ways. One is having more outreach clinics developed because we now have a clinic in Fort Walton Beach now five days a week. We have one in Panama City, which has, after their recovery from Michael has, really been able to get back into better semblance of a medical community there. We also have a long I-10 a clinic a couple of days a month in Bonifay, which serves that under part right below Dothan and Fort Rucker, Alabama.
(05:27):
Then what I’ve just recently heard is that there’s some money left over from the Horizon Oil spill that is going to be dedicated in several counties for improving their broadband and internet connectivity. So some of those are where we get a lot of patients for is going to be helped by this over the next 12 to 18 months.
Carol Vassar, podcast host/producer (05:47):
So what I’m hearing is you’re not static here in Pensacola. You’re actually going out to Bonifay. You’re going out to Panama City. Talk about the reason for having those clinics in those particular areas.
Dr. Mary Mehta, Nemours Children’s Health (06:03):
Yeah, that is where not only our military partners, as we serve a lot of military staff that come in here, and of course, they bring their families. So for us going to them, the physician going to them for having an outreach clinic really helps them come to a clinic and not have to drive two and a half hours from Panama City to come here for a visit if we can go to them. Now, there are some things we cannot do in those clinics and they know that they will have to do.
(06:30):
But even alternating with them of getting close to them really helps us help support them when they do need to make that two-and-a-half-hour drive into Pensacola for some specialized testing done at the hospital or surgery. We are really trying to balance keeping where the families need to be with the rest of their support staff versus taking an entire day off of work to make that trip, see the doctor and then turn around and drive all the way back.
Carol Vassar, podcast host/producer (06:58):
So I’m hearing distance transportation, internet access are barriers, and you’ve laid out some of the ways that Nemours is helping patients to overcome those. Are there other barriers that you’re seeing or hearing about?
Dr. Mary Mehta, Nemours Children’s Health (07:11):
Oh, financial, obviously. They have to take off work. They have to take either a vacation day or a no-pay day for them to make it there. That’s why our partners with our social workers and other agencies in town outside of Nemours that help with that transportation is really critical for us to be successful at what we do and get the cares that the child needs.
Carol Vassar, podcast host/producer (07:32):
Are you still practicing clinically yourself?
Dr. Mary Mehta, Nemours Children’s Health (07:35):
I am, I am. I see patients about three days a week. I still travel out to Fort Walton and Bonifay. That’s a big joy in my life to be able to go do that.
Carol Vassar, podcast host/producer (07:45):
Talk a little bit about that being a joy, being with the patient seems to be a passion.
Dr. Mary Mehta, Nemours Children’s Health (07:50):
Oh yeah. Oh yeah. Well, the fact that we can do what we do in the majority of cases in these outreach clinics without all of the extra support staff and extra technology sometimes, that is really meaningful for the families. We have also found by doing that. We have a very low no-show rate. The parents, we’re coming to them so they know that they need to make that appointment here and to make it happen, and the families, especially where the husband and wife have had to decide, one has to go to work in the military, the other one has to take their child, that actually helps them both hear what our recommendations were and make them more able to comply with our medical recommendations for the child.
Carol Vassar, podcast host/producer (08:33):
Are there any patient stories, without going into detail, that would be HIPAA noncompliant, that stay with you perhaps from some of these other locations, that stay with you, that kind of inspire the work that you do clinically and administratively?
Dr. Mary Mehta, Nemours Children’s Health (08:49):
Yeah, I think the fact that we’re, especially Panama City, we take care of and support from a cardiac standpoint, the level three NICU out at Gulf Coast Regional Medical Center in Panama City. A lot of those premature infants that we have helped the neonatologists there make it through to discharge. The fact that then we would keep a family from having to put that little premature baby in a car seat, drive two and a half hours, that we’re able to say, “No, we’re in the building right next to that hospital where you’ve been living and we’re going to make it safe as we can for you to be able to see that child.” That is just worthwhile for that. Even though Nemours continues to reach out and support by telemedicine at many NICUs across the state, the ability for us to get in the car and we do the drive for those little fragile newborns is just really what makes it worthwhile.
Carol Vassar, podcast host/producer (09:38):
This all really feeds into the idea of Well Beyond Medicine. How are you, Dr. Mehta and your team here and your team out in the community, how do you see and envision that you’re going well beyond medicine?
Dr. Mary Mehta, Nemours Children’s Health (09:53):
I think that we’re doing it in multiple ways. One is partnership with local organizations in our cares suite to provide either backpack support for the heart of Pensacola team that is developing with American Heart Association, with going with MANA, collecting food. We identify families here that have met some of the social determinants of health needs and can help get them to the organization that they may not know about, but we do through our social worker. I think that we’re also doing it through some special programs with the University of West Florida of underserved students for first time college students to give them a clinical experience here in our clinic to encourage them to pursue their MD, PhD program or their desire to go to medical school.
(10:41):
We currently are working with three students now into an NIH funded program to make their dreams come true someday, and that just continues to feed the students that are really interested in healthcare and taking care of children and it may not just be in peds, but help them for our future physicians and nurses and all that to go through.
Carol Vassar, podcast host/producer (11:03):
So it sounds like you’re building the workforce of the future for Pensacola, for the Panhandle and for parts of Alabama.
Dr. Mary Mehta, Nemours Children’s Health (11:11):
Absolutely, absolutely.
Carol Vassar, podcast host/producer (11:13):
To you personally, what does well beyond medicine mean?
Dr. Mary Mehta, Nemours Children’s Health (11:17):
To me it means that just what I do within these walls is just a very, very small amount of healthcare that we need to get more children healthy. Doctors have to get out of their clinic or their hospital out to what really helps children become healthier.
Carol Vassar, podcast host/producer (11:39):
There’s a very robust research program out here. Talk about the research that’s being done with a specific you had mentioned in the last podcast about cystic fibrosis and the research being done in that area here in Pensacola, in the Panhandle. Talk about all of that.
Dr. Mary Mehta, Nemours Children’s Health (11:57):
Yeah, so our pulmonary division is the cystic fibrosis center for this region of the country. The next closest is either in New Orleans, Alabama or down at UF. So we have almost 150 patients that travel from all around to come to our program. We are also one of the top-ranked programs and have been allowed into the Therapeutics Development Network. So we do have those research grants to come into Pensacola. Dr. Olidemer has continued to improve all aspects of that program. From when he started here, not even eight years ago, to have about 45, now we’re up to 150, it attests to those families knowing that we are a very quality site that makes a difference and have encouraged people to come here. But we do have many ongoing research projects through that collaboration with the Cystic Fibrosis Foundation.
Carol Vassar, podcast host/producer (12:53):
Are you doing any research yourself at the present time?
Dr. Mary Mehta, Nemours Children’s Health (12:56):
I can’t fit one more thing on my schedule.
Carol Vassar, podcast host/producer (12:59):
That’s fair. That’s fair. You’re still doing surgery?
Dr. Mary Mehta, Nemours Children’s Health (13:03):
No, I do clinical echoes and fetal. I still do all that, but not surgery.
Carol Vassar, podcast host/producer (13:08):
But not surgery.
Dr. Mary Mehta, Nemours Children’s Health (13:09):
Yes. But we do refer to our program at Nemours in Orlando.
Carol Vassar, podcast host/producer (13:13):
All right. How far is Orlando from here? Just to give people perspective, especially if they’re listening from outside of the state of Florida, how far is Orlando from here?
Dr. Mary Mehta, Nemours Children’s Health (13:21):
About seven and a half hours drive, a different time zone. A flight…there are two flights daily coming up if they’re on time, and for the rest, you have to go through Atlanta or another bigger airport to come into Pensacola.
Carol Vassar, podcast host/producer (13:35):
But you’re doing as much as you can here in Pensacola. Anything I haven’t asked you that you’d like to share about what’s happening, what’s new, what’s on the horizon for specialty care here in Pensacola?
Dr. Mary Mehta, Nemours Children’s Health (13:47):
Well, partly is our partnership with Nemours Children’s Hospital in Orlando that Dr. Weerden actually comes up here once a month to see the patients that are going to need surgery ahead of time. So they already have that relationship and bond with the parents, and he’s met the child in their territory here in Pensacola. We have an interventional cardiologist coming in. If a patient needs a cath, he’s going to meet them ahead of time. Same thing is going to occur with electrophysiology. If they need a pacemaker or something, they come here first to meet them unless it’s an emergency. One of our biggest exciting things is our development of our adults with congenital heart program that will start with Dr. Michael Brumund.
(14:26):
So that will allow us to go from age 21 to 30, 35 for complex repaired congenital defects that can move now beyond childhood or up to age 21 up higher with specialists that there is a new certification in that the American College of Cardiology has developed. He has been recently recruited and will be coming up here probably once a month as we get the program going. That resource is not available anywhere in the Panhandle. So that will bring the expertise to us through our Nemours program and can all be on the same platform, our electronic medical records, so.
Carol Vassar, podcast host/producer (15:08):
Let me ask this about that program on the horizon. It goes up to you said age 35. That’s well beyond pediatrics. Are these issues that were discovered in childhood, and are continuing for these patients?
Dr. Mary Mehta, Nemours Children’s Health (15:23):
Yes. Obviously, if a child is born with only half a heart, like a hypoplastic left heart, and the palliative procedure is not creating a new ventricle, it’s actually rerouting the blood that can work. But then usually we can get them through childhood with these things, but they still have problems ongoing into adulthood. Over time, and the recent statistics is there are more adults living with repaired congenital heart disease than there are children. So our success in surgery and all of that is still going to bring them into adulthood. But the adult cardiologists are not used to this kind of anatomy, and that’s not been their expertise and necessarily training.
(16:06):
So that’s how the American College of Cardiology and the academies got together to develop this very unique specialty that includes all of our specialists that we have now, but it helps them transition better to what could be a very complicated time of their life because of just their anatomy that as they move into adulthood and hopefully keep doing lots of things that normal adults would do, but they have to have special attention to their heart.
Carol Vassar, podcast host/producer (16:35):
Will this help to fill a gap for these patients until the adult cardiologists, specialty adult cardiologists can take over?
Dr. Mary Mehta, Nemours Children’s Health (16:45):
I absolutely think it will. These very big large centers across the country have developed these programs a while back, but the cities the size of us and some of the bigger cities don’t have this kind of specialized program that Nemours is bringing to the Panhandle. The patients themselves are having to travel a very long way, like for Atlanta, for instance, to be able to get this kind of program that is specialist that does that transition from childhood up into what would we expect as coronary artery disease that we normally see in the older of heart failure. The cause of a 25-year-old with heart failure that’s had repaired congenital defect is completely different from coronary artery disease of the 60-year-old and that needs to be addressed.
Carol Vassar, podcast host/producer (17:34):
So you’re bringing something really new to this area.
Dr. Mary Mehta, Nemours Children’s Health (17:37):
Absolutely. Absolutely.
Carol Vassar, podcast host/producer (17:38):
Well, Dr. Mary Mehta, thank you so much for having me here today and for being part of the Well Beyond Medicine Podcast.
Dr. Mary Mehta, Nemours Children’s Health (17:45):
Oh, thank you for having me. I loved it.
Speaker 3 (17:47):
Well Beyond Medicine.
Carol Vassar, podcast host/producer (17:49):
Thanks for listening to our conversation with Dr. Mary Mehta, Vice President, and Chief Medical Officer for Nemours Children’s Health in Pensacola, Florida.
Are you listening from the Florida Panhandle area that Nemours serves? How do you see Nemours in the community going well beyond medicine? Leave us a voicemail at nemourswellbeyond.org. That’s nemourswellbeyond.org. While you’re there, check out our other episodes, subscribe to the podcast, and leave a review. Thanks to Che Parker, Cheryl Munn, and Susan Masucci for their help with producing today’s podcast episode. Join us next time for an encore episode about the Nemours Can Grow Garden, a great example of going Well Beyond Medicine. Until then, remember, together, we can change children’s health for good – Well Beyond Medicine.
MUSIC: (18:42):
Let’s go! Well Beyond Medicine.
