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Physicians Providing Leadership for Rural Communities - NC Medical Journal Article written by David T. Tayoe Jr, MD

Posted: 12/18/2014

Title:  Physicians Providing Leadership for Rural Communities

Author:  David T. Tayloe, Jr., MD, FAAP

Our practice provides community leadership by targeting adverse child outcomes:  unplanned pregnancy, chronic mental health disorders, tobacco addiction, motor vehicle injuries, child abuse/neglect, obesity/type 2 diabetes, school failure/drop-out.  Physicians can address long-term child outcomes during office visits but need to collaborate with other groups to assure success.  They must provide leadership and form coalitions within the community with like-minded professionals in order to really improve child outcomes.

Unplanned Pregnancy

I was on our school board (1983-91) when it became concerned about student pregnancy.  The board hired a health educator and I served as her supervisor so she became linked with our practice.    Pregnancy rates were cut in half after one full year of this program.   Today, our practice oversees the Wayne Initiative for School Health (WISH), a private/non-profit corporation that operates six school-based health centers in schools that serve families of at-risk students. The centers utilize the electronic health record of the practice and enrollees receive services at Goldsboro Pediatrics whenever the schools are closed.   Pregnancy rates are significantly lower in the WISH schools.

Chronic Mental Health Disorders

Private sector mental health professionals  provide over 5000 consultations per year in the WISH  centers.   We have implemented a program in an elementary school where at-risk children identified by the school nurse and social worker receive mental health services on-site from a private sector mental health professional, and hope to duplicate this model in other elementary schools.  There are two mental health professionals at Goldsboro Pediatrics and the practice arranges telemedicine  consultations with the Department of Child Psychiatry at ECU for patients who need  a child psychiatrist.

Tobacco Addiction

The practice participated in an American Academy of Pediatrics program, Pediatric Research in the Office Setting (PROS),  to develop a system for educating patients and their families  about the dangers of tobacco addiction and for linking smokers with the NC Quit Line.  To continue this valuable program, the practice is collaborating with Prevention Partners.

Motor Vehicle Injuries

The NC Pediatric Society worked to pass car seat legislation during the mid-seventies.  After  I arrived in Goldsboro, I convinced the Goldsboro Junior Woman's Club to establish a car seat loaner program at our hospital. 

Child Abuse/Neglect

In the early nineties, we learned that  intensive home visiting can reduce early child abuse and neglect.  Through a strong partnership with our local Head Start agency, we established Wayne County First Steps, a Healthy Families America intensive home visiting program.  At this time, we are in the process of converting to the Nurse Family Partnership model for intensive home visiting.




School Failure/Drop-out

For the past decade, the practice has raised about $40,000 per year to participate in Reach Out and Read, an early literacy program whereby primary care providers give new  books to all patients 6 months to five years of age at all well child visits.  A 2013 report from the Annie Casey Foundation stated that 66-80% of fourth graders (nationally) are not reading proficiently.  We met with the administration of our public schools to discuss school readiness.  We learned that far too many children, in spite of our Reach Out and Read effort,  enter kindergarten unprepared to learn to read and that our community needs to do more to improve the language skills of preschool children.  We have organized a steering committee of  partners (Smart Start, Head Start, health department, hospital, public  schools, mayor, public housing authority, public library, Cooperative Extension Service) and have conducted a community forum. Our goal is to work with this coalition to improve the school readiness of  kindergarten students.

Childhood Obesity/Type 2 Diabetes

 The practice partnered with the health department and Family Y to obtain grant funding for the CHANGE for Children  Program (Commitment to Healthy Attitudes in Growth, Nutrition and Education).  Scholarships are available for indigent youth.   Enrollees attend wellness sessions at the Family Y two nights a week for ten weeks so that a dietitian, a fitness expert, and a health professional can  teach them healthy exercise and eating habits.   The practice joined GoWayneGo,  a countywide effort to improve wellness,  spearheaded by the county commissioners, the hospital, and the health department.  The practice is starting  a quality improvement program administered by the American Academy of Pediatrics to improve the outcomes of overweight/obese children.

Our practice is a real medical home for the children in our catchment area. We are integrated with  our state  Medicaid model, Community Care of North Carolina (CCNC).  Today, Goldsboro Pediatrics operates four offices where 17 pediatricians, 7 nurse practitioners, 1 physician assistant, 2 mental health professionals,  1 certified lactation consultant, and 2 CCNC care coordinators provide comprehensive health services for the pediatric age-group.   Our practice continues to provide leadership for our community so that more of our children grow up to be responsible, happy, economically independent adults.   


David T. Tayloe, Jr., MD, FAAP

President, Goldsboro Pediatrics, PA

2706 Medical Office Place

Goldsboro, NC  27534

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