After an educational career that took him from Florida to New Jersey then to Kentucky and North Carolina, Brett Smith, DO, is now in eastern Tennessee, working as the only pediatric rheumatologist in Blount County. He’s now on staff at Blount Memorial Hospital and is a member of East Tennessee Medical Group in Alcoa, Tenn.
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Explore This IssueJuly 2016
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Dr. Smith says, “I took a rheumatology rotation in preparation for boards. Plus, my mother has psoriatic arthritis, and I didn’t know much about that.” He says, “I thought I wanted to be procedure oriented in my career, but” during the rotation, he found he enjoyed the complexity and diversity of the conditions and the patients.
He also found he liked outpatient medicine, because he doesn’t have “to be gone all the time. It’s better for the family. It fits my lifestyle,” he says. And it gives him ample time to garden, to keep bees and to spend time with his two children, his physician wife and both sets of grandparents who live nearby. His practice includes two other rheumatologists, and the retired doctor he replaced had been in practice for more than 25 years. The area is small enough that “everybody knows everybody,” he says. After years of moving around, it seems Dr. Smith has found the place to settle.
Have Passport, Will Travel
Rheumatologist Viviane M. Bunin, MD, PhD, assistant professor of clinical medicine at Houston Methodist Hospital, is a traveler. Her medical degree is from the University of Pernambuco in Brazil, and she earned her PhD at the University of Sao Paulo in collaboration with Necker Hospital in Paris. She completed a post-doc research fellowship at the Hospital for Special Surgery in New York and University of Washington in Seattle. She completed her American residency at Baystate Medical Center—Tufts University School of Medicine in Massachusetts. These days, she makes the commute to Bermuda for three to four days every four to six weeks to provide rheumatology care to patients on the island, seeing 10–12 patients a day. “I thought I’d see simple cases, like gout,” she says. “But where are the gout patients?” Instead she sees patients with overlapping diseases.
When rheumatology patients are very sick, they can go to Johns Hopkins, Boston or New York, but there is no follow-up when they come home. She says, “There is little or no continuity of care.” There are adult patients who went to Boston Children’s for pediatric treatment and now have no follow-up.