Specialty Care in a Rural Setting
by Joshua Levs

Part 1 – Listen online
Part 2 – Listen online

Throughout Georgia, like in the rest of the country, people who live in rural areas often have trouble getting the kind of healthcare they need. Some have to drive hours for specialty care that could save their lives. But for residents of three rural counties, all that has changed thanks to an innovative clinic that is also making its services available to those who can't pay.

The beginnings of this story start in the last century, when a young doctor named Robert Cowles moved to rural Tennessee to open a medical practice. According to his grandson, Dr. Bob Cowles, his grandfather didn't want to do it, but the Governor of Tennessee asked him.

Today, in a modern way, Bob Cowles is following in his grandfather's footsteps. Cowles has set up a state-of-the-art medical facility in Greensboro, Georgia, near Lake Oconee. The new clinic has separate buildings that look like villas, and each focuses on a different medical specialty.

It's rare for a rural area to offer this kind of care – and it wasn't easy to create. But it was Cowles' dream. And he and his family wanted to move out of the city to this beautiful area. That meant giving up a successful full-time practice in Atlanta as a urologist and starting this clinic all on his own.

It succeeded quickly. He opened up a urology practice here in 1999, and his first week he saw 14 patients. Now he sees that many an hour.

That's partly because of the lack of competition. So the demand was there, but there was a limited supply of specialists. To attract other doctors, he had to offer more than patients and the beauty of Lake Oconee. As a financial incentive to get good doctors, he offered them a chance to be part owners of the clinic and participate in various profit centers of the clinic such as laboratory, x-ray, surgery, cancer, and other things.

The clinic is growing, with 42 doctors on staff. Because of Reynolds Plantation, Lake Oconee has attracted a large, wealthy population, and many of the residents have insurance. But before Cowles hires a doctor, he asks them whether they are willing to look after people who don't have any money. And if the answer is "no," then Cowles suggests they practice elsewhere.

The Cowles Clinic serves Medicaid patients and in the past year, according to Bob Cowles, has given out $200,000 in free medical care to those who couldn't pay and did not have insurance. He says that's much like what his grandfather did decades ago in rural Tennessee.