HJAR May/Jun 2024

DIALOGUE 14 MAY / JUN 2024 I  HEALTHCARE JOURNAL OF ARKANSAS excellence for chronic disease and diabe- tes. The big one, I'm sure, you've heard about — the Mounjaro and Ozempic. That's one of our diseases. Also, any chronic disease that you don't have to check in a hospital for — rheumatology is one of those things that we want to really dig down deep. As I said, it's like a university or a center. I've got to have really good doctors to do that. We're looking at a neurological center, too, that is integrated within our system. For me, as a doctor, that's just heaven because when I started, I sure didn't think that we were going to be looking for specialists of that caliber. I told you that we have a psycholo- gist, an addictionologist, and a psychiatrist already, but we need to build those pro- grams up. Editor Given your experience, what advice would you offer to aspiring healthcare professionals, especially those interested in community medicine and addressing health disparities? Collier I think it's a great field, and it is challenging. It's different than when I started 43 years ago — the systems are more developed. I think [it takes] just the willingness to serve in those areas. From what I see, it's not that bad, so I would encourage somebody to do it. I'm like a recruiter. Doctors and nurse practitioners can live in Little Rock and can come out to Cabot or England. In the beginning, we had problems recruiting people because they wanted to be close to fine dining and malls and stuff like that. But now, because the roads are better, you're able to get out to one of our clinics in less than 40 minutes. That's what I try to convince them, "Hey, it's not that bad. It's a lot better than when I first came out." A team approach is another point of my practice — it's about the team instead of an overbearing provider. Editor Arkansas ranks bottom for maternal and infant mortality. You're probably front and center in a lot of those rural areas. What's your thought on that? Collier My thought is it is just the lack of those services, the lack of the OB-GYNs, and these smaller hospitals being able to adapt financially. Now, that's an area that ARcare has not gotten into, not to say that we wouldn't. But you're talking about running a program 365 days a year with multiple doctors to do the deliveries. That's why the numbers are so bad. Now, we did that for probably 10 years. I don't even know that if you threw money at it you could cure it, because I have talked to hospital administrators in different parts of the state — they all have the same problem. I know it's there, but I really haven't been part of the solution to the way we are with these other problems because I do think that you can get spread too thin. Even for us, some people think that we're spread pretty dang thin. I was in a meeting inWashington having a similar conversation and somebody told me, "Well, Dr. Collier, it seems like there's so much going on. How do you keep up with this?" That is part of the problem, and part of keeping up with it is there are some things you have to let somebody else do. Maternal and child health and obstetrics is a major full-time problem. Editor I feel like I'm missing something. You have such a pulse on this community and what is happening there. What should I be asking you that I'm not? Collier The engagement in each town. I do this for myself and for our employees. I would say total community engagement is the thing that I thinkARcare and leadership is ... Another way to say it is like we're running for a political office, but we just don't even know what our office is. We're on the campaign trail all the time, so we're listening to what people are saying. Yeah, we know about maternal-child health, but, hey, what can we do about it? And about behavioral health? One thing that we haven't covered now is we have two schools — actual schools — one in Searcy and one inAugusta, and I think we have about 250 children enrolled in those schools. Editor Elementary schools? Collier No, they're daycares — six weeks to 5.5 years. We have one inAugusta and one in Searcy. That's really been eye-opening. We have school-based clinics. I think we have one in Malvern now. We have pharmacies. With the phar- macy, we started out saying, "Hey, wher- ever we have clinics, we ought to have a pharmacy." Well, that's great, but you have to have pharmacists to work in those phar- macies, so over the years, we built out a pharmaceutical system. And that's been great for patients. When I graduated medi- cal school at UAMS in 1980, I never dreamed or never thought that I'd be so involved in all these community activities, these non- mainstreammedical issues. So, you have to have life-long learning and desire to keep trying to get better. Editor If you could whisper in your ear as you were starting these clinics now, what would you whisper to that young ambitious doctor? Collier Oh, that's a hard one … to calm down. That's what I would whisper — to calm down, take it easier, and to think things through even better than I have. That's what I would've done. Editor I love that. Now, you mentioned how hard you worked in the beginning and now I think that we are realizing, one, that gets a lot of stuff done, but two, it's not great for mental health. How do you practice mental health now, and how could you have practiced it better? Or did you feel like you needed to practice it better at that time in your life? Collier Well, your definition of mental health … I've done a lot of reading now that we've gotten more into behavioral health, substance abuse. I try to read out in front