Vitalsschool of medicine

Big Moves in Big Bend

In Texas’ Big Bend region, there are a little more than 33,000 people in a million-mile radius. Within the rugged terrain, physicians are scarce. But, not for long.

Jeff Davis County opened the Davis Mountain Clinic in Fort Davis, Texas, in collaboration with TTUHSC to provide primary care services and Texas A&M Health to provide behavioral health services. Now, this community of about 1,200 people, located roughly four-and-a-half-hours southwest of Odessa, will have expanded access to health care.

“This new innovative model shows that two academic health centers can collaborate to address rural health care needs,” Adrian Billings, MD, TTUHSC associate academic dean of Rural and Community Engagement, says.

A woman stands in a small room speaking to a group of five adults who are attentively listening. She gestures near a medical workstation with a monitor showing a video call featuring two people. The room has light blue walls, an air conditioning unit above the monitor, and a sign reading "Frontier Medicine" on the wall. The scene appears to be part of a telemedicine or community health demonstration.
Provided by Texas A&M Health
Community members in Fort Davis, Texas tour the new Davis Mountain Clinic.
The clinic offers a new access point for care, a retrofitted shipping container designed by BUILD, a student-led program within Texas A&M University. TTUHSC medical residents provide primary care, and Texas A&M Telehealth Institute covers telehealth counseling. Billings helps coordinate a team from TTUHSC Lubbock and Permian Basin. He and Martin Ortega, MD, regional chair of Family Medicine, coordinate a collaboration team, which includes TTUHSC’s Division of Rural Affairs and the Rural and Community Engagement and Family Medicine in the Permian Basin.

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care shows large swaths of Texas, including Fort Davis, are categorized as Primary Care Health Professional Shortage Areas.

“Rural residents live less length of life than urban patients; have more chronic pain than urban patients, are sicker and they have more chronic conditions,” Billings says. “The root cause of those disparities is a lack of access to health care services.”

Without intervention, challenges could worsen. That is the draw as well for TTUHSC alumnus Toby Hamilton, MD, (Medicine ’00) who is working on a separate venture to help rural patients. He is the CEO of Hamilton Health Box, a Houston-based company that creates prefabricated “micro-clinics” designed to provide affordable, high-tech primary care.

Employees in Houston register patients via a video screen. An off-site physician uses portable devices, sometimes operated by artificial intelligence, to conduct everything from diabetic eye exams to breast cancer screenings and heart check-ups.

“We’re trying to take care of people,” Hamilton adds. “And when you do that, everything else falls into place.”

He expects to open four or five Hamilton Health Boxes in the Big Bend region in the coming year. There are already 10 in Texas and a total of 30 nationwide.

For Billings, this also adds an extra layer of care on top of existing telehealth services in other parts of the area.

“You know, telehealth can’t deliver babies, can’t respond to emergencies,” he says. “It’s not the only solution, but at least it’s part of a multimodal solution to the rural health care problem.”

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