Alumnus looks deeper, sees new way to provide quality care for often overlooked patients
Since July 2012, Christopher K. Echterling, '88, M.D. '92, has been the founding medical director of WellSpan Bridges to Health—an innovative "ambulatory intensive care unit" that targets York County, Pa. patients who are particularly high utilizers of inpatient and emergency department services. Echterling's multidisciplinary team of physicians, nurses, and social workers addresses not only their patients' chronic health conditions but also underlying, contributing factors such as poverty and mental health issues.
"Our patients have legitimate medical problems, but it usually becomes pretty clear that other issues are complicating their ability to deal with those medical problems," says Echterling. "Often there is a history of loss or trauma in their lives, which has made it difficult for them to build trusting relationships. Sometimes their priority is not their diabetes, but other issues like the grandchild for whom they have sole responsibility."
In little more than a year, Bridges to Health has both enhanced the quality of care and reduced inpatient stays and emergency room visits by more than 25 percent.
Echterling is also the medical director of the Healthy York Network, a community collaborative comprised of hospitals, non-profit groups, government agencies, and private physicians that annually provides $30 million worth of free, coordinated healthcare to 8,000 uninsured patients. As the WellSpan Medical Group's associate medical director for quality and innovation, Echterling is helping to spearhead the group's ambitious goal of providing quality, patient-centered care within its 64 primary and specialty practices.
In early September, Echterling met with Beverly Mackereth, secretary of Pennsylvania's Department of Public Welfare, and her staff. "Our efforts caught the attention of the department," reports Echterling. "I feel blessed that I can be in the trenches with patients, but also have this audience to have a voice about broader policy issues. Sometimes when you're dealing with either big policy issues or just individual patients, it can feel futile. So it invigorates me to be able to do both. Each informs the other."
Until last year Echterling also spent a dozen years as the medical director of the York Hospital Community Health Center, WellSpan's major site of care for the underserved. He supervised the center's family medical and pediatric clinics, as well, and until 2009, its OB-GYN clinic. For 15 years he also provided care for children and adults in the center's HIV clinic.
In talking about his community health center experience at the York center, Echterling also sums up his philosophy and career: "When I left that role last year, our practice had some of the best quality statistics of any practice in our medical group," he says. "We might have to work differently or more intensely, but our experience proves that our patients are just as capable of receiving outstanding care and getting healthy as anybody else."
A native of Lancaster, Pa., Echterling earned his pre-medicine B.S. degree from Penn State, where as a sophomore, he became one of the first two students to be accepted into the College of Medicine's integrated undergraduate-graduate degree program. At Hershey his advisor was pediatrics professor Cheston M. Berlin, Jr., M.D. Each week Berlin would ask Echterling and two other students what they had been learning, quizzed them, and then took them to visit an inpatient with a relevant condition.
"He'd connect the learning to the human being, and through that we got to see his sense of humanity and compassion," recalls Echterling. "He was probably the best thing that happened to me at the College of Medicine." Dr. Graham Jeffries was also influential, introducing Echterling to medical mission work for nine weeks in Kenya during his fourth year. Echterling would later go to work in missions with his children in Ethiopia, India, and Guatemala.
After three years as a family practice resident and chief resident at York Hospital, Echterling served another two years with the National Health Service Corps at a federally qualified community health center with offices in York and Adams counties—and never left the area. Echterling credits his wife's support for his success. Says Echterling, whose son, Ben, is a junior mechanical engineering major at Penn State, "I love what I do. I think I do it well and feel that this is what I have been called to do."