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Improving Clinical Care

ck_BHclinic-68The Bateman Horne Center, a center of excellence, is leading the way in the medical advancement and treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia (FM) through integrated medical research and clinical care. The Bateman Horne Center (BHC) is the only clinic in Salt Lake City providing specialized clinical care for ME/CFS and FM. Only able to treat 10-20% of the people who call for an appointment, many of whom travel great distances, we seek to not only increase our capacity but engage in activities that will educate healthcare providers and ensure quality care across the US.

Formerly the Fatigue Consultation Clinic (FCC) and the Organization for Fatigue & Fibromyalgia Education & Research (OFFER), BHC been committed to the education of medical providers from the beginning.

Hard Copy Education:  After a patient’s evaluation in the clinic, a formal, typed, 6-10 page document is sent to the primary care provider (PCP) and any other requested clinicians, delineating the patient’s symptoms, function, onset history, an academic explanation of how they meet MECFS and/or FM criteria, and treatment strategies.  Thousands of such reports are in the PCP records of our patients.

CME:  Our first Continuing Medical Education (CME) conference on the subject of CFS/FM was in 2003, followed by 2004, 2005, 2007, 2010, 2012, 2014.  Each offered 6-10 hours of credit and was attended by approximately 150 medical professionals.   We intentionally used a different major, local CME provider each year to add credibility and broaden our reach—Intermountain Health, Utah Medical Association, VA Employee Education System, University of Utah for the physicians.

Dr. Bateman also helped produce two CDC CME programs in 2012, one on sleep in CFS and one on diagnosis and management of CFS.  She also played a key role in the two Medscape CME courses for physicians, Chronic Fatigue Syndrome: The Challenges in Primary Care (2012) and the CDC’s CFS Public Awareness Campaign launched in 2006.

Of course, Dr. Bateman frequently lectures at the IACFSME scientific and clinical conference (every two years) on topics related to treatment.

Education of Physician Assistants and Nurse Practitioners:   Dr. Bateman teaches a 2 hour lecture in the Utah Physician Assistant curriculum on ME/CFS and FM, and write test questions to be included on the final exams.  This intense educational effort has been provided for more than 200 PA’s in training. She has also provided update lectures at yearly Physician Assistants (PA) CME conferences, which reach hundreds of PAs in practice.

Patty Jeys PA-C has donated her time to speak at yearly PA CME conferences and also teaches a 2 hour lecture on CFS/FM in the Nurse Practitioner curriculum at the University of Utah.  This effort has reached hundreds of NPs going out into practice.

Learning opportunities in the clinic:   Our door is always open to clinician observers.  We have had PA s, nursing and pre-medical students, medical residents, and even physicians, sit in on patient visits. One skeptical family practice doctor sat in for several observation days, and then referred his daughter to the clinic after he had learned more about the illnesses.  The son of a longstanding patient spent time observing  in the clinic, became a physical therapist, and is now  influencing the care of patients in the community.  We often invite selected providers to lunch with our entire staff and share experiences about patient care—sleep specialist, psychiatrist, physical rehab, pain specialist, etc. They go away with new insights.

Last spring Dr. Bateman gave a lunch talk to pre-medical students at a nearby university.  6 students spent time in the clinic working on a variety of research projects, sitting in on patient visits, and 4 students learned how to take a history and began interviewing new patients prior to their clinic appointments.  Two of these students were hired to work all year, one in the research department and one as a medical scribe.

Read more about our learning opportunities HERE

IOM Report on clinical diagnostic criteria: “I saw this as an opportunity to influence the future.  It was a forum to share my clinical experience with other diagnosticians, especially important until we have developed objective biomarkers of disease that are available to clinical diagnosis.  I felt a responsibility to be sure the voice of the patient regarding access to primary care medicine was heard in that effort.” Said Dr. Bateman about her involvement in the IOM Committee for Diagnositic Criteria for ME/CFS.

Read more about this effort HERE.

Publications in the medical literature:  Published medical literature is the only way to reach/teach an academic medical community entrenched in the principle of “evidence based medicine”   Although it is not routine or easy for primary care clinicians to publish in major scientific journals, Dr. Bateman made a commitment early to partnering with others in the field—scientists and clinicians—in order to build the scientific literature.  The BHC research willing patient base has contributed to papers on XRMV, exercise induced gene expression changes,  cardiopulmonary exercise testing, the long term follow up of almost 1000 patients.  The Chronic Fatigue Initiative pathogen discovery study and the CDC multisite study will continue to result in numerous descriptive high quality academic papers.

Expert Consensus Documents to help clinicians diagnose and treat MECFS:   Dr. Bateman was a contributing author on both the IACFSME Primer and the ICC Primer designed to assist clinicians. These documents are freely available to interested clinicians.

Read more about Dr. Bateman HERE and HERE