The Health Wagon, in conjunction with Dr. Joe Smiddy, Pulmonologist, offers the only free Lung Cancer Early Detection Program in Southwest Virginia. Dr. Joe Smiddy secured a mobile unit to provide free chest x-rays, arterial blood gas tests, and pulmonary function testing for The Health Wagon. Dr. Joe, as we know him, went the extra mile and went to truck driving school to learn the art of driving the mobile unit to these clinics. The first free Lung Cancer Early Detection clinic was held in December 2006. Medical exams as well as medication and education on smoking cessation were also given. The mobile unit has provided over 1,000 chest x-rays.

Future Lung Cancer Early Detection Clinics are being planned, contact us for more information.

The Need for Care

According to The American Cancer Society, Lung Cancer is the number one cancer killer in the United States. In the U.S. alone, an estimated 160,000 lives are lost each year to lung cancer - more than colon, breast and prostate cancer combined. Currently, only 15% of cancers are detected when they are small solitary pulmonary nodules in the 9-14 mm size. Small lung cancers found within this range present the most significant opportunity for earlier treatment for patients. It is estimated that lung cancer caught at this stage may be cured or controlled in up to 85% of all cases. Early-stage lung cancer screeing with chest x-ray represents a tremendous opportunity to improve early detection and save addtional lives. This tool can help radiologists detect more small, subtle and suspicious nodules at an early stage.

The geographic area served by The Health Wagon, described as a lung belt, is associated with an increased incidence of major lung diseases which are most often only recognized in late stages. The prevalence of adult smokers is 30%. The average age of onset of smoking in adults developing lung disease is age 10. Passive smoking remains prevalent, restrictive laws are minimal and not enforced. Additional risk factors for major lung disease include coal mining, asbestos exposure, and prevalence of histoplasmosis. Limited facilities are available for diagnosis and ealry detection lung cancer. The Health Wagon has no way to perform chest x-rays on patients who would normally have a chest x-ray if being evaluated in another setting. Ideally, patients over age 50, with greater than 30 pack years of smoking, and lung symptoms should all have chest x-rays. Most of our patients have never had a chest x-ray, or not had one in numerous years.

The county health departments in the region do not have x-ray capabilities. Futhermore, local hospitals are small, financially threatened, and unable to meet the existing needs.

Enhanced benefits for patients

The provision of x-ray services will enable The Health Wagon to offer enhanced benefits for our clients; some of which include:

• Quality high patient care with enhanced outcomes with integrated evidence-based best practices guidelines and management

• Early detection of lung cancer with improved patient outcomes

• Reduction in morbidity

• Reduction in mortality

• It is felt that with the augmentation of this needed service that our existing services would be positively impacted and certainly in the end benefit many individuals that are in so desperate need of health care.

• Diabetes Clinic

Dr. Rhinehart serves as the Diabetologist and Medical Director of the Johnston Memorial Diabetes Care Center in Abingdon, VA where he has been in practice since finishing his medical training in 1995. Dr. Rhinehart has been awarded recognition from the American Diabetes Association (ADA) and the National Committee for Quality Assurance (NCQA) Diabetes Physician Recognition program for providing high quality care to individuals with diabetes since 2002. In collaboration with Mountain State Health Alliance, Dr. Rhinehart held his first diabetic clinic at our Clintwood office on May 17, 2011. These extensive diabetic clinics will be held quarterly. In addition, he will be seeing patients via telemedicine.