Sullivan County Democrat
Callicoon, New York
March 10, 2009 Issue
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Jeanne Sager | Democrat

Dr. Gary Good

Sullivan 'AIDS' doctor back in business

By Jeanne Sager
By Jeanne Sager

MONTICELLO – If he builds it, Dr. Gary Good is hoping they will come.
The infectious disease specialist who opened his new office this week in Monticello, has after all, changed the face of AIDS and HIV care in Sullivan County.
Good was in training at the time in Camden, NJ, in 1994 and he kept hearing about Sullivan County, an area of New York with an alarming rate of HIV diagnoses.
Raised in the Wilkes Barre area of Pennsylvania, Good was looking for a chance to get back to rural living, and he soon learned that he could do so and still follow his calling to specialize in infectious disease.
Arriving in the county in 1994, Good said he found a population that was very sick.
“It was a population you didn’t develop a really long relationship with,” he recalled.
It was still relatively early in terms of HIV and AIDS treatment, when medicines being used to treat patients were still relatively unsuccessful. Coupled with that was the lack of resources in Sullivan County, where the HIV patients have traditionally been from a lower income bracket, often without health insurance.
He came to Harris to head a program in a trailer in the back parking lot at what was then Community General Hospital. It later moved into the hospital building, and expanded along with the hospital, staying as the facility took on the name Catskill Regional Medical Center.
By the mid-2000s, the staff included not only Good but a nutritionist, case managers, and a nurse practitioner to provide care to a population of more than 220 patients. Many of those patients were what the staff referred to as members of the 10-year club.
They were survivors, patients whose health was stable, whose life expectancy went from the dire prognosis of most patients when Good arrived to something akin to the rest of the county’s population.
But as the hospital itself went on the critical list, Good said he saw a need to take the clinic elsewhere.
“Throughout the hospital’s problems, their focus was really on core activities,” Good said. “The outpatient services were really being let go.”
Through talks with Hudson River Healthcare, a non-profit that set up an office in Monticello in 2005, Good was able to secure a new home, one that came with an alternate funding source to keep in place the resources for the patients.
“Promises were made, and it looked like it was going to be a good move,” Good said with a sigh. “There were a lot of people who warned us, ‘They’re not what they seem to be.’”
Still, with no home left in the hospital, Good took the jump. The clinic took its hits. Staff was reduced from an all-time high of 16 people to a staff of five, including Good.
Dental services done at the CRMC program weren’t carried over, and Hudson River told Good his nurse practitioner would have to serve dual roles as a provider for the HIV/AIDS clinic and for the general practice – seeing patients on both sides.
Good was asked to do double duty as well, although he said his five days a week in the office were spent with such a high caseload he never did.
With a high rise in hepatitis C cases in recent years, Good said he was seeing not just HIV and AIDS patients but those infected with the highly infectious but curable hepatitis as well.
As the months went on, Good said he heard rumblings that the tide was turning. He applied for and got grant funding for what he dubbed an exciting drug trial – the type of thing he’d been told HRH’s federal grants suggested they get involved in.
Management turned him down.
Then he heard a large grant was coming in for telemedicine – a process that would allow a doctor to review patient charts without having to come to Monticello.
“I could see, oh, I’m becoming expendable now,” Good said.
On Oct. 27, he was shown to the door.
HRH Vice President Allison DuBois said she could not speak about the decision to cut ties with Good out of respect for their previous contract.
“We really are focusing on the future and on the community,” DuBois said,
She said the current staff, a full-time nurse practitioner who splits her time between HIV/AIDS care and general medicine and a doctor who visits one day a week from Peekskill to provide care in Genesis, the HIV clinic, are top notch healthcare workers.
Good doesn’t dispute that.
He has the utmost respect for Dr. Christine Kerr, the visiting physician from Peekskill.
But where he spent five days a week in Monticello, she’s there once a week with a second day open for appointments on an as-needed basis. She rotates to the other HRH clinics, he said, including Peekskill, Beacon and Poughkeepsie.
And the patients who followed Good to HRH are still calling him. They’re calling him at home, frustrated by difficulties they report with navigating the HRH system.
Good couldn’t abandon them.
“There’s need here,” he said. “I really wanted to bring state of the art HIV care to a rural setting. When you’ve been taking care of patients for 14 years, they’re not patients, they’re family.”
He secured office space in Monticello, at 427 Broadway, Suite 1, and has been working with insurance companies to become accredited.
He’s been told he can’t make it happen without grants, but Good says he has to start somewhere.
“It’s going to be a lean few months,” he said with a grin. But his plan is to create a non-profit, begin applying for the drug trial funding that he’d secured in the past, and start bringing in donations and other funding sources to add case managers and the like to his staff. In the meantime, he is beginning to network with Sullivan County agencies that he said should be working hand in hand with those caring for patients with infectious diseases in the county.
“I used to say let me just see the patients, I’ll let you do the administration,” he said. “I realize now it can’t happen that way. I need to be involved.
“I want to let the patients know, I haven’t let them down,” Good continued. “I’m not disappearing, and I want to offer them the same services I always have.”
To reach Dr. Gary Good, stop by his new office or call him at 794-6813.

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