Whitesburg physician named country doctor of the year defends Affordable Care Act

Feb. 27--If you're from around here, Dr. Van Breeding knows your name.

In fact, you probably have his personal phone number. Breeding's take on that is that patients don't call him unless they're scared, and if they're scared, he wants to be the one to help them. He takes care of patients from birth to death, from hospital to nursing home. He is a bit suspicious of "hospitalists," because who can take care of you better than the doctor who knows you, your family, your family tree and the ailments that have befallen your kin?

Breeding, a primary care physician and director of clinical affairs at Mountain Comprehensive Health Corp., is the 2017 Staff Care Country Doctor of the Year. The Plano, Texas-based medical staffing company has awarded the honor each year since 1992. Staff Care praised Breeding for "an admirable commitment to treating patients regardless of their medical condition or ability to pay. ... You are one of the pillars on which your community stands."

Breeding is the first Kentuckian to receive the award since 1997, when Claire Louise Caudill of Morehead, who delivered more than 8,000 babies during her 50-year career, was awarded the title.

Breeding, 55, a Letcher County native, decided to become a local doctor as a child, seeing his ill grandmother having to travel great distances to visit doctors, leaving home at 3 a.m. to make an appointment on time.

"I always knew I wanted to come back here."

But he also knew it was important that he knew Lexington doctors and had access to the networks, including that of UK HealthCare, that could give his patients an advantage. So he networked to make sure he could get his patients advanced care, and quickly.

"I don't have to call a service; I can call their cellphones," he said of Lexington doctors and specialists. "I've got that ability to get my patients in quickly."

Breeding's father was a coal mine worker, his mother a schoolteacher. He has three daughters with his wife, Pauletta, whom he identifies as being from the "Knott-Floyd line," which is a distinction Breeding can make because he can identify every hilltop building and neighborhood over a multi-county area.

Breeding talks very fast, like someone reading the terms and conditions at the end of a radio commercial pitch. Indeed, Breeding talks so fast and on so many subjects -- the good that the Affordable Care Act has done his area in bringing in patients before their diseases become serious, Appalachia's problems with smoking, drugs and lack of prenatal care, the Farmacy program to provide patients with health problems access to fresh fruits and vegetables -- that it requires an aerobic listener to keep up.

Breeding starts his day at 4 a.m. He likes to take an early-morning walk before doing rounds at the Whitesburg hospital. Going by the post office, he'll talk to the coal miners who congregate outside.

"He treats each patient as a friend and neighbor and is devoted to providing health care access to a population with the dual challenge of having some of the country's highest rates of cancer, heart disease and diabetes as well as being located in one of the most poverty-stricken areas," said Dr. Michael Karpf, the University of Kentucky's executive vice president for health affairs.

Breeding went to the University of Kentucky for undergraduate studies and medical school. He was a medical resident at UK HealthCare.

The Affordable Care Act brought Breeding and the clinics at which he works more patients. He said his patients got "bamboozled" politically by those who called their expanded medical care "Obamacare" and called for its repeal. Barack Obama, perceived to be anti-coal, was unpopular in the mountains, and hence a program identified with Obama would likely be reviled.

Asked whether they liked their expanded health care, Breeding's patients would say yes.

But call it Obamacare and ask the same question, they would say no.

"We got insurance to patients who have never had care before," Breeding said.

Now he fears they might lose it.

In Eastern and southeastern Kentucky, getting patients in for early screenings is crucial: The area has high rates of breast, uterine, ovarian and colon cancers, and patients benefit from early detection.

Breeding said when he got his first colonoscopy at age 50 and had a benign polyp, he wanted to be able to open up screening to people who think they can't afford or fear getting a colonoscopy.

Breeding said he sympathizes with his patients who struggle to stretch paychecks until the end of the month; so he tries to schedule appointments earlier in the month, when patients can buy gas to get to the clinic. His patients can't take a bus, like Lexington patients, and a filled gas tank is required to get just about anywhere in the mountains.

He's a nice guy, the country doctor of the year. Breeding talks about local fundraisers and the need to show area residents how to improve their diets in an area that has become dotted with fast food drive-throughs selling cheap and greasy but filling fare. He even talks about showing local residents the goodness of romaine lettuce with a missionary fervor.

"I have a good time while I'm at work," Breeding said.

It shows.

Cheryl Truman: 859-231-3202, @CherylTruman.

___

(c)2017 the Lexington Herald-Leader (Lexington, Ky.)

Visit the Lexington Herald-Leader (Lexington, Ky.) at www.kentucky.com

Distributed by Tribune Content Agency, LLC.