Ep. 15 | Brian Griner, MD, Internal Medicine and Pediatrics

Transcript

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- Welcome to another episode of What Brings You in Today.

- I'm Erika Bennett. And I'm

- Taylor Fisher And today I am here with Brian Griner, MD, Internal Medicine and Pediatrics. Also the owner Griner Medical Group, but more importantly, the godfather of Primary Care, Valdosta, Georgia, I would say. So Dr. Griner, what brings you in today?

- Well, I'm here to talk about a mixture of things both high and low and in between.

- Alright. You've been here for a while. You've, I mean, you're well known throughout our community, have served thousands and thousands of patients. I think everybody has been seen by Dr. Griner.

- I've had contact with quite a few people. Yes, I'll, I'll, I've been here for 25 years, started in 99 and straight out of residency and I've enjoyed every second that I've been here. That's the summation of everything. I've made a lot of good friends over the years, a lot of patients who are family members. We were just talking with one of your cohorts today about her grandmother and today would've been her birthday. And she was a beloved patient, not just to welllike, but she was beloved and she was always a bundle of energy. It is connections like that that make it easy to be a primary care doctor.

- I mean, what made you decide to become a doctor? Tell us about where that passion started.

- Well, I was born up in Berrien County Hospital.

- I didn't know you were a Berrien County

- Native. Yes, I am.

- Okay.

- So that is, and that's a kind of a common connection we have there, miss Erika. Yep. And I was born there. My mother worked in the hospital initially and then she went to go work with one of the local doctors. But my afternoons were spent in the hos in a hospital room doing my homework. And so I knew everyone there. I knew the people who worked in the cafeteria. I knew the people who do the janitor work. I knew all the nurses. I knew most of the doctors. And so it just kind of became a, almost a rite of passage that I would most likely become a doctor. And followed through on that. At the time, I knew I was probably going to become a primary care physician. I was thinking more family practice until I got into med school. And then I kind kind of steered in this different direction than I'm in now, which is essentially like family practice. Just a little more detailed. And I've never looked back. It's been, it's been a good rollercoaster ride.

- Well, what I heard from that is that I need to bring my children to work more often.

- Yes. So

- That they

- Can get, so that being said, you know, so they can get inspired. There's been times been times that I've carried both my son and my daughter up here to the hospital with me. My oldest is gonna be going into speech therapy, so quasi medical. But my other two are looking at going into medicine as well too. One of them even told me that he wants to come back and replace me. Oh. But not necessarily in a good way. I think he wants to kind of take over but do something different. So, but that being said, I mean that's, you know, I think that type of fostering or mentoring even an early age is key for everything there. I mean it's, it becomes more of a relationship, a different type of relationship I have with my kids on a different sort of common ground. But it's the same sort of thing we kind of do with our patients as well. We try to get that common ground. So not only to let them, not just necessarily trust us more, but to understand what we're trying to get 'em to do, to get them believing that they can make a difference in their life. And once they get to that point, then everything comes a little bit easier.

- Yeah. So a lot of people don't have primary care providers here in our area. When we did a, you know, survey not too long ago and it was like 70%, and I think a lot of it's probably the younger, like 18 to, they just hadn't felt the need for it yet. Right. They're that kind of that in between. But what are, what are you, what is your advice to people to try to get them to take their health kind of seriously and make sure that they're getting check checkups regularly and what the importance of it, like how do you explain that to a patient? Well,

- I, I I, I think a, a good thing about that is, is that as they're coming along in school, you have an opportunity as a pediatrician try and make some positive influence on them. And one of the things I try and impart on a lot of these kids and all there, they may not know what they're ultimately gonna be, but they need to have a vision of where they wanna be at. And part of that vision is that I wanna go from point A to point D at some point and how do I need to get there? Well, it's not laying around on your phone all day long. It's not vaping and smoking and doing other things that you know, that are not gonna be beneficial to you both physically, mentally, and those types of things. Trying to get them to see that part of it early on. Then as you become a young adult, trying to choose some healthier habits as well too. And if you have some sort of genetic predisposition, 'cause there's some, that's one thing we can't escape is family history. Is that maybe I should seek out a medical professional sooner rather than later. One of the beauties I think I have with my practice is I see both real pediatrics all the way down from birth upwards and all. Yeah. And they kinda limb that down to pediatricians. Some of our family practice people do that as well too. And they're able to make that intervention as well, is that these parents say, well, you know, I'm, I'm having a, a call for a cold. Can you help me out? I said, yeah, we can get you work in and kind of get you, get you take taken care of. And that opens the door. For instance, I've had a, a subsegment of our community come in for one family member had diabetes. Well then they wanted me to see another family member, another family member. And these people are in their forties and fifties. And that has now turned into about a hundred family members who had no preventive care done whatsoever. Yeah. Because of a language barrier. Hmm. And so as a result, you know, we're making some headway there. Yeah. Trying to keep them healthy, you know, because these people, they work from sunup to sundown seven days a week. So to convince them to come in and take some time off is a big ordeal. But then you can say, look, you know, I'm getting these other problems taken care of so you can work longer if you wanted to or go spend more time with your family.

- When I imagine people don't know like they, their normal or their healthy is different. Like they, they think that is life as like, does that make, does that make sense? If you are, if you're living with, let's just say pain and you start to just, that becomes your daily life and you don't even know a life without that

- Pain or you think it's not serious enough Yeah. To see a doctor you don't, you know, wanna be, you don't wanna bother a physician with this what you think is something small

- Or even along those other lines or just so you have another sub segment. You know, we have, you know, gyms all over the place. People are working out more and all there and they think, well, I'm working out. I'm gonna be healthy. Well, there may be some other things that are coming up because of that, like the chronic pain issue. Like, you know, pain in a certain area may be a sign of something simple, but it could be something, a sign of something more severe or serious, you know, it could be, the reason why you can't run on that treadmill as long is because you know you're going to be the oldest living member in your family and you're only 40 because everyone else died of heart disease. That's a normal history we get here in South Georgia. Yeah. I mean it's estimated by 2050. I think a recent thing, our recent story came out this week, 61% of people have cardiovascular disease.

- Yeah. And it's probably higher here in our area. Exactly.

- In the southeastern United States. I mean, we live in a cardiovascular belt, a hypertension belt, an asthma belt, a a migraine belt. I mean whatever bad belt there is where you live in that belt. So there's lots of pathology there.

- And I would ask like, what is like common things that you see or what's prevalent to our area? But I have a feeling I'm gonna get the answer that Dr. Connell had about what he's sees in the er. And it's probably just all over the place. Anything and everything you see. But is there anything,

- In my case, I see anything and everything. And then fortunately we've also started carrying a reputation. We take care of a lot of the weird and esoteric things as well too. We get those diseases that they're like one in a hundred thousand. Yeah. Whether it's genetic diseases or other unusual occurrences. We have a lot of that in our clinic. I mean the, the mantra in our clinic is if it looks like a zebra, start looking for the albano zebra because us probably how they're

- Priced. Yeah. What's the craziest disease you've ever, or

- I could go on. I mean, just

- Something that's, that we probably never heard of. A bizarre.

- So there is one, there's a genetic disease called hypoglycemia. Not glycemia, but glycemia. It's an inborn era of metabolism. And these kids are born in, unfortunately they're not gonna make it. It's a very unusual disease and they have tremendous amounts, whole body's affected. It is, it's very sad. And I have two siblings are affected with it. Wow. And we've seen, I mean I could write a book on the number of unusual things I've seen.

- Well I know I texted you a photo one time of my son's head. He was losing his hair because I think he had a ringworm and remember that. And it was like, because he plays football and stuff and wore helmets and what have you. I promise he does take showers. But it had, he started losing his hair and you had to put him on that medication that he had to take for like 30 days. Yeah. Because it would not go away. It was exactly. It was like bizarre back. So I bet you get,

- We'll get a lot of stuff.

- So when do you sleep is my question because I can never figure that out. 'cause I see you here morning, night, middle of the day. And then you're also over at your clinic too. So

- Between two and

- 4:00 AM Okay. Is that healthy to get two hours of sleep?

- No, it's not. But that's why I'm able to plug myself into the wall, you know, recharge, so,

- Okay. Well you,

- Yeah. But yeah, my day typically does begin about four 30 every day. So yeah, I get up, start reviewing records and all for the coming day. And

- What time do you go to bed

- For real? If I can. 10 o'clock. Okay. So,

- All right, well you're one of the few physicians that still sees patients in the hospital, right? Yes. So that's why I said I see you here like morning, night, during the day. 'cause you also serve on our board. But I mean that's that you, that's a lot.

- It is a lot.

- You but, but yeah. How do you do it? I just,

- But too much is given much is required.

- That's right. That's

- Right. So that's the way I review it as well. I've always viewed it as, so, you know, if I've been given a, the ability to take care of people, then I take care of people. Oh, I'm not gonna waste the talent. So Yeah.

- Well that is so sweet. I know one, my son, my other son, you've cared for all my children. But he had some kind of rare something where he, he was a baby and I, I don't even know that we ever figured out what exactly happened to him, but I remember that I took him to your walk-in clinic that, 'cause of course I, as a healthcare professional, we don't ever use the er. Right, right. We're like, we could be half, you know, dead on the side of, we're like, no, we're not. It just doesn't require the er. But anyways, I had taken him to your walk-in clinic and they were like, you need to go to to the hospital. And I'll never forget when I came in and I was going up the elevator to pediatrics, you were walking in and you met me on the elevator and just like started listening to him and figuring it out. I mean he was only like six months old or something. But that certainly made an impact to me. And that's when I was like, this doctor has got going on. 'cause he knows what appreciate that, knows what he's doing. But then being able to see how you serve on our board of directors and just the different leadership roles that you also serve on here at the hospital. Tell us a little bit about what you see, like your view of our health system.

- Well, it is a processes in evolution, adaptation, whatever term you wanna put in there. We've come a long way from where I started 25 years ago when I started. We did not have a cardiovascular program and a lot of our other programs were very fledgling and just not that mature. And we've grown well beyond that. I would say we are a, as a term that Mr. Dean likes to use as a, a destination for healthcare. We are a major driving force in that we have people here who are trained on an incredible level in all areas of our medical staff. Not just in the sub special world, but in some of our primary care people as well too. And I think, you know, seeing that evolution of the medical staff has been a a, a great thing. You know, seeing the fact we're able to keep more of our babies in all here, thanks to our neonatologist. Seeing that we're able to do more of our heart procedures, whether it be tavr, whether it be the high complex PCIs, whether it be bypass valve surgery, the vascular procedures that we do, the electrophysiology that we do. Even a lot of the high risk OB that we do here too. In addition to taking care of the bread and butter that we have to deal with every day. The pneumonia, the COPD, the diabetes, the high blood pressure, the cuts, the scrapes, everything and in between. And we just kind of slowly but surely plotted our way forward and kept getting things better.

- Yeah. It's really cool from my perspective, just seeing, especially how much growth we've seen in the past couple of years, it does make you proud to be in this community and proud to be in this health system at this time because it's gonna impact, I mean we're, we are becoming like a regional destination for care and creating something very special for our community and for our families that live

- Here. I agree. I agree totally. And you know, we have our challenges. Every, every system has their challenges and all, but I think one of the big things that with our challenges, we don't seem to back down from them and we try and help kind of frame it a way so we can kind of, like I said, keep moving forward, you know, regardless of the challenge that comes up. And you know, during the covid time this community rallied around us. And I think that was a good thing for us in, in that regard. I mean we were,

- I, me too. I mean it was a horrible thing in general, but everybody came together required we had to every, every department, every physician, I mean everybody was just coming together to see, you know, how we were gonna best right. Deal with this.

- But the community came together too. They did. Absolutely. They were very supportive. Absolutely did. And that goes a lot there. I mean if you have the support of your community, you can do a lot. I mean, you know, otherwise we'd be like some other local area hospitals that are floundering and all there and closing down and I don't see that happening. I don't see us being as vulnerable as what we were once were. So

- Yeah, that's, I mean there's a lot of hospitals that are shutting down or at risk, especially in Georgia and rural areas and being able to build a new ER in Baron County. Right. I think speaks volumes. And then the expansion project that we have here going on.

- Exactly. I mean both these projects are huge. I mean the expansion up in Burien will be bigger, the entire hospital I was born in. So that's a great thing. You know, the expansion project, we're gonna be starting down here to increase the availability of care, not just through the emergency room, but also for our women and our infants and all is going to be tremendous.

- Yeah. I mean you get to see it all. 'cause you literally, you see the babies, the babies that are born. So when you have a child, you have to know who your, their pediatrician is gonna be. And when you're still in the hospital before you ever leave, the pediatrician comes by, introduces themselves, you know, sees your child and then, and then you're also seeing patients that you know are at the very end of their lives. Yeah. So

- How often do you see babies and then see them when they have children? Has that happened to you throughout your

- Career? I have. It's kind of strange how this occurs. You know, over time I've had some grandparents I've taken care of then I've eventually take care of their kids and then their, their grandkids and then sometimes it works backwards that way. But I have, I've got about 15 or 20 that I have seen since birth who have gotten married and then started raising a family on their own.

- That must be a cool feeling.

- That's a very cool feeling. So, and especially when they say, we know whenever I was a baby, Dr. Barner is my doctor and it really starts making me feel old. But I like it. I mean it's a good feeling. I mean it's, it just gives that warm fuzzy inside.

- Yeah.

- Oh yeah. Because they're trusting you. They're trusting you with their care, but then they're also trusting you with the care of their child. And I think that Yeah. You know, speaks volume. So Yeah.

- I think when we talk to Dr. Bloch, she had a similar thing was that she's, 'cause she's been in the community so long as well, I've seen the little kids and then now sees them as adults with their kids. Exactly. And I just think that's so cool to watch people grow up like that.

- It is, it is a very cool feeling.

- What do you see as one of the biggest challenges that our community faces just in general with health access to health and or I mean, is it just lack of education about how to be or a lack of prioritizing it? What do, what do you think?

- I think a lot of our constraints are on some level economic and it's economic beyond what we can deal with, you know, within the health system itself and all there. A lot of people feel disenfranchised because of economic reason being the main thing there. I, I don't think it's goes much beyond that. There, I feel like they, if they come to the hospital that they, they're afraid that they won't be able to be taken care of or that something bad really is going on. And so there's a little bit of a fear factor in there too. And that there's gonna be something we can't fix. I think there's some elements to that there. It is. It is a very mul, multifactorial problem. But I'll go and tell you it doesn't matter, regardless of their ability to pay, if they show up here, they'll be taken care of. Yeah.

- And I think that's an important reminder too, that we are a not-for-profit health system and we do treat anybody regardless of their ability to pay. And it's important that we remain, you know, vital or vibrant in this economy and in this area. Because if you don't have your not-for-profit health system that can care for you, then where do you go? You know, where do you go? Who cares for those

- People? Exactly. So and so, I mean, you know, if you look at all these doctor TV shows, they always try and paint that in such a negative connotation. Well we can't do Ms. Jones's surgery because her, her insurance won't approve that. You know, if it's something that is a standard of care then it's a standard of care and we're gonna do that here. That's what we do day in and day out. 365 days outta the year, regardless of which service you're on here in the hospital. Yeah,

- I know it could be scary for anybody coming to the hospital. I mean you have so many different factors that, that they are considering as they're coming in number one probably, probably being money finding, you know, like what is this gonna cost me? You know, what are, what are they gonna find out's wrong with me? And I think that our healthcare team really tries to do a good job of understanding that patients most of the time don't wanna be here. You know, it's scary for them and then trying to console them and give them the best care that they can to alleviate those concerns. But

- I agree. I agree.

- Let's talk about the significance of the Mercer partnership.

- Ah, that's a good thing.

- Yes. Yes. So we just announced that we, you know, we have our residency program. So we've got graduate medical education and that's for those that don't know anything about medical education, you weren't, you did not grow up in a hospital and go to Vietnam. Exactly. But for those, that is, if you, after you get your medical graduate from medical school, then you come here, you can do your residency training where you decide, you know, you specialize in whatever you're gonna, whatever your field is gonna be. So we have our internal medicine residency program, which is what the degree you have. That's, yes. And then we also have transitional year that's starting next year. And then we also have Mercer University School of Medicine third and fourth year clinical site. So we'll have those students coming this summer. Exactly. So tell us what it means from a big picture perspective.

- Okay, so I've been affiliated with Mercer now for almost 20 something years. I've been one of their professors in their rural health rotation. 'cause they've always been a big proponent of that. Trying to get people back to some of the more medically underserved communities throughout the state of Georgia. And that's been one of their, their mantras are edicts. And it's been very beneficial in that regard here. A few years ago when we started to start up this residency program in a more earnest thing, they help affiliate with us so that we can kind of move forward with that. And that program has taken off. I mean we're putting out, you know, several new physicians and we'll be doing that. You know, our first real graduating class will be the end of this coming year in 2025. And we've

- Already have two. We already have two from that class that have signed on to stay in our community. And

- So see that's new knowledge to me. But that is great and that the other data would show that we'll probably get one or two more of those other ones to stay in our community as well too, in an area that needs more doctors. Along those same lines with the transitional year allows us to train some of the other people who are going into some of the other areas like ophthalmology, radiology to anesthesia, anesthesia's another one too. So they can get some of that baseline internal medicine training before they go on and start dealing with all these other issues. And so I think that's a big boon for us as well too. This opens the door for other residency possibilities. Now that sounds great now, but what does that really means? I think what it means is that we become more of a teaching institution and we start having that teaching mentality go around that it makes you raise your own internal bar a little bit more. You just don't do things just to do 'em. You have to start thinking about why am I really doing this? How can I impart do someone who doesn't know what I'm doing, why I'm doing what I'm doing? And that helps to educate them. It also makes you, I think, a little bit more conscious of dealing with patients and all there so that you can explain to them a little bit better. Not just go and do and go and do. And I think it just, like I said, raises that internal bar for all of us. But it's also a great boon for our community as well too. Because these are people with higher paying jobs, bringing in here, bringing in more money to help out with some of the tax base, which can allow us to do things like help be underserved because that's where a lot of our money comes from in that regard. And so those things are good in that regard. But then you toss in the third and fourth year of medical school, now you're fixing to raise that internal bar even higher because you really are teaching people and they are going to, they're, they're sponges and every one of them that've been down here so far in this trial run that we've had want to come back. Well at least the ones who've been in my office. Yeah. A lot of them already signed up for fourth year sub ais so they can come back and see about lost again. Yeah, that's a great thing. Yeah.

- Well 'cause there was many years where we hardly had any physicians coming to our community, new to the community. And certainly we've seen a lot more in the past couple of years. We've probably had about 80 I think come, come through or move here to serve. But the needs are there. We have the population, we need primary care, we need specialists here. And it's hard to recruit individuals that aren't from here just to cold Turkey, get them to move to South Georgia in general. Now I think our organization is becoming more attractive to those people. It's getting a little, it's getting easier. But

- Some of that might be due to some of the public relations people we have around the

- Maybe, I don't know. But y'all have to act, y'all have to perform our award winning podcast. I think that's right.

- International Awards

- National. But yeah, I mean, so having this educational component to our health system not only elevates the care that you're gonna receive, but then those people staying in our community and then serving in our community and building our community and everybody kind of doing that in tandem is, it's just

- Pretty cool. I think it's great. 'cause I remember maybe six or seven years ago I wanted to see a a, a GP and I wanted specifically to see a female GP and I, there was only like one that I could pick from. Yeah, yeah. And now to look at our, you know, thing we have with all of our physicians. There's so many and it just makes me so happy. Happy that more, you know, more choice. A woman wants to see a woman, she has all these choices of physicians.

- Yeah, for sure. I lost my train of thought. So yeah,

- Sorry. No, I just was saying that that's great because I look at our residency class and there's just so much diversity there. So you know, if someone wants to see a doctor that looks like them Yeah. They have that option with the internal medicine residents. Yeah.

- So it also gives variety of choice to our Exactly. To our community.

- And that's so important I

- Think. But I think a lot of this is, goes back to the fact we just have one huge team working here all the way from our environmental services people who, you know, make your room pleasant so you can Right. Feel like you're safe, secure, and clean in their, to our nutrition services people who make sure you have the meals that you need to our nurses at the bedside, giving you the medicines that you need to get you better.

- I refer to our hospital as like a mini high school. This, well it's also like a mini city within a city because you have so many different departments that work together and have to support each other to make it successful. And so many behind the scenes jobs that people have no idea about. I mean, think about,

- I I don't think people know how much the maintenance people do here. Yeah. I mean, you know, people like Ricking, this crew come in anytime there's, anytime there's a leak, whether it's Christmas day, Christmas night, they're here.

- Yeah. I mean before I started working here, I didn't know how many jobs were available within a health system and you just don't think about it. I mean I never occurred to me marketing obviously and then all these other people areas,

- People always ask us like, how do you, what, why do you have to market a hospital? Like what, what, what do, what do you do? And I'm like, well there is a lot to tell. I I and I say we don't really have to market it, we just have to tell our story and we have to tell the story of the people that work here. Right, exactly. Because they're do, they do phenomenal things. So that makes our job easy. But there's so many stories to tell. There's

- Exactly lot today happen. We're having an honor walk occur. Yeah, absolutely. I mean that's a huge story in and of itself.

- It is. It is. It absolutely. So that for those that don't know is when someone is an organ donor, they can choose to be a part of an honor walk where our staff and physicians will line the hallways as the patient's going from their room to the operating room just kind of in solidarity and then also out of respect for their decision to donate their organs and essentially save dozens of other lives through their donation. Exactly. So that's, that's a very touching event. If you've never been a part of one, it's, it'll get you every time. Yeah. Oh yeah. So, but we are grateful for those that choose to do that because that's another important part of the organization is that organ donation. So

- Definitely

- You wanna ask your famous question.

- Yeah. Well you said he is here all the time, so I'm assuming he is gotta eat. Well he is here. That's right. But we always like to ask our guests at the end, since most of them are physicians and you guys are here all the time, what your favorite meal is at the spice or the cafeteria?

- Well, I guess favorite meal or most common meal? Probably the same thing. So whenever I come in here on the weekends and Lee is working the Spice Lee and everybody knows Lee, everybody knows Lee. I don't have to order. He's already got the two pieces of toast on the thing. He's making me my bacon, egg and cheese. And now the other lays have learned that too. So I don't even have to order, he just woke up. God forbid I ever wanted to change my order, but I know

- They already have it ready. That's

- Before you get there. So, but they

- Have the care day day

- Never

- Say anything would,

- I would never would just be like,

- Thank you. What? And it's so good. I mean they fix it just the way I want it. So yeah.

- We had Dr. Ly mention that too about the Selena in the coffee, the Starbucks. She can also does that with the coffee, get to know order and have it ready for you before you even make it to her station.

- So now my second favorite thing would have to be some of the muffins from the spice. Yeah,

- It's good muffins.

- They're very addictive.

- Well Kara Hope gets the chicken tenders all the time and she has had her order pre-made for her as well.

- Hers is very easy though. It's just chicken tenders and french fries. Curly,

- Curly fries. Fries, ally, curly fries.

- Okay.

- The curly fries are good. But those

- Are both like breakfast items. So do you ever get anything else that's not breakfast, like lunch or dinner or anything?

- Not really. Just curious. I just keep going. Yeah.

- Yeah. He doesn't mo he don't, he doesn't stop to eat,

- That's the thing. Yeah. Yeah. We already heard he only sleep two hours.

- Yes. Yes. Well, Dr. Grinder, we appreciate you and thank you. It was my pleasure for coming on with us and just thank you for everything that you've done throughout your career, throughout your time here to help our organization be successful and help us deliver the best care to our patients.

- My pleasure.

- So, all right, well thank everybody else for tuning in and if you have any questions, comments, you know, you can always share those with us. We'd love to have certain guests on that you are interested in hearing from and we just thank you for your support. Yes,

- Thank you everyone.

- Thank you very much.