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The Outer Banks Hospital Celebrating 20 Years of Growth and Innovation with Daniel Dwyer, MD
Dr. Daniel Dwyer, the Chief of Staff at The Outer Banks Hospital, joins us to celebrate the 20th anniversary of The Outer Banks Hospital by reminiscing on the history of how our hospital came to be.
Featured Speaker:
Daniel Dwyer, MD
Daniel Dwyer, MD is The Outer Banks Hospital Chief of Staff. Transcription:
The Outer Banks Hospital Celebrating 20 Years of Growth and Innovation with Daniel Dwyer, MD
Denise Schnabel: Hi, everyone. Welcome to Outer Banks Health, the official podcast series of The Outer Banks Hospital and Medical Group. This month marks 20 years since the hospital opened. We will be celebrating with weekly episodes that feature guests who will speak about life before TOBH as well as its early years. We will close the series with the bird's eye view of future growth and innovation.
We are your hosts, Denise Schnabel.
Wendy Kelly: And I'm Wendy Kelly.
Denise Schnabel: Today, we will be speaking with a doc who began practicing locally more than 25 years ago, well before the hospital opened its doors. We're not saying that you're old. Currently, he serves as the hospital Chief of Staff and Regional Medical Director of the Vidant Medical Group.
Wendy Kelly: He's one of three physicians at Outer Banks Women's Care. If you've had a baby here, you probably know him. He's the OG of OB on OBX, Dr. Dan Dwyer. Hi, Dr. Dwyer.
Dr. Daniel Dwyer: So you picked me because I have the most gray hair? I like that. That's very nice. Thank you.
Wendy Kelly: Not at all. Not at all. The most experienced.
Denise Schnabel: Most experienced.
Dr. Daniel Dwyer: That's a good word, experienced.
Denise Schnabel: Thank you for being here.
Wendy Kelly: Yeah, welcome.
Dr. Daniel Dwyer: I appreciate being here and I can't believe it's been 20 years since the place opened. And whether it was six months ago or six years ago, it's all the same place in my brain. So I'll try and give you some insight into the fun adventure that is The Outer Banks Hospital.
Denise Schnabel: That's amazing.
Wendy Kelly: Prior to the hospital, you once told a story about practicing in the Bronx when you first started out.
Denise Schnabel: And that's why you chose the field.
Wendy Kelly: And that's why you went into OB-GYN.
Dr. Daniel Dwyer: I had no intention of being an OB-GYN when I went to medical school and my medical school was in New York and we were associated or affiliated with many hospitals. And one of them was a place called Lincoln Hospital, which is in the middle of the South Bronx, just about 10 blocks north of Yankee Stadium. And my first day of my third year, and the third year of medical school is the first time you get to wear a little white coat and go to a hospital. And in a teaching hospital, you can always tell how experienced somebody is by the length of their coat and how much stuff is in their pockets. And so my first day with a little white coat with enough stuff in my pockets to perform brain surgery, I was assigned to the labor and delivery unit. And by the end of a 36-hour shift, I delivered 12 babies and I fell in love with delivering babies.
Denise Schnabel: Aww, nice.
Dr. Daniel Dwyer: Yeah. I got the adrenaline rush. No one told me that I was going to be awake for 36 hours, but I seemed to fit.
Denise Schnabel: So then how did you end up down here?
Dr. Daniel Dwyer: Well, you know, the early '90s was a crazy time. It's when they invented the word managed care. And there was a time in medicine where, if you wanted to have any say on how you practiced, you wanted to go to a small town. So if you actually look at a lot of the docs who are still practicing down here, you know, Dr. Ruiz, Dr. Terryberry and myself, Dr. Jenkins, we were all going to school at a time where there was the pressures and opportunities look to be going to small towns. And we all ended up having-- at that time, it was Albemarle Hospital. They built, I think, at that point, a regional medical center up in Kitty Hawk, was a new building. And they opened that, put some operating rooms and offices and a CAT scan. I think they've had a mobile MRI and we started practicing medicine on the Outer Banks.
And I remember my partners were a little concerned because the hospital was in Elizabeth City and I was the idiot. I love the hospital, love the people, love the area. But the area there just wasn't kind of a fit for me and so we became the idiot who practiced medicine in Elizabeth City, but I live out here. And when we did that, we committed to having the first kind of full-time practice, because what most of the hospitals were doing at that time, we would travel from the town where the hospital was, whether it was Chesapeake, the great docs, Dr. Hammer and Gray, had an office down here and their team commuted here. Dr. Terryberry's practice, my practice, actually, Dr. Bowling's practice all commuted here from Eatonton, Elizabeth City or Chesapeake, because if you had to have a baby, everybody had to travel.
Wendy Kelly: Well, that's interesting. So, if you were on call, you're like, "I gotta get up and drive all the way to Elizabeth City"?
Dr. Daniel Dwyer: Oh, no. Yeah. Well, yes. What I would do, I just became hospitalist before it was cool. So when I was on call, I was on call one night a week, one weekend a month, and I would travel to the hospital. So my patients had no idea where I lived. So when I was there, I just stayed over there and it was busy enough. Labor and delivery tends to happen in the middle of the night anyway. So I learned early. I don't like to get that I-need-you-now-call in the middle of the night. I'd rather just be there.
Denise Schnabel: Had you ever been to the Outer Banks before that?
Dr. Daniel Dwyer: I visited here and we did our interview. And at that time, when we interviewed for the job was the first time I'd ever been here and the office that my practice had was the corner office at Regional Medical Center. So they kind of showed me where I would be doing my charts. And at that point, I'm sitting on the desk. And in one window, I can see Seascape Golf Course. And on the other window, I can see the ocean. I'm going, "I think I could probably make it here. If it doesn't work out, I'll just go back to New York," you know?
Denise Schnabel: Yeah. Yeah, absolutely.
Wendy Kelly: Any interesting stories from back then before this hospital was built? There's folklore that folks delivered along the side of the road sometimes.
Dr. Daniel Dwyer: Well, yes. I still have a patient that every time she sees me and we laugh and cry at the same time. I remember it was a Memorial Day weekend. And when I first moved here, they were still building the second bridge from Currituck, right? So there's one bridge and so the Saturday traffic actually extended all the way up from the Whalebone junction to the Chesapeake line and it was big. And so it was a Labor Day weekend, the dad actually was a volunteer fireman. And so he had one of those flashing red lights. And so the whole place was a traffic jam and we knew something was happening. And so he was driving north in the center lane. I was driving south in the center lane. I wanted to get one of those little red lights and I went to join the volunteer fire department and they wouldn't give me one because they knew I would just use it.
Wendy Kelly: Right. That's probably a good idea.
Dr. Daniel Dwyer: No, you can't have a red light. And so we met, I think it was Wachovia Bank or I forgot where we met. We made it to a parking lot and we had a baby.
Wendy Kelly: Wow.
Denise Schnabel: That is crazy. Wow.
Dr. Daniel Dwyer: Yeah, it was fun. Not really fun. She didn't think it was that much fun. But she did fantastic.
Denise Schnabel: No, but she was fine. Yeah.
Dr. Daniel Dwyer: And mom and baby were fine and she still remembers that, I think.
Denise Schnabel: That is great.
Dr. Daniel Dwyer: Yeah. But, you know, one of the major impetuses to having The Outer Banks Hospital was the fact that so many people were delivering babies on route. I mean, the baby delivering was a big driver. And actually, the craziness, you know, we were essentially a startup company that was a partnership between Chesapeake and, at that point, it was I think University Health System from Greenville. And, initially, we couldn't recruit a surgeon right off the bat. So we opened up and we had some locum surgeons, but no real surgical service. And so the only real service that opened up gangbusters was delivering babies.
And Dr. Kling was recruited from Dr. Hammer and Gray's group. And he was just a great guy and he had some midwives who were doing a great job. And the anesthesia service realized that paying close attention to safe women's anesthetics was primary. And at that time in many small hospitals across the country, getting an epidural in labor was viewed as maybe not necessary, it was elective. And so a lot of small hospitals were not getting pain relief for their people in labor like we were. So we were fortunate that our service didn't have to compete with other things and the anesthesia team really kind of embraced women's healthcare. So it was awesome. Some great people.
Denise Schnabel: So regional was not delivering babies?
Dr. Daniel Dwyer: No. We delivered a couple of babies in regional but never on purpose.
Denise Schnabel: So you were the very first Chief of Staff for The Outer Banks Hospital?
Dr. Daniel Dwyer: No, I was one of the first three, I think. At that point, you know, if you think of what happened in medicine back then, the person who was Chief of Staff or Chief of the Department was the one who didn't make the meeting. So I remember we were on vacation with one of the docs, actually with Dr. Chase. If you're listening, Dr. Chase, I'm going to tell a story about you. We were skiing and they had a meeting and they elected him chief of staff because he wasn't there. And he was going, "No!" So usually, back, you know, in the old days of medicine, the person who wasn't at the meeting or the person who probably needed the most coaching, we would make you chief of something. And that's how I ended up being chief of staff. I needed the most coaching. So they made me chief at some point. I don't know what it was.
And I think the advantage we've had as a small hospital, you know, because when you come out of training, it's a big choice to practice in a rural setting.
Wendy Kelly: Yes, it is.
Dr. Daniel Dwyer: And a lot of smaller hospitals still are kind of struggling with how to provide great care in a rural setting. And actually, we were designed when all of that was happening. So we were designed to do state-of-the-art diagnosis or state-of-the-art transport, because there are many conditions that we really shouldn't treat in a small hospital in the middle of nowhere. And actually even still, I mean, the number one reason why I would need to go to the hospital, as a middle-aged guy, it would be a heart thing. So we have state-of-the-art diagnosis and transport, but there's really nothing here that will treat a heart attack. And we don't pretend to do that.
You know, small town medicine is about knowing what you do, doing what you do as well as anybody does it, identify people who who need something that you don't do, and then just get them where they need to be and don't waste any time or money and don't lose the information. And so it's really been really cool. As we start developing new services, we're continually trying to design or to decide what do we do and what do we do well.
Wendy Kelly: Exactly. And the good news about being here is that if, unfortunately, that heart attack happened, you come here, you get stabilized. You know, you don't try and go somewhere else because we don't have that kind of high-end service. You get stabilized here and transported.
Dr. Daniel Dwyer: Without a question. And it's actually the coordination, even from the beginning. The importance of our ED docs just coordinating with our EMS EMT. We've got some of the best people around and it's all coordinated. It's coordinated care to a high degree from the time you called 911 to get to you because, there's some things that, you know, we just want to-- it's getting the right care at the right time at the right place. And that's really what the name of the game is, which has always been our focus.
Denise Schnabel: Right.
Wendy Kelly: Over 20 years, what do you think the biggest innovation is for The Outer Banks Hospital?
Dr. Daniel Dwyer: There's been so many. I mean, when you think about it, again, when I started in training, if you're having your gallbladder out, you had a big incision and you were in a hospital for seven days. Now, we've got surgeons here who do gallbladders through a telescope incision, you're out in 24 hours. You know, even our first hysterectomies here all tend to be abdominal hysterectomies. Now, the vast majority of them are minimally invasive. But if I had to pick one thing where we've probably pushed the envelope the farthest in the 20 years, I'd probably say in cancer care, it would have to be, you know. It's been amazing.
I mean, if you actually look at our numbers historically, and until we really committed to it, the residents of our area were more likely to be diagnosed farther along in their cancer than in other areas. So, the commitment to doing both diagnosis, coordination of care with other centers and treating the people here with state-of-the-art radiation and chemotherapy here even, I think that's probably our biggest advance in the 20 years.
Wendy Kelly: I think you're right.
Denise Schnabel: That's a great answer.
Wendy Kelly: Absolutely.
Denise Schnabel: All right. So I hate to bring this up. But what are your thoughts on the pandemic?
Dr. Daniel Dwyer: My thoughts on the pandemic? Oh, yeah. I have many thoughts on the pandemic.
Wendy Kelly: You were the first to get the vaccine on the Outer Banks, right? In Dare county.
Dr. Daniel Dwyer: Because they want to see if a grown man does cry with a shot. I get that. I know that.
Wendy Kelly: But Julie Tillett was excellent and administered... Our RN.
Dr. Daniel Dwyer: She did. I didn't feel a thing. It was good.
Denise Schnabel: How would they have handled at 20 years ago, do you think?
Dr. Daniel Dwyer: Wow.
Denise Schnabel: Right?
Wendy Kelly: Good question.
Dr. Daniel Dwyer: I don't know. How would they have handled that 20 years ago? We would've been at a significant loss. I don't-- Yeah. So I actually don't even want to think about that.
Denise Schnabel: If you were to think about... Yeah.
Dr. Daniel Dwyer: Yeah. Wow. But, you know, the one thing that I would say is that, regardless of then and now, we have good relationships. What I was so impressed with the pandemic, the pandemic, which is terrible. And I'm going to say, hopefully we're going to say good riddance to it pretty soon, but I don't know what's going to happen. I was so impressed when we ended up closing everything down because we didn't know what was happening and all kinds of different counties were trying to figure out what to do. And I'm listening at these meetings and just listening to the people in our area, the people from the health department, the people from our emergency management teams, all the people from the hospital, Ronnie, and things like that. In many counties, these relationships may not exist or they may not be strong. The reason why we've had success at the hospital over 20 years is because our community is so strong and so used to pulling together. I mean, so these were people you can tell had respect for each other. You can tell these were people who were coordinating their efforts. So I was just amazed.
And it's humbling because, you know, doctors, if you have five doctors in a room, you have five people in a room who think they're the smartest people in the room. And it's these kinds of things that you realize that there are many doctors and some of them are physicians, you know.
Denise Schnabel: So, how did the community react when the hospital got here? Like we have strong community ties right now, amazingly, but like when the hospital came...
Dr. Daniel Dwyer: Well, the hospital came-- actually, it was, you know, the kind of the big political fights that I remember going on in that time, was the building of the high schools and the building of the hospital. So, you know, when you actually think about your child's education, your child's health, those are two things that people are going to fight for. And so it wasn't cantankerous, but it was a spirited debate amongst them, and people were getting into different camps. But as soon as the hospital opened, we're all at that point trying to figure out how do you work it together. And then you have to realize, let people learn that what we can and we can't do and give them the best experience they can. And, you know, from our standpoint, as an OB-GYN, you just try to do the best thing you can. And then if generally-- I remember the marketing strategies of the early, late '80s and '90s was, if you take care of moms, moms will tell the family where they're getting their healthcare. We wanted to make sure that when you're coming in either to have a baby or to have an experience to do the best thing you can.
And the tough part from, you know, the ED, the ED was where a whole lot of businesses happen, business happens for the hospital. But walking into an emergency room is never a good thing. So nobody's ever planning to go in there. So you can walk into one of the best EDs in the country that technically is great and walk out of there thinking, "I didn't like that." So, I think it's been a little snowball effect and, over time, you can see that as we added services, added staff, added things, I think we've come to the point where I think everybody's pulling in the same direction on most days.
Denise Schnabel: Awesome. Excellent.
Wendy Kelly: In hospital years, 20 years is still young.
Dr. Daniel Dwyer: Yes.
Wendy Kelly: And we, you know, I think have come pretty far with what we're doing here in a rural setting in just 20 years.
Dr. Daniel Dwyer: I think it's huge. And I think we've had, I think probably four or five CEO's a couple of interims at the time. And each one of them has moved the ball in a direction towards better care and better access.
Wendy Kelly: You're absolutely right.
Dr. Daniel Dwyer: Yeah.
Wendy Kelly: Any other memories of the 20 years? Any where you look back, you laugh to yourself or you're like, "Wow, that was amazing" or "Wow"? Anything?
Dr. Daniel Dwyer: Nothing that I should say in public, you know? You know, earlier on, I think probably a good memory would be initially it was a difficult decision to tie my horse to a small hospital. So it was coming into a point of my career that I was concerned when I first got here whether or not I'd be kind of fencing in my skillsets too much, right? Because there's a lot of things that you can do in a larger hospital that you really shouldn't do in a small hospital. There's some people who I can care for in a larger hospital, but you're actually part of a larger team that sometimes is not here.
Wendy Kelly: Right.
Dr. Daniel Dwyer: And I was really kind of debating as to whether or not I should be doing this, right? And I was one at night. And one of my patients was having a difficult time and she was going to the operating room. And it was a visitor who I'd met that night and it's probably now five o'clock in the morning that things are... and the nurse who was taking care of her in the ED came to her to the recovery room, and then actually ended up driving her home to where her kid was, because this is somebody having a problem that was a visitor. I'm thinking, "Boy, this is the kind of team I want to be on," you know? So it was one-- and I know who that nurse was. I'm not going to say her name because now as I'm thinking about it, that could be one of 50 nurses that I've worked with here.
Wendy Kelly: You're absolutely right. Great stories come out about us. And that's really wonderful to know that it really kind of was from the beginning, that's who we were.
Dr. Daniel Dwyer: Yeah. I've spent a lot of hours in our buildings, so I know a lot of people who work here and I've seen a lot of people over the years, but I wouldn't want to be anywhere else. Yeah.
Denise Schnabel: Excellent.
Dr. Daniel Dwyer: Great people.
Wendy Kelly: Well, I know the community wouldn't want you anywhere else and I'm going to make you uncomfortable because you know you're a beloved physician here. People know you. You've been around. You've delivered most of the young ones, 20 and under. And we're just grateful that you're a part of the team.
Dr. Daniel Dwyer: Oh, thank you.
Wendy Kelly: Yeah. Anything else you want to share with us about the 20 years? We just really appreciate you being here.
Dr. Daniel Dwyer: I just can't wait for the next 20, you know?
Denise Schnabel: Yeah. Absolutely.
Dr. Daniel Dwyer: We're just getting started.
Wendy Kelly: Thanks, Dr. Dwyer.
Denise Schnabel: Well, thank you so much for being here with us. We really appreciate your time.
Dr. Daniel Dwyer: You're very welcome. Thank you for asking me.
Denise Schnabel: If you've enjoy this episode, share it on your social channels. To hear more Outer Banks health history, check out the podcast library at theobh.com/podcast. This is your host, Denise Schnabel. Stay safe.
The Outer Banks Hospital Celebrating 20 Years of Growth and Innovation with Daniel Dwyer, MD
Denise Schnabel: Hi, everyone. Welcome to Outer Banks Health, the official podcast series of The Outer Banks Hospital and Medical Group. This month marks 20 years since the hospital opened. We will be celebrating with weekly episodes that feature guests who will speak about life before TOBH as well as its early years. We will close the series with the bird's eye view of future growth and innovation.
We are your hosts, Denise Schnabel.
Wendy Kelly: And I'm Wendy Kelly.
Denise Schnabel: Today, we will be speaking with a doc who began practicing locally more than 25 years ago, well before the hospital opened its doors. We're not saying that you're old. Currently, he serves as the hospital Chief of Staff and Regional Medical Director of the Vidant Medical Group.
Wendy Kelly: He's one of three physicians at Outer Banks Women's Care. If you've had a baby here, you probably know him. He's the OG of OB on OBX, Dr. Dan Dwyer. Hi, Dr. Dwyer.
Dr. Daniel Dwyer: So you picked me because I have the most gray hair? I like that. That's very nice. Thank you.
Wendy Kelly: Not at all. Not at all. The most experienced.
Denise Schnabel: Most experienced.
Dr. Daniel Dwyer: That's a good word, experienced.
Denise Schnabel: Thank you for being here.
Wendy Kelly: Yeah, welcome.
Dr. Daniel Dwyer: I appreciate being here and I can't believe it's been 20 years since the place opened. And whether it was six months ago or six years ago, it's all the same place in my brain. So I'll try and give you some insight into the fun adventure that is The Outer Banks Hospital.
Denise Schnabel: That's amazing.
Wendy Kelly: Prior to the hospital, you once told a story about practicing in the Bronx when you first started out.
Denise Schnabel: And that's why you chose the field.
Wendy Kelly: And that's why you went into OB-GYN.
Dr. Daniel Dwyer: I had no intention of being an OB-GYN when I went to medical school and my medical school was in New York and we were associated or affiliated with many hospitals. And one of them was a place called Lincoln Hospital, which is in the middle of the South Bronx, just about 10 blocks north of Yankee Stadium. And my first day of my third year, and the third year of medical school is the first time you get to wear a little white coat and go to a hospital. And in a teaching hospital, you can always tell how experienced somebody is by the length of their coat and how much stuff is in their pockets. And so my first day with a little white coat with enough stuff in my pockets to perform brain surgery, I was assigned to the labor and delivery unit. And by the end of a 36-hour shift, I delivered 12 babies and I fell in love with delivering babies.
Denise Schnabel: Aww, nice.
Dr. Daniel Dwyer: Yeah. I got the adrenaline rush. No one told me that I was going to be awake for 36 hours, but I seemed to fit.
Denise Schnabel: So then how did you end up down here?
Dr. Daniel Dwyer: Well, you know, the early '90s was a crazy time. It's when they invented the word managed care. And there was a time in medicine where, if you wanted to have any say on how you practiced, you wanted to go to a small town. So if you actually look at a lot of the docs who are still practicing down here, you know, Dr. Ruiz, Dr. Terryberry and myself, Dr. Jenkins, we were all going to school at a time where there was the pressures and opportunities look to be going to small towns. And we all ended up having-- at that time, it was Albemarle Hospital. They built, I think, at that point, a regional medical center up in Kitty Hawk, was a new building. And they opened that, put some operating rooms and offices and a CAT scan. I think they've had a mobile MRI and we started practicing medicine on the Outer Banks.
And I remember my partners were a little concerned because the hospital was in Elizabeth City and I was the idiot. I love the hospital, love the people, love the area. But the area there just wasn't kind of a fit for me and so we became the idiot who practiced medicine in Elizabeth City, but I live out here. And when we did that, we committed to having the first kind of full-time practice, because what most of the hospitals were doing at that time, we would travel from the town where the hospital was, whether it was Chesapeake, the great docs, Dr. Hammer and Gray, had an office down here and their team commuted here. Dr. Terryberry's practice, my practice, actually, Dr. Bowling's practice all commuted here from Eatonton, Elizabeth City or Chesapeake, because if you had to have a baby, everybody had to travel.
Wendy Kelly: Well, that's interesting. So, if you were on call, you're like, "I gotta get up and drive all the way to Elizabeth City"?
Dr. Daniel Dwyer: Oh, no. Yeah. Well, yes. What I would do, I just became hospitalist before it was cool. So when I was on call, I was on call one night a week, one weekend a month, and I would travel to the hospital. So my patients had no idea where I lived. So when I was there, I just stayed over there and it was busy enough. Labor and delivery tends to happen in the middle of the night anyway. So I learned early. I don't like to get that I-need-you-now-call in the middle of the night. I'd rather just be there.
Denise Schnabel: Had you ever been to the Outer Banks before that?
Dr. Daniel Dwyer: I visited here and we did our interview. And at that time, when we interviewed for the job was the first time I'd ever been here and the office that my practice had was the corner office at Regional Medical Center. So they kind of showed me where I would be doing my charts. And at that point, I'm sitting on the desk. And in one window, I can see Seascape Golf Course. And on the other window, I can see the ocean. I'm going, "I think I could probably make it here. If it doesn't work out, I'll just go back to New York," you know?
Denise Schnabel: Yeah. Yeah, absolutely.
Wendy Kelly: Any interesting stories from back then before this hospital was built? There's folklore that folks delivered along the side of the road sometimes.
Dr. Daniel Dwyer: Well, yes. I still have a patient that every time she sees me and we laugh and cry at the same time. I remember it was a Memorial Day weekend. And when I first moved here, they were still building the second bridge from Currituck, right? So there's one bridge and so the Saturday traffic actually extended all the way up from the Whalebone junction to the Chesapeake line and it was big. And so it was a Labor Day weekend, the dad actually was a volunteer fireman. And so he had one of those flashing red lights. And so the whole place was a traffic jam and we knew something was happening. And so he was driving north in the center lane. I was driving south in the center lane. I wanted to get one of those little red lights and I went to join the volunteer fire department and they wouldn't give me one because they knew I would just use it.
Wendy Kelly: Right. That's probably a good idea.
Dr. Daniel Dwyer: No, you can't have a red light. And so we met, I think it was Wachovia Bank or I forgot where we met. We made it to a parking lot and we had a baby.
Wendy Kelly: Wow.
Denise Schnabel: That is crazy. Wow.
Dr. Daniel Dwyer: Yeah, it was fun. Not really fun. She didn't think it was that much fun. But she did fantastic.
Denise Schnabel: No, but she was fine. Yeah.
Dr. Daniel Dwyer: And mom and baby were fine and she still remembers that, I think.
Denise Schnabel: That is great.
Dr. Daniel Dwyer: Yeah. But, you know, one of the major impetuses to having The Outer Banks Hospital was the fact that so many people were delivering babies on route. I mean, the baby delivering was a big driver. And actually, the craziness, you know, we were essentially a startup company that was a partnership between Chesapeake and, at that point, it was I think University Health System from Greenville. And, initially, we couldn't recruit a surgeon right off the bat. So we opened up and we had some locum surgeons, but no real surgical service. And so the only real service that opened up gangbusters was delivering babies.
And Dr. Kling was recruited from Dr. Hammer and Gray's group. And he was just a great guy and he had some midwives who were doing a great job. And the anesthesia service realized that paying close attention to safe women's anesthetics was primary. And at that time in many small hospitals across the country, getting an epidural in labor was viewed as maybe not necessary, it was elective. And so a lot of small hospitals were not getting pain relief for their people in labor like we were. So we were fortunate that our service didn't have to compete with other things and the anesthesia team really kind of embraced women's healthcare. So it was awesome. Some great people.
Denise Schnabel: So regional was not delivering babies?
Dr. Daniel Dwyer: No. We delivered a couple of babies in regional but never on purpose.
Denise Schnabel: So you were the very first Chief of Staff for The Outer Banks Hospital?
Dr. Daniel Dwyer: No, I was one of the first three, I think. At that point, you know, if you think of what happened in medicine back then, the person who was Chief of Staff or Chief of the Department was the one who didn't make the meeting. So I remember we were on vacation with one of the docs, actually with Dr. Chase. If you're listening, Dr. Chase, I'm going to tell a story about you. We were skiing and they had a meeting and they elected him chief of staff because he wasn't there. And he was going, "No!" So usually, back, you know, in the old days of medicine, the person who wasn't at the meeting or the person who probably needed the most coaching, we would make you chief of something. And that's how I ended up being chief of staff. I needed the most coaching. So they made me chief at some point. I don't know what it was.
And I think the advantage we've had as a small hospital, you know, because when you come out of training, it's a big choice to practice in a rural setting.
Wendy Kelly: Yes, it is.
Dr. Daniel Dwyer: And a lot of smaller hospitals still are kind of struggling with how to provide great care in a rural setting. And actually, we were designed when all of that was happening. So we were designed to do state-of-the-art diagnosis or state-of-the-art transport, because there are many conditions that we really shouldn't treat in a small hospital in the middle of nowhere. And actually even still, I mean, the number one reason why I would need to go to the hospital, as a middle-aged guy, it would be a heart thing. So we have state-of-the-art diagnosis and transport, but there's really nothing here that will treat a heart attack. And we don't pretend to do that.
You know, small town medicine is about knowing what you do, doing what you do as well as anybody does it, identify people who who need something that you don't do, and then just get them where they need to be and don't waste any time or money and don't lose the information. And so it's really been really cool. As we start developing new services, we're continually trying to design or to decide what do we do and what do we do well.
Wendy Kelly: Exactly. And the good news about being here is that if, unfortunately, that heart attack happened, you come here, you get stabilized. You know, you don't try and go somewhere else because we don't have that kind of high-end service. You get stabilized here and transported.
Dr. Daniel Dwyer: Without a question. And it's actually the coordination, even from the beginning. The importance of our ED docs just coordinating with our EMS EMT. We've got some of the best people around and it's all coordinated. It's coordinated care to a high degree from the time you called 911 to get to you because, there's some things that, you know, we just want to-- it's getting the right care at the right time at the right place. And that's really what the name of the game is, which has always been our focus.
Denise Schnabel: Right.
Wendy Kelly: Over 20 years, what do you think the biggest innovation is for The Outer Banks Hospital?
Dr. Daniel Dwyer: There's been so many. I mean, when you think about it, again, when I started in training, if you're having your gallbladder out, you had a big incision and you were in a hospital for seven days. Now, we've got surgeons here who do gallbladders through a telescope incision, you're out in 24 hours. You know, even our first hysterectomies here all tend to be abdominal hysterectomies. Now, the vast majority of them are minimally invasive. But if I had to pick one thing where we've probably pushed the envelope the farthest in the 20 years, I'd probably say in cancer care, it would have to be, you know. It's been amazing.
I mean, if you actually look at our numbers historically, and until we really committed to it, the residents of our area were more likely to be diagnosed farther along in their cancer than in other areas. So, the commitment to doing both diagnosis, coordination of care with other centers and treating the people here with state-of-the-art radiation and chemotherapy here even, I think that's probably our biggest advance in the 20 years.
Wendy Kelly: I think you're right.
Denise Schnabel: That's a great answer.
Wendy Kelly: Absolutely.
Denise Schnabel: All right. So I hate to bring this up. But what are your thoughts on the pandemic?
Dr. Daniel Dwyer: My thoughts on the pandemic? Oh, yeah. I have many thoughts on the pandemic.
Wendy Kelly: You were the first to get the vaccine on the Outer Banks, right? In Dare county.
Dr. Daniel Dwyer: Because they want to see if a grown man does cry with a shot. I get that. I know that.
Wendy Kelly: But Julie Tillett was excellent and administered... Our RN.
Dr. Daniel Dwyer: She did. I didn't feel a thing. It was good.
Denise Schnabel: How would they have handled at 20 years ago, do you think?
Dr. Daniel Dwyer: Wow.
Denise Schnabel: Right?
Wendy Kelly: Good question.
Dr. Daniel Dwyer: I don't know. How would they have handled that 20 years ago? We would've been at a significant loss. I don't-- Yeah. So I actually don't even want to think about that.
Denise Schnabel: If you were to think about... Yeah.
Dr. Daniel Dwyer: Yeah. Wow. But, you know, the one thing that I would say is that, regardless of then and now, we have good relationships. What I was so impressed with the pandemic, the pandemic, which is terrible. And I'm going to say, hopefully we're going to say good riddance to it pretty soon, but I don't know what's going to happen. I was so impressed when we ended up closing everything down because we didn't know what was happening and all kinds of different counties were trying to figure out what to do. And I'm listening at these meetings and just listening to the people in our area, the people from the health department, the people from our emergency management teams, all the people from the hospital, Ronnie, and things like that. In many counties, these relationships may not exist or they may not be strong. The reason why we've had success at the hospital over 20 years is because our community is so strong and so used to pulling together. I mean, so these were people you can tell had respect for each other. You can tell these were people who were coordinating their efforts. So I was just amazed.
And it's humbling because, you know, doctors, if you have five doctors in a room, you have five people in a room who think they're the smartest people in the room. And it's these kinds of things that you realize that there are many doctors and some of them are physicians, you know.
Denise Schnabel: So, how did the community react when the hospital got here? Like we have strong community ties right now, amazingly, but like when the hospital came...
Dr. Daniel Dwyer: Well, the hospital came-- actually, it was, you know, the kind of the big political fights that I remember going on in that time, was the building of the high schools and the building of the hospital. So, you know, when you actually think about your child's education, your child's health, those are two things that people are going to fight for. And so it wasn't cantankerous, but it was a spirited debate amongst them, and people were getting into different camps. But as soon as the hospital opened, we're all at that point trying to figure out how do you work it together. And then you have to realize, let people learn that what we can and we can't do and give them the best experience they can. And, you know, from our standpoint, as an OB-GYN, you just try to do the best thing you can. And then if generally-- I remember the marketing strategies of the early, late '80s and '90s was, if you take care of moms, moms will tell the family where they're getting their healthcare. We wanted to make sure that when you're coming in either to have a baby or to have an experience to do the best thing you can.
And the tough part from, you know, the ED, the ED was where a whole lot of businesses happen, business happens for the hospital. But walking into an emergency room is never a good thing. So nobody's ever planning to go in there. So you can walk into one of the best EDs in the country that technically is great and walk out of there thinking, "I didn't like that." So, I think it's been a little snowball effect and, over time, you can see that as we added services, added staff, added things, I think we've come to the point where I think everybody's pulling in the same direction on most days.
Denise Schnabel: Awesome. Excellent.
Wendy Kelly: In hospital years, 20 years is still young.
Dr. Daniel Dwyer: Yes.
Wendy Kelly: And we, you know, I think have come pretty far with what we're doing here in a rural setting in just 20 years.
Dr. Daniel Dwyer: I think it's huge. And I think we've had, I think probably four or five CEO's a couple of interims at the time. And each one of them has moved the ball in a direction towards better care and better access.
Wendy Kelly: You're absolutely right.
Dr. Daniel Dwyer: Yeah.
Wendy Kelly: Any other memories of the 20 years? Any where you look back, you laugh to yourself or you're like, "Wow, that was amazing" or "Wow"? Anything?
Dr. Daniel Dwyer: Nothing that I should say in public, you know? You know, earlier on, I think probably a good memory would be initially it was a difficult decision to tie my horse to a small hospital. So it was coming into a point of my career that I was concerned when I first got here whether or not I'd be kind of fencing in my skillsets too much, right? Because there's a lot of things that you can do in a larger hospital that you really shouldn't do in a small hospital. There's some people who I can care for in a larger hospital, but you're actually part of a larger team that sometimes is not here.
Wendy Kelly: Right.
Dr. Daniel Dwyer: And I was really kind of debating as to whether or not I should be doing this, right? And I was one at night. And one of my patients was having a difficult time and she was going to the operating room. And it was a visitor who I'd met that night and it's probably now five o'clock in the morning that things are... and the nurse who was taking care of her in the ED came to her to the recovery room, and then actually ended up driving her home to where her kid was, because this is somebody having a problem that was a visitor. I'm thinking, "Boy, this is the kind of team I want to be on," you know? So it was one-- and I know who that nurse was. I'm not going to say her name because now as I'm thinking about it, that could be one of 50 nurses that I've worked with here.
Wendy Kelly: You're absolutely right. Great stories come out about us. And that's really wonderful to know that it really kind of was from the beginning, that's who we were.
Dr. Daniel Dwyer: Yeah. I've spent a lot of hours in our buildings, so I know a lot of people who work here and I've seen a lot of people over the years, but I wouldn't want to be anywhere else. Yeah.
Denise Schnabel: Excellent.
Dr. Daniel Dwyer: Great people.
Wendy Kelly: Well, I know the community wouldn't want you anywhere else and I'm going to make you uncomfortable because you know you're a beloved physician here. People know you. You've been around. You've delivered most of the young ones, 20 and under. And we're just grateful that you're a part of the team.
Dr. Daniel Dwyer: Oh, thank you.
Wendy Kelly: Yeah. Anything else you want to share with us about the 20 years? We just really appreciate you being here.
Dr. Daniel Dwyer: I just can't wait for the next 20, you know?
Denise Schnabel: Yeah. Absolutely.
Dr. Daniel Dwyer: We're just getting started.
Wendy Kelly: Thanks, Dr. Dwyer.
Denise Schnabel: Well, thank you so much for being here with us. We really appreciate your time.
Dr. Daniel Dwyer: You're very welcome. Thank you for asking me.
Denise Schnabel: If you've enjoy this episode, share it on your social channels. To hear more Outer Banks health history, check out the podcast library at theobh.com/podcast. This is your host, Denise Schnabel. Stay safe.