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Posted December 4, 2013
Case Study: How Graduate Medical Education Has Made a Difference for One All Children’s Family

Tommy Loope is like most active, healthy 5-year-old boys - perhaps even more so. He's a member of a Clearwater area swim team, plays organized soccer and finds time for T-ball, too.

But his parents, Peter and Amy Loope, know that their thriving son might not be alive today if the state had not funded an expansion of the Florida Newborn Screening program several years before he was born.

As a result, doctors at All Children's Hospital were immediately able to detect that Tommy had a rare condition called congenital adrenal hyperplasia (CAH) - a cluster of inherited disorders of the adrenal gland that left him unable to produce the the vital hormone cortisol. With the diagnosis made when he was only days old, due to the additional tests made possible, Tommy began a critical treatment regimen that likely saved his life.

"Quite candidly, had we not had that Newborn Screening Test, Tommy probably wouldn't be with us today," says his father. "We were lucky to catch it."

Yet that's not the only crucial state medical funding that makes the Loopes feel fortunate today. Their son has benefitted profoundly from funding of the Graduate Medical Education (GME) program, allowing for continuity of care for Tommy with a doctor who saw first saw him as a pediatric endocrine fellow at the University of South Florida, and now as head of the endocrinology program at All Children's. 

She is Pallavi Iyer, M.D. - the only physician the Loopes will need for Tommy through his early 20s, thanks to the GME funding that allowed Dr. Iyer to come into their lives during fellowship.

"What Tommy had was pretty rare - one in about 18,000 kids have it," Peter says. "And we met Dr. Iyer on Day One in the emergency room at All Children's, where we got our diagnosis. She was a fellow, working with the senior attending physician at USF at the time, Dr. Dorothy Shulman. And she's been part of the team that's guided us through this from the very beginning."

When Dr. Iyer became an attending, the Loopes had a big decision to make: Whether to stay with a senior attending doctor, or go with a less experienced junior faculty member  with a bright future - a person they had come to know and trust.

 "We decided it was important for Tommy to have a continuum of care over the next 15 or 20 years, and that's one of the reasons we chose Dr. Iyer," Peter explains. "We'd already developed a good relationship with her. As a fellow, you're a little freer to be patient-centric, which she was with us. Dr. Iyer was really able to help us through that early six-to-eight-month window when we were still figuring out what his condition was."

And she has continued to help the Loopes ever since, illustrating the vital importance of GME funding and its immeasurable impact on children with chronic illnesses in need of the best care possible.

"It's hard enough for a family to feel that their child has a condition that may be life long," Dr. Iyer says. "But over time, and with a physician you can trust and build a relationship with, it makes a world of difference. That's not only for the families to feel comfortable asking questions, but also for the child to see the same person over and over again."

"If you can have residencies and fellowships where you can start building those relationships - especially if you can keep them until the physicians can become full attending physicians - that's even better. The Loopes have been a great family to work with. And over time, I've learned from them just as much as they probably have learned from me."