Dr. Stanley Galant reflects on 16 years behind the wheel of CHOC Children’s
Breathmobile Program
In 2002, Stanley Galant, M.D., hopped aboard a borrowed van with only a
nurse, a driver and a pledge to bring vital asthma and allergy care to
underserved children in some of the poorest neighborhoods in Orange County.
Sixteen years later, CHOC Children’s Breathmobile has changed the
lives of more than 10,000 sick and suffering kids in Orange County. The
borrowed van, which Dr. Galant modeled after a program in Los Angeles
County, evolved into two well-equipped 36-foot RV-style clinics. The effort
has become a reliable and relied upon mode of care that continues to benefit
the children and families it serves.
After changing the paradigm of care for allergy and asthma sufferers in
Orange County, and reducing hospitalizations and emergency room visits
by as much as 80 percent, Dr. Galant is semi-retired, mentoring the next
generation of Breathmobile physicians who will one day inherit the keys.
While every road trip must come to an end, Dr. Galant says the thought
of putting this part of his career into “park” is bittersweet.
“After the first day that we went out to schools, I remember I took
my staff out to coffee and said, ‘This is one of the best days of
my life.’”
“This was such an underserved group that would never have gotten
this kind of specialized care,” said Dr. Galant.
One of the most common chronic illnesses in childhood, asthma affects 20
percent of minority and inner-city school-aged children, compared with
10 percent nationwide. While underserved communities have long been eligible
for life-saving allergy and asthma care, accessing that care has been
historically difficult. For some families, coming to CHOC Children’s
for pediatric allergy and asthma care would have meant missing school
and work, and taking as many as three buses to see a specialist.
In addition to schools, Dr. Galant and his Breathmobile team make stops
at community health clinics and community centers. The visits have made
a major impact. For example, by driving directly to their community, the
team is able to offer treatment, medicine and follow-up care to a group
that had fallen through the cracks. Research into the team’s work
found the Breathmobile drastically reduced hospitalizations, school absenteeism
and ER visits for these children.
Dr. Galant says he was inspired to begin the program after hearing a lecture
in 1999 by Craig Jones, M.D., who was then the Director of the Division
of Allergy/Immunology in the Department of Pediatrics at the Los Angeles
County + University of Southern California (LAC+USC) Medical Center. Jones
presented impressive findings at an Asthma and Allergy Foundation of America
conference about how mobile clinics improved health care and lowered hospitalizations
and ER visits.
It was a simple and elegant idea, and Dr. Galant couldn’t wait to
take it out for a spin. In 2003, a year after driving around in a borrowed
van, Dr. Galant received a California endowment grant to officially launch
the program. CHOC Children’s purchased a Winnebago, outfitted it
with two fully equipped exam rooms, and Dr. Galant hired a medical fellow
and hit the road. The program also includes asthma-trained bilingual providers
who complete an asthma and allergy evaluation for each child, including
a physical exam, a breathing test and a skin test. A second mobile clinic
joined the fleet in 2007.
While the hospitalizations and absentee rates point to a wildly successful
program, Dr. Galant is most proud of the relationships he and his team
have managed to make by taking health care on the road.
“The biggest need in the community is sociological more than medical.
When you think about the barriers to care, they are access, cultural compatibility,
cost and continuity of care,” Dr. Galant said.
The Breathmobile addresses all four by providing consistent care from consistent
providers every four to six weeks regardless of ability to pay. This builds
trust, and trust leads to the kind of medical compliance that keeps children
breathing easier.
“When you tell a parent, ‘I want you to give this medicine
to your child every day even though they seem fine because we want to
prevent asthma,’ you have to have their trust,” Dr. Galant
said. “Why would a parent trust someone they don’t know and
will never see again? The attitude we have is, ‘We care about you.’
That’s the philosophy we try to espouse.”
To that end, the Breathmobile also makes house calls in cases that meet
a certain threshold, delivering free dust covers and connecting adults
to smoking cessation, mold and cockroach abatement programs to help provide
a healthier environment for the kids.
“By reaching out to the community and working with schools, we’re
able to achieve good results,” he said. “I want this program
funded in perpetuity. CHOC and Hoag have been terrific and have supported
us for years. We want to work closely with them to keep this program going.”
Another major way the Breathmobile reaches out to the community is by hosting
the “Air Power Games®,” an annual one-day event sponsored by CHOC Children’s and
held at Santa Ana College. Created for children ages 5 to 14 with asthma,
the fun and unique event includes 50- and 10 0-meter runs, long jump contests,
javelin tosses and an obstacle course.
Dr. Galant says the event is beneficial because it features educational
booths for families to learn about asthma and resources — but most
important, because it introduces youth to a higher education setting,
while instilling in them the realization that they too can become Olympic
champions.
Dr. Galant says he would like to expand the scope of the program by developing
small clinics within the highest-need communities to accommodate more
patients. He is also interested in expanding into other needed areas of
health care affecting the kids he’s seen, including childhood obesity.
Regardless of his next destination, it’s likely Dr. Galant will drive
toward it at full speed.