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For Lee Greer, MD, enhancing the quality of care for the oldest and frailest north Mississippians makes for both a compelling mission and a stimulating personal profession.

"I've always had an interest in geriatrics beginning in medical school," said Greer, who practices with Internal Medicine Associates of Tupelo as the area's lone physician focusing exclusively on geriatric patients.

"It's a terrific specialty that really allows you to have a lot of clinical judgment in taking care of the elderly," he said.

"It's very rewarding to me to take a client who's not done well or has had functional decline, and to do some medical adjustments or therapy or use a multidisciplinary team to help improve that patient's quality of life."

In outpatient and inpatient clinical and consulting work, Greer finds a daily challenge to merely managing each patient's delicate balance of medications and health issues.

But taking that mission a step further, he's also focused on another equally delicate balance — that of boosting the quality of elder care while also ensuring programs can be financially sustainable for healthcare systems.

For that reason, Greer is currently part of an executive healthcare-focused master of business
administration program at Yale University, which has him commuting from his home in Pontotoc to New Haven, Conn., every other weekend.

He's scheduled to complete the 22-month program in May as part of a class of 20, which includes other physicians as well as healthcare professionals in the areas of pharmacy, insurance, biotechnology and law.

"I have a strong interest in clinical quality of care, and this really sheds a new light on the different models of healthcare," he said. "It gives me some knowledge into the business world of healthcare, and takes my perspective from just that of a physician to also understand the administrative position."

Finding ways to boost quality of care for the elderly will be the focus of a new two-year grant under Greer's oversight through a Practice Change Fellows award. The program through Atlantic
Philanthropies provides $90,000 and support from local and national mentors in building leadership and developing a new geriatric program. In Greer's case, he will be leading a project focused on patients with congestive heart failure, adding a new aspect to their care within a rural healthcare system. The program is to include CHF education days at the 22 primary-care clinics operated by North Mississippi Medical Clinics Inc., which Greer serves as assistant medical director.

The clinics' electronic health records system will allow Greer and his multidisciplinary team to identify CHF patients with a recent hospital stay, and invite them for additional education aimed at helping them understand their condition.

"Especially with the rising cost of gas, there is a challenge to getting older patients to our large centers to get the appropriate workups," he said.

"Part of this effort is to bring to places like Eupora or Calhoun City those services we would normally provide at our large centers. We can bring a portable EKG, as well as a dietician, pharmacist and home-health representatives to these local clinics."

The goal is also to work with patients' local physicians to improve their medical regimens, he said.

Greer received notification of the grant award in June; the program starts Sept. 1. He and his team will afterward display their results at programs around the country as part of nationwide idea-sharing among geriatric-care leaders.

"We hope to show this model as somewhat sustainable for other healthcare systems to use, as well as beneficial to patients," he said.

Providing leadership in the area of senior care will be all the more important in Mississippi and elsewhere, as the number of aging baby boomers far outpaces the number of specialists focused on their care.

"There have been numerous studies showing there's going to be a great need for geriatricians, and that all primary-care physicians must ramp up their knowledge and treatment of older adults," Greer said.

In his own practice, the bulk of his patients are those who suffer from dementia and memory loss due to stroke, Alzheimer's disease and other causes. His patients include those he sees for primary care, as well as those he's called in for inpatient or outpatient consultations.

Greer, a native of Tupelo, received his medical degree summa cum laude from the University of Mississippi School of Medicine. He completed his residency in family medicine at the University of Tennessee-Jackson and Jackson-Madison County General Hospital, where he served as chief resident.

He practiced with Pontotoc Medical Clinic and was chief of staff at North Mississippi Medical Center-Pontotoc before pursuing specialty training with a fellowship in geriatric medicine at the University of Alabama-Birmingham.

He is board certified by the American Board of Family Medicine, with a certificate of added qualification in geriatric medicine.

In addition to his clinical and administrative duties, Greer also serves as a member of the Board of Directors for the Institute for Quality in Healthcare, and was appointed as part of the clinical workgroup for the Governor's Taskforce for Healthcare Information Technology.

"That's an exciting project — trying to piece together healthcare technology across the state," he said.

Greer and his wife, Reena, a veterinarian, have one daughter, 5-year-old Rani. As a family, they enjoy showing quarterhorses and raising them on the 45-acre farm where they live in Pontotoc.

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