When pediatric cardiologist David Crowley walks the halls of Dartmouth-Hitchcock Manchester, his Dartmouth-Hitchcock Medical Center identification card swings with the pace of his stride, hanging from the Boston Children's Hospital lanyard around his neck. Crowley, a doctor at DHMC's outpatient location in Manchester, attends to patients in both Manchester and Boston.
"I wear it as a sign to say I'm affiliated with these two great institutions," Crowley who splits his time between Children's Hospital at Dartmouth in Manchester and Children's Hospital Boston as part of a partnership between the two hospitals said.
The partnership, which began last June, facilitates an exchange of physicians between the two physical locations and provides services to New Hampshire children who previously had to wait to see a specialist or travel to Boston for care, John Modlin, interim director of CHaD, said.
Pediatric physicians in gastroenterology, nephrology and cardiology divide their time between CHaD and Children's Hospital Boston to address patient needs, Modlin said.
Maireade McSweeney and Nirav Desai, pediatric gastroenterologists at Children's Hospital Boston, commute to New Hampshire to work at CHaD every Thursday.
"It's more expensive for patients to have care delivered in Massachusetts than in New Hampshire," Desai said. "The nice thing is that they have the Children's Hospital resources without that extra cost."
McSweeney and Desai also benefit from the partnership by gaining experience practicing in southern New Hampshire, McSweeney said.
The bridge between the two medical centers allows an ease of care that would have been impossible without the partnership, Desai said.
"One of my colleagues at Dartmouth had referred a patient down to be hospitalized in Boston," McSweeney said. "I was able to log on to the Children's Boston system, print out the things I needed to know and give that to the team."
Additional benefits of the partnership include improved recruitment, more referrals to Boston and increased cost efficiency, according to McSweeney.
The formalized partnership, now approaching the end of its first year, has enabled CHaD to recruit top physicians, Norman Berman, CHaD's chief of cardiology, said.
Crowley said he waited to accept his job offer until the partnership was formalized. As a result of the relationship between the two institutions, Crowley said he can practice his technical training in fetal echocardiography imaging and transesophageal echocardiograms at Children's Hospital Boston, which he could not have done at CHaD.
"It's great for Dartmouth-Hitchcock to say we're affiliated with the No. 1 hospital in the country," Crowley said.
As a result, CHaD has been able to expand its physical capacity in a cost-efficient manner, Modlin said.
"That meant that CHaD didn't have to hire extra physicians," he said. "When you hire a physician, you frequently have to bring them on full-time. We might not have the necessary demand or the need to hire a full-time position."
The increase in referrals made possible by the agreement also benefits Children's Hospital Boston, Crowley said.
"The more referrals they get and the more procedures they do, the better they are financially," he said.
Although leadership from CHaD and Children's Hospital Boston formalized the institutions' partnership last summer, the two hospitals have had a "long-standing, very close relationship," according to Berman.
Casey Bolton, a resident of Pittsfield, said this relationship has benefited her family since 2008.
When she was 20 weeks pregnant, Bolton was referred by an ultrasound technician to CHaD when the technician could not take images of her fetus's heart, she said.
Doctors told Bolton that her son would be born with hypoplastic left heart syndrome, a congenital heart defect, she said.
"We couldn't have his birth in New Hampshire," she said. "We would need to have his birth be planned in Boston so that he could go to Children's Hospital Boston immediately at birth."
Until her son Parker was born in December 2008, Bolton and her husband saw CHaD physicians regularly and traveled to Children's Hospital Boston for biweekly appointments, Bolton said.
Today, while the family travels to Children's Hospital Boston for major procedures, CHaD physicians perform Parker Bolton's routine care, she said.
"It's been a blessing to not have to leave the state and deal with Boston traffic and parking," Bolton said. "Everyone is on the same page. It doesn't feel like two different facilities for us. It's nice to have a local contact and a distance contact."
Because traveling to Children's Hospital Boston is an "all-day event," regular check-ups in Manchester impose less upon the family's schedule, Bolton said.
"Parker likes the convenience of it," Bolton said. "It doesn't interfere with his play time too much."
Patients generally seem to appreciate the increased hospital access that the partnership provides, especially because the care administered before and after a major surgery can occur locally, Modlin said.
Patient care needs will guide the partnership's future, he said.
"We are actively considering expanding the program to other medical and surgical sub-specialties," Modlin said.
Such sub-specialties may include neurology and orthopedics, according to Modlin.
