Early life lesson shaped rural doctor

Dr. Adrian Billings talks to Kathy Johnstone of the State Office of Rural Health in Austin during Tuesday’s Building the Basin Permian Basin Workforce Summit at the Odessa Marriott and Conference Center. (Ruth Campbell/Odessa American)

Being able to call his family physician after being exposed to rabies inspired Dr. Adrian Billings not only to list his home number in the phone book, but also to advocate for healthcare in rural and underserved areas.

Billings is on the rural residency track faculty at Texas Tech University Health Sciences Center in Odessa, and he supervises Texas Tech resident physicians on Fridays in Alpine, where he lives. The rest of the week, he is in Odessa.

Recently, he won the National Clinician of the Year Award from the Association of Clinicians for the Underserved.

“It was very humbling, but also validating that the work we’re doing out here is really important and needed,” he said. “I think it gave me some more resolve to keep fighting the good fight, keep doing the work that we’re doing.”

The main influence for choosing his profession was Billings’ family physician, Dr. Ramon Garcia in Del Rio.

“He was the doctor who delivered me and took care of me into college,” he said.

“When I was a junior in high school, I was working for a veterinarian because I thought I wanted to become a veterinarian. I’d helped Dr. Davis, the veterinarian, on multiple necropsies on animals. I was showing 4-H lambs in high school, and one Saturday I drove up to the pen and discovered one of my lambs had died unexpectedly, so I decided to perform my own necropsy.

“Without any gloves, I made an incision from the neck down to the pelvis and at the end of five minutes I had blood up to my elbows. I also had no idea what this animal had died of after that five-minute long necropsy,” Billings said.

“The county extension agent found out what I had done and worried that perhaps this animal had died from rabies and that I had just had a pretty significant exposure … so he suggested that we send the animal’s brain off to the Texas A&M veterinary diagnostic laboratory in College Station. And I’ll never forget that next Saturday when the county extension agent called me with the results that the animal had indeed tested positive for rabies, and he suggested that I needed medical attention immediately.

“Nobody in my family was in medicine, so we all felt as though I was probably about to become sick with rabies and had a high chance of dying. So I went to the Del Rio phone book and looked for the home phone number for my family physician. In bold I found his office number, but unbolded beneath his office number was the residence number for Dr. Ramon Garcia.

“I didn’t think anything on a Saturday morning of trying to reach out to my family doctor at home. I called the number and after about a five-minute conversation he told me I was going to be OK; that I did not need to seek any further … care,” Billings added.

He said he never forgot that and has used it as a teaching point for his medical students and resident physicians who have rotated with him over the years.

In his time of need, Billings said his family physician exhibited three three A’s. He was available, accessible by answering the phone and very affable.

“He didn’t seem put off that one of his patients was interrupting his quiet time on Saturday with his family, and so to honor him I have listed my home telephone number in the Alpine phone book for the past 16-plus years and have felt that it’s been a service to my patients to offer them this service that Dr. Garcia kindly offered me and his patients when I was a child,” Billings said.

Billings earned a bachelor’s degree in biomedical science from Texas A&M University.

“I didn’t get accepted to medical school, so I entered a Ph.D. program at the University of Texas Medical Branch in Galveston and received a Ph.D. in experimental pathology,” he said.

But he still felt a calling to reapply to med school.

“I reapplied at the conclusion of my Ph.D. and was accepted, thankfully, the second go-around and stayed at the University of Texas Medical Branch for medical school and then I went for my family medicine residency at John Peter Smith hospital in Fort Worth.

“They let me stay an extra year, and I developed an obstetrics and gynecology fellowship for family physicians that is still ongoing,” he said.

Billings received a National Health Service Corps Scholarship, which is a federal program for physicians and some other health disciplines. He owed four years of practicing in a medically underserved area of his choosing. Alpine qualified, so he served his four years and never left.

“My practice was very diverse in the sense that … I did clinic and clinic included home visits as well,” Billings said. “I also did hospital work, taking care of my patients in the hospital, kids and adults. In addition to that, I delivered babies, including doing C-sections and tubal ligations; different things that are needed for maternity care, so (I) really had the full spectrum of family medicine.”

This used to be common but is less so now, especially in urban areas.

“… But certainly in rural areas this is still very much needed where there are not specialists who can do this and so family medicine — definitely that breadth of family medicine — is still needed in our rural hospitals,” he said.

Another teaching moment that Billings uses is the example of how far people have to travel from the Big Bend area to see specialists, or even primary care physicians.

Ten years ago, Billings had an elderly patient who needed to see a specialist in Odessa. The daughter was also a patient of hiss.

“… The elderly mother needed to seek specialty care and on their drive back south of Monahans they were involved in a head-on collision and both and the mother and the daughter were killed in that accident,” he said. “Had they been able to see that specialist locally in the Big Bend, they likely both would still be living and that helped me drive my advocacy for trying to bring more healthcare to our rural communities.

“To some extent with COVID and telehealth being more available, that is an option, but I still feel that these rural communities … need physicians and healthcare professionals in their own communities to try and meet those needs that cannot be met via telehealth,” he added.

A family physician by specialty, Billings sees himself as a community doctor trying to meet the needs of the community inside and outside the walls of the clinic and hospital.

Billings has been practicing medicine for 16 years in Alpine. Officially, he has been with Texas Tech since 2013, but was volunteering prior to that. “… I came onboard full time here at the Odessa campus in August of this year,” he said.

Having grown up in a border town, he speaks Spanish.

“I grew up knowing the need to speak Spanish and hoped I would come back to the border community to practice medicine,” he said. “I knew it would be one less barrier for me and my patients if I was able to communicate with them in Spanish.”

In Alpine, he said, a fair amount of his patients speak Spanish. But one day a week he goes to Presidio, which has a majority of Spanish speakers.

“It’s needed everywhere, but more so down in Presidio,” he added.

Dr. Timothy Benton, regional dean and professor at Texas Tech Health Sciences, said Billings is an incredible, “well-deserving physician.”

“He’s not only an M.D., but also a Ph.D. and has a research background, so he brings tremendous strength from the scientific realm, but the fantastic thing about him, too, is that he’s a people-oriented person,” Benton said.