According to research published in Population Health Metrics (2009), the southern and Appalachian states have the highest prevalence of diabetes in the United States. That's why Andrew S. Rhinehart, MD, doesn't slow down. As a diabetologist and the medical director of the Johnston Memorial Diabetes Care Center in Abingdon, Va., Rhinehart and his team of diabetes care specialists see daily the urgent need for quality diabetes education and care in the southwest Virginia/northeast Tennessee region. "The cause is really three-fold," explained Rhinehart, "It's partly genetic, partly dietary, and partly the geographic restrictions to healthcare in this area."

 

Because of this shortage of diabetes care in the region, the Diabetes Center sees patients that might live several hours away, which keeps Rhinehart and his staff on their toes. "We can't just say, 'Let's do a fasting test tomorrow morning'—that patient may live three hours away," said Rhinehart.

 

And while his job may be a challenge, Rhinehart embraces it wholeheartedly, as he described, diabetes is his life. "Everything [in my life] is surrounding that, from my travels, . . .to writing books about it, to reading about it every night."

 

Continued Rhinehart, "It's a great field to be in; it's so nice to help people who are struggling. And really, the education is more important than I am here." Consequently, a desire to help people is what started it all for Rhinehart. Originally from York, Pennsylvania, Rhinehart was a strong student in the math and sciences and sought to be in a field where he could match his strengths with his desire to help people. "I know it sounds typical," said Rhinehart, "But it's true, there aren't a whole lot of choices where you can accomplish things like that."

 

He began his training at Juanita College in Huntingdon, Pa., and then continued straight through, attending medical school at the University of Maryland and completing his residency in Internal Medicine at East Tennessee State University in 1995. Rhinehart then went straight into private practice in Abingdon after finishing his residency, working for 14 years with the same group.

 

Since then, his specialty training with diabetes has been what he describes as somewhat serendipitous.

 

In 1999, diabetes educators in the area took notice of how well Rhinehart cared for his diabetes patients. Indentifying him as a "champion" for diabetes in the area, they asked him to serve in the position as medical advisor to a new diabetes education center at Johnston Memorial in 2000.

 

Rhinehart agreed and since then has been awarded recognition from the American Diabetes Association (ADA) and the National Committee for Quality Assurance (NCQA) for providing high quality care to individuals with diabetes. Very few physicians in the area receive such recognition.

 

In 2005, the center's diabetes educators Lora Reynolds and Melissa Mullins, along with Rhinehart, envisioned a comprehensive care center, where diabetes patients could receive not only education, but medical care as well. At the same time, Rhinehart had been invited to join an endocrinology practice, and when Johnston Memorial officials heard about the offer, they asked Rhinehart what it would take to convince him to stay. "Open the comprehensive center" was Rhinehart's reply and last July, Rhinehart and the Johnston Memorial Diabetes Center opened their doors.

 

"Basically, we added me to the education center," explained Rhinehart. "And we also have brought in other care providers who patients with diabetes need to see, such as a nephrologist and a wound care expert."

 

They have also added an additional certified diabetes educator and a podiatrist.

 

Rhinehart uses his infamous globe comparison to describe the care patients receive at the center. What one person sees on a globe will be different from what another person sees; likewise, diabetes patients are viewed through unique perspectives, and the center brings all of these perspectives together. "We have assembled a diabetes care team so the patient doesn't have to," said Rhinehart. "And we talk to each other rather than sending letters, and at times talk to the patient all together."

 

As Rhinehart explained, what the center is trying to achieve as their ultimate goal is quality patient care, and they believe if patients are educated about their diabetes, and if they are receiving good care, and they are meeting their treatment goals, the Center is meeting its goal.

 

And while most insurance plans cover all the costs associated with the center's comprehensive care, any education that isn't covered, the center offers regardless of payment. "We believe patients should receive the education they deserve," enthused Rhinehart.

 

As part of his initiative toward patient education, Rhinehart has written two books, I Have Diabetes!! Now What? and I'm Taking Insulin!! Now What? A third book in the series about diabetes' complications will be coming out soon. "Diabetes is so different than any other illness," said Rhinehart. "Patients have to check sugar, know about carbohydrates and maintaining glucose, how to care for their feet, how to use insulin—there are so many things they have to know—rather than just popping a pill to take care of say, high blood pressure, for instance." 

 

Fortunately, no one in Rhinehart's family battles this disease he spends so much time treating, and family is an important part of Rhinehart's life. Affectionately known as the "Big Dog Daddy," Rhinehart's family consists of three children, two stepchildren, and four grandchildren. "We are busy, busy folks," Rhinehart chuckled.

 

He and his wife Deana have been married almost three years and the whole family enjoys staying healthy together, as they regularly exercise—biking, running, swimming, or simply just playing. "With a son playing middle school football and another playing JV, we spend a lot of Friday nights at the football field."