MIST in Alabama

A 60-year-old woman in Huntsville, Ala., swallowed a large number of aspirins, plus some sleeping pills and tranquilizers. Her local doctor, knowing that she needed help fast, but unsure of the proper antidote, made one telephone call. A brief consultation with an expert on drugs gave the puzzled physician the simple answer. A quick stomach pumping brought the woman out of danger. Three months ago she might have died.

The reason she did not was MIST, Medical Information Service via Telephone, a new consultation service created last July by the Medical College of Alabama in Birmingham. Until the advent of MIST, all the woman's doctor could have done was to seek help at random. Instead, he was able to telephone a central switchboard; the operator immediately put him through to MIST's pharmacologist, whose specialized knowledge may have saved the patient's life.

Closing the Gap. MIST's concept and operation are simple, but its effects are far-reaching. Begun as a pilot study that covered only four counties in Alabama, the project is now bringing the advice of medical specialists even to some of the most remote corners of the state. The idea was developed late last year by the Alabama Medical College dean, Dr. Clifton K. Meador, whose experience as a physician in Selma, Ala., had led him to believe that there were serious "defects in the communications between physicians and med ical centers." Meador decided to close that gap.

Approximately one-third of the medical college's faculty of 359 members are regularly active in the consulting service. These medical experts are on call for periods ranging from one week to a month at a time. Their specialties cover almost a dozen different areas of medicine, including surgery, obstetrics-gynecology, infectious diseases, toxicology, endocrinology, neurology and nutrition. Advice in allied health fields, such as hospital administration, pharmacology and dietary service, is also available.

Unique Service. The MIST duty rosters are manned by experienced physicians on the faculty, including some with national reputations. They include Dr. John Kirklin, former chief of surgery at the Mayo Clinic and now chief of surgery at the medical college; Dr. T. Joseph Reeves, chief of medicine at the college and a renowned cardiologist; and Dr. Thomas W. Sheehy, formerly a medical adviser for the U.S. armed forces in Viet Nam, now director of MIST and professor of medicine at the college. They take on the extra duty without pay, have already dealt with scores of cases ranging from heart blocks to overdoses of pills.

On call for MIST 24 hours a day, seven days a week while they are on the duty roster, these physicians provide a unique program. It is the only hospital consulting service in the U.S. that is available to nonaffiliated physicians without cost. "It brings medical service right into the physician's office," says Sheehy. "Nowhere else can a doctor call a medical center free of charge and receive personal answers to his questions from some of the most highly qualified specialists in the nation."

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