Jennifer Lail Wertman '75
Providing a Familial Approach to Healthcare
If Jennifer Lail Wertman ’75 could snap her fingers and fix one healthcare problem in this country, she would see to it that every child had health insurance.
“With as much wealth as this country has and as much money as we spend on healthcare, every child should be insured and every child should have a medical home—a place where they are known by a person, where they have a record,” she said.
Wertman, a primary care pediatrician at Chapel Hill Pediatrics and Adolescents, served as North Carolina’s representative to the National Initiative for Children’s Healthcare Quality’s Medical Home Learning Collaborative on Children with Special Health Care Needs in 2003, and continues to serve in a leadership role as project director of the North Carolina Title V Medical Home Grant Project. The focus of the project is the “medical home” concept, a model for providing special needs children with primary care that is accessible, continuous, comprehensive, and culturally effective.
Said Wertman,“We ask, what are the ways we take care of these children? What are the communication obstacles? What are the things that make it hard for a child who has leukemia, for instance, to be cared for when the leukemia is in remission? They go back to their regular doctor and then what happens?”
This is the heart of Wertman’s work. With the amount of specialized care for children now, including intensive care units, cancer treatments, and treatment surrounding premature birth, she’s seeing more and more patients with chronic conditions.
“One in every five homes has a child with a special healthcare need,” Wertman said, “and approximately 18 percent have a chronic health condition—something that’s going to last longer than a year, something that’s going to require more services than a ‘regular’ child.”
This work with special needs patients has become a primary focus for Wertman, who has been in practice for 27 years.
“I really like taking care of complex children, and it has become a niche for me,” she said. “The chronic conditions of children are the ones that are compelling us these days. When I was a younger pediatrician, we worked a lot with infectious disease. With vaccines, many of those diseases have been immunized away. Now, instead of treating children with pneumonia and meningitis, we’re treating depression, chronic asthma, obesity—things you can’t fix in a 10-minute visit.”
Wertman’s practice over the years has evolved to reflect this shift, and that’s where the “medical home” concept comes into play.
“Part of what the medical system is dealing with is adapting from the acute care visit to the chronic care model, where you actually are dealing with conditions over time, you’re assuring that the conditions are cared for, and you’re measuring that the condition is getting better.”
Realizing that the acute visit model doesn’t work for the chronic care condition, Wertman turned her attention to how to take care of people long term and provide on-going support.
“When I was in medical school, a baby born at 26 weeks gestation was not considered viable,” she said. “There was no question about whether or not you were going to resuscitate. Now, a 26-week baby is resuscitated, put in intensive care, cared for for three or four months, sent out to a pediatrician, and has the issues related to extreme prematurity.”
Wertman said the number of children with chronic conditions is increasing because survival rates from prematurity and trauma are increasing. Children severely injured in car accidents, for example, are taken to intensive care units that have the high technology to care for them.
“The results of that event have to be cared for long term,” Wertman said, “Whether they be learning issues or problems with mobility.”
In Wertman’s busy practice, she takes care of children with conditions like cerebral palsy and down syndrome, and while she acknowledges that she sees sorrows in her line of work, she also witnesses many joys. It is the notion of family that is at the center of what she does.
“I have a great time,” she said. “It’s an amazing gift to be a part of people’s lives over a span of time. I get to watch families grow up.”
A child herself when she first knew what she wanted to do with her life, Wertman announced her desire to be a pediatrician at the family dinner table when she was in the eighth grade.
Years later, it was from the lobby of Forrer Hall that she called her mother to say that she had been accepted into medical school, and she considers her Transylvania education a gift that set the tone for her career.
“(Former chemistry professor) Monroe Moosnick is close to sainthood in my book,” she said. “The faculty is the thing that is so rich at Transy. My professors at Transy understood college students. They could recognize our cognitive potential and keep it directed where it needed to be.”
Wertman attended the University of Kentucky Medical School and completed residencies in pediatrics at the University of Florida Shands Teaching Hospital and Duke University Medical Center. In 2005, Transylvania presented her with a Distinguished Achievement Award in recognition of contributions to her profession, community, and alma mater.