Serving Barnwell County and it's neighbors since 1852
Every weekday for nearly 20 years, before the rays of the South Carolina sun would break the first light of dawn, Dr. Dean Koukos would wake up and begin the two-hour drive from his home in Bluffton to Barnwell Family Medicine. In the car ride, Koukos would listen to medical tapes or study Greek, the language he spoke until age five.
“He believed in patient first,” said Dale Koukos, Dr. Koukos’ widow. “He liked people in this community who are salt-of-the-earth, they work for a living, they’re honest with each other.”
Within a month, Barnwell and Allendale counties lost two dedicated physicians. Koukos, 75, died on March 12 while Dr. Bobbie Ayers, 76, of Low County Health Care System’s (LCHCS) Fairfax location died on February 21, leaving behind a void in the local health care system.
“Our current providers have already stepped in to fill this void. We are consistently hiring, growing and doing our best to add more providers and services when the community needs them,” said Morgan Reuis, marketing coordinator and executive assistant for LCHCS.
Dr. Koukos saw upwards of 40 patients a day and up to 5,000 patients a year, according to Dale Koukos.
“He was our most productive provider at all of our clinical sites,” said Jennifer Rahn, M.D., chief medical officer of Low Country Health Care System (LCHCS), which operates multiple health care facilities in Barnwell, Allendale, Bamberg and Aiken counties. “He loved the community of Barnwell and the patients. As an organization we’re going to continue to bring on additional providers. But Dr. Koukos was just a rare, wonderful individual. It’ll probably take two providers to do what he was doing.”
Dr. Ayers worked for LCHCS as a locum tenens physician - or temporary provider - for 6 months before joining full time. He saw an average of 12 patients per day.
“He had the best quality numbers for the organization, meaning he provided the most comprehensive and well-rounded preventative care,” said Reuis.
The loss of Koukos and Ayers comes at a time of a local shortage of health care workers, as well as ongoing changes within the local and national health care system as a result of the pandemic and supply chain issues. Covid also took its toll on health care workers across the country who worked long hours.
The loss of Koukos and Ayers extends beyond lost labor and medical knowledge, but also relationships. Having patient-physician relationships built on trust, Barnes said, is a key part of building a strong health care system in a small community.
“We do try to make it so the patient is comfortable,” said Dr. Ashley Barnes, CEO of LCHCS. “It is important for these patients to get to know them, trust them and like them, and that takes time.”
Understanding the history of his many patients and the nuances of the health issues that they faced were the two doctors strengths, according to Rahn.
“It’s not just a diagnosis on a chart, there’s more to it,” Rahn said. “There’s little nuances to each condition. Every diabetic is not the same, every depressed patient is not the same. There’s little characters about folks.”
Ayers, who worked in Fairfax for 12 years, was known for being quiet.
“We loved him,” said Barnes. “He did such a great job. He was private, but if you talked with him one on one he was truly caring. He cared a lot about his patients.”
Lari Gooding, the chief executive officer of the Allendale County Hospital, worked with Ayers and Koukos for decades. Gooding, whose hospital is also facing similar shortages of healthcare workers, is also looking for new nurses and physicians.
“I hired Dr. Koukos years ago,” Gooding said, referring to a time where he worked at Barnwell Family Medicine. “You’re always hesitant to hire somebody who says he’ll drive an hour and forty-five minutes to get to work. [But] if you can provide a situation where [doctors] are happy if they're happy living elsewhere, commuting [and] loving what they do at work, they’ll be there a long time. Dr. Koukos was the prime example of that.”
Dale Koukos said she hopes whoever fills Dr. Koukos’ position will respect the need for local healthcare in small communities; Dr. Koukos took the job in Barnwell despite it paying less than his former job. In a medical system built around profitability and not treatment, she worries that the next generation of doctors will be focused on money.
“Medicine is becoming a big money-making thing,” Dale Koukos said. “He wanted the job [in Barnwell] on the spot. He liked what he saw: a small community in need of good physicians.”
As LCHCS mourns the loss of two of their own, the organization’s dedicated team remains committed to providing quality health care to the communities they serve.
Elijah de Castro is a Report for America corps member who writes about rural communities like Allendale and Barnwell counties for The People-Sentinel. Your donation to match our RFA grant helps keep Elijah writing stories like this one; please consider making a tax-deductible gift of any amount today.
