UTHCT's Dr. David Coultas doesn't just want to treat chronic diseases, he wants to prevent them

Tuesday, March 27, 2007

For Dr. David Coultas, the physician in chief at The University of Texas Health Science Center at Tyler, it’s all about learning.

“I like the variety of taking care of patients, teaching medical students, training doctors, and learning through research,” Dr. Coultas said.

A nationally known pulmonologist, Dr. Coultas was a contributing author to the U.S. Surgeon General’s report on the effects of secondhand smoke that was issued this past summer.

“The Health Consequences of Involuntary Exposure to Tobacco Smoke” found that even brief exposures to secondhand smoke can cause harm. Dr. Coultas wrote about the respiratory effects in adults from exposure to secondhand smoke in one of the report’s 10 chapters.

After reviewing 25 years of studies of the effects of secondhand smoke, he found evidence suggesting that it can cause symptoms such as coughing, wheezing, chest tightness, and difficulty breathing among people with asthma and healthy people.

Secondhand smoke also may have a role in adult onset asthma and may make it harder for people with asthma to manage their disease.

Dr. Coultas chose pulmonology – the diagnosis and treatment of diseases and problems of the respiratory tract – because of a physician who mentored him during his internal medicine residency at the University of New Mexico.

“Jonathan Samet, MD, had a broad perspective, not only about clinical medicine, but also public health. He is an outstanding researcher and an enthusiastic teacher. Those attributes got me excited about the field,” he said.

Dr. Samet was a pulmonary epidemiologist, studying the incidence, distribution, and control of pulmonary diseases within a population.

Dr. Coultas realized the importance of public health after treating many patients with chronic illnesses caused by unhealthy behaviors and inadequate access to health care. Many suffered from diseases caused by excessive alcohol consumption and cigarette smoking.

“You realize that just taking care of incurable diseases is not all you want to do. You want to be able to prevent these diseases,” he said.

“Every day there are unanswered questions in patient care. As a clinician, you know the questions that are most applicable to patients. You put your research hat on and ask, how could I answer those questions, and then you design research to find the answers,” Dr. Coultas said.

“Right now I’m concentrating on how to improve the health of people with COPD, chronic obstructive pulmonary disease, using different methods of rehabilitation,” Dr. Coultas said.

“We know that pulmonary rehabilitation programs at hospitals improve the health of patients with chronic lung disease. But people who need this therapy can’t come to a center three days a week for the rest of their lives." he said.

"We’re developing ways for people to successfully do this rehabilitation at home, to continue it in their everyday lives so they get the ongoing benefit,” Dr. Coultas added.

He has submitted a research proposal to the National Institutes of Health that would evaluate new approaches to pulmonary rehabilitation at home and see if they improve patient outcomes.

This five-year research project would build on the results of a similar, smaller project funded by Tyler’s Fair Foundation. Results from this smaller project provided crucial data for the NIH grant application.

Many patients come to Dr. Coultas because of persistent cough, shortness of breath, or abnormal chest x-rays.

“These are common occurrences, but the reasons people have these symptoms are complex. A specialist’s job is to take a very in-depth evaluation and history. The primary care physician and specialist work as a team, with the specialist providing expertise and knowledge that the primary care physician may not have access to,” he said.

Board certified in internal medicine and pulmonary disease, Dr. Coultas is interested in COPD, pulmonary fibrosis, and occupational lung disease.

Before coming to UTHSCT, Dr. Coultas was professor and associate chairman of the Department of Internal Medicine at the University of Florida Health Sciences Center in Jacksonville, Fla.

Dr. Coultas also was a professor of medicine at the University of New Mexico in Albuquerque. He received his medical degree from the University of Florida Medical School in Gainesville and completed his residency and pulmonary training at the University of New Mexico.

Besides being a clinician, researcher, and teacher, Dr. Coultas also serves as the Health Center’s physician in chief.

“My role is to be an advocate for the physicians, to create a team of physicians, mentor them, and help them provide the best patient care," he said.

"If the organization is healthy, you can have an even larger impact on improving the health of patients than you do as an individual doctor," Dr. Coultas added.

“I’d also like to raise awareness of UTHSCT’s outstanding medical care, increase recognition of our excellence in the treatment of pulmonary disease, allergies, infectious disease, and occupational medicine. Then there’s our cutting-edge research in pulmonary diseases such as COPD. These are all centers of excellence at the Health Center,” he said.

“As an academic medical center, we’re an integral part of the development of East Texas. We complement the other health systems, and we train physicians for them,” Dr. Coultas said.

“Physicians in residency programs tend to stay in the region where they trained. We get outstanding residents here, in the family medicine and occupational medicine residency programs, and many will stay in this area after they complete their training,” he said.

“An academic medical center has a real economic impact. It creates jobs in patient care and research and trains health-care providers. That foundation is attractive to firms considering locating facilities in East Texas,” he said.

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