AcuteCare Telemedicine Blog


Eagle Scout, AcuteCare CEO Dr. Matthews Gwynn Does His Best To Help Others

Being a good scout has carried Dr. Matthews W. Gwynn through life, to the post of chief executive officer of AcuteCare Telemedicine, and consistently as one of America’s Top Doctors, according to U.S. News and World Report.

An Eagle Scout’s life lessons are a solid foundation for Dr. Gwynn, now 55, as he strives, on his honor, to do his best to help others. “It teaches you to do the right thing if you take it seriously,” he says of Scouting’s influence.  “In my blood I always try to do the right thing. I believe there is something to be said for society that, if you simply follow the Scout law and motto and think like that, it sounds hokey, really hokey, but the world is a better place.”

Dr. Gwynn was born in Baltimore, Md., then moved around in his early years, to Cincinnati, Ohio, Raleigh, N.C., and Reston, Va.

With his father’s encouragement, he grew into the idea of becoming a doctor. As a chemistry major with a liberal arts education, it was his love of science and problem solving, plus his maternal grandmother, that cleared the path for Dr. Gwynn’s career. In his teenage years, he helped take care of his grandmother after she’d suffered a stroke. “I came to understand the frailties of people,” he remembers. “I realized I could make a living at it and also help people get better.”

He is a graduate of the College of William and Mary and the University of Virginia Medical School. He completed an Internal Medicine residency at the University of Alabama in Birmingham, and then returned to the University of Virginia for his Neurology residency. He is also a partner in Atlanta Neurology.

The challenges and riddles of Neurology are what eventually drew Dr. Gwynn in. “I loved the fact that it was a puzzle and the diseases were highly interesting and very challenging,” he says. “Not particularly easy and not everybody could do it. It required a very formal thought process to come to the right answer.” He says he was discouraged at first, “that there was nothing to do for people” he adds. “It was the old saying ‘diagnose and adios’ in neurology.” So he went into general medicine residency to find something to help people get better. But he changed his mind and realized he was fascinated by Neurology, just as the field was developing quickly.

Dr. Gwynn realized that telemedicine was a rising frontier in the field of Neurology. “The current economics in medicine is unfavorable for many neurologists to stay in hospitals. Almost all liability comes from there, and it is very disruptive to your primary income source, which is your private practice,” he says.  This exodus creates a real void. “Telemedicine is not a fad. It’s a demand that is growing,” the chief of Neurology at St. Joseph’s Hospital in Atlanta adds. “We are trying to use this opportunity to fill the gap.”

The CEO sees the professionals at AcuteCare Telemedicine as “competent, punctual and engaging.” He says they embody the “Three A’s of Medicine”: ability; availability; and affability. “They are competent and have a wide breadth of clinical neurology experience and knowledge and are leaders in their field,” Dr. Gwynn adds. “They are engaged. We are people-people. We provide expert advice and with patients we are able to empathize and help them really well; better than most of our colleagues.”

Dr. Gwynn is also director and founder of the Stroke Center of Northside Hospital and recent chairman of the Department of Internal Medicine. He says the ability to connect with people is crucial in telemedicine. “It’s amazing how well that works,” he says. “Within five seconds I can gain the trust of the patient as much as if I were in the room by greeting them with a smiling face and respect.

We all find commonality very quickly with our patients,” the husband of 27 years and father of two says assuringly. “A lot of people are very frightened when they have neurological symptoms, because it is so foreign to them. It’s an enigma. So we’re there to try to put them at ease and figure out how to help them.”

Dr. Gwynn has also become a national expert leader in using botulinum toxin for medical treatment of chronic migraine, movement disorders, spasticity, and other disorders, and he trains other physicians to use it in their own practices.

The doctor enjoys a round of golf in what little spare time he gets. He also likes to cycle and backpack and enjoys classical music.

The Eagle Scout in a white coat gets his inspiration within each new day. “I love that every day is different and that I am going to see interesting people,” Dr. Gwynn says. “That people are going to come to me asking for my advice and wanting me to help them and make them better. I can’t help everybody but I can listen to everybody and ameliorate their suffering.”

He is also fond of the direction AcuteCare Telemedicine is taking. “By the end of next month we’re going to be in six states and many different ERs,” Dr. Gwynn says, “and I can reach anyone from anywhere. I can even have an influence on someone’s care 2,000 miles away in Arizona. That’s very cool.”



Botox – The Poison that Heals

Ounce for ounce, a molecule made by the bacterium Clostridium botulinum is the most potent neurotoxin on earth. A tiny amount ingested or introduced to the body through wounds has been enough to paralyze all the muscles in a human for more than long enough to allow suffocation from respiratory failure. The structure and biology of this large molecule, primarily made of protein, was deciphered just in the last century, but its ability to quickly and easily get into humans made it of great interest to scientists and physicians around the world.

Over time after its discovery, physicians came to understand that there could actually be medicinal qualities to this poison. One such interesting properties of botulinum toxin was its mechanism to weaken muscles by being taken up by the nerve endings attached to those muscles. This shuts down the nerve endings and their communication with muscles which keeps the muscles from contracting. When exposure is due to a bacterial infection, the toxin is widely distributed, coming into contact with nerves throughout the body, including those of the chest and diaphragm, resulting in breathing paralysis.

But what would happen if a tiny amount of the toxin was isolated and injected right at a site of a muscle in doses that were too small to have any effect elsewhere? Using a small dose would preclude weakness developing throughout the body and produce effects just locally. In fact, this is exactly what happened; an ophthalmologist who was a previously involved with the Army project injected eye muscles of children with crossed eyes (strabismus), weakening the muscles that were pulling too far and straightening out the gaze. The results were very good with few or no side effects.

Ultimately, many other indications came along, all based on the theory that relaxation of muscles can have a desired effect. By far the most publicized application of Botox in particular has been for the treatment of wrinkles – popularized as a fountain of youth in a bottle. Shortly after, it was discovered that patients with chronic headaches, including migraine, who received Botox for wrinkle treatment in the foreign were alleviated, incurring fewer headaches.

The mechanism of action regarding headaches is unknown. Some scientists suggest that the relief results from the interaction of Botox with sensory nerves as well as its known effect on motor nerves. There is evidence of this, but it remains a mystery how it works. Studies clearly show that it does not get into the brain or spinal cord and so does not affect pain centers there. The muscle relaxation itself probably doesn’t play a huge role, though there are sensory receptors within muscle fibers that may be influenced.

The story of this poison that heals is truly fascinating and represents one of the most important medical advances in the last two decades. The future could be even more interesting, as it may be possible to use the properties of some parts of the botulinum toxin to bring other molecules into nerves and have effects on them. This may have implications in trying to restore function and vitality to weakened nerves from many diseases. But for now, millions of people have found that Botox is at least worth a shot.

Read a more detailed history and perspective on Botox here.