{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/0c4sj1cf25/manifest","type":"Manifest","label":{"en":["Dr. Denise Rodgers"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2011-04-29 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Jessica Muller, Ph.D. (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["American Academy of Family Physicians","family medicine","family physician"]}},{"label":{"en":["Subject"]},"value":{"en":["Denise Rodgers, MD (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156804/file/286765","type":"Canvas","label":{"en":["Media File 1 of 1 - Rodgers_Denise_2011.04.29.mp3"]},"duration":5260.51513,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156804/file/286765/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156804/file/286765/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/286/765/original/Rodgers_Denise_2011.04.29.mp3?1755114787","type":"Audio","format":"audio/mpeg","duration":5260.51513,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156804/file/286765","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156804/file/286765/transcript/82534","type":"AnnotationPage","label":{"en":["Dr. Denise Rodgers interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156804/file/286765/transcript/82534/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"It’s April 29, 2011. We are at STFM in New Orleans and I am interviewing Denise Rodgers.  \n\nSo, let’s begin. Why don’t you give me your full name?\n\nDenise V. Rodgers.  \n\nWhere and when were you born?\n\nI was born in Jefferson City, Missouri on June 23, 1952. \n\nAnd where did you grow up?\n\nI grew up in Flint, Michigan for most of my life. \n\nCan you describe your parents a bit?\n\nMy mother was a nurse. She did hospital nursing at the beginning of her career. But for most of my childhood, she was a school nurse. And my father was a psychologist who taught at the local community college as well as having a private practice in the community as well as doing a lot of forensic testing for criminals in Flint.\n\nI know you have one child. What is her name? How old is she?\n\nHer name is Zori [?] and she will be thirteen next week. \n\nAnd she is what grade in school?\n\nSeventh. \n\nAnd you live where now?\n\nMontclair, New Jersey. \n\nWe’ll come back to why you’re there in Montclair in a little bit, but finish first with your childhood. When you were growing up, who were your role models? Did you have any and who were they?\n\nProbably my parents actually were my most significant role models. I remember from a very young age wanting to be a doctor. I think I first started telling people I wanted to be a doctor when I was about five. And I remember wanting my mother to always tell me stories about her work and the illnesses that she dealt with and what was going on with the kids that she was taking care of and all that. My parents obviously had a very strong work ethic and education was very important to them as was social justice. My father, in particular, was very involved in the Civil Rights Movement. He actually participated in the original March on Washington. He was very, very active in the NAACP, the local chapter. He was involved in boycotts in Flint for stores that didn’t treat blacks correctly and that sort of thing. I really got a lot of my values and aspirations from them.\n\nWhy did you decide you wanted to be a doctor? Do you remember back to when you were five?\n\nAt five it was more of this amorphous, kind of “I want to be a doctor.” But I think that I liked the stories that my mother told but I wanted to do more. I wanted to sort of be the person in charge, quite frankly. And that was my view at the time of the difference between nursing and physicians. And then many years later Marcus Welby came on TV and I was totally into that. I thought, “Oh yeah, that’s definitely what I want to do” because it was the drama of the medical aspect that was going on, but then there was dealing with the family dynamics and all of that stuff. And I thought “Oh yeah, this is for me.”\n\nSo Marcus Welby?\n\nYeah, so Marcus Welby I guess was my other role model. Although maybe I related more to Steve Kiley, to tell you the truth – the guy on the motorcycle.\n\nWhat took your parents from Missouri up to Michigan?\n\nA job for my father, quite frankly. He worked in a series of places and got a job in Flint – and it was good. We were in Flint in the heyday of General Motors. So it was a booming, thriving town. Everybody bought a new car every two years. Everybody was employed. A lot of people did overtime. People had summer homes in the Upper Peninsula. It was very, very different from what it is today. And my father, quite frankly, was a real sort of big fish in a little pond. A lot of my teachers in school, growing up, had my father as a teacher in the college and he was just very well-known. We never went out in the town where there weren’t people who knew him, who would come up and talk to him. At the time, when I was a kid, I was mortified by the whole thing.\n\nDo you have any one or two stories that stand out from your childhood that you’d like to tell us about?\n\nOne of the stories from my childhood that I sort of carry with me, for good or for bad, is when I was about five I remember playing in the front part of our house with a hula hoop. And I was rolling the hula hoop on the ground, spinning it so it would roll out and then come back to you. I remember doing that and it was going toward the end of the sidewalk. And a car full of, looking at it retrospectively, white teenagers stopped the car, stole the hula hoop and called me the “N” word. And I remember going into the house pretty upset, saying okay, this is Flint.\n\nHow did your parents handle that?\n\nThey were angry, obviously. There wasn’t much they could do. They stole it and went away. The other probably significant story from my childhood is that when I was in third grade, they integrated the schools in Flint. So, basically it was de facto segregation. Then, I guess it was 1960, they decided to integrate the schools. So I was one of six black kids who went to what had then been the all-white elementary school. And my first day of school my teacher told me to sit in the back of the class because she knew I wasn’t going to be able to keep up with the other kids – and I should just sit in the back of the class and not talk very much. So, I went home and told my father. He knew who had done it, so he went up to talk to my teacher. And the irony in this story, of course, is that my teacher’s daughter was in my father’s class at the time. So there was this sort of karmic synergy to this whole thing. And, of course, I didn’t sit in the back of the class and I participated in class and it all worked out.\n\nDid she realize who you were at that time?\n\nNo. \n\nWhere did you go to high school?\n\nI went to boarding school in North Carolina, Palmer Memorial Institute in Sedalia, North Carolina. It was an all-black boarding school. It was good. It was an interesting experience.\n\nAnd why did your parents send you there?\n\nIt’s funny, I don’t know 100% for sure. But I think that as I got older, once I had integrated the schools a lot of social life was with my white friends. And as I started getting older, I remember there was a white guy who invited me to some sort of school fair or something like that. And we ended up not going because his parents were very concerned. This was pre-high school, so there was nothing going on. And I think my parents started to say okay, let’s try to minimize this kind of craziness in your life. And if you go to an all-black school, you don’t have to worry about that kind of stuff. And I think they also thought I was going to get a better education at a private school as well. It wasn’t just to accommodate my social life that they sent me to boarding school.\n\nWere there many black families in Flint at the time?\n\nYes. But there was a real geographic and sociologic divide. Actually socioeconomic divide. \n\nSo, when you say you integrated that school, you were the only middle class back who happened to be in that school?\n\nWhat happened is the family of a prominent physician in town sued to actually buy a house in the white neighborhood, which was maybe a half mile from where I lived. But once that happened, they couldn’t then deny those kids going to that school. And I think the decision was made, let’s widen the boundaries a bit so that they aren’t the only black kids in this school. So that’s why there ended up being about six of us who ended up going to the school.\n\nWhere did you do your undergraduate work?\n\nAt Oberlin.  \n\nAnd why there?\n\nBecause when I visited it, I really liked it a lot. And there were a lot of people there who were doing kind of cool stuff. It was the 70s and it was a very political time. And I was political, so it was perfect actually.\n\nWhat did you major in when you were there?\n\nPsychobiology. \n\nSo, you still knew that you wanted to be a physician?\n\nI did. Although I had a crisis of confidence when I took physics. I did not do well in physics in undergraduate school. So I was like “Oh my gosh, am I smart enough to do this? Can I do this?” I then shifted over and did more psychology and thought maybe I’ll be a psychologist. I liked interacting with human beings and I knew I wanted to be in the helping professions, if you will. So, when I got out of college I did a year of science at Wayne State University. I did physics and biochemistry and all that kind of stuff mostly to give myself a sense, can I really do this and succeed? Because I certainly didn’t want to go to medical school and flunk out. So, by the time that I got to medical school I really felt that was grounded enough in the sciences to be able to succeed – and I did.\n\nYou took one year off and then you went directly to medical school after that?\n\nYes.\n\nAnd where was that?\n\nI went to Michigan State. And Michigan State, at the time and I think still today, really had much more of an emphasis on primary care than the University of Michigan did. It was a much more user-friendly environment. So, when I got to Michigan State, three other students and I, who all decided we wanted to be in family medicine, approached the Department of Family Medicine about creating a longitudinal outpatient experience for us through our first two years of medical school. So we did something called the FORR project which represented actually the first initials of our last names. So, we said it was FORR. We set up this project and we went to the family practice clinic once a week, half day. It was a totally, totally radical thing to do. Obviously, a lot of schools do it now and give students these experiences. But all of the other specialties thought you’re cutting into their experience. Because our intention actually was to do it all four years. We actually only ended up doing it three. But why should they get to do this? It was quite something. Because the other thing we did as well, and I think we did this once a week, we had social medicine rounds. There was a guy named Sid Katz at Michigan State at the time. And Sid actually is the person who developed the whole notion of measuring activities of daily living and instrumental activities of daily living. So he was the ADL, IADL guru guy. Which actually sort of came back into my life when I did geriatrics, but that’s a different story. Sid was also very progressive in terms of thinking about health care and how health care is organized and that sort of thing. So, he worked with us and we set up a series of seminars looking at the health care system and how could we make it better and what was going to be the role of family medicine in that and all that. Because remember, these were the relatively early days of family medicine. Roy Gerard was the department chair at the time. Jim O’Brien was faculty at the school. And really, they guided us through this. Doug McKeag. All these guys made this happen. It was quite something.\n\n    \n\nHow early on in medical school, or maybe before, did you decide that family practice was something that you wanted to pursue? \n\nIt was Marcus Welby days, the influence of that, because I liked the idea of taking care of families. But family medicine for me was really a political decision because I believed that if you really looked at people’s health in the context of systems, you first look in the context of their family, then in the context of community, but in the context of the society at large. And you begin to have people understand that there are influences on their health related to their jobs. Influences on their health related to what goes on in their community, the kind of environment in which they live. If people looked at these issues through a health context, that would be a way that they would then be inspired to want to make change and to really say we’re not going to accept all of these polluting coal generator plants in our neighborhoods because it isn’t good for my health. We are going to say we need occupational protections in our workplaces so that we don’t get adversely affected in our health. So, it’s really a way to look at health but also to look at health as a way to make political change.\n\n  \n\nSo, you came into medical school with these views pretty well-defined?\n\nYes, I was at Oberlin. You spend a lot of time at Oberlin thinking about what needs to change and how one might be able to accomplish it. \n\nSo, at that time there was actually a Department of Family Medicine at Michigan State?\n\nAbsolutely. \n\nSo, you gravitated towards that right away?\n\nAbsolutely. \n\nAnd then you and these three other people were able to create this longitudinal experience?\n\nThat’s right. And two of the three went into pediatrics. Best laid plans. And two of us ended up in family medicine.\n\nDid you start that your first year?\n\nYes. We started the second part of our first year. And it’s interesting because it was an interesting lesson for me in mentoring because it was Andy Oxman [?]. Two other women – Sue Ritter and Aretha Fowler and Andy was really the impetus for this. So, Andy grew up in Denver. His father was a physician. A relatively comfortable background. Andy has a sense of empowerment that I never had experienced before that up close. And he said okay, this is good but we could make something better. Why not? I was like, oh no, you can’t do that, you can’t do that. He said “So, let’s put together a proposal.” And it was a really important, important lesson in my life that if things aren’t the best they can be, try to make them better. And that there’s no harm in trying. There were some things we wanted to do that we didn’t get to do as part of our experience. And that was okay because we were able to influence our education. But what it also allowed us to do, and I know this now more retrospectively than I did at the time, is it also allowed us to become very familiar with the power structure in the school. I mean we had to go to the dean with this and have conversations with the dean. And obviously we were interacting with the department chair. When I think now about the levels at which we were interacting in this project of first-year medical students, it was pretty surprising. But we did and it was good.\n\nThinking back to those days when you went to the clinic a half day a week, what was that like for you? What did you learn?\n\nSome of it was just basic. We got to do hands-on stuff sooner than other people. We would go in and they would let us listen to hearts and lungs and all that kind of stuff. But we also learned people’s stories. And because we were connected to the family doc faculty, when we returned we would often see the patients when they returned. So we got a sense of what this concept of continuity meant. You know, this whole notion of taking care of people over time and sort of seeing the progression of their illness or the progression of their wellness, if you will. So that’s mostly what I remember being struck by.\n\nBut it was enough to really confirm your decision that family medicine was what you wanted to do?\n\nYes.\n\nLet me get the chronology straight. What year was this?\n\nI was in medical school from ’75 to ’79.  \n\nThe mid-70s. So family medicine had been around for a couple of years in its concept?\n\nYes.\n\nThen let’s move to the next phase. Did you go directly to residency?\n\nYes, I did. My intention in medical school was to go be a family doc in the rural South. That was the plan. And then in my fourth year a woman in my class did a rotation at Montefiore in New York. She said you’ve got to go there. They’ve got this incredible program. They’ve got this thing called social medicine. So okay, fourth-year electives – so I went to Montefiore to do an elective. Actually, I did a number of electives in New York. But I did adolescent medicine at Montefiore and I hung out with the social medicine people. And goodbye rural South because it was clear to me that this was the program I wanted to go to. And it’s amazing because I’m crazy, I only ranked two programs in the Match. I ranked Montefiore and I ranked the University of Connecticut as sort of my backup because they were in Hartford. And by this time I sort of knew I wanted to be in the Northeast. Thank god I got into Montefiore – so I did.\n\nWhy initially rural South?\n\nBecause it seemed like from a theoretical standpoint it was a place where I could work with underserved African-American communities – and that was my goal. Again, if you think of the political framework with which I’m coming to this, so I want to work in underserved communities. I want to look at models of empowering people who are underserved in order to improve their health. And it seemed like the rural South would be a good place to do it. And I’d been in North Carolina, so it wasn’t that I don’t have a concept of what the rural South was like.\n\nSo then Montefiore. In your thinking about it before you got there, what did it represent?\n\nIt represented this whole other way of thinking about the role that health care can play in social transformation. So here were people who were not only had the same kind of concept that I did but were actually doing it and studying it and writing about it. I mean this was one of the few places in the country where an explicit agenda of the training program was not only we’re going to teach you how to be good doctors but we’re going to teach you how to be good doctors in the context of social medicine, of public health. It was and remains just a phenomenal program.\n\nSo, at that time it really was one of the few in the country that had that very explicit …\n\nYes, Cook County, Sand Francisco General, Montefiore.  \n\nThat must have been tremendously exciting for you.\n\nIt was incredible.  \n\nSo, you were from 1979 to?\n\nI was there from ’79 to ’84. I finished my residency in ’82. The one thing I should say though is it was also an awakening like I’d never had in my life. First of all, I go from community hospital in Lansing, Michigan to a major academic health center in the Bronx. So, I go from I’m a medical student and maybe we take care of two or three patients, we’re on call and there’s a blood drawing team and there’s a lot of nursing support and all that. I go to Montefiore and there are like seventeen patients on my service. We’re on call every third night. The nurses don’t do a whole lot because they’re busy doing their thing. So you’re drawing your own blood. You’re taking your patients to X-Ray. This was long before work hour limits. This is like, oh my god, I have never worked this hard in my life. So the first few months were a total period of 24/7 panic. Because I don’t know this stuff. I don’t know how to do an EKG. There were EKG techs in Lansing. I don’t know how to draw blood. I’ll never forget one night, in the middle of the night we get this admission of a patient who needs an NG tube. I don’t have a clue how to put in an NG tube. Thank god for the nurses. So, I got to this nurse and ask, “Can you help me?” The nurse was wonderful. She taught me how to do this. Thank god I learned very, very early in my career sort of not only the importance of nurses in a hospital environment but also the degree to which they can make or break your life as an intern. You know, you piss off the nurses, they can call you every half hour about a Tylenol order. It was also a different way, again retrospectively, I was learning about team care. I was learning about what are the different roles of different people in the health care environment. And I think that one of the challenges for physicians is often we get in that environment and we start off saying okay, I’m a doctor so I’m captain of the ship. Well, the truth of the matter is that certainly in the early residency days you are so not the captain of the ship. And if you’re smart, you’re a member of that team and learning from and collaborating with – and ideally those lessons carry forward. My perspective in my role now is that doctors bring patients to hospitals in the sense that you decide where a patient should be admitted and the like. Nurses actually keep people coming back to that hospital. And it really is the quality of the nursing care that makes a huge difference. But not only that, if you think about how health care is structured in the hospital, it’s really the quality of nursing care that is as important, if not more important, than the quality of the medical care. And so those were early formative years in terms of thinking about those relationships.\n\nYou talked about the importance of nurses. You talked about team care. How else did your experience at Montefiore shape you?\n\nObviously, I’m in New York City. So just the whole reality of the fabric of New York. You grow up in Flint, Michigan, the world is black and white. You come to New York City and the world is anything but. And so all of that, the richness of sort of understanding the complexity and the multiculturalism that existed there. In Flint, Michigan, again at that time, you get a sense of class a bit. But you come to New York and the stark realities of the levels of poverty and the levels of wealth are also quite remarkable. It was also just transformative in my thinking. And quite frankly, in Michigan I never really worked very much with the poor. And in New York, obviously our clinic was in the Bronx and we worked in very poor communities. We started out in one clinic and then very soon after, probably six months or so after I started my residency we moved to Family Hill Center on 193rd Street in the Bronx. And soon after we moved to 193rd Street in the Bronx came the arrival of a group of Cambodian and Vietnamese refugees who were placed there by the International Refugee Committee – obviously people fleeing the [Vietnam] War. And so you take the poverty of the largely black and Hispanic population that were in the Bronx, then you add into that mix this population of people who come by and large from rural Southeast Asia who have language barriers, who have health problems that we’ve never seen. I mean all the parasitic disease, all this kind of stuff. So again, it was challenging but very exciting times. And it was a time of really just enormous learning of medicine. I mean the variety of health care problems that you saw and took care of was just amazing. So what would come to be sort of one of the more formative experiences…I guess there were two formative experiences in my residency program. One really had to do with, I did a lead poisoning prevention project. We started taking care of these Cambodian kids and they started coming in with high lead levels. There was a pediatrician named John Rosen at Montefiore who was sort of a lead guru. So, I was working with John and we would have to consult with him, what do we do, because some of these kids had levels high enough that we were doing chelation therapy. It was really a significant problem. So, we finally figured out that these kids were eating paint chips from their buildings and getting lead poison. Then I hooked up with a woman name Maxine Golub who was a community organizer at the time and we organized a rent strike for the people in the housing. We worked with the city department of health obviously to have them work with the landlords. But we also said you have to clean up these apartments or these people aren’t going to pay their rent. That was my first real experience and also understanding that there are resources in communities that you can work with to achieve health outcomes far more powerfully than if you just try to do it in the context of a medical system alone. I mean there’s what I can do as a doctor. But what I can do as a doctor combined with a community organizer was really incredible. And we had community health workers who we would then train people in the community about how to teach people how to clean up their houses. You know, sweeping up the lead chips and vacuuming and all that kind of stuff.\n\n    \n\nAnd the second experience?\n\nThe second was at the end of my internship year. We were taking care of a young Puerto Rican man who used intravenous, injecting drugs and who had a chronic [?] esophagitis. And at the time the attending on my service was one of the best infectious disease people at Montefiore. Dr. St. Ange [?], she was just incredible. We were trying to care for this guy and all the stuff we knew how to use was not working. And we watched this guy get sicker and sicker and sicker. Eventually, on a night that I was not on call, he became very despondent and depressed over this, so he pulled out his central line which is what we were using to treat him. So the team that’s taking care of this guy, he’s bleeding out all over the place, we know nothing about universal precautions, obviously, at that time. And obviously it turns out, of course, retrospectively this made died from AIDS. So it’s an interesting window to understand sort of seeing the epidemic at its very beginning, having this window into it, knowing how much we didn’t know and then gradually learn more and more about this. And then obviously in the subsequent years the issues of HIV/AIDS and caring for patients just became more prominent in my career. I remember being at an APHA meeting in the early 80s. I think it was in Washington. I remember having a conversation, walking down the street in Washington talking to this guy about do we think it’s airborne and how much risk are we looking at. And then having this conversation about no, no – it’s only in gay men, so it can’t really be airborne. Then walking more and more and kind of saying it doesn’t make sense that it’s only in gay men. There’s nothing biologically based about being a gay man that would make you susceptible to AIDS. Now, at this point as well, I haven’t made the connection to this guy back at Montefiore. So I’m not connecting the dots. And for everything we could tell, this man was heterosexual. But I remember just the uncertainty, we don’t know, and a certain amount of fear. But also a certain amount of this is what you signed up for. It was interesting because this is sort of post-Vietnam War kind of stuff. But there was almost a way that you had a military analogy. It was like we signed up. Nobody told us we had to go to medical school. Nobody told us we had to do this, but we’re doing this now and we have an ethical obligation to take care of these patients. And obviously once I moved to San Francisco, this became an even bigger issue.\n\nSo, you left to finish your residency in 1982. When you left your residency, what were you trying to do? What were you thinking about?\n\nI had a National Health Service Corps scholarship. So thanks to Bob Massad, the program director at Montefiore, I was able to actually fulfill my National Service Corps commitment in the same clinic where I had been a resident. So, I was  totally lucky and was one of the very last family physicians in that era to be able to get an urban site because they were sending family docs to rural areas in droves. As a matter of fact, a really good friend of mine had her life altered significantly because she refused to go. And then the whole legal craziness that created for her life went on for many, many years. So I stayed in my clinic. I was assistant medical director for the clinic and was just cranking out patients. It was a little bit of teaching but really, again, was able to hone my clinical skills so it was just kind of more time to really be able to do this. As a matter of fact, right before I left that job, one of the highlights of my career – which I must say humbly my colleagues certainly in more rural areas experienced this all the time. So for me personally it’s great, but it happens for family docs a lot, which is I did the preschool physical for a kid that I had delivered as an intern. So I was able to sort of be that arch, that five-year period of time. It was just very cool to be able to do that. Then I left.\n\nAt that time, what were your views about family medicine and what kind of family physician you wanted to be?\n\nI was convinced that family medicine was the way to go. The other thing I guess I didn’t talk about is by the time I got to Montefiore, of course, family medicine bashing was very much in vogue. I wish I could say it’s gone away now, but it certainly hasn’t. But it was in full swing. I remember there was a cardiologist I worked with who I liked and he liked me a lot. This guy was constantly trying to convince me to go into internal medicine and then cardiology. I mean it was “you’re too smart for this, why would you do this, it’s for social medicine people.” People had no qualms about saying that nonsense to you. And quite frankly, it made me even more adamant that this is what I should be doing and this is the way to go and this is a much more rational way of delivering health care. For probably the first twenty years of my career, I was very actively involved in the American Public Health Association as well. So, I’m not only looking at health care from a public health perspective but from a global perspective and clearly primary care is the way to go there. So I had a lot of reinforcers to buffer me against the barrage of anti-family medicine sentiment that was so frequently thrown my way. And I think also my history and my father’s history of struggling for what’s right kind of made me say this isn’t appropriate. I’m not going to let you put me down just because of the specialty choice I’ve made. Although there was many a day when I was like okay, I’m this black woman family doctor. I’m just giving them one more thing to discriminate against me.\n\nAnd by that time you said you had honed your clinical skills. It sounds as though you had also honed your political skills.\n\nSome. I didn’t necessarily think about it in that way. I think what I had honed was my vision about how it could be. Although I have to say that what I realized actually working in very, very poor communities is that the poorest of the poor actually, with rare exception, do not feel a level of empowerment to really talk about this is what’s going on in my community and how do I work to make change, to improve my health and to improve my overall livelihood? The poorest of the poor are so busy surviving. How do I get food to feed my children? How do I get money to pay my rent? I mean that’s the reality of the lives of the poorest of the poor in this country. And I think the other thing that I learned along the way and continue to learn is most people in this country don’t have a clue about how truly poor people live in this country. We turn a blind eye to it. We don’t want to know. I think discrimination against the poor, quite frankly along with homophobia, are the two most acceptable discriminations we have in this country. And quite frankly, nobody is really out there talking about ending discrimination against the poor. At least we have a gay rights movement. We really believe in this country, if you’re poor it’s because you don’t work hard enough, you don’t try hard enough. You haven’t figured out how to pull yourself up by your bootstraps, because that’s how it’s supposed to work. And so it really changed my notion about how much bigger empowerment would occur in the context of health. And I became much more focused on empowering people within themselves, within their lives. Talking to people about self-esteem. Talking to people about these are things you can have control of. So the conversation, rather than saying “we’re going to get rid of the coal generator plant” became much more “I want to talk to you about how to go and talk to your child’s teacher about insuring that your child gets an appropriate education.” Not allowing this child to keep coming home with D’s and F’s in their homework. You don’t understand why and you don’t feel empowered to go to that school and say okay, what are we going to do to make sure my child now starts to learn? So that became a different kind of focus. It became much more also talking to people themselves about how do you improve your own skills? How do you go to night school or adult learning programs? It was an important lesson in some ways. It was sort of Maslow. You know, “The Hierarchy of Needs.” There’s the theory of it. But then when you live it, you understand that if you can’t make sure that people find ways to make sure they have food and housing, you can’t talk with them about how they change the world.\n\n \n\nWhere do you see your role as a family physician fitting into all of that?\n\nIt was sort of thinking at a larger system’s view. It was very clear to me that I can talk to diabetic patients about what to eat and how to exercise more. Very early on you say the grocery store in my neighborhood sucks. Quite frankly, in the Bronx I go to the bodega that hasn’t seen a fresh vegetable in ten years. And you think I’m going to go out running in the park where the drug addicts hang out? You know, get serious. And so then it became more thinking about what are ways in which we can enter in communities and really then begin to make a difference at that level? Are there ways we can do partnerships with people to talk about things we can do in communities? So it was that sort of evolution.\n\nYou said something a little while back that I would like to return to just to make sure we’ve covered it. You said that you left Montefiore with a vision of what it could be. And I’m not quite sure that I understand what you meant by “it.”\n\nAgain, leaving Montefiore with this notion of a practice and making a difference in patients’ lives. Again, at Montefiore I learned the lesson of Maslow. I left Montefiore, I worked in a community clinic half-time. Then I did teaching in the residency program the other half of the time. So it was like okay, I’m going to go here and see these patients and just do this. But I also always sort of felt it important to be in an educational environment. I wanted to continue to be teaching because learners make you think about what you’re doing and they kind of push you a bit. And so that’s what I did for a couple of years.\n\nSo, you left Montefiore. And where did you go?\n\nI went to San Francisco, the residency program at San Francisco General. Quite frankly, my program director from Montefiore, Bob Massad, who was a mentor, essentially helped me significantly get that job. And so I went out to visit. And it’s so funny because the level of my naiveté sometimes is really shocking to me, looking back retrospectively. I go to San Francisco in January. It’s rainy, it’s foggy. It’s like why do people want to live here; I’d never been there in my life – and I was like okay, fine. But I heard they had a good program and the program is affiliated with UCSF. But know nothing from UCSF. I had no idea of the quality of…I’m an East Coast snob. I know nothing about California. So, I’m totally based at the General. Like I said, I did half-time clinical care and half-time teaching. And sort of reluctantly I sacrifice and leave New York to go to San Francisco. And, of course, I came to totally love San Francisco, as you well know.\n\nSo why that particular place?\n\nBasically Bob sent me there. Bob Massad sent me on this journey to find myself, if you will, because he literally decided. And it was with a conversation with me, that he wanted me to see more of the world than just Montefiore. I think that was his insight into me. And so he arranged for me to go to the University of Washington, Seattle, UCLA, San Francisco and Cleveland, I believe. I went to Case [Western] as well. He wrote all of these letters of introduction for me. And I go and visit these places and I’m applying. And it isn’t like they had a job that I applied for. It was more, let me see what you’re doing and is there any way to fit in? So, at the end of my three-day visit to San Francisco, they offered me a job. And that was it. Again, you look back and think about this and it’s amazing that that’s how I got a job in San Francisco.\n\nWhat was it about the program that you liked?\n\nIt was so much like Montefiore. It was very political, working with underserved population, affiliated with the community clinic. A lot of their graduates were doing the same kinds of things graduates from Montefiore were doing.\n\nSo it felt familiar?\n\nOh, absolutely.  \n\nWhat was your first job there?\n\nI was a preceptor in the Family Health Center half-time. And I worked at Southeast Health Center half-time. That was my first job. I had no administrative responsibility whatsoever. It was a perfect job.\n\nHow long did you have that position?\n\nI did it for about two years. And then I got an opportunity to do a faculty development fellowship in geriatrics because Joe Verbachia [?] from the department had written this grant to train geriatricians – he was a geriatrician. I was sort of, I’m interested in doing something different, let me do this fellowship. So I did the fellowship and through doing that I get involved in teaching geriatrics in the medical school. So then I get this window into UCSF and start to meet the people on the Parnassus campus in addition to what I’m doing at the General. So that kind of opened a different door for me. I ended up being on the admissions committee for the medical school and just kind of doing stuff there as well as doing my thing in the residency.\n\nAnd then what?\n\nIt’s almost not an “and then what” because I think that contemporaneous to this I am, as Peter Sommers will tell you, a bit of a rebel rouser. Because the one thing that was different at San Francisco General from Montefiore was the incredible emphasis on the Family Medicine Inpatient Service. The Family Medicine Inpatient Service was the be-all, end-all at San Francisco General. And it was and is a wonderful service. They do incredibly good work, very high quality care. Mary Ann Johnson and Ron Goldschmidt were sort of running it at the time. Outstanding folks. Also doing work with AIDS patients. Because that’s the other thing that’s going on in San Francisco when I get there, that we are seeing a lot of young gay men with AIDS, many of whom are dying. I mean we had a resident die. We had nurses in our clinic die. We are living this epidemic and we’re also in the midst of the political milieu issue around the epidemic. We’re marching and protesting and trying to figure it all out and being saddened by the level of illness and death we’re seeing. So on the one hand, our Inpatient Service, in addition to the AIDS ward, was on the forefront of taking care of people with AIDS. And yet there was very little emphasis on the Family Health Center, at least in my opinion. So I’m pushing and saying “We’ve got to pay more attention to family health” because quite frankly, as family docs we’re outpatient docs. I mean we do some inpatient care but most of our graduates, when they get out of this place, are going to be doing outpatient stuff. We need to make them the very best at doing that work. And so that sort of movement with Bob Drickey and Emilie Osborn, we all worked together to put more emphasis on family health and I think we were successful in doing that. And now I think the program has a very nice balance of both. I think there’s a very strong Family Health Center and also there’s a very strong Inpatient Service.\n\nWhen did you become residency director?\n\nIn 1989.  \n\nYou had been there already awhile?\n\nYes, I had been there for five years. \n\nWhat led you to become a program director?\n\nIt was clear to me that as an educator you really get to influence what future doctors will be like. And I think having the experience of working to sort of transform the emphasis of the program more towards the outpatient side gave me a sense that there are other ways that one can then influence the bigger structure. And I wanted to try to do that. I wanted to insure that we maintain very strong behavioral science teaching – which obviously under Kalislusky [?], the General was way ahead in most programs in the country around that and wanted to really push how do we think about doing stuff in the community? How do we maintain the strength in our program? And you get to influence these things as a program director.\n\nHow long were you program director?\n\nI was program director from ’89 to ’97.\n\nWhat would you say was your toughest challenge when you were there?\n\nI don’t know if I could identify any one toughest challenge. One is that particularly after I became program director, I became very militant around stopping anti-family medicine stuff and had major battles with the department of OB/GYN. The interns would come back in tears about being treated badly and all that kind of stuff. And I would just go head-to-head with these people and say “This is not acceptable. You don’t get to do this. You don’t get to treat my interns like this.” And over time…and I think in part because I also got involved in the medical staff structure, so I began to interact with the departmental leaders at a different level, I think I was able to earn their respect and then become even more effective in fighting those battles. But I think that those were difficult times. It’s very difficult to have your interns suffer the discrimination of being family docs and hearing all of this nonsense, “you’re not good enough, you’re not smart enough, we don’t want to teach you” kind of stuff. So, that was one. Obviously, we always had economic issues. Quite frankly, at the time they seemed bad but they were actually relatively minor compared to what we have now. But writing grants and all of that. Then we went through a period of actually having the program on probation, which was one of the real darkest days of my tenure. A lot of it had to do with space. We had inadequate space in the Family Health Center. Some of it had to with some curricular issues. And so there was just a period of years of having to get that straightened out. Very painful, questioning am I really qualified to be a program director and what have we done here and that sort of thing. People rallied around. I never felt alone in my need to get us back on track. Quite frankly, the probation gave us the leverage. We used to be just on the first floor of Building 80. But it allowed us to expand the clinic to two floors to Ward 85 and Ward 81 for the clinical operation. But a very, very difficult time. And then there were always resident issues. As any residency director can tell you, there are always resident issues and resident drama kind of stuff. But it prepares you a lot for future life, I think.\n\nSo, what are you proudest of in retrospect of that time?\n\nWithout question I’m most proud of the people we have trained and what they have gone on to do. In 2001 there was a reunion with the class of 1991 at one of their houses that I got to go to. I’m sitting around this table listening to what these people have done and I just had this enormous sense of pride. And I look back at most of our graduates and they are doing incredibly meaningful work in a variety of settings. Some are in academics, some are in community clinics, some are in private practice. There’s a variety of places. And to sort of think that I played some small role in who they turned out to be.\n\nHow about a disappointment from that period in your life?\n\nI don’t know that there were major disappointments. One of the things that we were able to do is to really expand on the role of family medicine. The hospital decided to build a patient skilled nursing facility. I negotiated to take that over. We did a mental health facility. I negotiated to take that over. I’m not sure we continue to do the mental health facility. But certainly we continue to do the---- [skilled nursing facility?]. Maybe the disappointment was the amount of negotiation struggles that we had to do. But in some ways I think it helped make us stronger and gave us a better base. I guess the hardest thing was after I became…I became residency director. A few years later I became Chief of the Family Medicine Service as well at the hospital. Then I became Chief of Staff of the hospital, which was also the whole other way of looking at the hospital system and interacting with different departments and that sort of thing. I really liked it. I think maybe one of the hardest things, after I finished doing all that, it was clear that there was really no place for me to grow further at UCSF and I guess maybe that was a disappointment. If I’d never gotten the phone call about coming to New Jersey, I think I would have just stayed there and been fine doing what I was doing. Again, a lot of retrospect vision.\n\nIn retrospect is there any one thing that you would have done differently?\n\nNot that I can think of actually. And I think in part because much of what I did then, as is this case now, I try to do in consultation with others. Major changes to the program, that sort of thing. I’m famous for saying that the residency is not a democracy. On the other hand, I really value particularly input from the faculty and residents as well. Residents just have a shorter view of things. So I don’t know. I think it’s probably better to ask the people I worked with if they think there are things I probably should have been doing differently.\n\nHow did you learn the things that you needed to know to do that job?\n\nI had wonderful mentors. And certainly on the residency director side. Peter Sommers, who had been the director before me, stayed on the faculty. So there was always Peter to go to. George Saba who was the director of behavioral science. So I had people that I could consult with. But I also had incredible program director mentors. So I would go to the AFPRD, is what it was called in its time, the Program Directors meeting in Kansas City every year. And every year the Academy would sponsor all of us going to a baseball game. So, you go to the baseball game and you’re sitting in Royals Stadium in Kansas City and I’m getting mentoring from all these seasoned ---- Frank ----, John Blasa [?]. All these people who had been residency directors. And we’re sharing our sort of war stories and that kind of thing and just getting a lot of advice and learning. STFM as well. Marian Bishop was a major mentor of mine. How did you do it? Tell me your secret. That kind of thing. John Frey. Just learning that if you talk to seasoned people here at STFM, they have a lot of accumulated wisdom that people are totally willing to share. I never, ever, ever had anyone say to me, I don’t have time to talk to you about this. People were incredibly available. I think sometimes they were surprised that I came up to them and said “Can I talk to you?” or whatever. But that has been enormously helpful throughout my entire career, just this ability to find people who are willing to help and I listened to a lot of the time.\n\nYou left in 1997 and went to New Jersey. Why did you go to New Jersey?\n\nDavid Swee, who I had met here at STFM, calls me up and says “I have the perfect job for you.” I say “I have a job, I’m not looking for a job.” So, it turned out the American Public Health Association was meeting in San Francisco in ’97. So he calls and says “Just meet with the chair of the search committee because he’s going to be in San Francisco for APHA.” That was in October of ’96. So, I said fine. It’s this job to be Associate Dean for Community Health at Robert Wood Johnson Medical School. To make a very long story short, two things are happening that sort of make it important or make it reasonable for me to go there. One is my parents are getting older, they’re in Baltimore, there are more issues going on with them that’s making me think that I need to probably get closer to them. And New Brunswick is the home of Johnson \u0026 Johnson and has very close connections to the Robert Johnson Foundation. So, we’re talking about me going to an environment where you have real resources to community health stuff. I mean this isn’t just some theoretical, I’m going to have to go someplace and figure all of this out in isolation. So, things just kind of worked out and there I go. And I end up in New Brunswick, New Jersey. Never imagining, having lived in New York, would I ever live in New Jersey. But here I am living in the Garden State.\n\nYou were in that position for how long?\n\nI was in that position for eight years, until 2005.\n\nWhat were the challenges that you faced?\n\nThat was a job where I got to translate what I had been teaching for years and sort of thinking about theoretically into action. I spent six to eight months doing nothing but meeting people in that job and listening to them and hearing what their concerns were. Having that title gave me entrée into all kinds of community-based organizations. They got a chance to get a sense of who I was. And then I got this opportunity to bring them all together and talk about what are things we want to do. So we created this initiative called Healthier New Brunswick 2010. It was really a community-based initiative to develop some health improvement projects. It was hard but fantastic. People come in, you’re from California, what do you know about us? You know, how dare you think you can come in. So I was very clear, I’m not coming here to tell you what I think you ought to do. I am coming here to facilitate conversations where you talk to each other about what you want to do and see how I can bring to bear the resources in medical school to help facilitate having that happen. It was great, although constantly going for grants and money and all that kind of stuff. And again, the backdrop of getting a lot of support. The first dollars I got were from Johnson \u0026 Johnson. It was wonderful.   \n\nWhy did you leave that position?\n\nThe relatively new president of the university, John Patella, in September of 2005 recruited me to become his Chief of Staff with an aim to implement the newly-minted strategic plan for the university. So in my mind, I’m like wow, I can take all this community stuff and we can put it statewide. We can take what we’re doing in New Brunswick and do something in Newark and Camden and throughout the state. I can influence the education research missions. You know, how do we increase the amount of population-based research we do. So I had my own agenda. But also, we had this strategic plan and I’m going to participate, obviously, in helping to facilitate getting it implemented. And then a series of events occur. So, I do that in September of 2005. We get a federal monitor in December of 2005. I end up spending way too much time with the federal monitor because my role at the university was liaison with them. And there were some very, very dark days for the university. So my quick vision of oh my god, I’m going to get to do all this cool, wonderful stuff was quickly turned into you’ve got a tough row to hoe here. Then I got my current job because when the last president left and we got a new president, he asked me what I wanted to do. And I didn’t want to be liaison to the federal monitor anymore. The person who preceded me in my current job was a casualty of the federal monitor investiga-tions and all of that. So, I said this is what I want to do. I want to do academic and I want to add the clinical piece to really better tie it all together. So I became the Executive Vice President for Academic and Clinical Affairs.\n\nSo that is your current title?\n\nThat is my current title.\n\nSo you were the federal monitor from 2005 to 2007?\n\nNo. We had the monitor actually from 2006 to 2008. I was the liaison to the monitor basically from December 2005, sort of doing the pre-work of the official monitor. This is a very complicated legal process. But then in April 2006 I stopped being the liaison. So it was a relatively short time. It just felt like ten years.\n\nSo you’ve been in your current position since?\n\nFrom April 2006 to now. That would be five years.\n\nGive us, again, your title and the institution itself?\n\nI’m the Executive Vice President for Academic and Clinical Affairs at the University of Medicine and Dentistry of New Jersey.\n\nWhat do you think are your challenges in your current position?\n\nIt’s interesting. I’m a family physician in this position and I still have a faculty appointment at Robert Wood in the Department of Family Medicine. But I have now this university-wide view of the world and we have a $1.6 billion [?] budget in a state that’s broke with declining resources and eight schools to oversee. So there are enormous challenges.\n\nHow about any successes?\n\nI think one of the most important successes for me is I really have been able to bring together the deans of the eight schools so that they really work collaboratively on a number of initiatives. I meet with them weekly. We really talk about how to develop a shared vision for what the university could be. The backdrop right now, however, is that there is a move in the state to actually break up the university. And so now the work really focused on in a period of enormous uncertainty how do I work to ensure that people keep their eye on the ball? That people remember we still have to fulfill our obligations. There are hundreds of students who rely on us getting this right. There are thousands of patients who rely on us getting this right. Yes, there are a lot of changes and a lot of discussion about what the structure will be. Our cheese is getting moved all over the place. But we still have to teach, do patient care, do our research, serve our communities. So that’s a lot of what I do right now.\n\nYou spoke earlier about family medicine bashing and your experience of that early on in your career. So, here you are, a family physician, working in a very different kind of environment, at a very different level of power in administration. Do you still encounter that kind of family physician bashing?\n\nI don’t personally, but certainly the students I mentor and work with do. It’s outrageous. I talk about it now at AAMC at every opportunity I get. I talk to Darrell Kirch about it. This is just not acceptable.\n\nIs there anything more you want to add about your current position and what you do?\n\nIt’s interesting, I do think my training as a family physician has helped me enormously in this position for two reasons. One is as a family doc, we work with a lot of specialists that have a sense of what they do because of the nature of our work. So that gives me a different entrée when I have to talk to the chair of surgery or the chair of ob/gyn or the chair of pediatrics or whatever. And so I have a bigger view, if you will, than if I were a retina-specializing ophthalmologist kind of thing. But I also think that what you learn in terms of dealing with systems and people and culture is very important. Each of our schools has a very different culture. The whole reality…I heard it in theory many, many years ago that culture will eat strategy for lunch every day. It is so true. And making cultural change is enormously difficult. But the kinds of cross-cultural training that I’ve gotten as a family physician, the kind of work I’ve done in teaching cross-cultural effectiveness has really been very helpful in terms of how I think about the different schools that we work with as well.\n\nSo you really put to work your experience, being a family physician?\n\nAbsolutely, yes. Obviously I’m very biased in this. But I think if we had more family medicine leaders in academic health centers, we would be much better overall as academicians than we are. I really do believe that.\n\nI’d like to turn now to your participation in STFM. How you got into the organization and how you’ve seen your path.\n\nI came to my first STFM meeting in 1989 in Denver. One of my first memories, it was so white. I was like “Oh my god, where are the people of color here? What’s up with this?” And then as I often say, it snowed on May 1st that year and there were all these white people running in the snow. I said “It’s so white and they’re all crazy.” So, it was like this moment of…but then I found other people of color in the organization and quite frankly, also, as you know, found a number of whites as well. And we actually started the Group on Minority Health. And that has been one of the most important things that I’ve done in my career, to be a part of starting that group, because we had an aim to both look at how we work as family physicians to eliminate health disparities. We had an aim to look at how do we support under-represented minority faculty to become successful in academic family medicine. But also how did we work to promote more people of color becoming involved in the organization and in the leadership of the organization. I think that we have been enormously successful in getting people of color involved in the leadership of STFM. I think we have been moderately successful in supporting minority faculty to become successful in their own careers. Although I’m not sure that now we are as successful with the younger cohort as we were with the cohort that I came in with. And obviously we have all been enormously unsuccessful in eliminating health disparities. If you ask me what I’m disappointed in, I remain disappointed in my inability to have family medicine take a very active, vocal, clear role in articulating and advocating for the elimination of health disparities. And when I talk about health disparities, I’m talking about obviously health disparities by race ethnicity. But I’m also talking about health disparities by socioeconomic status. Because I believe that every time we look at care for the poor in this country and health outcomes for the poor in this country, I think we find disparities that are not that different than what we find in African-American and Latino communities. It’s important that I also say that many of the disparities that we find in African-American and Latino communities have nothing to do with poverty. There’s almost a way, we would like it if that’s what the issue is, but it isn’t. And I think that as family physicians, particularly around health care disparities, we are the primary care advocates for these patients. So the volumes of evidence about the differences that people get in treatment in the health care system…but if everybody had a family doc and if we were all doing our jobs to make sure our patients got cardiac caths when they need them and got appropriate cancer therapies and got appropriate pain control and just a list of areas where have health care disparities, I believe, without question, we could turn around many of these outcomes. And I just feel that I have not been successful in getting us as a discipline and as an organization to embrace it.\n\nYou have had several positions in the organization. Of those different positions, and if you would describe them briefly, what do you feel the best about?\n\nI was on the Education Committee. I was Member-at-Large and then I was President. And obviously the whole thing that goes along with being President. I am enormously proud of my year as President. I did some risk-taking things in my year as President. The opening keynote speaker in my year as President was Angela Davis talking about health care for women in prisons. There was enormous backlash in the organization. There were a number of people who sent emails in protest. There were many people who quite STFM and said they didn’t want to be associated with an organization that would invite somebody like her to speak. Meanwhile, she’s a tenured professor at the University of California when I’m inviting her. But for that year we had a record year of attendance and it was wonderful. We also did a Fred Friendly Seminar on family medicine bashing. So I felt like I was able to bring that issue to the floor and get different voices around the table and call it out for what it was. Some of the voices in opposition of family medicine weren’t as strident against family medicine in that session as I know they are outside of that session, so I was a little disappointed about that. And then I did a project called the STFM Diversity Project where I got people to send slides of their patients and their residents and faculty sort of representing all of the diversity of who we care for and who we are and I showed that during the meeting – and it was wonderful. Kevin Grumbach gave an incredible plenary about the status of health care in the country and where we needed to go. Then Rachel [Naomi] Remen was the speaker as well. I worked my entire year on pulling this all together and really being able to shape it into the kind of meeting I hoped it would be – and it was wonderful.      \n\nWhat lasting impact do you think your tenure as president has had in the organization?\n\nIt’s interesting – I would never presume to think that my tenure as President has had a lasting impact on the organization. I would like to think that my work with the Group on [Minority Health] and my continued advocacy for issues related to the poor and people of color and and disparity have at least caused us to continue to have those issues discussed at STFM. So while I feel like I have not gotten where I would hope to have gotten, I still feel like this is an organization that by and large embraces the notion that we do want to eliminate disparity, that we do want access to care for everyone, that sort of thing. But I don’t think I did it. I think it’s really collaborating with others that has really allowed that to happen.\n\nYou have been a contributing factor?\n\nI would say I contributed, yes. \n\nWhen you start thinking about family medicine as a specialty, looking back and where it’s been and where it is now and where you think it might be, what are the differences, in your mind, about the field itself?\n\nWe continue to be plagued with an inability to get the best and brightest students to go into family medicine and I have concerns about that. I think that we ought to be harder to get into. I think we make assumptions about who we are as family physicians, about the quality of work we do and all of that, that I’m just not convinced of. And I think we need to be more rigorous in evaluating ourselves and our outcomes. Family medicine has really taken a lead in terms of getting the electronic health record into people’s offices. I think we need to take a lead in looking at outcomes, but finding ways that physicians can do that safely.\n\nWhat kinds of outcomes? \n\nHow well are you managing your diabetic patients? How well are you managing your hypertension patients? Oh, by the way, is there a difference between how well you manage your patients with heart disease who are men versus women? Is there a difference between the outcomes of your African-American diabetic patients and your white diabetic patients? I think until we begin to really do that and demonstrate our ability to make those differences…and not in the academic setting because I think we have an ability to do that. We can publish some of this in an academic setting. We don’t do as much as we should, but that’s an easier window. It’s really these other 50,000 steps… \n\n(Recorded conversation ends.)","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156804/file/286765#t=0.0,5260.51513"}]}]}]}