{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/183416vq4x/manifest","type":"Manifest","label":{"en":["Dr. Marian Bishop (Part 1)"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Date"]},"value":{"en":["1991-05-05 (created)"]}},{"label":{"en":["Agent"]},"value":{"en":["Dr. William Ventres (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["American Academy of Family Physicians","family medicine","oral history","family physicians"]}},{"label":{"en":["Subject"]},"value":{"en":["Dr. Marion Bishop (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}},{"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"]}}],"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/3629/collection_resources/150941/file/278349","type":"Canvas","label":{"en":["Media File 1 of 2 - Bishop_Marian_Pt1_91_a.wav"]},"duration":1882.90654,"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/3629/collection_resources/150941/file/278349/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150941/file/278349/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/349/original/Bishop_Marian_Pt1_91_a.wav?1750867225","type":"Audio","format":"audio/wav","duration":1882.90654,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150941/file/278349","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150941/file/278349/transcript/81408","type":"AnnotationPage","label":{"en":["Dr. Marian Bishop interview transcript 1 [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150941/file/278349/transcript/81408/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Interview with Marian Bishop\n\nMay 5, 1991\n\nPhiladelphia\n\nQ. - William Ventres, MD\n\nA. – F. Marian Bishop, PhD, MSPH\n\n____________________\n\nQ.  I think the most, the first point that I wanted to ask you was, and some of these things you've, you know, we talked about the Keystone transcript and we've talked about some of these before, but really to talk about when you got involved in family medicine, activities in family medicine, and what that meant to you, and if you could kind of review that, that would be I think a good starting point for me to set up some other questions.\n\nA.  Okay. It was serendipitous. I ended up marrying a physician and he was recruited back on the faculty at the University of Missouri, Columbia, and the dean, who was, who recruited him back, was a member of the Willard Commit-tee, Vernon Wilson? And I think from his – he also was a general practitioner in the sense that he went to medical school late and really did not do any subspecialty training. He, I think from the impact on the Willard Commission, was convinced that he wanted a behavioral scientist. He did not know what that behavioral scientist should do, but he wanted one. And when he recruited my husband and found out that I was a sociologist, he decided he should have me. So I went to the University of Missouri, really with no job description, superimposed on a department that was called then, what was that department called? Community Medicine and Medical Practice, because there was no depart-ment of family medicine or general practice per se, and that's sort of how I got into family medicine. And I went to Missouri in '63, actually '61, so green behind the ears that I can't believe it. And also very young. And then as the specialty came along there were not – still in those days not very many behavioral scientists, or social scientists in medical schools. They were fairly few and far between. And being close to Kansas City, the Academy knew I was there and invited me and my husband, who's a psychiatrist, to come over and talk about what could the behavioral sciences' impact be for this new discipline. It really turned me on, that group of people, and being sort of nonfocused at Columbia, I decided that would be the place that I'd rather find a home. There was some question whether or not I might identify with psychi-atry, but I really never did, it never took, and that family medicine impact of meeting the people in Kansas City, and that's where I first met Gayle, by the way, and Silas Grant, whose name that some people recall but not too many, he was on the Commission, the AAFP Commission on Education at that time, and let's see, who else. In fact there's a, there's floating around in the archives a picture that was taken at that time, Roy Gerard, you would not recognize Roy Gerard in terms of dark hair.\n\nQ.  You said that really turned you on, getting involved. What was it about, this – getting together with these people, or the ideas that were presented that really excited you at that time?\n\nA.  I thought that was the first group that I'd met in medical educa-tion, 'cause I really never planned to go into medical education, this just sort of happened, but I thought that group of people that related through family medicine, through the Academy, that was talking about curriculum, was the first group in medical education that I'd met that sort of captured a melding of the behavioral aspects, the individuals, the patients as indivi-duals, more than just diagnose the condition, put a pill in, you know, put a shot in, poke something up or down, and it seemed to me like that was the first group that I saw that really melded what interested me. So I think that's what turned me on.  \n\nQ.  Was there something – I’m getting the sense that there was something different from what conventional medicine, or the medicine that you had been involved in at Missouri, was going on and what these folks talked about doing.\n\nA.  Well I think Missouri was trying to do it, but this was on a, that was at a local level and this was at a broader, national, you know, bigger impact than at a local institution. And I think you can do it at the local level, but I've always had a major interest in organizations and administra-tion and, broader than just teaching a course or at an institution. It seemed to me like the Academy, and at that time the Society, was still not in exis-tence but was an organization that could impact on a national level.\n\nQ.  Was this a, did your role then change when you went back to Missouri? As you [    ] involved in this, and how did that, if it did, how did that change?\n\nA.  Well, Missouri rather early put in a quote “behaviorally-oriented” course. It was called Human Ecology. And I started out, in order to...\n\nQ.  That's what you were teaching?\n\nA.  Yeah. In order to get it into the curriculum it was actually headed by a physiologist, because it was a basic science course. He was a very broad-based physiologist, but it was a team approach. I was on the team, a psychol-ogist, a pediatrician, a psychiatrist, geneticist. He headed it for two years and then I took over that course and directed it for I think two or three years, in '67, I believe, '66 or '67 I took that course over. So we don't, we'd had this behavioral – but this was not, that course was not tied to family medicine, it was a generic, basic science course for the practice of medicine.\n\nQ.  And yet when you went, and that was your role when you went to Kansas City to [    ]?\n\nA.  ...to look at, mm-hm.\n\nQ.  And when you came back, did things change, change your involvement, what was your involvement in – at that time, after going to this meeting?\n\nA.  Well, the meeting in Kansas City was a fairly small meeting, that I'm talking about. It was a, it was really a meeting that was set up before they even had the curriculum set. And remember, the first focus in the Academy and for the discipline of family medicine was really to residency training. The undergraduate focus came in much later. Our first focus was, what should the content of residency training – we did not have a family practice resi-dency or even a general practice residency at Missouri at that time. We were not one of the original grandfathered-in residencies. I was at Missouri when our first, when we put in our first application and got our first residency there, in family medicine, but I'm not even sure it was called the family practice residency in the very first days. In retrospect you can look back and say, was this an important milestone. But I think as you’re just moving down the pathway, each sort of step is an accumulation and it builds on it, and it's difficult to say that, like Saul on the road to Damascus, you suddenly had a flash of light and life was changed completely.\n\nQ.  So that didn't happen, but that was one of a process, or...\n\nA.  Yeah, and a lot of people impacted my own teaching, and I think in turn I impacted others teaching in family medicine. I wish for example that I could take the credit for thinking of role playing. Actually, I did not, and a guy who wasn't even involved in medical education worked with my husband and myself in terms of role playing to teach librarians, of all things. And we translated that into family medicine and Gayle Stephens credits Bob, my husband Bob Froelich and me, with certainly introducing him to the idea of role playing. And we were the first to put it into the curriculum at the University of Missouri with the medical students. And that was back in about, oh, '65, '64, '65. So those kind of things, you know, just sort of moved on and they spread and I'm sure somebody else at some point in time brought it in under another, from another point of view and another direction. It was about that time that we got interested in teaching medical interviewing, and real-ized that there was no textbook. So we put out a preliminary textbook on teaching medical interviewing. And to our knowledge, published the first textbook in 1979, I guess, for medical students. Again that was a parallel track with family medicine, but not, you know, not just targeted toward that. To me personally, I think you're not comfortable in a discipline unless you find a home. And being a non-physician, you sometimes are classified as a non-physician, you're something that is not something, as an identity. Family medicine was never, you were a non-physician but you were always identified in family medicine as a family medicine educator. And that's been that open door for an eclectic group of people all the way through, that I think's really been important. If you look at our discipline, we have theologians, we have health economists, we have sociologists, we have social workers, we have pediatricians, some of the early department, or some of the early residency directors were pediatricians, not family physicians. Mark Hansen, for example, at Wisconsin, and Roger Lienke, who was the first residency director at the University of Oklahoma, which was one of the grandfathered-in residencies, were both, came out of pediatrics.  \n\nQ.  And not out of general practice.\n\nA.  Not out of general practice. We've had some psychiatrists and some internists who have kind of come out of that – Jerry Perkoff is an internist, not – Jack Colwill came out of internal medicine, not out of family practice.\n\nQ.  So that you actually came from a discipline other than...\n\nA.  I came from a discipline of the sociologist into the...\n\nQ.  But you felt accepted and part of the process.\n\nA.  Yeah. In fact sometimes I forget that that's my roots, that I'm not a family physician in the sense that I've internalized so much the ethos and the, sort of the culture of family medicine.\n\nQ.  What about, just kind of to take from what you just said, what are the, to yourself, as an educator in family medicine, what are the principal, what are the things that make family medicine, in that ethos or that culture, that make it special, and maybe those have changed over the years, but maybe what made it special in the '60s and then I'd also like to have you speak to what makes it special today.\n\nA.  I'm not sure it's changed that much, at least what attracted me to it in the '60s was the emphasis on the patient as a person, and the patient as an individual, and I think we still have that emphasis today, at least I see in the family physician faculty at the University of Utah that emphasis on looking at the needs of the individual and working with the trainee, you know, the resident and the medical student, so that they too see that as opposed to the procedure or the diagnosis or whatever. So that attracted me. Then the other thing is in the teaching, looking at the process of decision-making and how do you involve the patient and the family, the larger socioeconomic group that impacts on that patient and their problem, and to the process of caring, and even getting the larger concentric circle, because I also have an interest in community preventive medicine, that you look at that community or that social milieu. That was a part of the Willard Report, and even a part of the Millis Report, and I think we've not lost that, although to varying degrees individuals and programs do some parts of it that are better than others. I think it's still at least a verbalized, targeted focus.\n\nQ.  Why is that important to family medicine, versus any other discipline?  \n\nA.  I don't know that we could claim exclusivity, and certainly the general internal medicine and the general pediatrics has moved in and said that's a part of their interest too, and it's always been a major part of some people who are interested in health promotion and disease prevention, so I don't know that it's exclusive, but certainly from the very beginning it's been a part of the discipline of family practice, and it's been a verbalized part, so...\n\nQ.  And a special interest of yours at some...\n\nA.  Well, for me, yeah, there would be no reason for me to be, as a non-physician, to be in health care or medical education if the whole focus were on diagnosing the illness and pushing the pill and pushing the procedure.\n\nQ.  Sure. I'd read somewhere that you'd written that as a historical movement, looking at the history of medicine, it actually was in that Keystone report, that looking back, family medicine will be seen as one of the major developments in medicine in the last, in the '60s and '70s. Still think that's a valid statement?  \n\nA.  Yeah, I think family medicine did some things that probably other disciplines are going to end up having to do for survival. One is the, that they did not grandfather anybody into the specialty just by the fact that they said they were one. Everybody had to pass the same certification exam, and it's my understanding that family medicine was actually the first who did that, so...\n\nQ.  That's right.\n\nA.  So I think that has now come to be accepted rather than unique. The recertification every seven years, whether seven years is right, the right number, but the idea of renewing and recertifying for capability, I think, was unique and will come to be the norm rather than the exception. I think we're beginning to see renewed emphasis on ambulatory care all the way across the board in the specialties and again that will come to be an accepted rather than the unique and the unusual. The emphasis on that doctor-patient relation-ship seems to me to be coming back into its own, whereas at one time family medicine almost had an exclusivity on it. I guess for me, one of the personal, kind of annoying things is the discovery of the medical interview by the internist. Because family medicine as a discipline put a lot of emphasis on developing the interviewing, the interpersonal relationships, and the interviewing skills, and now the internists have discovered it and it's suddenly become legitimate, you know, and really an important – whereas, in fact for family medicine if you look at our meeting this year, I think there's only one session on interviewing, whereas if you had come, looked at our program for family medicine back in about, oh, '79 or '80 or '81, we would have had just lots of sessions on, how do you teach interviewing? It's become so much a part of our norm that we don't think we need to spend that much time on it. So there are about five things that it seems to me that family medicine as a discipline took the lead in, that now other disciplines are finally catching up and rediscovering, reinventing the wheel.\n\nQ.  Again, to change a little bit, in this interview I get to touch on a lot of subjects, because for the audiotape, or the videotape I'm trying to find special topics.\n\nA.  Which you want to cut and paste?\n\nQ.  That's right. Kind of looking back over your involvement since the early '60s, and then in the late '60s getting involved in family medicine, later on becoming more involved in the Society of Teachers of Family Medicine, what have been the highlights in your personal career in this whole involve-ment, and that may be, you know, administrative, it may be personal more, it may be some patient involvement, I'm not sure. I'll leave that open to you.\n\nA.  Well, I haven't thought about that, but just off the top of my head I would say, when you're talking about me personally...\n\nQ.  About your involvement.\n\nA.  ...how many times in one's lifetime do you have the opportunity to get in on the ground floor of something? You know, it's sort of a, again is a serendipitous event, and I had the opportunity at the right time at the right age, to get in on the ground floor of a, what I think was a movement, a change in medical education. So I actually, my own growth and development, and even my own chronological age has paralleled and gone with that development. You know, I was in my 20s when this happened. I happened to be somebody who went right through undergraduate and graduate school and never stopped, so had a PhD at 24, and so my own chronological growth, my own professional growth, though I never planned to do what I've done, has paralleled the growth of this, of both the discipline as it has matured, but the organizational development. And I think that's a unique opportunity for people. It won't happen for you because of your youth, but something else may come along that would provide that. By being able to grow with it, I've watched, well I have a cadre of friends, many of whom are in the same 8 to 10 years of decades, and we've sort of grown old together, and they've been a very special group of friends, and a group of friends that I have always felt that if I ever got into trouble for any reason I could pick up the phone and say, 'Gee, I need help, and I need A, B, C or D,' and they – if it was within their power to do it they would respond. And I have felt that I would do the same for this group, and it's a – I think that's a unique event in this day and age of sort of anonymity even among professional colleagues.\n\nQ.  So these are professional colleagues that you have, but also personal friends?\n\nA.  Yes, it was a small enough group as we started out that these, that you didn't come to a meeting, for example, where there were 800 people.  There were maybe 100, and they gradually added to it so you began to know the new people, that you don't have that opportunity today, given our size. And I think that's a unique kind of development, that maybe you do in a different kind, maybe you do in a small church group, or some sort of another group, but you just have to be at the right place at the right time for it to happen to a national professional, in a national and professional setting.\n\nQ.  So that's been really meaningful to you, to be part of this...\n\nA.  Yes, and if you come back to the group, to these meetings, I think there still is a cadre of 40 or 50 people of, many of us have known each other from the very beginning, and have those ties. Now I think my own, if I had not come into medical education at the time I did, I think my own career would be quite different, because I really don't know what I would have done if I hadn't found this home in family medicine. In fact I don't think I would have stayed in medical education. It was never my intent to be in medical educa-tion. I just sort of fell into it and it seemed easier to do that for the time being while I was raising a family to see what I really was going to do. But I did find that sort of comfortable niche and comfortable home, and have never moved out of it, even though it was not an original career goal.\n\nQ.  Do you have any ideas on where you might have ended up, or what directions you might have taken?\n\nA.  Well, all of my – yes, all of my graduate planning was geared toward higher education, and it was really my original intent to try to be a college president. I no longer have that aspiration because the job has changed so that it's not attractive, but in the '50s, it was an attractive – and that's why I've got a PhD in an academic discipline and an administrative degree at the master's level because that was the preparation that one needed to do to go into that direction.\n\nQ.  So you actually completed both of your degrees before entering into teaching at...\n\nA.  Yes. I went right straight through. I had a BA and two master's degrees and a PhD degree before I ever took a job. Then I went back at the University of Missouri because they had, while I was on the faculty there they developed a master's degree in public health, so while I was on the faculty there I picked that one up as a three-year, sort of on-the-job training just to get some credentials in a medical field.\n\nQ.  Any other highlights over your years of family medicine?\n\nA.  Well, for me personally of course I think being selected and elected as President of STFM has to be a highlight. It was a milestone, being the first woman president, and now Marge [Bowman] is the second in all these years.\n\nQ.  A long time.\n\nA.  Yeah, and I still remain the only non-MD president. And I thought that it was a barrier that needed to be broken, given our stated openness for the multidisciplinary inclusion in family medicine. So it was a professional need for the discipline but it was also important to me, so I have to say that was certainly a highlight, one which I very much appreciated and enjoyed and felt that it was a milestone.\n\nQ.  Any other, in looking at the history of family medicine or the development of it, any kind of thoughts that you have that you think are important that we haven't talked about, that you think should be included?\n\nA.  What are you thinking of?\n\nQ.  Well, I'm wondering if there are any other aspects of the history, how family medicine fit into the society at the time, we've talked a little bit about the medical society, but how it fit into the society as a whole. That may be one avenue.  \n\n[tape switched over]\n\n...haven't talked about that you think are important...\n\nA.  Well, there's certainly been far more eloquent than I could be in terms of looking at using the word, you know, the words counterculture and how did we come out of the '60s and the '70s and where are we going? I don't think I could improve on that. If I think what is our biggest challenge in terms of future, I don't think our challenge in family medicine is any different than the challenge for medical education, particularly undergraduate medical educa-tion, that since World War II undergraduate education has been built on the backs of bootlegging from federal dollars for research. We just never got into that piggy trough to the extent that other departments did, but you know, I am a Chairman of a department, one of two non-MD Chairmen of family medicine in the United States, so one of my biggest headaches is a firm financial funding base. But that headache for me is no different than my colleague who's the Chairman of internal medicine or pediatrics. In fact, it may be a little less because we never got so dependent on a source that's clearly going to dry up. So I think the whole of medical education has a challenge in terms of how we're going to restructure, again I'm not speaking of the residency but at the medical school, how are we going to restructure medical education and the cost of that so that we can either continue the Cadillac that we've become used to trying to aspire to, or have an adequate Ford or Chevy as a training program for medical students. Now I'm not pessimistic that in this restructuring family medicine will be looked at as an unnecessary discipline and there will be an attempt to cut family medicine out of the pie. I personally think we have enough inroad as a discipline nationally that we're here to say. Now I may be proven wrong ten years from now and be surprised, but I think we will not get, there will not be an attempt in this restructuring to get rid of family medicine, I think we're a key player. There will be an attempt to cut our resources, but I think it will be a part of the attempt to reorganize and restructure the whole resource funding of the entire medical school. Residency education is in a different kind of a funding base, and I think will be looked at differently, because of patient care revenues and that kind of support.\n\nQ.  I'm going to finish up with one kind of last question, and that is, looking at – being not a physician, late '60s, early '70s, and yet seeing physicians enter family medicine, a new field, what do you think attracted them to family medicine, in the programs that, with whom you worked, and then perhaps today, what can continue attracting people to family medicine, again clinicians, and I think this is especially important from your point of view, because you came in from a behavioral scientist point of view.\n\nA.  I believe family medicine was a part of its times, you know, that late '60s and that mid-'70s, even into the late '70s, depending upon the state and the location where you were, was a time of great or comparative social unrest, emphasis on social values, and family medicine was a natural response to that. I don't see that same emphasis in the general population right now, and that may be as much a part of why the interest in family medicine has declined, compared to when we were beginning to expand and peak as anything else. So a lot of the people that I knew in the '70s that entered family medicine were sort of social reformers. And I think we still have those today, but not in the numbers, and a little different kind of an approach. Maybe we're, we may get a more stable, in terms of numbers, group of people who are interested in family medicine for different reasons. I think the economic pressure to, in fact somebody else said this, and I can't think who, that they wondered if the recent increase in applications to medical school, which has now begun to come back up, is not because young people are not stupid, they look around and they do not see that physicians get fired from corporations like GE or Unisys or Hercules or whatever, and that may, they may come into medicine and family medicine from a different point of view. But I think we'll get a resurgence back. I don't think I can do much better than that. We always have the people who like being generalists, who like the lifestyle that rural or an urban practice offers, so we'll always have that category, and then for a period of time I think we had this group of people who were going to reform through family medicine and it was a new movement. A new movement always attracts those people, some of those people. I think we'll begin to attract other people, though, both for security – don’t want to get into an over-supplied area – who like the lifestyle, will look at us as favorably.\n\nQ.  Great.\n\nA.  I think it's terrific, though. I look back and I wonder what in – I feel a little like James Stewart, you know, in what is that – you know, the Christmas, where Clarence the angel comes and shows him what life would have been like if he had not been born? I often wonder what in the world would my professional life have been like if family medicine hadn't been, come along just at that time? It would have been much, much different I know.\n\nQ.  I'm sure it would have been. But you say that with a smile, so I'm presuming that you enjoyed...\n\nA.  Oh, I would go back and do almost everything again. You know, if I had a choice. There are a few things I might do a little different, but in terms of my tie to the discipline, I wouldn't give it up for anything. So it's been great for me personally and professionally, and my husband, although he's a psychiatrist, you know we've shared a lot of the same interest, and I think given his choice he'd still be teaching family practice residents rather than psychiatry residents.\n\nQ.  Is that what he's doing now?\n\nA.  Yeah.\n\nQ.  Do you have anything else you want to add?\n\nA.  No, I'd be interested in your project.\n\n[interruption]\n\nA.  ...but if you look at the disciplines, now maybe emergency medicine will go through this same, because it's one of the more recent specialties, but if you look at the disciplines, how many organizations do you know where every President is alive but one? So you realize for STFM, Lee Blanchard is the only nonliving president of the organization, and partly that's because look how young Lynn Carmichael was when he was the first President, and I don't know of any other organization that I belong to where every President is alive and well and functioning.\n\nQ.  And especially since you know them all.\n\nA.  And I think for new members coming in, they don't – they think of this as being a lot like The Long Gray Line of West Point. And actually that Long Gray Line is not very long, it's pretty short, and in 25 years it's been a remarkable growth. Even though the numbers, if you think of organizations in size, 3,000 isn't terrific size, but if you look at the universe of what's out there and from where we started, it's a pretty remarkable growth story. You know the other thing, just for me personally, is my personal acceptance into the Academy, and how I don't feel at all like being an outsider. I go to all the Academy meetings, have always been accepted, and a non-dues-paying member, for which I'm grateful, but I think there are a, and I'm not unique in that, there are others who are non-dues-paying members who are accepted very much into Academy activities. And again, how many of the other disciplines have that kind of exchange with academicians who may not be \"one of them\" as a card-carrying member. So I think all of that has contributed to the growth of the specialty. I'm a Tom Johnson awardee, through the Academy, and that – maybe that’s been an important thing, that we've put the family, the concept of family in the discipline of family. We've had some spats in the sense of competition and not being sure who should do what and which brother or sister should be on first base, but in general we've worked it out internally and I think that's been a terrific experience for me and for the discipline.\n\n[interview ends]","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150941/file/278349#t=0.0,1882.90654"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150941/file/278382","type":"Canvas","label":{"en":["Media File 2 of 2 - Bishop_Marian_Pt1_91_b.wav"]},"duration":755.01018,"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/3629/collection_resources/150941/file/278382/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150941/file/278382/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/382/original/Bishop_Marian_Pt1_91_b.wav?1750873093","type":"Audio","format":"audio/wav","duration":755.01018,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150941/file/278382","metadata":[]}]}],"annotations":[]}]}