{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/4m91835w89/manifest","type":"Manifest","label":{"en":["Dr. Neil Brooks"]},"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":["2012-03-06 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History","Interview"]}},{"label":{"en":["Agent"]},"value":{"en":["Sandy Panther (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["American Academy of Family Physicians","family medicine","family physician","Dr. Neil Brooks"]}},{"label":{"en":["Subject"]},"value":{"en":["Neil Brooks, 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/150965/file/278401","type":"Canvas","label":{"en":["Media File 1 of 2 - Brooks_Neil_12_a.wav"]},"duration":3150.19575,"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/150965/file/278401/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150965/file/278401/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/401/original/Brooks_Neil_12_a.wav?1750875453","type":"Audio","format":"audio/wav","duration":3150.19575,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150965/file/278401","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150965/file/278401/transcript/81412","type":"AnnotationPage","label":{"en":["Dr. Neil Brooks interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150965/file/278401/transcript/81412/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I would like to start when you were born, and then we will go chronologically as best as possible through to the current time. If you would, please tell us where you were born, to whom you were born, give us a little information about your parents and what they did, brothers and sisters and grade school information.\n\nI was born in Manchester, Connecticut on November 17, 1942. My parents lived in what was then called Rockville, Connecticut – and since I wanted to be close to them, I moved in with them right after my birth. We initially lived in my grandmother’s house and I think six months later they purchased a house of their own. Rockville is a small town. At that time, less than 7,000. I think at the time of my birth, probably more around 3,000. So I grew up in Rockville. As I said it was a small town. So small that we had three-number telephone numbers and the operators knew where everybody was all the time. You really didn’t have to say a number, you just say who you wanted to call. And if they weren’t there, the operator would get them at somebody else’s house. A nice community to grow up in. We never locked a door. People wandered in and out of our house willy nilly and I enjoyed that very much. My father was from New York and my mother had spent time in Connecticut and also New York. She was married young, about the age of eighteen. My father came to work for his uncle in a textile mill that was at one time in Rhode Island and moved twice, but ended up in Rockville. And over time he finally became president of that company which was called Amerbelle. It was a textile mill employing about 400 workers, very busy all the time, quite successful. So I was considered among the wealthy in the community, although we certainly never thought ourselves as wealthy or even well-to-do. But based on the community standards, we were well off. I grew up here and the first school I went to was called the Pollywog School. It had three classrooms, six grades. When I went to first and second grades there, I had the same teacher for both grades. And obviously you were exposed in that way and learned the second grade work, so it became a little redundant in the second year. But the teachers were very caring. At times I felt like the odd person out because of status and the fact that I was Jewish and that was very rare in our community. People really had, for the most part, no idea what being Jewish meant. And I met some anti-semitic stuff at times. But overall that rarely happened. I progressed through our local school system. I was enrolled in several different schools as the town grew and eventually ended up in a school that was close to my neighborhood. And that was great. That was seventh and eighth grade. And one of the great things about it is I had a collie and he was attached to me at the hip. He went with me wherever I went. He wasn’t allowed in the movies, but aside from that he went everyplace. And he followed me to school every day and then he would go home and at the end of the school day he knew to come to the school (I never knew why) and he would be waiting outside for me and I would go home with him. On several occasions he came into the school with me. The teacher would say “Bring him in, he can sit in the back of the classroom and observe things.” He was a patient dog, very friendly. That ended up being the first instance that made me famous. At my graduation from grade school, grade eight, I was selected to give a speech. I’m not sure what criteria led to that, but I was given the outgoing speech. And it was a very warm, muggy night and I had gone to the school early. And as usual my dog followed me. I went into the school and he somehow figured out that we were in the auditorium and the door was open and it was hot and muggy and he plunked himself outside. They began the ceremony. My parents were sitting in the front row. I got up to give my speech and the dog heard my voice and meandered into the auditorium. But more than meandered, he tried to run up to the stage, which was somewhere inconvenient since the band was in the way. So he managed to go for the drums and caused some excitement. My mother grabbed ahold of him and he spent the rest of the time sitting at her side during the graduation. Somehow the press picked this up and lead story was “Dog Goes to School Every Day and Decides to Graduate with the Class.” I had my not even the fifteen minutes of fame, maybe twenty seconds. But it was a funny incident for all of us. I participated in most of the usual activities. I was a Cub Scout, maybe one of the worst Cub Scouts ever. Only exceeding that standard in my Boy Scout days. I found out that I wasn’t manufactured for camping and being outside and my parents knew nothing about it. So the first time we had an outside camping trip was in April. Remember this was Connecticut and there was a hill that we went camping on top of. My parents gave me two blankets and everybody else had to use sleeping bags. So I had probably the coldest night of my life. Actually, there was a fire which I managed to put my feet in with my boots on, so I warmed my feet but destroyed my boots. I made it through the night, but I think that was the last time I wanted to do camping. That’s probably it through grade school. What other things do you want me to say?\n\nThat’s perfect for grade school. Did you ever have any siblings? \n\nYes, I have a sister who was an only child. That is not an oxymoron. My sister is ten and one-half years younger than I am. And so were led very separate lives. We were raised very differently. My father decided that I would work for anything I wanted. And so if I wanted a bike, I worked for it. Or if I wanted to go someplace, I did things. I picked peas and delivered newspapers and whatever. And I thought that was a standard. Everybody did that, by the way. If I didn’t do that, I would have been different than all the other kids. My sister, my father wanted to spoil and that she would only marry a guy he would approve of. I was embarrassed about riding in my father’s Cadillac, my sister was upset that he didn’t have a Rolls. My sister is a wonderful person, by the way. She’s kind and terrific. She had a Porsche that she drove, and that’s at the age of nineteen. She’s fifty-eight now, but she’s still okay. So the relationship we had was always kind of one of distance because we were temporally not close to each other. And also I started getting involved in all kinds of things, so I wasn’t either physically around or didn’t have time. But when we were together, we fought like normal siblings fight. I would tease her whenever I could and she would yell that I had done something bad to her, so we go the equal end of the stick. So that’s why I say my sister is an only child.\n\nIf you would like to go on with high school? \n\nAfter grade school I just continued on in our small town. I went to our local high school which at that time was in the old building built in probably the 1920s and it was the high school for not only our town but the surrounding areas. And students for special things, any advanced classes were there. And I would walk to that school. It was about three-quarters of a mile from my house. I did walk every day unless I got a ride from somebody. My parents didn’t believe that you would shuffle somebody back and forth to school and I should say that during that time I was very involved in my synagogue too. And I would be there a couple of afternoons a week and Saturdays. So that took up time when I wasn’t in school. And at the end of my sophomore year, a new high school was built in our town which was about four miles away from me. So now I started taking a bus. That school acted as the regional school for all the ag[riculture] activities. So a large number of students were there from other towns. But it was also used to bring people into the ag program who had no interest in that program but really wanted to go onto college. And my high school offered a better opportunity for doing that. We certainly had none of the problems that exist in schools today. Our big problem was somebody chewing gum or scraping their feet on the floor. The quality of teachers, some were very good, some were poor. For an adequate education, the most valuable courses I had in high school were mechanical drawing, which I took in my freshman year and it gave me some ability to organize things. And the other was typing, so when I got to college I could put my thoughts into readable sentences since I have absolutely awful handwriting. Everything else seemed to be secondary and easy to learn. Certainly math and sciences. When it came to languages I was probably one of the poorest students that had ever been created. An interesting tidbit is that I took care of my first and second grade teacher after I returned to town, about twenty years ago. A lady named Mrs. Brown. A very kind lady. I thought she was old when I had her as a student. This is forty-five years later and now I’m taking care of her. She was quite elderly but very sharp. And we were in the hospital and one of the nurses in the local hospital, who went to high school with me, said to Mrs. Brown, why didn’t you ever teach Dr. Brooks to write? She responded “He was my best student ever and his writing is perfect.” Which just shows how kind and how we categorize things, changes and thoughts. So I went to four years of high school and had some interesting experiences from how I was picked for a pre-college science center, which was an experimental program run through, I’m not sure of the department in D.C., but it was the first year. They only had two programs the first year and I participated in one at the University of Bridgeport in Connecticut. There was another one in the western United States. And that gave me the opportunity to deal with a lot of science projects, to visit places like the national laboratory where they spent significant time with us handling equipment which I never would have handled otherwise. And had talks by people who were very interesting, involved in areas of science, which some we weren’t much aware of and some we had some knowledge. But they were trying to interest this group of students in scientific endeavors. So that was a special event. And the other one was Boys State here in Connecticut. And I happened to be the campaign manager for a student named Joe Lieberman who was indeed Senator Joe Lieberman. So I may have been his entrée into politics. He doesn’t remember me, but I have written to him personally and got a response saying yeah, I think I do remember that. I gave no speeches at the high school graduation. Enjoyed high school. I liked school. I’ve got to say, being a teenager is a little bit tougher than I imagined and I relished my years after being a teenager better than those years.\n\nInteresting. I feel the same way. In high school did you have any interest at all in going into medicine or did that come later? \n\nActually, I never even considered medicine. One thing, as I was terribly squeamish, I didn’t like putting worms on hooks. I certainly didn’t like taking fish off hooks. Luckily, I rarely caught a fish. But I just couldn’t see myself doing that. And in some biology class we did something with some internal organs which I found revolting. So I never even thought of it. My interest was … I worked for my father. He had a textile plant and I worked there every year from the time I was sixteen on during the summers. I worked twelve and sixteen hour shifts because that’s what my father did and I thought that’s what you were supposed to do. And my plans were to go into business. Go to college – I was particularly interested in chemistry. Possibly get a degree in chemistry, then possibly go to textile for a graduate degree and then go into his business. I never thought of getting a MBA, however my father had a partner who was head of finance for the company. He was a CPA. His son became a CPA and he was going to take over that part. And it would have been an ideal match. The two of us get along famously well, so I don’t know whether it would have worked out. But that was my plan. So I went to Rensselaer. I only applied to two schools, Rensselaer and MIT. I had somebody say I’m the only person they ever heard of that used MIT as their safe school. I went to Rensselaer because that’s where my father decided I was going. He had met somebody who had worked on The Manhattan Project. I can’t think of his name, but he went to Rensselaer and my father said that’s where he wanted me to go. So I went to Rensselaer with plans of being a chemistry major. And people think I’m exaggerating with this, but I’m not. In my junior year one of my fraternity brothers said he wanted to go to medical school. Now this is one of the dumbest guys I’ve ever known. He wasn’t dumb in intelligence. He was dumb in common sense of the ability to put things together. I said to myself, if he can get into medical school then I can. So that was the decision point. I had other factors. Our family doctor was probably my hero. His name was Seymour Comer. Whenever he came into a room, everybody hushed and wanted to hear what he said. And he was always sought after in every way possible, in many ways which a lot of physicians don’t like. You were always considered in your community to be a professional person, so that certainly was a factor. And the day I told him I was applying to medical school and ended up applying to the same school he went to, which is Hahnemann.  I applied to others as well and was accepted at a bunch. The only one who didn’t accept me actually was Yale, who wished me luck in the paramedical career. They don’t produce family physicians, so I wasn’t their high … but that was a strange way to make that decision, but I did. There were things that came out of that. Because of that I had to take comparative anatomy at the University of Connecticut because it was impossible to take at UConn [he must have meant Rensselaer, and New York schools required that course. So that gave me a summer experience at the University of Connecticut. My first occurred after I took German at Rensselaer. I said I’m the world’s worst person at languages. I managed to take German I three times, finally passing German I and II and UConn. That was important because I planned on getting a PhD in chemistry. And you were required to have proficiency in a language, in German, in order to get a PhD in chemistry. I knew one person at Rensselaer who was in the PhD program for seven years. And it seemed the only thing that was keeping him there was his inability to pass the German course, so I doubt that I would ever have gotten the PhD at that point. But things worked out very well for me. I chose medicine, something I’ve never, ever regretted. And I think my father felt that I’m probably not going to be able to do it, but I fooled everybody. So that was my selection. Rensselaer, I belonged to a fraternity there. We had an incredibly strong fraternity system. I held all the offices in the fraternity including managing the bar and being treasurer and the president, which was an invaluable experience because it taught me how to kite checks, how to avoid paying people or making people think you made them when you hadn’t because we had to get delivery of the food. We always paid everything in the end. It was just that we were always behind. Interesting how that leads to a life experience, that I would be able to handle finances. I never have kited a check in my life after that, but it got me to understand what happens when you struggle. Rensselaer was primarily an engineering school but had all sciences. I think at the time I went there, there were 3,000 students and about twenty women. It was highly unusual to see a woman there. And just about the time I graduated, they developed a dual program with Albany School of Medicine. So at that time they had a six-year program. But I would not have been eligible since I already graduated. And that six-year program was a killer for people who took it, so I’ve never recommended that to anybody. I managed to get through medical school. That was in Philadelphia, Hahnemann, which is now Drexel. It was a great medical school for being a clinician. If you want to be a researcher, you went to the University of Pennsylvania. And we realized that very quickly but their students and our students got together at a place like Philadelphia General Hospital. They knew everything about knowledge and little about clinical medicine. We didn’t know some of the stuff they knew, but at least we knew how to take care of patients. Philadelphia General Hospital was a huge hospital. I believe 2400 beds. It covered about four city blocks. We worked the standard for the time, average 120 hours a week. And your life was devoted to being an intern. Or when you were a student there, you worked like an intern. As a matter of fact, everybody moved up a level. Students were interns, interns were residents, resident were I don’t know what. And attendings appeared once in awhile to tell us what we might have done wrong and hopefully what we had done occasionally right. Was it good medicine for the patients? I don’t believe so. But it was great medicine for learning. The learning experience was incomparable. So we’ve seen the last of that kind of care for patients, thank god. And we’ve seen the last 120-hour week. But it certainly made you understand what happens with patients on that continuity basis through acute medicine. Not the continuity basis we have in family medicine.\n\nWhen you left your internship at Philadelphia General Hospital, then did you immediately go into private practice? \n\nLet me talk a little bit about that because this is historically of interest. I graduated at the height of Vietnam, 1968. We were rapidly moving troops in. And all physicians who graduated from medical school were going into the military. That was virtually without exception. There was something called the Berry System [Plan] at the time. Now the Berry System was a way that you could get a waiver to go to a residency rather than going straight from an internship into the army. And they probably wanted you to have at least one year of residency. So Berrys were issued in one- and three-year deferrals. It was by lottery. And I got a one-year deferral which means I would have spent one year in a residency and end up going into the army as an officer, but almost certainly sent to Vietnam. There was one possibility of a way of another alternative, and that was the U.S. Public Health Service. The U.S. Public Health Service only took about 120 physicians a year. And many internists, people who were graduating, applied for those positions. They were either the Coast Guard or you might go to Alaska or something. Or the Indian Service, which was then your Native Americans or panhandle United States or Alaska. Or Bureau of Prisons. I applied and asked for the Bureau of Prisons. There was a selection process which I was totally unaware of, how they selected. And I was selected to be in the Bureau of Prisons. That was only with a lot of angst because the Berry had an expiration date. They day that the Public Health Service wanted to announce, what happened was several days after the deadline date of the Berry. So I was able to delay the final date for the Berry somewhat. Constantly called up the Public Health Service and finally was approved for the Berry program without a guarantee from the Public Health Service. I was told that I probably would be selected, but they couldn’t say anything. And I was selected, so I spent three years in the U.S. Public Health Service. I was the chief medical officer at Ashland Federal Youth Center in Kentucky. A very, very interesting experience. There were approximately 400 inmates between the ages of seventeen and twenty-five, 25% of whom went to sick call every day. These were young, healthy males. This was before major drug addiction, before AIDS, before things that made people really sick. And the vast majority of them were there for a violation called the Dyer Act which is taking a stolen car across the state line. So they weren’t particularly violent, except for a few. So the workload for a physician was not that heavy. And I had a department with three what they called at the time Med Exers (?). They were army, all from the service who had been called into the service and worked at the Bureau of Prisons and were highly experienced. So they took care of the routine stuff. I was in charge of anything that wasn’t routine. It gave me the time to read everything I had never had time to read in my internship. So it was actually, from that, highly educational. I met many interesting people and people to this day who we call our friends. Even some of the prisoners, although I have not heard from any of the prisoners in the last twenty-five years. There’s one I’m worried about who somehow I was a team leader for his, I think it was the parole board. And at my insistence we rejected his parole. He said to me you’re lucky I have a dime on me, which meant he had ten more years to serve and he intended to kill me when he came out. I don’t know what happened to him and I didn’t get killed. So I guess that worked out in the end. But the prison service is unlike anything else.\n\nAt what point did you meet Sandi? \n\nLet me mention one thing I forgot, going back to my family doctor. The day I got accepted to medical school, I called home and said I got accepted. He asked me to come into his practice. He said “When you’re done, will you come into practice with me?” My answer was yes. That’s what I kind of wanted. And we were in practice together for thirty years. A wonderful practice and a wonderful team. So that was a bit of serendipity, but it certainly was wonderful for me. And family practice was always my goal, even when the head of internal medicine told me I was a dodo bird at Hahnemann. I once wrote him a letter from the Chief Dodo Bird.\n\nSandi and I met two weeks before I started medical school. I went to a wedding in Philadelphia. The wedding was my father’s partner’s son, who I mentioned before, Allen Schweidel (?).  And he was getting married and my family was going. So two weeks prior to entering medical school, we all went to Philadelphia. And I was sitting at the same table as Sandi, talked to her, danced with her. Arrived in Philadelphia knowing nobody and had gotten her number. So I called her up and that was it. I was hooked. So I never went out with anybody else after that. We were married after my sophomore year in medical school. Sandi’s parents were among the nicest people in the world. They coddled me. I guess they wanted their daughter to marry a doctor and they thought I had a chance. They actually treated me better than Sandi. So we were married my sophomore year in medical school. We didn’t know what having no money meant since we didn’t have any time to spend any money. Sandi earned something like $2800 a year, which was pretty good. I earned $1200 as an intern. By that time she had become pregnant and left her job. So we got by mainly eating with Sandi’s parents and I ate at the hospital most of the time. We even went out once in awhile. But going out then was a whole lot cheaper than going out now.    \n\nAnd you said Sandi resigned when she became pregnant. So you have one son, is that correct? \n\nYes. My son was born in February of 1969. So it was during my internship that she had the baby.\n\nAnd his name? \n\nHis name is David. He now lives in Phoenix with his wife and my granddaughter. I think of her as my granddaughter rather than their child. She is without a doubt the most beautiful, fantastic, intelligent child that has ever been created. Unfortunately she’s not a princess; she’s an empress which outranks princesses. She’s in total control of everything, especially me. Not Sandi, but me. I just say yes. Whatever she wants to do is fine with me. And so I love nothing better than going there and playing with her and taking her to the movies and being with her. The last time we were there Sandi had a cold and was ill and unable to do anything for a couple of days. And I was totally taking care of Emma. And at the end of one day Emma decided to show me her dance routines. And I watched them for a little while. These, by the way, are made up. I said “Emma, you’ve got to let me rest for a second.” And whenever I rest like that, to zone out I play ----. And Emma told her parents that she was upset with me because I was too tired to watch her dance but I had plenty of energy to play ---. So she’s over it, I’m over it and we’re going to see her again as soon as possible.\n\nI’d like to go back again to when you left Ashland. What careerwise did you do after that? \n\nWhen I finished my term at Ashland …I actually asked to stay in Ashland. We enjoyed it a lot. And I also asked to stay in Public Health Service and they bumped me a rank. But I had made a commitment to my partner. Interestingly, after my first year at Ashland, during the summer I came home and for two weeks practiced in his practice as a physician. There was no probationary period or anything at that time. As long as somebody in the hospital made sure things weren’t going crazy wrong, you can do that. So when I finished up there, I went directly back to my hometown, what is now Vernon, Connecticut, which if you look on the thing is called Rock-Vern because of the merger between the city of Rockville and the town of Vernon. And I settled into practice and became immediately busy. My partner, I was there a year and he decided to go away for two and one-half months. At that time we could practice the full scope of family medicine. I would assist in surgery. I actually never did surgery. But when he went away for two and one-half months, I was on call for two and one-half months. We had other family physicians who would cover under some kind of emergency, but that’s not the way it worked. So I was on call for two and one-half months straight. With OB it’s a little bit different. The only way we could do that was the world was opened up to answering service. The lady who was the head nurse at the hospital opened an answering service. And this is before the day of pagers or cell phones. When you went someplace you signed in and as you went from place to place, you would call the answering service and say where you were going and Mrs. Masanko (?) seemed to be able to find us anywhere we were. So if I had a woman in labor or a newborn to take care of, she always knew where to find me. So it was kind of a unique thing we had a made life easier, especially when you had a call schedule like that. I had a direct extension from the hospital at my home and I also had my office line at my home so that an evening when I was going to bed or whatever, I would call the answer service and say I would take things directly. Because when somebody called at night, invariably you had to do something. It wasn’t a matter of telling them to go to the emergency room, because if I told them that, I had to go to the emergency room because we had no emergency room doctor. So it was like two or three years before we had even a part-time emergency room doctor. And whoever was on call, covered the emergency room. And the family physicians and internists covered that. But there were only five or six of us total. We would have someone covering the emergency room on weekdays and weekends. So we managed to do that and it actually worked. It wouldn’t work today, but in that time and place it did.\n\nIt was interesting because once I got involved in the Academy all I heard about was the fights over OB privileges and how the obstetricians didn’t want to cover the family physicians. We were exactly the opposite. During my internship, was on OB for a month and then did some other evening coverage on it because I liked it. The first day I was there I delivered ten babies. I didn’t know anything at first. The resident came and said here’s how they come out. The nurses were really good, thank god.  And over the course of a month, I probably delivered just over 200 (?) babies, and over the course of a year ---. So I had more experience probably than I would get today as a family physician. But when I came here and I had gone to OB, I met with the obstetricians. There were two at the time. And the obstetricians were dying to have more people deliver babies because they couldn’t handle the workload. And their rule on helping us was that we should always call them, no matter what, at any time. If the baby had to be delivered by c-section, they would charge. If the baby was delivered by vaginal, we would charge. And when nine years later I said I can’t do this anymore because I have to have a life and I would like to do other things for the Academy, they begged us not to stop doing it. There were by then four of them but they still wanted us to help them. And they knew us and trusted us. But the time had come to stop and I did. But there was never anything about competition or feeling that somebody was going to take something away from you or forcing you to do something you didn’t want to do. It was quite the opposite. And again, a small town, a small hospital, a close-knit medical staff. We all had lunch together every day. We constantly talked about cases. We had ongoing education on a daily basis. We had consults with anybody. And we actually practiced a high level of medicine in the community hospital, so that was very good.\n\nDid you hold positions within that hospital over the years? \n\nYes, I did. You couldn’t hold  a position until three years. At three years I was asked to serve on the executive committee. And they made an officer and then within another five years I was Chief of Staff. I kind of liked doing that kind of thing. And people didn’t want to do it, so I moved along a little more quickly than normal and I was willing to do the work in most issues that was not to their liking. So I was Chief of Staff at a really young age. I experienced some interesting things. We had another family physician who had a crazy temper. Actually, I got along very well with him. He would call me up in the middle of the night to holler at me because he didn’t want to follow the rules. And I had to be the one to tell him that he had to follow them. But he accepted it well. Another old-time internist wanted me to go out and have a fistfight with him. I told him that after five days he had to have a ---physical done. He became my sister’s father-in-law and probably one of the best grandfathers you’ve ever seen and a wonderful father-in-law, although we had had some discussions early on. When I was Chief of Staff, I became a member of the board of trustees of the hospital. And I remained in that position for many years after I was Chief of Staff. I served as chairman of the Department of Family Medicine and developed the quality assurance program at the hospital. I was involved in financial committees and fundraising and the development of new programs. The initial merger talks of the hospital with another, which eventually went through, I was deeply involved in that. I also became very involved in managed care. It was in the late ‘70s when we first heard Kaiser [Permanente] was coming to the area. That worried us greatly, that Kaiser would come in and take over. So I was not involved in the Medical Society, but I had a lot of contact with the Hartford County Society, which is a big medical society around here. And I found out that they had a special committee on what we called HMOs at the time (we weren’t sure what to call them). But I was made a member of that committee which then developed a large --- which became an HMO and was eventually run by the Blues [Blue Cross-Blue Shield]. And that gave me much experience there. I was involved in many of the things within the Blues and certainly all the contact with the physicians and all the issues over utilizations and costs and how you manage things. While I set up the quality program at the hospital, the major emphasis became quality in that group. So I developed much experience there too. And at the same time I became involved in the CAFP, the Connecticut Academy of Family Physicians. The day I came to the Connecticut [AFP] there was no thought that anybody would not join the medical society or the professional society. The medical society because they sold the insurance and that was the easiest way of getting it. The professional society because that’s what you did.\n\n(Break.)\n\nDr. Brooks, why don’t we now switch over to your service. And I would assume from a chronological standpoint, you started within the [Connecticut] Academy of Family Physicians before you moved to the service with the AAFP? \n\nRight.\n\nIf you would, discuss both your state level and your national level. \n\nI can segue into that. Marjorie Purnell (?) was a family physician who ran the county medical society and she became the president of the Connecticut Academy of Family Physicians. In I believe 1976 one day she said to me “I want you to come to a meeting with me.” Now Marjorie never demanded anything and if I was given an order by her, I figured I probably best carry it out because her wrath was unacceptable. So I went to a family physicians’ meeting. And that in a restaurant in which it’s still held today. When I went to the meeting I had no idea what was going on. Didn’t know any of the people. But it held a certain interest to me. People were talking about stuff that I thought was important. The executive was a guy named Art Schuman (?), who he and I took an instant liking to each other. And the doctor, Joe Czarsty, was there, who later became a chairman of the board of AAFP. And he and I struck it off. So I was appointed at that first meeting to be on the Rural Health Committee which was as dysfunctional a committee as you’ll ever see. That was my first introduction to a committee meeting through CAFP. But I still had that inkling of an interest, so I went to another meeting and another meeting. And after you’ve been to three meetings you’re asked to serve on the board. So I was a member of a committee for a year or so and all of a sudden I was a member of the board, not knowing what going on either. Actually, I became extremely involved at that point. One of the things that was going on in Connecticut is the new medical school had a department of family medicine. The medical school wasn’t particularly interested in funding that department. And as a result, the Connecticut Academy of Family Physicians became very involved in this. That happened simultaneously with my being part of it and beginning to rise through committees and stuff. So all of a sudden I was very involved in state politics, and I had a meeting with the Speaker of the House and the Attorney General. And we had the ---to the Legislature of them giving line items to the University of Connecticut for their educational purposes, ---support family medicine. But that got me involved with a lot of other people in the state. Some from the medical society, some from the Department of Health. But there was a lot of involvement there. [The] Connecticut Academy of Family Physicians along with the Ohio Academy of Family Physicians had a program called Core Content Review of Family Medicine. That’s a home education thing. It sends out questions to physicians. You have to answer the questions but you also have to explain the detractors, what’s wrong and what’s right. An educational process which has become more and more involved over the years. At one time we would say something is right because it’s intuitively obvious. That doesn’t go anymore. And because I became involved in that, the Core had a meeting every year simultaneously with the national meeting. And I think this is late ‘70s, maybe in ’80, I went to one of the national meetings because I was required to be there. And went to the Congress of Delegates, which I had no idea existed, I had no idea how it worked. My interest in earliest grade school, I became interested in Robert’s Rules [of Order] because I felt it had a mathematical preciseness to it and I like math. So when I got there and I saw what was going on, I said wow, this is pretty interesting. And I don’t remember who the presiding officer was that year.  Nixon I think was not only President of the United States, he [Sam Nixon] was President of the Academy. And I was just kind of awestruck at their ability to do things. And at the end of that meeting, I was with Art Schuman and I said I think someday I can do that. And he looked at me aghast and didn’t even comment. He felt it was not worth a comment. So after that I went to every meeting every year mainly as a member of Core. I became eventually an alternate delegate from Connecticut to the Congress and eventually a delegate and I was appointed. Because of Joe Czarsty became Chair of the Board, there was at one point an opening in a committee that was outside the screening process because it was late in the year. It was a Committee on Mental Health. I kind of had an interest in depression and people may have been aware of it, but I don’t think Joe was. But he appointed me to the Committee on Mental Health which many of my colleagues felt was more than appropriate that they should have somebody as mentally sick as me on the committee. I served about a year on that committee and they got rid of the committee but merged it into another, what then became, I believe, a commission. And I was the only one carried over. And because of that I know was the Chair of Mental Health and Addiction, they had a subcommittee. This was kind of an unusually fast way of getting to a position like that. And I became the Academy’s representative on things having to do with mental health and addiction. That led to me being very involved with something called the Link (?) initiative which was a federal project that met frequently in Washington. So I was constantly writing reports to the board about what was going on. And that commission was eventually with another which I was on. So I became somewhat known within the Academy for that. At the same time, previous to the society, I kept going through the chairs in Connecticut and served as President in Connecticut. That was actually at a time when there wasn’t terrible excitement and that was an easy year. But with the Academy there was always something going on. I actually became a delegate in ’89. And I wanted to run for the Board. That’s where I could best serve. And in 1992 the Vice Speaker’s position came open. And my thought was there was a guy running for Speaker that nobody wanted to run against. He was considered a shoe-in and actually was uncontested. And I said to Art Schuman, let’s do this. I want to run for Vice Speaker.   Ziggy [Charles] Zimont was the name of the other physician. I said Ziggy is going to win this but it will give me a chance to have name recognition and then I’ll run for the Board next year, actually was done not infrequently in the Academy at that point. And so I ran for the [Vice] Speaker’s position. The only person I checked with outside of Connecticut now was Rich Roberts. He was well-known and I wanted to know if he was going to run for the position because I felt that he would be unbeatable in doing that. And he said no, he had no interest at that time. And so I was the outsider, unknown person running against Ziggy who had done everything there was in the Academy. Connecticut, and this is unusual for a state, was able to raise all kinds of funds from outside sources for the campaign. Large amounts of money. But actually got money in excess of the campaign cost. So Connecticut became the first state to use running for an office as a non-dues income ---, not very much …but I always wonder when states say they can’t afford it, what you can do to try to fund it. We didn’t spend a lot. We were way below what a lot of people spent. But we did it with a little bit of panache. We had a great deal of fun doing it. I’ve always had the ability to do public speaking. It actually comes fairly easy to me. And this was at the time when the turnover was extremely rapid, the delegates for the Academy. And I didn’t realize how much weight there was in actually just giving the speech. I worked on that speech for probably nine months. I honed every word of it. I would give it in the shower, I would give it in the car, I did it in my head at dinner. I can’t tell you the number of times I did that speech, but it probably exceeded 1,000 – because I really wanted it to work. I tried to call some of the delegates. They didn’t know who I was and they didn’t care. I found that a fruitless venture. But I was able to give the speech and to personalize it and talk about things I think people were really interested in and talked about the vision ---. Ziggy decided to hold up offense and give a speech, ---. Probably not the best thing to do in the fiber of the speech, but to everyone’s amazement, including Ziggy, I won the election. As my name was announced I said oh boy, what have I done now? Went up and thanked everybody with the exception of Sandi who I totally forgot. It took several years ---, but she understood --- I was so totally shocked. And I got the position. Probably the best office in the Academy is the Vice Speaker’s office. You don’t get any of the blame and you can have all the fun. I was able to work with Charlie Aswad from New York. He eventually resigned as Speaker because he was going to become CEO of the New York Medical Society. So he never ran for anything beyond that. Charlie was about my height. Maybe a couple of inches taller. And we referred to ourselves as Twin Towers. I think we made things fun at the Congress of Delegates. Had to keep people interested. And so that was a great experience, especially working with Charlie who was a very solid, serious person but was willing to go along with whatever pranks I would pull. And there were some things that maybe we shouldn’t have done, but we did. One absolute rule we had and I had is never embarrass a delegate in any way. Always deflect anything on yourself. And that’s an important thing for a person in the Speaker’s position to remember. And people have to think the process is there and correct. Charlie and I were not strict constructionists when it came to the rules and procedures of Sturgis [Standard Code of Parliamentary Procedure]. And at times we would allow something to be done that you would probably have to rule out of order. But nobody in the Congress objected and we were getting to the place we wanted to go. So we would operate that way. And I think the Congress appreciated that. When Charlie left, I was now the Speaker. No one ran against me and I was elected Speaker. The thing that happened to me as the Vice Speaker …the first year I was Vice Speaker was 1992. Now you may recall in 1992 President Clinton had been elected (this was actually going into 1993). And number one on his agenda was the Clinton Health Plan. And so the Academy was obviously very involved in that from the beginning. Not involved with Clinton but as a policy, how were we going to react to that, what did we think of it. And the initial plan really was pretty much in line with what we wanted. And so after a board meeting lasting two solid days of discussion on what to do about the Clinton Health Plan, the Academy said, and this is a quote, that “The Clinton Health Plan is a good starting point for health care reform.” Our members heard that and our members who were somewhat to the right of most of us became infuriated. This was now happening at a time when our [AAFP] President couldn’t go to some ---. So they sent the Vice Speaker who was new and didn’t know anything. So I was sent to two places. One was Georgia, I believe, where they had some people who were not too happy about this. And one person started to berate me and one of the Georgia members, I’ll never forget, was a great gentleman, got up and said we do not treat our guests like this. And that was the end of anything going on there. But they did express that you will talk in a civil manner, don’t holler at people. The other place I was sent was California, whose meeting that year was in L.A. or San Diego. And the Orange County contingent was not happy with what went on. And I know little about politics at this point and I had people hanging over me for three days telling me why the Academy was wrong and demanding that I explain why we had done what we did. It actually was interesting from my standpoint, actually fun. And I think that I actually persuaded some of them that we may have made the right choice. And maybe our wording could have been different, but we did. After that I went back to California several times. I was invited there. So it was a great experience. And I think if it hadn’t been for the controversy at that time and the initial animosity of some of the members, I might not have had that. Actually, I think that was my first state meeting. I think Georgia was next. The relationship between the states and AAFP, the dynamic was obviously a very interesting one. In 1992 I ran for Vice Speaker. In ’95 or ’96 I said I’ve been in this position long enough. I really liked doing it, I enjoyed being the Vice Speaker and Speaker. I loved being the presiding officer, but I felt that it was time to move on. When I was elected Vice Speaker, I didn’t think I would ever run for President. I wanted to be Speaker and I said those guys who are President are too good. I couldn’t imagine myself in that position. But after the few years of experience I said I’m going to try to run for the presidency. And we had four candidates that year: Jack Verhoff from Ohio, Dale Moquist and Susan Black. That was the last year of the Vice President. That’s why there were four candidates. So it was a very interesting time to run. I believe I am the last non-residency trained president. There may be one after me, I’m not sure. But everybody else had been residency trained. Dale was very dynamic and well-known and residency trained. So I felt I had a major disadvantage with that. If the Speaker is able to work well with the Congress, has some obvious advantages from that position. And so it was a fairly close election. I was able to win. Dale and I have been friends ever since. When we were on the Board together, we became closer after that. There was an initial period when I think there may have been a feeling that he wanted it. But that was more other people than Dale and myself. Dale became head of the delegation for AAFP and the AMA and did a wonderful job. He was superb. And I have to say I had the same feeling when I was elected President – oh my god, what have I done? I think everybody has that feeling. But really also a feeling of joy and feeling that we had a chance to do something special. Those years on the Board literally flew for me. And you don’t realize that the President and President-Elect and now Chair of the Board would become somewhat separated from the rest of the Board. You got elected with everybody else, to serve with everybody else. And all of a sudden everybody else you were elected with are gone. And so they develop a special relationship. One of my goals was to make sure that everything we did was to make the Board whole, to have everybody involved, to not have a feeling that there was a separation between those three offices of the Board. And the most important person in that effort was my wife Sandi. Sandi became the pooler, the social director, the person who gets people involved. And she had an openness to everybody that was remarkable. She would make sure that everybody was invited to dinner. She would make sure that people were not left out in any way. If there was a person who was not included, she got ahold of them and made sure they were. And that was not always the case in the Academy. But I think it’s made a significant difference in the culture of the Board. We had gone from a system in which only the men who were going to be an officer or board members, there were no women in that position when I came on, and that was the wife’s responsibility, to be the wife of a doctor. That was her job, as was the case to be the wife of a member of the board. And there was an absolute feeling on the board at one time that people whose spouses didn’t attend and participate would not be allowed to move forward. And that was based on the model of medicine at the time. It wasn’t because it was the Academy. That’s the way things were when you practiced medicine. The doctor’s wife was the doctor’s wife and the doctor was the doctor. The doctor’s wife always referred to her husband, when introducing him, as Doctor. It was just part of the culture. And I think that we were able to see that and move to a point where it was perfectly okay for them to have their own job and knew what they wanted and to come or not come. My wife disagrees with me and says that’s not true. But I think it’s much more true now than it was at one time.\n\n(Dr. Brook’s wife Sandi): I hate to interject, but if the spouse on the Board were female and her spouse, doctor or otherwise, was male, the expectation for them was not the same as the female spouses. I can cite examples but won’t where if they didn’t come to a meeting, nobody said anything. But when it was a female spouse, it was well, what else would she be doing but following her husband here to the meetings and advocating for him? And it really was a culture of if you weren’t there, you were harming your spouse. That if they were looking to advance on the Board and you wanted to see them advance, you showed up. I don’t think the culture has advanced where I’d like to see it. But it’s advanced from when we first got on the Board. (Yeah, I saw it change over time too.) But not as quickly as you would have expected. Especially when there were so many two-income homes, whether it was medical or otherwise. You would think you would have seen a culture shift more quickly than we saw. \n\nSo that was an internal effort within the Academy, to bring that around. And the other thing, I really worked hard on the issue of diversity. I was involved with various groups that were working on that. I was at a meeting of the students and residents one summer and they go through a political process of what’s supposed to make them aware of what goes on I the Academy. So there was a young guy there, an African-American, who was military. And I was talking to him and asked “Why aren’t you running for the delegate position?” and he said “Well, I can’t do that, nobody knows who I am,” and I said “Yes, you can” and spoke to him about it, and that’s Warren Jones. And obviously something came of that. But there were several people that I kind of mentored and were glad to see that some of them were able to move on or do other things, other places, that were important. So I think the diversity issue within the AAFP was also an important thing. And I’ve got to say, one of my present disappointments is the lack of women who now want to run for positions. I understand it. I understand how hard it is to be an officer or a board member of AAFP. We worked really hard to get the women involved and now I think I see that they’re finding themselves so busy and so involved that they choose not to. I hope that’s not true, but that may be a concern. From a policy standpoint, during my years there were obviously all kinds of issues that kept coming up over issues of training, health care reform, different subjects. The major ones actually revolved around CPT coding. Which my best friend at the time was Doug Henley, and still one of my best friends, Doug was on the CPT and was actually enamored with CPT.  When they came out with the coding rules, I made the statement that it’s too broke to fix, which was a good catchphrase for that time. We kind of worked hard to try to get rid of all of the craziness that was required in documentation, but I lost. They eventually went through and physicians have adjusted to the system. It creates a medical record that’s unusable but …and I was really worried about family medicine because we deal with such complexity and the ability to stay within the demands of this were just enormous. Now I see all the medical records from my subspecialist colleagues who send me a four-page printed thing that they generate in the office that states a whole physical exam and somehow forget that the lady had a hysterectomy or a leg is missing or she has a scar where a lung was removed. I get a report of a normal physical exam, but that’s because it’s all boiler plate. So that system certainly has its problems. But we’ve lived with it and we’ll move on to other things. Another issue …this is also a time of movement towards quality. Trying to figure out how you demand quality. The person who did most of that certainly is Bagley, but it was something that was also on my plate, though not to the extent that Bruce was there. I had the opportunity to service with wonderful people too. Pat Harr who was the President before me, we had a fantastic relationship. He was all into smoking and stopping it. And we had wonderful times together. Doug Henley, who was the immediate person before that ---Lanny Copeland. Every one of them brought their own special skills and interests and that really makes the Academy dynamic. We weren’t cookie-cutters of each other. We had different ways of viewing things. I was often the iconic one. I would take the other side. Even though I might feel one way, I always wanted to make sure that other sides were heard. So I would very often vote against my own position because I understood that the best way was what I heard. And sometimes that was appreciated and other times not so appreciated. I don’t think people really understand when you do that. But that’s always been my way of operating. I’m never afraid to say anything. I’m lucky I don’t embarrass myself more often. But I think people understand where I come from. There are a lot of issues we deal with constantly and we’re all going to have different ideas in the best way to do them.\n\nOne of the things that came about while I was there is Bob Graham announced his resignation, which when I heard of it my heart fell several inches. It turned out the transition was extremely smooth, and Bob made sure of that. But when you look forward to having a Bob Graham at your side and all of a sudden you think it may be somebody else, you worry about that. But Doug came on and it went very well. Certainly nobody will ever replace Bob. He was a special person. And then I had my relationship with the Foundation. When you finish up on the Board of AAFP and you’ve gone through the offices, there is a feeling when you leave that everything is over. That is far from the truth. I had been involved with the Academy. I had already become involved with the AMA through the Connecticut State Medical Society. When that went out, I switched over to AAFP and was an AMA delegate. And I don’t know how many years on the Foundation. But was able to work with that staff and Sandy, you especially. And learned about insurance and rules of insurance and things I didn’t know, which is always great. And we met some dynamic people from the industry and that was a special experience. So the presidency leads on to other things. And within two weeks of the time I wasn’t president, I had a series of calls of people asking me to do stuff. I had stayed away from the pharmaceutical industry as president. And all of a sudden they started calling and I became involved in some of those projects. And through that I became involved with medical device companies. We had a great experience with them and learned lots of stuff I never knew and filled up lots of time. I was wondering what I was going to do with all the time I had. I had the odd experience of always being the largest producer in my practice, even the years I wasn’t president and chair of the board. Because I didn’t know you’re not supposed to work 365 days a year. And after going to Hawaii overnight, for a one-day thing in Hawaii, I came back and a week later had bypass surgery. So it kind of says to you that maybe there is a time where you need to slow down just a little bit. But two years later I had forgotten that lesson and was back to my old habits of working and basically said “this is crazy” and said “I have to slow down” and did. But to this day my interest in the Academy is unflagging – what goes on with family physicians, what’s the latest political nonsense how we’re going to deal with one issue after another. It’s an exciting time. I guess Chinese proverb is protecting us from living in exciting times. But I happily see successes begin to happen. Certainly understand the travails of the practicing family physician, I actually had a two-month trial of retirement. There was a period of time where I couldn’t work because of issues with the malpractice company, which were resolved. But I definitely flunked at retirement. I could not be retired. Playing out there every day is fun for awhile but you’ve got to have intellectual challenge. You’ve got to have people asking what to do. You’ve got to be involved in learning new things. So I am very lucky. Now I’m the medical director for a nursing home and I go in seven days a week. And I do that for two reasons. One is that’s what I’ve always done. I don’t understand how you work less than that. And the second is my wife who says we’re married for better or worse but not for lunch. So I have to have a place to go. But we’ve managed to rate the nursing home in the highest level in Medicare and the highest rating in the state. So I think the value of that has been there. I really love medicine. I don’t have time constraints. So if I want to sit down with somebody and talk to them for an hour and one-half, I can do that.  I can spend time with families. I can do what I wish. There are certain things I’ve got to get done. But I do them on the schedule that I set and nobody else does. And so that’s a terrific way to practice medicine, we can’t do that in practice. It doesn’t work. People aren’t going to pay us for that. But when you’re in the position that the payment isn’t important as what you’re doing, it really is something everybody should have the opportunity for.                          \n\n                              \n\nAre there any views on the important issues in the specialty at this point that you feel we’ve not discussed? \n\nImportant issues in the specialty. I like things technologically enhanced. I like using computers and things like that. I’m worried that they become a barrier to interacting with our patients. And virtually every doctor I see is computerized. Around here everybody has an electronic medical record. I think I’m only aware of one physician who doesn’t. So maybe things are different here than the rest of the country. But I think physicians who bury themselves behind their computer, they’re looking at the screen and not looking at you. They’re not interacting in a way that I think is the best way physicians should interact. That’s not the family physician I see because my family physician is the person I brought into my practice. And although we have a full electronic record, that’s not the way she works. But I certainly have seen it with other physicians. Technology has a useful element but also is a barrier. I think it’s something we deal with, but we need to understand much better what qualities about how we achieve it. I think we’re still in the infancy of the quality revolution. A payment reform the Academy is working on. But I think we haven’t really considered all the approaches yet. And we’re not going to be the ones who decide that. The politician is going to decide that. And we need to develop partnerships that are far outside of medicine to help accomplish that. And the Academy has been pretty good at that. I think the members aren’t aware of some of the things that are going on. I wish there was a way to keep them more informed. But the Academy has done a remarkably good job within the constraints of what they can do. I have only admiration for the present officers and I think it’s going in the right direction. Would I have done exactly the same as they have done? Probably not. Nobody would do things exactly the same. They’re probably a lot more correct about things than I would be. But I think from a family medicine standpoint, I think they’re going the right way. In the practice, however, in our community there’s getting to be no family physicians. Family physicians leave, they don’t come. Recruiting one is very difficult. Family physicians do not earn the national averages here in the northeast. And if you call up and try to get an appointment with a primary care physician around here, good luck. There are some you might be able to get an appointment with. Most likely those are the ones you wouldn’t choose for your physician. The ones who are excellent at what they do just don’t accept new patients, period. They’re extremely reluctant to take on Medicare patients. I don’t know any family doctors here who completely exclude groups based on insurance. But there’s a big hesitancy to do that. And that presents problems for Medicaid and Medicare patients and Tricare patients. But most of us say that there’s an ethical requirement to do that. We’re not in a hurry where you just say oh, somebody else will do it. But unless we do something to correct the financial inequity and really the work inequity, we’re not going to succeed in the system. I think the medical home model is terrific. A great way of doing things. I’m not sure about its efficiency. I speak to physicians who think seeing fifteen patients a day is just the right amount. They would like to earn $250,000 a year doing that. And their expectations on how much they have to work and how much they’re going to get paid just don’t align.        \n\nI think family medicine should be a four-year residency, without a doubt. I don’t think you can possibly be proficient in what you need to be in three years. But I think the way residents are taught the way practice is going to be is not the reality of what practice is like. And so I had the opportunity of teaching a lot of residents through a course sponsored by the Foundation. And what I saw constantly is just a misalignment of the expectations of what they’re getting and what’s going to be. What the reality of practice is and how it’s going to be. And unfortunately we’re not in a place anymore where you can hang up a sign and go into practice except in some very unusual locations. You have to go in with somebody, in a group. You have to have somebody take care of all those things involved. Third-party payers, Medicare. So it removes some of the flexibility that physicians have always had. And also in my era, I’m the old cantankerous guy …when you went into practice, you picked a spot and chances were about 80% that you were going to stay there the rest of your life. I think the fact, as I understand, when residents first go into practice, the chance of staying there long term is about 25%. Very much different than my experience. And maybe they’re right and that’s the way it should be. But when it comes to providing communities with care and developing relationships and all those things that I’ve done over just under forty years where you know everybody. You can’t go anyplace without somebody saying hello or thanking you or inquiring after yourself. We live in a community that allows that. We’ve grown a little bit from the 3,000 or 4,000 when I was born. It’s more like 35,000 now. But it’s still very rewarding to be in a place where I now take care of in the nursing home multi generation of families that I cared for in practice. I’ve not yet had any of my pediatric patients. But I don’t think that will be too long. So it’s a special pleasure to have that kind of community contact. Those of us who have it, cherish it. And I think those who don’t have it, don’t even realize it’s there. But models of family medicine have changed. I think that we need to constantly restudy how we do things and how we accomplish things and what’s important. But the one thing that’s always important is the ability to sit with our patient and hold their hand and talk to them about things that are important to them. Understand where they are, who they are as people. And then I’ll take care of them over a long period of time and it makes a difference.\n\nSince we have come to a conclusion on this, do you feel there is anything else that you didn’t cover that you would like to go back and cover? \n\nI slid over so many things. I’m not going to tell you my most embarrassing moments or things I did wrong. And I’ve had my screw-ups over time. It’s the way we learn. I think I’ve covered the important things. I’m asked frequently by parents or students, what do you think of medicine? What do you think about being a doctor? My answer has been it’s the greatest profession there ever has been or ever will be. I think the rewards that we get, even if they’re not financial, are so substantial that to have the ability to do what we do and not take it or not try to get it, you’re doing yourself a great disservice. You’ve got to want it though. You’ve got to understand that I you’re going to go through some tough times and some sacrifices and it ain’t going to be easy. But in the end …I know physicians who hate what they do. Every one of those is a physician who went into the field for money. If you want to go into medicine for money, God forbid you take that route. If you want to go into it because you care about people and you’re interested in people, and it doesn’t matter if you’re a radiologist or a dermatologist or any other “ologist,” they all can do that. Then you should be all means do it. The characteristics of doctors are changing constantly where Type A driven people like we are less and less, I think. And that’s probably good. But you need those Type As around to drive other people to work maybe a little bit harder or a little bit more. And the other people have much better family lives and sacrifice less. But has its advantages and each has its disadvantages. But medicine is a great career and I would never choose anything other than family medicine.\n\nI have to thank you, Dr. Brooks. This has been enlightening for the future. I will tell you that as you reflect on this interview, if you can think of other items you would like to discuss, we can certainly reconvene and add to it. This is a living document, so we can always go back in and add to it.                    \n\nI am sure I will think of other things. It’s a pleasure doing this. You don’t get the opportunity to talk about yourself very often.\n\nNo. And I will say now that I have just been absolutely thrilled being able to do these interviews because it allows me to learn in depth about those people that I worked with and respected so much over my 34 years. So I thank you for allowing me to do it. \n\nActually, who is sponsoring this?\n\nThis is all done through the donations to the Foundation. \n\nYes, I assumed that. I think that’s a worthy project, anything we can preserve from what happened in the past and let people have an opportunity to look at it.\n\nWhen we did the videotapes on some of the Past Presidents, that was under their years of President. It wasn’t on their life. So that’s what has made this so much fun. And it’s so much more inclusive to see where people came from, why they chose family medicine. \n\nI should say I’ve been asked several times if I’ve lived in my community all my life. And my response is “Not yet.”\n\nThat is a great way to end it. \n\n(End.)","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150965/file/278401#t=0.0,3150.19575"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150965/file/278402","type":"Canvas","label":{"en":["Media File 2 of 2 - Brooks_Neil_12_b.wav"]},"duration":3389.86212,"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/150965/file/278402/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150965/file/278402/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/402/original/Brooks_Neil_12_b.wav?1750875459","type":"Audio","format":"audio/wav","duration":3389.86212,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150965/file/278402","metadata":[]}]}],"annotations":[]}]}