{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/513tt4hg93/manifest","type":"Manifest","label":{"en":["Dr. Nancy Dickey"]},"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":["2007-07-16 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["oral history"]}},{"label":{"en":["Agent"]},"value":{"en":["Lindsay Young (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","family physician","American Academy of Family Physicians"]}},{"label":{"en":["Subject"]},"value":{"en":["Nancy Dickey, 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/162262/file/295025","type":"Canvas","label":{"en":["Media File 1 of 2 - DickeyNancy_01_Access.mp3"]},"duration":3778.6275,"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/162262/file/295025/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/295/025/original/DickeyNancy_01_Access.mp3?1760546294","type":"Audio","format":"audio/mpeg","duration":3778.6275,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025/transcript/85346","type":"AnnotationPage","label":{"en":["Dr. Nancy Dickey Interview Transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025/transcript/85346/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Let’s start with some basic biographical family data. Can you give your name in full to start with? \n\nNancy Jean Wilson Dickey.\n\nWhat is your present title? \n\nI’m the President of the  and Vice Chancellor for Health Affairs of the Texas A\u0026M University System.\n\nWhen and where were you born? \n\nI was born in  in September, 1950.  \n\nWhere did you grow up? \n\nI spent my first almost ten years in South Dakota on a small farm in a tiny town, Park (?), South Dakota. And then my parents didn’t actually own the land but sold everything about the farming business and we moved to Sacramento, California for about five years. And then spent the rest of my time in . So I graduated from high school in Texas, went to college and graduated from college and medical school in Texas. And married one of them, so I’m there forever.\n\nDid you have any role models when you were young? \n\nI had lots of role models in terms of persistence and hard work. But I don’t recall knowing any physicians. In fact, knew my first woman physician when I was in high school. And bless her heart, I probably don’t consider her a role model. None of the things that she demonstrated attracted me into medicine. \n\nDid you have any role models in any other senses, even if wasn’t related to medicine? \n\nOh, absolutely. My parents were both very can-do people and I would consider both of them role models that had minimal advantages and yet raised seven children and continued to advance their lives. I had a couple of role models in terms of teachers in high school. I at some point began to call them mentors. And continued identifying individuals that I both want to model myself after but also that in the mentor kind of relationship, approach them and say can I tap on your shoulder occasionally and will you give me your assistance in terms of understanding organized medicine or academic medicine and those kinds of things. Sam Nixon from the Academy of Family Physicians was a long time mentor for me. Frank Webber who was a family physician and dean of my medical school at one point was a wonderful mentor who unfortunately died prematurely. And I would have loved to have him around for more years. And the first man I went into practice with, Dr. Isaac Kleinman, is probably still, in my mind, the epitome of a family physician. IsaI never go wrong by asking myself what Isaac might have done.\n\nDid you have any special dreams or goals when you were young? \n\nI really don’t honestly remember thinking a lot about what I might want to do until perhaps in high school. And in high school I did begin to think about what it might be like to be a physician. But I was discouraged from pursuing that track. So I, being a fairly practical person, did not go to college as a pre-med major but went as a psychology and sociology major. I think probably most of my dreams, strangely enough, have come later in life in medical school and after I got into practice. And even today have goals and dreams of where things might go.  \n\nDo you have any stories from your childhood or your early years in school that you would like to share? \n\nI’m one of seven children. I’m the second oldest. I have an older sister and two younger sisters and three younger brothers. So most of my childhood memories are about family. Everything from gathering eggs, which we didn’t keep our chickens cooped up, so that meant crawling around the hay mound at the barn to find the eggs. Interesting for a woman who has moved into a position where I make decisions. Many times every day my family still laughs at the fact that as a child I was often torn and unable to make decisions. I used to go with my dad every morning to bring the cows in to be milked. And one morning we had made plans for me to get up to the school bus and go with my older sister and experience public education. Unfortunately, the school bus drove up about the same time my father fired up the tractor to go get the cows. So we still laugh about me taking two steps towards the tractor and two steps toward the bus. And finally put crying on the bus. So I remind them even indecisive children can grow up to make up their minds. Lots of vignettes. Again, family-related. I felt like I helped raise my youngest brothers and sisters. So I knew from an early age what it was to both rock babies and enjoy them and tear your hair out and say Oh, my gosh – somebody come home and take this over!   \n\nIt’s hard to believe a woman in her 50s, because I think most people think this life went away many, many decades ago, but I grew up on a farm that didn’t have indoor plumbing. And so to think that I have gone from a house that you either used a chemical toilet or an outhouse to being the president of a university sometimes has me rocking back on my heels and thinking what a country this is. And I still have relatives in the Dakotas. So when I go up and we drive from farmstead to farmstead, it’s an acknowledgment of what a magnificent opportunity it is to grow up in the .\n\nLet’s go on to talk a little about your career in family medicine. And if we have time at the end, we can come back and discuss kind of more education things. So what was the world of medicine, and specifically family medicine, like when you finished your residency? \n\nYou know, probably whatever generation you talk to, we tend to say ah, it was the golden age of medicine. I finished my residency in 1979 and started into practice with Isaac Kleinman, a man who had been a mentor throughout my residency training actually. I went to a small town, specifically because first, I like living in small towns but second, even then it was fairly clear to me that family medicine in the big city was going to be a very different animal than family medicine in a small town. I did obstetrics for 20 years. I delivered in excess of 4,000 babies and have done my share of c-sections. The first few years I was in practice I did most of my own general surgery. We covered our own emergency room. There were no full-time doctors at least for the first probably six or eight years I was in practice. And I think in many ways it was a very busy but extraordinarily rewarding time. You developed relationships with your patients such that when they called and said I’ve got this, this and this, you thought about whether you could take care of it over the phone or whether you should meet them at the emergency room. But it wasn’t an option to simply have the answering service refer them to the ER because you’re the one that was going to get called. It was a time of tremendous camaraderie among physicians. We had probably 20 active physicians on the hospital staff where I practiced. And we not only covered one another so people had time off but we learned from one another and taught one another. And despite the fact that we didn’t necessarily socialize a great deal together, we were a very close-knit group. I watch physicians today and the first thing, it’s getting harder and harder to find a place to do that full range of family medicine from admitting your own patients to delivering your own babies and maybe even having a role in the operating room. I see family medicine narrowing the scope of what they do. Fortunately, I think I also see family medicine moving more to, I don’t want to say technical because I don’t mean procedural, but for years I’ve been critical that patients believe that a white coat was a white coat, that it didn’t really matter. Unfortunately, I now believe I see some of my profession, including my specialty, embracing the concept that a doctor is a doctor is a doctor. And I think while all of medicine has something to lose from that philosophy, family medicine probably has the most to lose because it is our relationship with our patients. It’s our ability to hear multiple levels when they tell us a symptom or a concern. That is the power of family medicine. And it’s the continuity and intergenerational opportunities that make us so effective. And to some degree, we are trading those away. So in 1979 they were all there to be embraced, if one chose to, and it was truly a wonderful time. Because unlike going back more than 30 years, if we went back 60 years you certainly had lots of people who had that full scope of practice and intergenerational opportunities but they didn’t have the capacity to diagnose and treat that we had even in the late ‘70s. When you combine the opportunity for the best of what family medicine should be with the superb level of science and technology that the ‘70s, ‘80s, ‘90s have brought to medicine, I truly did finish my residency in a golden time for both physicians and patients. I made a good choice.\n\nSo the first position you had out of residency was going into private practice? \n\nYes.\n\nAnd why did you decide to do that? \n\nBecause that’s what I went to medical school to do – to be a doctor, to hang up my shingle and see patients. I probably never considered anything else. Except I mentioned one of my mentors being Frank Webber and when I finished medical school Frank Webber was the program director for a residency program. And he tried very hard to recruit me to faculty. And I remember looking at him and saying why would I want to do that? I’m about to do everything I’ve wanted to do, practice and make myself a part of this small town. And why would I want to come in and simply try to share with another generation something that I haven’t even done yet? So I never considered any other way.\n\nDid you stop practicing at some point? \n\nWell, I was kind of greedy. I did all kinds of things at once. I continued practicing until 1996 and I continue seeing patients in a part-time way even today. But in those 20 years of private practice I was also becoming very active in the American Medical Association and probably by the early ‘90s was spending close to half my time being a medical politician or an organization person even as I was practicing medicine. Even though I left my solo office from 1991 to 1996 I moved over to a community clinic and many of my patients moved with me. But I was the medical director for a community clinic. And during that time the community clinic became a Federally Qualified Health Center. So I continued that private practice time. But the reality is I was beginning to segue into both administration and academic. And did that partly because the demands from the American Medical Association had become pretty significant and it was hard to maintain a solo practice, at least. But also because I had three children, all of whom at that point in time were adolescents, early teenagers. And I discovered while lots of mothers want to stay home with their kids when they’re newborns and toddlers, the reality is when they’re adolescents and they indicate they want your time, they want it right then. So I discovered those years were a very good time for me to have a little more control over my schedule than private practice gave me. So I guess you could consider the first half of the 1990s my segue from private practice into a myriad of other activities including administration and academics.  \n\nSo did you find there was kind of an interplay between those various roles of faculty and medical leader and private practitioner? \n\nCertainly an interplay because they all touch one upon the other. The health policy issues that I dealt with at the American Medical Association were part and parcel of what was happening in the practice situation in terms of health maintenance organizations and managed care and how to deal with the uninsured, which was a major issue even then, was part and parcel of the issues with the Federally Qualified Health Center. And teaching students and residents, primarily residents at that point, gave me an opportunity both to explore the policy issues but also to kind of re-energize myself from a clinical perspective because things that had become a little hum-drum in terms of doing them yourself look totally different when you’re trying to explain to a resident why you do a particular thing or why you ordered a particular test or why you didn’t use a particular medication. So yes, I found them extraordinarily connected and interrelated. But I think in addition to the fact that they were an interesting package that all fit off of each other, all three of those roles gave me what I perceived to be more control because it was a much more scheduled kind of control. Although many of my staff would disagree, administration is something that often is you and your computer, you and your stack of paper. So if I wanted to go to a child’s volleyball game at 2:00 in the afternoon and was willing to do my paperwork, if you will, at","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025#t=0.0,660.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025/transcript/85346/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"at night after the kids were in bed, it was okay as long as the job got done. You can’t say that for patient visits. If somebody needs their annual physical, they’re not interested in doing it after your kids go to bed at night. So I think while all three of those pieces were interesting to me, a good share of the decision was made because I could continue doing very interesting things and still have more control of my schedule than I did in private practice.  \n\nCan you just give a general summary of the positions that you had after kind of broadening out from private practice? \n\nI moved over to the Federally Qualified Health Center. Was, at that time, on the American Medical Association’s Board of Trustees and spending about half my time doing policy, public speaking and meetings. And I was creating a piece of a residency. We had a formal residency program in Houston that sent three residents per month out to the small town where I practiced. And it was my role to create the curriculum and recruit the faculty and follow the schedules and that sort of thing. In 1996 for a variety of reasons I decided it was time to move on from there and I responded to an opportunity to become the founding program director of a brand new residency program in College Station, Texas, about 100 miles from where I was then practicing. So I moved to College Station in ‘96. And from ‘96 until 2000 I immersed myself in graduate medical education, finishing the paperwork to create the residency, recruiting faculty, recruiting the first residents and getting the program up and running. Meanwhile, I was still doing my American Medical Association stuff. And then in 2000 our medical school had some leadership upheavals and I left the residency program to become the interim Dean at the College of Medicine. I was there for 18 months and then applied for and was selected to the President of the Health Science Center and have been in that position ever since. \n\nWhat sort of unique challenges have you faced in your career or any barriers or obstacles you’ve come against? \n\nI certainly am aware of differences between how men and women are treated. The easiest place to point to is economics in terms of women are simply not paid as well as men are even for the same role. And while I think that I probably started medical school at a time that they were actively recruiting women and perhaps it even enhanced my ability to get in, there was little doubt there was some discrimination particularly when it came to getting into graduate medical education. Certainly when I finished medical school there was a fairly widespread communication that surgical subspecialties were large male specialties, orthopedics, neurosurgery. And I’m pleased to know that 30 years later there is no specialty in which there are not a significant number of women and increasingly women leaders and not just a handful of women in the specialty. I think there is little doubt that there is some discrimination still in terms of senior leadership roles. Sheer numbers alone point to that. And when I think academically speaking, there is still some discrimination in terms of how difficult or easy it is to become a full professor, a full professor with tenure. And at the same time I say all those things, I know them intellectually and I speak about them and I follow the data. But I have to tell you that I can’t say that I personally have experienced a substantial amount of discrimination. It may have been there and I was just not sensitive enough to pay attention to it. Or it may be that I just kind of lowered my shoulder and plowed on through it and didn’t acknowledge it. I have been extraordinarily lucky to have done a number of things that women hadn’t had the opportunity to do before. And I hope I’ve done them in a fashion so that others will follow in my footsteps. But with the possible exception of payment, I must say I don’t know that I personally have seen a lot of barriers. Other barriers, I think increasingly I believe we have some closed segments. For example, I’m not a classic academic. I didn’t come up through the assistant professor or associate professor taught 40 years ranks. And periodically I think I run into people who assume I don’t know enough or anything about academics. But again, it’s more a matter of I hear the criticism. I can’t tell you I think that it has prevented me from being able to do my job or be successful in the missions of the institutions I’ve served. So I think probably my family would just tell you I’m so bull-headed that the barriers are there and I didn’t notice them.  \n\nHow did you learn what you needed to learn in order to help you do your work? \n\nWell, centers (?) are a large part of that. And I certainly try to not only observe but I attempt to ask questions. I think part of the fun of life is continuing to learn. So if I’m not in a position that I’m continuing to learn something, I think I would be pretty bored. Maybe that’s why I keep seeing new opportunities out there. I think probably though the most powerful way to learn things you need to know is people who have done it successfully before you. So my clinical mentors were extraordinarily family physicians. Successful in terms of quality of care, successful in terms of patients like them. And they continue to stay up-to-date in medicine. When it comes to administration, I’ve tried to watch people around me that I believe are effective and far-reaching in terms of how they create their institutions. And so I think probably the most powerful learning tool out there is finding people that you think do it right and then trying to copy them.  \n\nWhat would you say is the position that you enjoyed the most in your career and why? \n\nNow generally I would have to tell you it’s where I am at the given time. But I mean that by saying when I was in practice I didn’t want to be anyplace else. And I have magnificently fond memories of those individual patients and the opportunities. I thoroughly enjoyed creating the residency program. I enjoyed being the Dean. And right now I have a fabulous challenge in front of me as the President of a university. So right now I’m having a ball doing what I’m doing. But I wouldn’t have missed any of the pieces leading up to it.\n\nSo then would you say there isn’t a position that you enjoyed the least? Or is there one that you perhaps haven’t enjoyed quite as much as the others? \n\nI can’t tell you there’s any that I haven’t by and large. I mean I could pick a day out of any of them and say I don’t want to go back there. I’ve enjoyed what I’ve done. I think when whatever you do is no longer fun then it’s time for you to go someplace else. Probably the closest to that that I have become, because many times opportunities have come before I decided something is not fun. But perhaps the closest I would come to that then would be the later years at the Federally Qualified Health Center where I was spending more of my time with American Medical Association policy issues and was probably not satisfying my employer, the FQHC. And so it wasn’t a particularly good time. When your employer is not happy with you, it’s difficult to be satisfied in what you’re doing. So if I had to pick a time that was the least reward, the most frustrating, it would probably be those last few at the FQHC.\n\nWhat position would you say you accomplished the most in? Or can you even decide? \n\nI think it depends on how you measure it. In terms of touching individual people, there’s little doubt private practice takes it in a heartbeat. But in terms of touching a broader group of people, I would probably say Chairman of the Board and President of the AMA. And I hope when I finish whatever time I’m given in this role that I will be leaving a legacy that will impact people for a long time to come.\n\nSo you have received many forms of recognition. Kind of a long list including multiple honorary degrees, the Family Practice Residency of Brazos Valley established the Nancy Dickey Leadership in Family Practice Lectureship. You were listed in a whole bunch of kind of lists of important people. The 100 Most Powerful People in Health Care. The Best Doctors in America. America’s Top Family Doctors. Who’s Who in many areas: Who’s Who in Managed Care, America’s Teachers in the South and the Southwest, American Women, Executives and Professional Women. So how does it feel to be honored in those various ways?\n\nI worry sometimes their standards must not be high enough. It truly is a tremendous honor to be selected by hopefully your peers or your patients. And I’m humbled by what those honors stand for and hope that I continue to do the things that cause people to vote for me or do things like create the lectureship. I think probably if anything it causes me to want to try a little harder and work a little harder to deserve the honors I’ve been given.  \n\nCan you describe how you have been able to do that work to accomplish so much? Is there any kind of root to your method or anything? \n\nI’m a bit of a workaholic. I used to laughingly say sleep is a waste of time. But I’m getting a little older and I enjoy it more than I used to. So I’ve always been a bit driven. And I don’t know where that came from but it’s served me fairly well. I like to be headed somewhere. I’m not terribly good at just meandering through life. So whether it’s taking care of patients. It was always an immense compliment to have a family member or occasionally a physician say you know, this patient has seen a number of people and nobody can figure it out, would you mind seeing her? Wow. Yeah, I would be delighted. So I guess in many ways I’m kind of an in-the-process or into-the-game driven person. And in an academic institution that’s kind of an interesting phenomena because their tradition is often to discuss something, what I’ve called ad nauseum, when I simply want to say let’s cut to the chase. What’s the goal of this discussion today? Where do we want to end up? And can’t we move the discussion a little more quickly to that point? Not that I’m trying to tell you what the decision is but rather if the purpose of today’s discussion is to decide if we’re going to do this or not then let’s tailor the conversation to that happening. And so when I got involved with the American Medical Association and discovered I really enjoyed organized medicine and I enjoyed the policy kinds of discussions that we had, it took some time (I mean I was a kid when I got started). It wasn’t difficult at some point to say I want to participate at the level that makes the most impact and that’s the Board of Trustees and ultimately in a position of elected leadership. I think that’s part of what accomplishment is about, I guess. It drives my husband nuts. I can’t simply watch the football game. If I’m really being lazy, I have a crossword puzzle laying on my lap. Otherwise, I may be flipping through journal articles or answering emails. So I don’t do purposeless things terribly effectively.\n\nI saw that you have traveled many places related to your career. What sorts of places and events have you attended? And do you have kind of brief stories about traveling you would like to share? \n\nThe traveling has been one of the exceptional rewards. I occasionally look back at that little farm girl and think I’ve played golf on five continents. I’ve got one to go because I don’t think they play golf on Antarctica. But maybe I go down there and just hit a golf ball so I can say I’ve played on all seven. I took a trip to Russia when I was Chairman of the Board of the AMA. And so I was the head of the delegation. Well, Russia is a fairly male-driven society and I said alright, I’ll go. But it’s because you kind of want to highlight that AMA has women leaders. Not many but they have some. And so I can remember sitting at dinner with the head of surgery at one of their academic institutions and saying to him do you have many women in medicine? He said oh yeah, yeah, half of our physicians are women. I said really? I said have you got women in the Department of Surgery? And he looked at me and said no. And, of course, what he didn’t say but what I knew was they train women physicians and those women physicians are primary care physicians who work the clinics. How audacious to suggest that they would be professors and chairs in academic institutions. So that’s the kind of environment. And yet as the head of the delegation, when we would do the social events the vodka would come out and they would toast us and it was my job to toast them back. I don’t drink a lot. It didn’t take a whole lot of vodka to exchange toasts back and forth before I was having a real challenge meeting my travel goals. I wondered whether those guys would leave those social events and say what are those idiot men doing letting this woman do the toasting and lead the delegation? Probably my second story would come from a trip I took as a result of the residency that we set up in College Station. We had a graduate of the medical school in Nepal and she had been in touch with many of her faculty back at the College of Medicine about the deplorable conditions, particularly in maternity care. So another faculty member and I and a student and a resident went to Nepal for ten days. Gosh, if you ever doubt the poorest of American medicine being worlds better than the best of medicine in other countries, you need to hop on an airplane and go see some of these places. But the opportunity to take an obstetrical course over and teach it to everything from their medical school faculty to some of the rural health workers who would be going back out to the very rural areas was truly phenomenal. Now remember, I came from modest beginnings. We were fairly careful. We carried bottled water with us even when we were in Kathmandu teaching. We spent a lot of time out in the country where we were very careful. But I finally broke down one day and said I really need the facilities. So somebody pointed me down the hall, said it’s the third door on the right. I went down and opened this door and thought I must have counted wrong. This really looks like a washroom, like a mop kind of room. And went back down and she said no, it’s the third door on the right. So I went back down. Now we’re talking about a floor that is awashed in water, with a bucket in the corner and a dipper and a hole in the floor. And I thought maybe I just won’t drink anymore liquid while I’m over here. This was in the best hospital in Nepal. Again, the opportunity to see a culture so totally different from ours. To be able to take a little bit of education over to that culture and at the same time to recognize that there were pieces of that culture that were real hard to embrace was probably one of the most tremendous trips that I’ve ever taken. Thank God I don’t live there. But I would go back again if I had the opportunity.\n\nLet’s talk about your involvement in the AMA. How did you first get involved with the American Medical Association? \n\nOne of my favorite words in life is serendipity and opportunity. I was a first-year family practice resident. One of my colleagues was well aware of the opportunities the AAFP allowed students and residents to be real participants in the Academy. The AMA, on the other hand, had a tendency to…they had a student organization and they had a resident organization but they preferred them to meet down the street from the real meetings. And so he had been politicking through medical school and a couple of years of residency and came in one day to the residency program and said we have succeeded. The AMA is going to let students and residents serve on their councils, which are the AMA’s policy-making bodies. And I thought hooray for you, that’s good work. He said these are elected positions. So I need two candidates for seven or eight councils, and I was really hoping you would do one. And I looked at him and said I have a nine month old daughter. I am an intern. Life couldn’t be any better for me. I’m just tickled pink to do what I’m doing. He said well, it’s a free trip to San Francisco. I thought, residents are poor. I was married to a schoolteacher; schoolteachers are poor. So I said okay, I’ll tell you what. Turn my name in. I’ll go. And then to myself said: but I won’t run very hard. I mean I’ll show up so he’s got two names on the ballot and I’ll get my free trip to San Francisco. And then I’ll come back and my life will be as it was. The guy whose name was on the ballot with me ran less hard than I did, he didn’t show up. So I got elected to a council as a resident and I was hooked. It was a council that dealt with health care policy. Payment issues, insurance issues. HMOs were just getting started with the Nixon legislation. Now I was hooked. I was sitting around the table with some very wise voices who had been leaders in medicine for decades. And here I was wet behind the ears and allowed to sit at the table just like they were. So I did that for two years as a resident. When I finished my residency I actually had the audacity to run as a real doctor. You’re not supposed to do that. You’re supposed to go back home to the Bylaws Committee for 20 years and then go back to the AMA. But I ran and lost and got appointed to the Ad Hoc Committee on Women and Medicine. They recognized that perhaps they should try to find a way to get a few of the increasing number of women to join because women did not then join the AMA in the same numbers as men. And as a result of being around for four years on the committee and on the council, I got an opportunity to be nominated to the Ethics Council and served nine years there. Probably one of the favorite things I’ve ever done because it was like getting a PhD in medical ethics. And from the Council on Ethical Affairs I was elected to the Board of Trustees. So it truly was serendipity. I happened to be in a residency where somebody thought this was a good thing and he cajoled me into putting my name up for something I really didn’t think I wanted to do – and I was addicted to it.  \n\nWhat sort of issues did you talk about in medical ethics during your position with the Judicial Council? \n\nI came on the Council in Christmas of 1980. They were dealing with amniocentesis and how to be sure it was only used for diagnostic purposes and not for gender selection. And that was a truly extraordinary conversation for the doctors who if you took me out of the mix probably averaged 70 years of age. But it was also literally the decade that biomedical ethics exploded. So over the course of that nine years on the Council we dealt with withholding, withdrawing life support from permanently comatose patients. We dealt with parental consent for sexually-related illnesses for teenage patients. We dealt with organ transplantation and consent and payment and those kinds of issues. It was an extraordinary time to be sitting in an organization that frequently ended up getting quoted as the AMA. It was Kevorkian, I guess, as well. But the AMA would get quoted, not the Council. But those opinions had all come from the Ethics Council which was originally five and ultimately nine individuals selected because of their expertise as physicians. Not because of their academic expertise in ethics. And it’s one of the few bodies that relies primarily upon clinicians as opposed to academically-trained ethicists.  \n\nYou were talking about how you were on the Board of Trustees and then were eventually elected President of the AMA. You were the first woman to serve on the Board and then become Chair and then also the first woman to be elected as President. So how did that feel to achieve both positions? \n\nIt felt very good. Those were all elected positions and were all hard-fought elections actually. The first sensation, having lost more elections in the House than I ever won, I lost an election to the Board and came back the following year and won it. So the first was pure elation, hallelujah, we actually did it. It was, in fact, somewhat difficult. And I never know whether it was my age because for this century I was substantially younger than the usual Trustee as well as the first woman. So I’ve never been sure whether it was because I was young or whether I was a woman or a combination. But I remember when the second woman was elected I think two years after me. She came in and we were standing at the foot of the Board table chatting. The then Chair looked down the table and said “My God, how many of these chairs do you want?” I think he was being funny but I think there was a little seriousness under there, too. You’re in droves all of a sudden. And so you did have to learn it’s a totally different kind of politics. The House of Delegates had at that time 450 members. And to run in an election you had to find a way to convince a majority of them to vote for you. It took some learning but I figured out that kind of politics. The politics in a room of 17 people is very, very different. So again, I relied upon looking around the room, deciding who I thought the best leaders in the room were and then inviting them to mentor me so I could move up tiers, if you will. For example, one of them said I’d like you to chair the Finance Committee. Why would I want to do that? What a miserable job. They said because you can’t be a serious leader if you can’t prove that you know what the finances are, you understand them, you can answer questions them and you can manage them. How true that was. They said you’ve got to carry some of the unfun water, if you will, before they’re going to give you the choice opportunities. Some of the social issues. I was married but I had children at home and my husband was working. So he rarely traveled with me. And frequently during the day the spouses, the wives would make dinner plans. Well, I didn’t have a wife at that table. So part of it was figuring out how as a young woman frequently unaccompanied, I made sure I didn’t get left behind the room service. I’m not sure anybody takes a young woman aside to say you’re a real threat. The guys’ whose wives don’t come don’t want to go home and have somebody pointing a finger that they’re forever going out to eat with you because unfortunately somebody will assume you’re doing more than eating dinner. And on the other hand, if the married folks whose spouses come all kind of pair off, that’s sometimes not really easy either because you have eight and you’re unaccompanied. So believe it or not, I’m relatively shy. I had to learn to be a lot more aggressive about arranging groups to go to dinner before I got to meetings so that I didn’t kind of fall prey to the spouses who weren’t at the meetings planning around me. I don’t think anybody ever intentionally...but I can remember actually asking, it was an Academy President, not the AMA President, said do you ever think about what those young women do? I said no. But if you put your arm around the guys and you head for the bar and you don’t make a specific invitation to the young lady, she may either assume you would rather she didn’t come or she may be shy and not know how to assert herself. It’s a totally different situation for a young woman, I think, than it is for a young man. The issues part is easier. The issues part is like being a good student. You do your homework, you decide which issues are important to you, that you’re going to speak out on, you learn to keep your ears open and your mouth shut so that...the last thing in the world you want to do is be the person that every time you open your mouth they roll their eyes because they think geez, that person has to say something about every issue on the table. So you pick the issues that you think are important to weigh in on. I think you have to learn to take a stand on issues that may not be the popular stand. When Bill Clinton was elected I can remember saying to people in some ways it’s reassuring because you could lick your finger and stick it up in the air. If you could make enough hot air, Clinton would do what opinion appeared to want him to do. Whereas a principled leader would have areas where it really didn’t matter that five out of seven or nine out of ten wanted him or her to do something. If it was based on a sound principle, they would stick to their guns. One of the important small group politics was somebody said to me don’t tell anybody you’ll support an issue or you’ll give them your vote until you’re sure where you are because it only takes once, when you said you would vote for somebody and you don’t, for you to have lost your integrity, their perspective of you. And that was good information. It’s true in even in a big election but it’s powerfully true in a small room where it’s reasonably clear who voted how. A real education. And chairing that Finance Committee probably helped me get the job as President of the whole thing. Because a solo practitioner who looked at $300,000 a year probably wouldn’t look real good to a $20 million a year organization. Being able to say that I had, in fact, been at the helm of a $250 million a year organization, that sounds a little better.\n\nWhat were you able to accomplish during your time as President through the AMA? \n\nOne of my greatest frustrations is that it’s hard to accomplish a lot in a one-year position. Even though it’s a three-year commitment, it’s one year that you’re at the helm. I believe that I was a substantive voice in terms of getting the AMA to acknowledge that we had to address the uninsured. It was one of my primary issues and it has finally come around to being one of the AMA’s top three issues. I believe I was able to carry a voice that the public heard as a compassionate physician. All too often I have heard that we sound like policy wonks and the average public, the average patient, wishes it sounded occasionally like we cared. And if there’s one skill I have, I think it is that I can take very complex medical stuff and translate it to common language. And I think I put that still to substantive use. I guess the third thing I would point to is, it was during my Chair of the Board and President years that we, at the AMA, moved the issue of errors in medicine and patient safety into position. It didn’t get the kind of national attention that we might have liked until the Institute of Medicine report came out in 1999. But we created the National Patient Safety Foundation in 1997. We testified about some of the things that needed to occur legislatively and policy-wise and I believe helped create the foundation that has led the last decade of emphasis on improving the safety and the error rates in health care delivery. So that’s not too bad, I guess, for a year’s work.  \n\nI saw something about you proposing a Patient’s Bill of Rights. Can you tell us about that? \n\nThis is starting the time the managed care was coming into full swing. Managed care does some things extraordinarily well. It integrates care and it helps identify possibly unnecessary care better than some other delivery mechanisms do. But as happens all too often when there are dollars involved, at least some purveyors of managed care also use the role of insurer to restrict patients’ access to some kinds of care and to some qualities of care that we thought were patients’ rights to have. And so in the late ‘90s, I guess it was about ‘97, ‘98, we created a piece of legislation called the Patient’s Bill of Rights which began to address some of the aspects of managed care that we thought were most damaging for patients. That in an emergency situation restrictions in terms of which hospital you could go to needed to have an out clause, if you will. Things that couldn’t be planned like chest pains or heart attacks. Patients needed to know their insurance was going to take care of their problems rather than potentially foregoing the care they were needing while they tried to jump through some artificial hoops. And ultimately many pieces of that legislation got passed and improved the protections for patients who all too often didn’t have a choice in determining the kind of health care insurance that they got, but rather got whatever plan their employer might choose for them. And so they were kind of the non-voting recipients while other people tried to save on their back. And it was an interesting time to try to educate Congress about the capacity of patients to make choices and the ability of doctors and nurses and others to lay out choices for patients and have them make educated choices. So that’s what was tied up in the Patient’s Bill of Rights.  \n\nWho are the people that you worked most closely in the AMA and what was your impression of those individuals? \n\nLike any elected organization, you had a constant changing face of who the individual leaders are. In fact, probably more so in organization like the Academy or the AMA because almost everything is term-limited. So unlike Congress where you have somebody that’s been there for 40 years, that’s generally not the case in organized medicine. But I worked very closely with Joe Painter who was Chairman of the Board and President of the AMA when I first came on the AMA Board. Joe is another Texan and a very soft-spoken, quiet leader with an absolutely 40 karat gold sense of integrity. He just unerringly did what was right for medicine and provided a voice of strength that was important because Joe was at the head of the Board table when we had some challenges in the paid leadership of the AMA in the senior staff. I think he was Vice Chair and then Chair. It took somebody with his sense of integrity to get an organization through a change of Chief Executive Officer when that wasn’t a voluntary change, if you will. I had a chance to work with a physician by the name of Leo Henikoff, a cardiologist from Chicago who was not an organized medicine person. He was an extraordinarily well-thought of clinician and an academician who was nominated to the Council on Ethical and Judicial Affairs. Leo, again, was one of those thoughtful people as we took on some of the most difficult ethics issues and attempted to write opinions that would essentially lay out the ethical guidelines for practicing physicians across this country. And he had a way of both hearing the perspectives from the then nine people around the Council table but also being able to kind of...we were trying to come to grips with withholding and withdrawing life supporting care. The question was where nutrition and hydration when artificially supplied. Not when somebody can sip out of a glass or eat off a fork. But when you have IVs or central lines or feeding tubes, was that medical treatment and could that be withdrawn from a patient the same way that a kidney dialysis machine could. And I can remember, again, Leo’s stalwart leadership as we dealt with tremendously difficult questions. If you had a child in the ICU from a head injury who was never going to wake up again, do you want the physician and nurses to continue to give them IV feedings and hydration forever? And the doctor in me said one thing but the mother in me said well, I’m not so sure. So Leo had a huge influence on me. John Tupper was the President of the AMA while I was on the Board. Dr. Tupper was the dean of a medical school at the time and his commitment to his students rather than just to philanthropy and buildings and programs certainly is one that I aspired to when I was the dean of the school and still find some of the most rewarding things I do is the opportunity to interface with the students. I think I could say almost across-the-board that the people that I had the opportunity to work with, whether they were paid staff or whether they were elected leaders that were there are among the cream of the crop. They are there because of their love of the profession, because of the desire to improve the profession and through the profession the provision of care for certainly all Americans and maybe all of the world. I could probably sit here all day and point to people that I aspired to, modeled some aspect of my behavior after. Good folks – because only good folks would give of their leisure time, their family time and their income creating time to do something for the good of the whole rather than for themselves.\n\nWhat would you say the AMA is doing better now than when you first started and what is it doing perhaps not as well as when you first started? \n\nI think the AMA is doing a better job of having diversity of leadership. There are meaningful roles for students, residents, young physicians, men and women. We are doing a better job of underrepresented minorities, though medicine as a whole has a long way to go. And unfortunately that means the AMA does as well. I think they are doing a somewhat better job of targeting a discreet number of issues so that they can have a bigger impact perhaps in a smaller number of areas. But it’s much better, I think, to have an impact in three areas than it is to be an inch deep and a mile wide. I think they are doing a less good job in looking at some of the issues that I think are important to the profession like professionalism and ethics because they’re spending too much of their time on the economics of health care. How physicians get paid, how much physicians get paid. They get involved in some of the interspecialty squabbles about who does what. And I think that as the voice of American medicine, albeit there are many voices with all the different specialties and geographic areas. The only voice that speaks across all specialties and all age groups is the AMA. And they should, in fact, look at the biggest issues. And they started out committed to education and ethics and I would like to see them get back there.  \n\nI saw that you’ve given numerous congressional testimony. Can you describe that? \n\nThat’s everything from exhilarating to absolutely terrorizing. I’ve blown up a time or two where you prep, you study, you have people ask you tough questions so you would be ready and you gave your five minutes of prepared testimony and they say thanks, bye. Once or twice where you didn’t even get to give your prepared testimony because they just kind of didn’t get around to it. That’s pretty frustrating. I’ve been there a time or two where something I said, and the one I remember most was Senator Moynihan of New York, we were talking about Medicare and how it paid for medical education. And I answered some questions and he kind of drilled me with those eyes of his and said “Have you got data to prove that?” Of course, you always had a couple of staff people with you. And I kind of turned and looked over my shoulder and they said we’ll get that. And I said oh God, I hope you really will. I have generally been treated courteously and an opportunity to present a perspective. Only once or twice been treated in a less than respectful manner. But it’s sometimes frustrating when you wonder if they are really listening or whether it’s a game you go through and you go up and say your piece and they’re busy planning what they’re going to have for dinner that night.  \n\n\nHow has family medicine changed since you became a family physician? \n\nI think medicine has changed. It has become increasingly subspecialized. And both the profession of medicine and our patients seem to have embraced the concept that every organ needs a doctor and that a generalist can’t possibly be as competent or effective as a left little toe doctor. I don’t think it’s good for patients. I’m sure it’s not good for the profession of medicine. And as the epitome of generalism, it’s not good for family medicine because we never intended to be the entity that knew the very most about the very smallest body of knowledge. But rather our training, our philosophy is to embrace not only the breadth of an individual patient and how their social and occupational and family aspects help contribute to wellness and disease. But even now how some families themselves can become, whole families can become patients and so forth. So increasingly subspecialized aspects of medicine have not been good for family medicine. I think we’ve become increasingly technical. We perceive we can no longer take the time to sit and listen to a patient and begin to narrow down what we think might be going on. So we do kind of a shotgun of x-rays and lab tests and evaluations, many of which we order before we even see the patient. And so we are turning out magnificent technicians but we have less and less respect and certainly dollars for physicians. William Osler is kind of the father of modern medicine and he said almost 200 years ago now, maybe 150 years ago, that if you would just sit down and talk to the patient, they would almost always tell you what was wrong. That hasn’t changed. What’s changed is our patients to listen to, and really listen to, the multiple levels the patients are communicating. It’s just so much easier to send them to the lab, to the , the  scanner and then hopefully you can put all the pieces together. But that’s not good for the patients. I had a colleague who was down visiting who said I was a terminal cancer patient for about three days. I looked at him and said there’s got to be a story here. He said I had some pain in my hip, and he happens to work as an administrator in a cancer research center. So, of course, in the good old American tradition it was hip, therefore that’s orthopedic. And he went down the hall to an orthopedic oncologist, of course, and said I’ve got this pain in my hip. The doctor said we ought to get an x-ray. And so they got an x-ray and said that’s a strange-looking thing right here, we ought to get an  of that. And so he got sent for an . I looked at my friend and said had this guy laid a hand on you yet or had you said anything to him beyond I have this pain in my hip? Of course not. So the oncologist read the  as this is almost certainly a tumor in the bone. And those are very bad tumors, especially in a middle-aged person. I’m not exactly sure why this guy backed off except that obviously then we were going to start doing things like biopsies and treatments. So he happened to go to his primary care physician and said I’ve got this pain and we have these x-rays and this . And the physician said let me take this over here, I’ve got a colleague across the hall who’s an orthopedist, a sports doctor kind of guy. And he took it over to the non-oncologist who said oh, I’ve never seen one of those in the hip but I see them all the time down in the ankle. He said that’s just an over-used tendinitis and some calcium deposits. He said I think if you take a little Advil, you probably could cure that. So he went from being a terminal cancer patient to six weeks of Advil and a little ice and a little heat and the x-ray cleared up. So I think only in America would you start with the oncologic orthopedist and work backwards to the generalist. That’s not good for family medicine. And to some good we, family physicians, have bought into it. You come in, I narrow your complaints down to a body system and I write you a referral to the appropriate organ doctor. And so I think we need to re-evaluate what patients want from primary care and what attracted us into primary care. Every family doctor has a little bit of a missionary in him, otherwise you wouldn’t choose a poorly-paying, hard-working specialty in generalist. But I think family medicine has changed and not for the better. I would like to go back and try to embrace the things that were powerful in 1970.\n\nWith all that in mind, what’s your sense of where family medicine is headed for in the future? \n\nWe did a superb thing in the Future of Family Medicine study and we, in fact, outlined many of the things that we need to do not only as a specialty but as a profession in health care delivery in the United States. I think we need to make sure that we imprint that in all we family physicians’ heads. And in turn we need to imprint that on academics’ heads because we are training tomorrow’s physicians. And we need to do whatever it takes from marching on Washington to writing checks to the right kinds of leaders to try to be sure that this next wave of health care reform, because I think it’s coming and soon, in fact embraces the concepts that were in the Future of Family Medicine report. It talked about a medical home. Not a family physician for everybody but a medical home that was going to help you navigate this complex system. It talked about the importance of physician-to-physician communication. But it also talked about the team and the fact that not everybody on the team has to be a doctor. If we properly utilize nurses and pharmacists and social workers and even home health care workers, we can spend a lot less money for a lot more care that probably makes everybody, from the person paying the bills to the patient to the family to the health care workers, much more satisfied with what we do. So I think probably the foundation stones for what family medicine means were, in fact, appropriately identified and laid out in the Future of Family Medicine report. But I think we have a lot of frustration ahead of us as we try to move the model that is American medicine to a more functional system that just happens to be one that will be much friendlier to primary care.\n\nDo you have any views on important issues in the specialty that we haven’t addressed yet that you would like to share? \n\nYes. I would say maybe we addressed it, and if I’m hammering old ground I apologize. I really believe that moving the modelist of American medicine is in fact a huge challenge.  But modifying our own specialty in the ways laid forth in The Future of Family Medicine should be much less difficult.  And so just like a lot of other things, we’ve got to take care of our own family first, that being the profession of family medicine.  I think we have to understand the importance of continuity to our patients.  And even as young men and women are coming out of medical school and struggling with how to have more of a personal life than perhaps my generation did, although I had a pretty good one, but to have what they perceive to be more of a personal life and still provide quality continuity of care - we’ve got to find a way to do that.  A white coat is not a white coat.  When doctors go in they get treated differently than other people.  So they probably don’t experience the same discontinuity that our patients do.  And so if we want to be able to work only half as hard as my generation worked, maybe we should take care of fewer patients instead of working two days a week.  People don’t get sick two days a week. If we want to spend more time in our offices then we need to work with our hospitals to say okay, maybe there is an advantage to having a cadre of physicians who care for patients when they’re in the hospital.  But if that’s the case then must find the mechanism so our patients don’t feel abandoned by the health care provider who has invested the time to know who that patient is.  Whether that’s a social visit or whether that’s electronic communication or whether that’s making darn sure I get a detailed copy of what happened and what decisions were made while that person was in the hospital, I’m not sure I have the answer.  But I can tell you that for patients, we cannot continue to say to them continuity in a medical home as long as it doesn’t impact my lifestyle.  So I think the first thing we have to do is we have to grab the lapels of family medicine and say quit preaching and start doing it.  \n\nYou’ve held various leadership positions throughout that we have talked about. Can you describe your style of leadership or your philosophy of management and how you developed that?   \n\nI don’t know how I developed it. It just happened.  It just evolves every time. I try hard to be a delegater and to encourage people to tackle as much as they’re capable of doing. I think part of a leader’s job is to nudge people to reach a little further and stretch a little higher. I would like to think one of the skills I brought from family medicine to leadership positions is the capacity to listen. I have usually thought of myself as a fairly hair-triggered temper. I was immensely proud the other day when one of my staff came in and said I don’t know how you sit there in these meetings and keep your cool when all this stuff is going around. And I thought wow, I must have learned something along the years. I think you have to listen. And then, again, I think a leader’s job is to either create a consensus or ultimately to make a decision if you can’t get a consensus, how do you make the call. I think a leader’s job is to be a little bit of a cheerleader and a little bit of a disciplinarian. And probably the piece I enjoy the most is a leader’s job is also to be somewhat of a visionary. So when you’ve got people who are working very hard to kind of get through the next block, hopefully you’re standing up on the bluff and saying you know, if you can just hang in there and keep going, there’s a lake out there or a seashore. You know, we’re headed that-a-way. And to me in many ways that’s the fun part. No world is perfect and no job will be without its challenges. But to always know where you’re headed, at least for now, and to help folks plan a route that will get you there is what leadership is all about. And that’s kind of fun.\n\nWhat would you say your biggest satisfaction from the experience of working in medicine would be? \n\nIt probably still has to be being able to say I made a difference here. So when I look back at taking care of patients, the ones that are easy to make a call on are I was standing there and that person is alive. Thousands of other people might have been able to do it, but I was the one standing there. And as a result that person is alive and that one is alive. Most babies deliver themselves. But once in a while if the right trained person is not standing there, a mother or a baby wouldn’t have made it. It’s a cool feeling. Again, I’ll jump forward to where I am now. I don’t believe it’s me; I think it’s an opportunity for a team of leaders. I just happen to have the honor of being the captain of the team, if you will. We are in the process of physically building a new campus. Wow, how cool to come back when I’m hobbling along as an old person and say I was there when we dreamed this up. We are creating new colleges. And that means that 20 years from there will be nursing students and pharmacy students and even medical students who will enter the helping profession as a result of things that I had an opportunity to be involved in. That’s pretty cool, too. And then AMA, lots of endless meetings. And that’s very frustrating because I missed a ball game or I missed a kid’s performance in a play. But often enough I could come back and say we made a difference. We changed the process of physician review in the state of Texas so it was fair for rural physicians. That felt good. We created some ethics policies that meant physicians would have reasonable principles and guidelines for making some of the toughest decisions they will ever have to make. And I had a chance to be at that table. That felt good. So every step offers different things to look back on, but those are some of the things I’ll probably remember the most.\n\nAre there any last areas you would like to talk about? More about your work in education or more about any other organizations you were involved in? Or just anything in general as your last opportunity to share your thoughts with future generations listening to the tape or set the record straight on anything you feel is important to address? \n\nI have now spent 30 years in medicine. And during a lot of that I’ve heard colleagues say oh, I would never want my children to go into medicine. I think probably what I would want to say is give me your kids for a day or a week or a month because I can’t imagine a better place to be. I’ve had a chance to participate with summer programs for kids who think they want to be doctors. And I can say to them in all honesty, what a magnificent profession. You can certainly take care of people. But you can also be an educator. You can be an administrator. You can be a researcher. You can change jobs a dozen times without ever having to go back to school. You can practice this profession anywhere in the world you want to go. I’m sorry the woman got breast cancer, but I must tell you that I’m a little envious of the family physician who went down to Antarctica and was going to provide their health care for six months. Well, you’re snowed in, you can’t go anywhere else. You can go to exotic countries or you can go to rural . I can’t imagine that there is any other profession that one could get involved in that would offer the extraordinary life experiences and opportunities to make a difference that I’ve had in medicine. So I hope I’m not done with this trip yet. Hopefully, 20 years from now I will have added a few more experiences to it. But for me, I would be thrilled if any of my children had chosen medicine and would encourage anybody who has the least thought they might want to be here to give it serious consideration because it’s a great place to be.  \n\nAnything else you would like to add? \n\nNo, we could talk for hours but...\n\nThank you so much for your time. It’s been great to hear about your experiences. \n\nThank you. I appreciate that. And if there are other things we can do, let me know. Otherwise, let us know where the oral history will be so we can hear what other people might have said.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025#t=660.0,3778.6275"}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025/transcript/85347","type":"AnnotationPage","label":{"en":["Dr. Nancy Dickey Interview Summary [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025/transcript/85347/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Interviewer: Lindsay Young\n\nInterviewee: Nancy Dickey, MD\n\nDate: July 16, 2007\n\nNancy Dickley, M.D. acknowledges that she has been “extraordinarily lucky to have done a number of things that women hadn’t had the opportunity to do before.” Included among these are her firsts as Chairman of the American Medical Association’s Board of Trustees as well as the Association’s President. Before being elected to these positions, she served nine years on the Council on Ethical Affairs and chaired the Finance Committee. \n\nToday she serves as President of the Texas A\u0026M Health Science Center and Vice Chancellor of its University System. Her 30-year career in medicine began in private practice that included obstetrics with 4,000 plus babies delivered during 20 years. She served as a medical director for a community clinic that became a Federally Qualified Health Center. Dr. Dickley’s next position took her to College Station, Texas, where she was the Founding Director of its residency program for four years. \n\n“The medical profession is a magnificent profession,” says Dr. Dickley. “You can take care of people, be an educator, be an administrator, do research, and practice it anywhere in the world.”","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295025#t=0.0,3778.6275"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295024","type":"Canvas","label":{"en":["Media File 2 of 2 - DickeyNancy_02_Access.mp3"]},"duration":1717.7715,"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/162262/file/295024/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295024/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/295/024/original/DickeyNancy_02_Access.mp3?1760546291","type":"Audio","format":"audio/mpeg","duration":1717.7715,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/162262/file/295024","metadata":[]}]}],"annotations":[]}]}