{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/639k35p63n/manifest","type":"Manifest","label":{"en":["Dr. Roger Lienke"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Description"]},"value":{"en":["\u003cp\u003eThanks to Dr. Roger Lienke, “We can now develop our teaching  programs more appropriately geared to the actual clinical practice.” He was one of the forerunners who set this motion in action when he started to develop family medicine residencies. It began on July 1, 1966, when he accepted a “calling” to present his “plan” in Oklahoma City at the University of Oklahoma’s Medical School. By 1967, a model clinic was built. By 1968, three residents were recruited. By 1969, guidelines were established for a family medicine residency which was one and a half years before nationwide guidelines were created. His program, which was recognized as a model clinic, was one of the first four in the nation. Today, the clinic employs 200 professional and support staff. Dr. Lienke’s efforts continued into the 70s at the University of Alabama Medical School in Huntsville as well as the University’s Branch in Anniston. Today, he holds the title of Clinical Professor Emeritus of Family Medicine from the University. \u003cbr\u003eAfter a stint in the US Army Medical Corps and, then, three years as a professor of pediatrics, Dr. Lienke decided that he was ready to go out into practice. He did so by spending a year in Minneapolis, Minnesota, at St. Louis Park Medical Clinic, a multispecialty clinic. Then from 1955 to 1958, he went solo as a pediatrician. By 1966, he had developed a five-man, well-balanced general practice in Robbinsdale.  He returned to this love of family medicine from 1977 to 1983, when he moved back to Oklahoma City to open a solo practice. Then he was asked to develop a family practice clinic in a large, local hospital where he stayed until retirement in 1989. But, retirement was short-lived. From 1999 to 1992, he practiced rural medicine “full tilt” at the Cook County Community Clinic in Grand Marais, Minnesota, where the Ojibwe Tribe Indian Reservation is located. He and his wife, Nancy, resided on the Indian village until 2004 when they returned to Oklahoma City to be near family.  \u003cbr\u003eToday, at age 88, Dr. Lienke recalls that one of his main reasons for starting the residency programs was to train doctors to replace the dwindling numbers of general practitioners. He believes that the family practice residency programs are helping to fill that gap.  \u003c/p\u003e (summary)"]}},{"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":["2010-08-26 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Don Ivey (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","American Academy of Family Physicians","family physician"]}},{"label":{"en":["Subject"]},"value":{"en":["Roger I. Lienke, MD (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"summary":{"en":["\u003cp\u003eThanks to Dr. Roger Lienke, \u0026ldquo;We can now develop our teaching \u0026nbsp;programs more appropriately geared to the actual clinical practice.\u0026rdquo; He was one of the forerunners who set this motion in action when he started to develop family medicine residencies. It began on July 1, 1966, when he accepted a \u0026ldquo;calling\u0026rdquo; to present his \u0026ldquo;plan\u0026rdquo; in Oklahoma City at the University of Oklahoma\u0026rsquo;s Medical School. By 1967, a model clinic was built. By 1968, three residents were recruited. By 1969, guidelines were established for a family medicine residency which was one and a half years before nationwide guidelines were created. His program, which was recognized as a model clinic, was one of the first four in the nation. Today, the clinic employs 200 professional and support staff. Dr. Lienke\u0026rsquo;s efforts continued into the 70s at the University of Alabama Medical School in Huntsville as well as the University\u0026rsquo;s Branch in Anniston. Today, he holds the title of Clinical Professor Emeritus of Family Medicine from the University.\u0026nbsp;\u003cbr /\u003eAfter a stint in the US Army Medical Corps and, then, three years as a professor of pediatrics, Dr. Lienke decided that he was ready to go out into practice. He did so by spending a year in Minneapolis, Minnesota, at St. Louis Park Medical Clinic, a multispecialty clinic. Then from 1955 to 1958, he went solo as a pediatrician. By 1966, he had developed a five-man, well-balanced general practice in Robbinsdale. \u0026nbsp;He returned to this love of family medicine from 1977 to 1983, when he moved back to Oklahoma City to open a solo practice. Then he was asked to develop a family practice clinic in a large, local hospital where he stayed until retirement in 1989. But, retirement was short-lived. From 1999 to 1992, he practiced rural medicine \u0026ldquo;full tilt\u0026rdquo; at the Cook County Community Clinic in Grand Marais, Minnesota, where the Ojibwe Tribe Indian Reservation is located. He and his wife, Nancy, resided on the Indian village until 2004 when they returned to Oklahoma City to be near family. \u0026nbsp;\u003cbr /\u003eToday, at age 88, Dr. Lienke recalls that one of his main reasons for starting the residency programs was to train doctors to replace the dwindling numbers of general practitioners. He believes that the family practice residency programs are helping to fill that gap. \u0026nbsp;\u003c/p\u003e"]},"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281720","type":"Canvas","label":{"en":["Media File 1 of 2 - Lienke_Rogers_10_a.wav"]},"duration":3578.77929,"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/153063/file/281720/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281720/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/720/original/Lienke_Rogers_10_a.wav?1752093138","type":"Audio","format":"audio/wav","duration":3578.77929,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281720","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281720/transcript/81621","type":"AnnotationPage","label":{"en":["Dr. Roger Lienke interview transcript  [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281720/transcript/81621/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"My name is Don Ivey, and I am the Manager of the Center for the History of Family Medicine.\n\nToday [is August 26, 2010 and] we’re speaking with Dr. Roger Lienke. Dr. Lienke, you are currently in Oklahoma, is that correct?  \n\nThat’s correct.   \n\nWe’re speaking by phone, we’re going to do an oral history today. Could you give us your full name, first of all?\n\nRoger Irving Lienke. \n\nYou’re presently retired, is that correct?  \n\nYes.\n\nWhat was your former title? You’re Professor Emeritus, is that correct?\n\nAt the present time I carry that title, Clinical Professor Emeritus of Family Medicine, University of Oklahoma. \n\nAnd you retired in 1991, is that correct?\n\nRight. \n\nLet’s start at the very beginning. Can you tell us when and where you were born?\n\nI was born in the little town of Lakefield in southern Minnesota, November 26, 1922. \n\nCan you tell us a little bit about your family, what you did and a little bit about your childhood and growing up?\n\nMy first three years were in the town where I was born. My dad had finished law school and was practicing as an attorney in that little town of Lakefield. We moved to a town nearby when my father was elected to the office of Judge of Probate for Jackson County. We moved to the town of Jackson, which was fifteen miles away and that move took place in about 1925. We were there until the end of that job as Judge of Probate. He lost in the 1936 election and we moved to another town, Windom, close by, where my dad opened a private law practice. That’s where I went to high school. From there I went on to pre-medical school at Macalester College in St. Paul, Minnesota; and then to the University of Minnesota in Minneapolis for medical school in the spring of 1943. \n\nAt what point did you become interested in becoming a doctor and a physician and specifically how did you get involved in general practice?\n\nWell, I went into the field of medicine in a way that was quite different from virtually all the other stories I heard about how students grew up in a medical climate, made house calls with doctors, worked in hospitals…all that sort of thing. For me it was just backwards. I remember the summer between my junior and senior year of high school. I thought, I’ve got to get serious about what I’m going to do when I go to college. I’d better have some idea what I’m going to do in life. I started by eliminating all those things that I did not feel comfortable with or that did not appeal to me or didn’t seem to fit me. I pretty well went through all the vocations and I guess medicine was about one of the last ones. I couldn’t find any reason why I should not be a doctor. So that was it…I said, well, I’ll be a doctor. \n\nAt that time you had no idea what you were going to do with your life?\n\nThat’s right. I was a good student, I was at the top of the class and I thought, I’m free to make virtually any choice I want to and I knew that I was going to work most of the way to get myself through school; it wasn’t a matter of money either. You asked about general practice. I went to Macalester College for the pre-medical years and medical school at the University of Minnesota. Both were accelerated because of World War II. I started Pre-Med in September of 1940 and graduated from med school in March 1945…no vacations, and streamlined courses. I guess it was about the start of the senior year I thought, I’d better make a decision which field of medicine I’m going to go into because all of it seemed interesting to me. I had conversations with the Chief of Pediatrics, Dr. Irvine McQuarrie, because he was the father of my wife’s best friend. I went to him for guidance and help in deciding what area of medicine would seem to be most appropriate for me. He talked me into joining his department. I thought, well that’s good; he’s honoring me by asking me to train in his department. In those days in the university hospital, you had a straight internship and then into the rest of the residency. So I started as an intern in Pediatrics and continued right on through the residency and finished it successfully. Most of us went through medical school as active duty members of the Army or Navy Specialized Training Programs. Whereas my classmates went off to either the Army or Navy on active duty after they finished the first year of graduate training (internship), I continued in the residency without interruption because I had been declared 4F, having gone to the emergency room a number of times for the treatment of asthma and that got on my record and I was no longer physically qualified. At the end of my residency I volunteered to go into the Army because I thought that my physical problems were sufficiently under control so that I could easily qualify. The Defense Secretary was asking for volunteers because the Korean War was starting, and I was accepted into the Army. I went on active duty in the Army Medical Corps and spent one year in New York at Fort Hamilton on the Pediatric staff, and one year as the post Pediatrician in Kansas at Fort Leavenworth at the Command and General Staff School and the War College.   \n\nAfter I got out of the Army, a good friend of mine asked me to come to Galveston, University of Texas Branch there in Galveston, and join the faculty in their Department of Pediatrics. He had worked with me as a resident in Minnesota go he knew me. So I went there and I was there for one year; but I thought, I’m not really cut out for the academic life. It was an interesting experience but I thought, I probably would do better in private practice in pediatrics. I started looking around and inquired for information from Dr. Charles May, with whom I had taken part of my residency in Minnesota. Charles May had gone from Minnesota down to be Chief of Pediatrics at the University of Iowa in Iowa City. When he got my letter asking for help, he said, “I don’t think you should go out into practice, I think you should come to Iowa City and be on the staff here. Don’t give up on academic life yet.” Nancy and I thought that sounded okay.\n\nNancy is your wife?  \n\nNancy is my wife. We were married between the junior and senior years of my medical school. She was a nurse.\n\nSo we went to Iowa City and I was on the staff there as an assistant professor of pediatrics for two years from 1952-1954 and then I thought, no, now it’s time for me to go out into practice. I joined a close friend of mine and some other buddies who were starting a multispecialty clinic in Minneapolis; actually a suburb of Minneapolis called St. Louis Park Medical Center. There were fourteen members at that time. I joined my buddy up there in their Department of Pediatrics and I practiced in that clinic for one year and went out to my own solo private pediatric practice in 1955. I continued to do that for three years. My practice grew rapidly and I took a partner. We had a successful practice but I became restless in that I had ideas about care of the whole family. We functioned as general pediatricians. My partner and I did consultations for other folks in the hospital near our office but it was not high-level consultative work. Most of our work was our own private practice. I was able to see more and more as I went through the months of that experience that I was not getting the picture. I felt handicapped because I was working just with the mother and the baby and I didn’t have a picture of the rest of the family and I knew that’s where the action was.   \n\nI’ll go back just a little bit and recount this. In my senior year in medical school there was such a shortage of house officers because of the war that the faculty asked for volunteers from our class…would anybody be interested in helping out the coverage at the intern level? I was one of those that qualified for that so I spent my senior year of medical school rotating through various services in the hospital as an actual intern. Although I was a substitute intern, I was able to function as a regular intern. So I had a rather complete rotating internship as a senior medical student, including delivering babies. I would take the streetcar over to a small hospital in St. Paul for unwed mothers who had been living there ,which was quite a common pattern in those days. We’re talking about in the early or mid-40s. I would go over there as a medical student and deliver those babies. Of course it was relatively easy to do because as is so often the case, hospitals like that are run by very experienced nurses and they would help me through any kind of difficulties and I never had any accidents or anything like that. \n\nBut there were no physicians present when you delivered?  \n\nThere were no physicians present. It was great experience for me and then I delivered some babies right in the university hospital as well, which was a good experience. I also assisted in delivering in another hospital where an advanced resident took me under his wing and showed me lots of things about obstetrics. Also, I would scrub in on surgeries and things like that.   \n\nGetting back to my transformation in pediatrics, I was in that practice with my partner from ’55 until ’58. At the end of that year I said to my partner, I need to expand into general practice. We were still pretty much using the word general practice. I don’t think we used the word family practice much at all then. I asked him if he would like to join me in doing that. He was a very skillful guy, but he said no, he would stay in the pediatric practice and so I set up my own office…and opened it overnight…for general practice and I felt comfortable and I literally did it overnight. On November 10, 1958, I was a pediatrician and on November 11, 1958, I was a general practitioner in a different office. Most of my patients came with me and it wasn’t long before the mother of one of my pediatric patients said, would I please deliver her baby? My practice grew and it grew rapidly. I added one partner after another. So from 1958 to 1966, I developed a five-man general practice. By then we were beginning to use the word family practice some. This was in the suburb of Robbinsdale, which is almost a part of Minneapolis, so it was a metropolitan type of practice. We delivered babies and assisted in our surgeries and did our own minor surgery in the office and had our own x-ray and did a fair amount of laboratory work right in our office.  \n\nIt sounds like you didn’t find the transition from pediatrics to general practice difficult at all, is that correct?\n\nThe only thing that was difficult at all was I felt just a little bit awkward dealing with the males, which is one of the reasons why I wanted to go into general practice because I wanted to work with the whole family. I wanted to have a better experience with the adult males. So that was a challenge but it was a welcome challenge for me, and it was welcomed by the families that followed me. I had many interesting comments about going from pediatrics into general practice. A lot of those comments were that I was going backwards by going from a specialty into general practice and I said, “No, I’m just expanding my practice…I’m not going backward.” Another comment would be something like, “Well, now you’re going to be a real doctor.” I actually felt that way; and the practice grew as a well-balanced family practice and we had a good time and we did very well. Then it was interrupted and that’s as far as I’ll take it until you ask me some more questions. \n\nThis might be a good opportunity to ask you, at the time that you got into general practice, what was the world of medicine, general practice like back then as opposed to nowadays?\n\nIt was what you’d call typical general practice, typical medical care for families throughout the communities of Minnesota. In those days, of course, farming was still very prominent. There were family farms…like half of my high school class was made up of farm kids. The rural scene was still very active and almost all that medical care was done by general practitioners. Then, of course, there were general practitioners all through the cities as well. Most of the specialists were in the big cities. I would say in the late ‘50s, general practice was still thriving and doing all right. Getting into the ‘60s it began to dwindle and that story is so big and so common that I don’t have to go into detail. It became clear that a problem was developing. There were not enough doctors out there to take care of the people in primary care. Of course, general internists and general pediatricians were covering a lot of primary care in the larger cities, but in all the small cities there were no general internists or general pediatricians. It was just the general practitioners.   \n\nI was busy, very busy, but not so much so that I turned down an opportunity to volunteer to help out in a clinic over at the university hospital. It had to be in the pediatric clinic; so I functioned as a pediatrician and then moved from there into what was called an experimental project called a comprehensive clinic for adults and children. I could see that there might be something possible for the training of primary care doctors in the offing. In 1964 I wrote a letter to the Dean of the medical school. I knew him because he was a resident in medicine when I was rotating through his service when I was a senior medical student. \n\nThis is the Dean of the University of Minnesota [Medical School], correct?  \n\nRight. The gist of that letter was: General practice is not being represented in the University in any form. Medical students, residents, the staff, they do not see general practitioners at all. The only relationship they had was to the L.M.D. – the Local Medical Doctor – who sent patients into the University when they were too complicated or when they didn’t have enough money. I made some suggestions on developing an outpatient facility that would be for primary care of folks just the same as the doctors throughout the state were giving care. He was interested enough and polite enough so that he gathered some of his faculty and held a luncheon and I presented this idea that there should be participation and visibility of general practitioners because that’s where half the care of the state was going, and they were not being represented at the University in any way. I did suggest at that time that a special clinic be set up and run by general practitioners who had some sort of role in the faculty. They listened to what I was talking about, but the Dean got up before the luncheon was over; he had an “urgent matter” in his office and he had to leave. Whether he really did or not is always a question on my mind. I think he did not. That was in 1964. It was not a surprise to me at all that he acted that way, having come up in the standard internal medicine ranks; there is no way in which he was going to depart from that tradition. I continued in my practice. Then in 1965 there was a big change. I don’t know if you want me to go further. \n\nTell us about that.\n\nIn the spring of 1965 I got a telephone call from my friend…dating back to medical school…by the name of Jolly West. Jolly West is a famous name in Oklahoma City. He was then the Chairman of the Department of Psychiatry and Behavioral Sciences. He was three years behind me in medical school. One of the most outstanding things I remember in my association with him was that he and I engineered a movement in which our medical fraternity developed its own eligibility rules for who was going to be allowed into our fraternity. Whereas, before it was only gentile white males. We ignored our national chapter and opened our fraternity to anybody who was academically qualified. That had a snowball effect and it wasn’t long before the sororities and fraternities on the campus of University of Minnesota had open eligibility; and discrimination ended. \n\nWhat was the name of your fraternity?\n\nPhi Rho Sigma. We remained friends with Jolly and his wife, Kay. Jolly had his psychiatric residency in New York and I saw him out there a number of times when I was in the Army at Fort Hamilton in Brooklyn and Jolly was at Cornell Hospital. He was on the phone with me then in the spring of 1965 and asked if I would come down. “Jim Dennis and I have been working on an idea and we’d like to have you come down and take a look at our place and see if you can do something about our general practice graduate program.” He didn’t quite know what he was asking and of course I didn’t know either. James Dennis was the Dean of the Medical School at the University of Oklahoma where Jolly West was. Jim Dennis was a friend of mine. I got to know him well in Galveston, Texas. He was a charter member of the American Academy of General Practice, practicing in Modesto, California. He left that practice to go into a pediatric residency at the University of Texas in Galveston. I was the instructor in pediatrics, now teaching this seasoned general practitioner who was there as a resident in pediatrics. We became good friends. That led to his joining with Jolly West to see if they could get me to come down from my practice to look at their medical school and see if something might be developed for training in general practice. And I came down. \n\nOne question comes to mind from what you’ve said. Why do you think your ideas were received so much more favorably in Oklahoma than at your alma mater?  \n\nThey weren’t necessarily received favorably. Jolly West himself was a brilliant man with great foresight and he understood the problems of the primary care physician and he understood the nature of illness and what health care really represented and what it was for and what directions it should take. To wit, his department was called the Department of Psychiatry and Behavioral Sciences. He surrounded himself with clinical psychologists and developed a big program in biopsychology that continues to do well and is famous in the country. He was just a broad-thinking, skilled person who understood that there was something about general practice that needed to be developed and changed. Jim Dennis knew that as a responsible head of the medical school, he needed to turn out some doctors for Oklahoma’s people. The state of Oklahoma was getting to be just like any other state at that time, this is now in 1965. The general practitioners were getting older, some were quitting, some were dying, and they were not being replaced. He said, “We need to do something about this.”      \n\nThe wheels don’t always turn very fast in a university. Time sort of went by, the months went by and then in September of 1965, Jolly was on the phone again and said, “We’ve been working on this and we really would like to have you come down now and take a look at our faculty and have them talk with you and see if there’s something we can do.” Nancy and I went down there in early October. That was a typical university-type visit where I went around and met different faculty people in their offices and they had a chance to look at me and I had a chance to look at them and they didn’t know what I was talking about. I knew what I was thinking about and I couldn’t say very much at that point but I did give them some general ideas of what I was up to. Here’s an example of where the faculty was: I sat down in the office of the head of the Department of Obstetrics and Gynecology and he leaned across the desk and he looked me in the eye and he said, “What are you doing here? I don’t believe in general practice.” I said to him, “Well, Dr. Merrill, I think that this school is to be congratulated with coming up with the idea that there’s a problem in general practice and that something should be done about it. And, as a university that’s putting out doctors the people need that they are looking into some way in which they can do that.” That was the best answer I could give him. I was prepared to give them a speech; but I didn’t have to do that. I gave enough ideas about my plan for what to do that by the time I left in a couple of days, they obviously had a favorable opinion of me and I thought that maybe I should do it. When I say I had a program plan, I had worked on the theory of family medicine, what primary family health care really consisted of, and how it should be taught. Some of my ideas and preparation came from my wife who was a cultural anthropologist. She was working in the field doing research at that time on an Indian reservation on a medical topic. I’ll just say briefly that she was studying the ideas that people had about health care and their experiences. Her methodology was basically phenomenology. Empathy in action is an easier way to say it. The theory and content of family medicine and related educational plans became more organized as I understood culture and the place of families’ health matters within cultural patterns. Of course, with the Indians, there is no separate activity called medical care. Everything is just one integrated composite of all of life’s activities: health care, social customs, religion and spiritual ideas, socioeconomic affairs, and recreation. I’ve given you just a little bit of an idea of the type of thinking that I was able to absorb and to learn and I realized that’s exactly what I was doing. That’s the reason why I went from pediatrics into family medicine because I wanted to see people in the context of their lives because that’s the basic principle of family medicine. It’s one of the three parts of the definition of family medicine. First, family medicine is the care of the whole family. Secondly, family medicine is the care of individuals in context…their world view and their total life situation, their nuclear family, their extended family, their larger community and the whole community of medicine. The third part: Comprehensive and continuing care requires the use of the whole “family” of health care workers. Most of them are nurses and doctors but it also includes the minister, the psychologist, the pharmacist, the neurologist, the radiologist, and so on.    \n\nThat general theory was the basis of my approach, and then there was the educational methodology. By the time that I arrived in Oklahoma City, I already had the plans laid out for the construction of the center of the training of family physicians and that is the model clinic. I felt there was no way to train or educate family doctors unless they had a laboratory and the laboratory of course was the clinic in which they were going to work the rest of their life. I had plans for the model clinic before I even met with the faculty on an individual basis for that first visit. Nancy and I thought about it hard and we talked with our kids, we had four children. It was just clear that this was something that we needed to do. My practice was going very well, it was very stable, and the five guys in our partnership had a very satisfying family practice; but this was, I guess you’d say, a calling. It was just too exciting to turn it down. This is kind of a humorous way of making a serious point. Nancy’s good friend, Katharine Densford, who was the dean of the School of Nursing, said to Nancy, “What kind of money are they offering?” Nancy wasn’t even able to tell her because she couldn’t remember that point. The actual fact was – at the time of my visit – there wasn’t any money ready for me. Later, there was $24,000 and that was the only money that was available at the time I said I would come down. That was to cover my salary and the salary of all my staff and everything that was necessary to run a program in graduate training of physicians for general or family practice. So some people would say it was kind of insane; but knowing that I had such strong support from the Dean of the medical school and people like Jolly West, I just was confident that some way they would find the money. I came down and I arrived here July 1, 1966 and there’s a different history from that point on. \n\nWell, would you like to get into that a little more now? First question that comes to mind is, how did you find the money?\n\nIt wasn’t easy. They started putting together a bond issue because it wasn’t long after I arrived here that I was able to spot a place where we could actually build a building and the lot had to be rezoned. It was right on the edge of the medical school property. It was rezoned for medical, to be included in the medical center. I had a spot there where we were going to build the model clinic…right on university property. They started a bond issue and then we got $5,000 from the local general practice group and got $25,000 from one of the drug companies, then there was another foundation. We gradually put together money so it wasn’t long before we were actually making plans. The building was started in late 1967, and by 1968 it was finished. We had purchased the land and on the edge of that lot was another lot that had a house on it. I changed the house around a little bit and actually opened a temporary clinic in that house called the University Family Medicine Clinic. That name was across the front of the house. I was beginning to see patients. I had one nurse to help me. She actually wasn’t a nurse, she was sort of a jack of all trades. We started seeing a few patients and then it grew and continued to grow. By the time 1968 rolled around, the clinic was finished and, as I remember, had twenty examining rooms, x-ray unit, a laboratory, conference room and the other stuff that goes into a clinic. I started looking for residents before that time. In May of 1968 our first resident arrived. We had another one added in July and another in September. So we had three residents that started that residency in 1968 in the summer, which was roughly one and a half years before the guidelines for creating a family medicine residency even came into existence. It was, of course, at that same time in late ’69 that family medicine became a new specialty. \n\nWe can move on to one of the points you suggested we talk about: what were some of the biggest difficulties? Well, one of the difficulties was starting a family medicine residency program before there were any ideas how to run a family medicine program because nobody knew what we were supposed to be doing. But some of us had the basic ideas. All you needed to get started was some experience in family practice and education. You know what you want to teach; so you get a clinic that serves as a proper place for doing that kind of teaching. \n\nIn this period of time, you kind of indicated that because of the lack of any kind of uniform standards at this point, I guess residency programs and family practice were kind of run by the seat of your pants. Was there much networking or were people starting to network from other institutions to try to get ideas together? How was that going on?\n\nThat’s a very good question because without that very phenomenon I don’t think any of us could have psychologically survived. Certainly Lynn Carmichael is the one that we have to give thanks to for that kind of development of community. The first conference that I went to was in the holiday season 1966, it was a half year after I arrived here. Lynn got it together, I don’t know what he called it ---- seminar or what; I don’t know if the word family medicine was in it; but he brought people from various places who were already beginning to do things such as we were planning. There were two or three guys from Canada and perhaps eight or ten from the United States. As I remember, it was about a three-day seminar which included some demonstrations of what he was doing with medical students to get them interested in going into general practice or family medicine. One of the teachers in that seminar was Hilliard Jason. That’s’, of course a well-known name in family medicine. Hilliard Jason is one of the leaders in educational methodology for our programs. That to me was a very important conference. Then there were other conferences where ten or twelve people would get together; you could see that the interest was growing. Of course, it was not surprising then because in 1966 the John Millis Report came out and also in 1966 the Ad Hoc Committee of the American Medical Association published its report, the Bill Willard Report. In those two reports it was very clear, “Let’s get going folks; we need family medicine; and this is roughly how we do it.” There was pretty good support from the thinking people from the American Medical Association. It was an ad hoc committee, and that was led by Bill Ruhe. Our own Dean, Jim Dennis, was starting to attend those meetings in ’65 and ’66. In February of ’66, four months before I arrived here, I came down to show Jim Dennis and Bill Schottstaedt my plans. I had written out much of the theory of family medicine by that time, and I showed them the plans for a model clinic. The outline of how we were going to construct the program and where it would be taught was on paper by early 1966 before the Millis Report and the Ad Hoc Report came out. Jim Dennis said that he was convinced that the committee took the ideas that he got from me, and those ideas became part of the Ad Hoc Willard Report. Maybe so, maybe not. In a sense, it doesn’t make much difference whether our Oklahoma program had something to do with that or whether it did not because things were happening all over the country. The Coggeshall Report also helped some. People were now encouraged because these powerful reports showed what needed to be done. It was not going to be done easily. It was really phenomenal that by late ’69 we had family medicine recognized as a specialty and the guidelines for program construction were issued. By that time, some of us had started our programs…ours in mid-’68.   \n\nYou talked about the fifteen programs. The way that I guess most of us think of it was that there were four programs that were actively training residents in the summer of ’68. Those were Lynn Carmichael’s in Florida and…\n\nWould one possibly be Dr. Gayle Stephens?  \n\nGayle Stephens, of course, that one I remember…and who was in Rochester?\n\nEugene Farley.  \n\nOh, Gene Farley, of course. I do consider myself as still having all my faculties even though I had to think about that seriously because I’m going to be 88 in a couple of months; and sometimes I wonder if I am thinking and remembering as well as I think I am.\n\nThat’s okay, I’ve got the list of the fifteen in front of me.  \n\nThose are the four that we consider to be the first four programs and I think you’d say that all four had some kind of model clinic. Even though they may not have been freestanding and as clearly-defined the way ours was. That doesn’t make too much difference. Ours was easier to understand because it stood there by itself on the edge of the campus with a sign across it: University Family Medicine Center. \n\nYou just mentioned three. Did you consider your program among those four?\n\nYes.  \n\nSo the four were University of Miami, Lynn Carmichael; Rochester with Dr. Farley; Wesley Medical Center with Dr. Stephens.\n\nAnd the Wichita program was related to…I think to start with it was related to Wesley Memorial Hospital. It may have had a loose connection with the University of Kansas but I don’t think so. I think it was basically sponsored by Wesley Memorial Hospital so it was a private hospital program.\n\nAnd yours being the fourth among those.  \n\nRight. \n\nMaybe at this point we might want to take a break. I’ll turn over the tape and we can resume in just a second.  \n\nSounds good. \n\n(Break.)\n\nWe were talking about the fifteen programs in the original list of people who were interested and actively developing something and we had already mentioned that four demonstrated by the summer of ’68 that they had viable programs with residents in training. I don’t think there were any more right at that point and we were talking about the University of Minnesota. \n\nI mentioned to you the irony that one of the fifteen was your old alma mater, the University of Minnesota, where they’d rebuffed you earlier.  \n\nYes. So they were beginning to look into it and they were stalled. Obviously things weren’t happening. Then, general practitioners were kind of the leaders in this…but I would say the citizens of Minnesota were equally strong in voicing their dismay that the medical school was allowing this attrition of doctors in the communities throughout the state. The legislature said to the University of Minnesota Medical School, “Here’s your budget for the next biennium, it’s got two lines in the budget. One line is for the medical school and one line is for a family practice training program. The family practice training program has to be started, or we want evidence that you’re doing something before we will release the funds for the rest of the medical school.” That’s the story. I don’t think it’s apocryphal, and there was $1 million for the family medicine program to get started. \n\nSo the initiative in that case came from the legislature?\n\nFrom the legislature. \n\nWho do you think prodded them to do that? Clearly there must have been some lobbying.\n\nThe general practitioners in the state and the people, the voters. It just plain happened. Minnesota is generally a forward-looking state and they’re right up there all the time when it comes to health matters and civic matters of any kind. \n\nLet’s get back to your program in Oklahoma at the time. Yours was one of the first fifteen that was approved by the Residency Review Committee back in December of 1968. Let’s look into that a little bit more, your experiences with that program. Did you run into any surprises along the way when you were developing this?\n\nIn a sense, surprised that I couldn’t appreciate the difficulties that I was going to have. I just didn’t realize how difficult it was going to be. It was somewhat of a surprise that one of the most difficult groups that I had to deal with was the state chapter of the Academy of General Practice. They were very leery and not supportive and for good reason and I don’t have any bad feelings about it. It’s understandable they couldn’t understand what we were talking about when they couldn’t see it. There were no guidelines, there was no training program. All they could see were things like a rotating internship. At the University of Oklahoma, they previously had a program of a rotating internship that went for two years and it was called the General Practice Graduate Program. It was a rotating internship in the hospital, of course. The general practitioners at that time all over the whole country were doing heroic things, in my opinion…taking care of folks. They did it the way they had learned to do it, through their rotating internship and then through their experience. It consisted of doing everything because they had to; because there wasn’t anybody else around. Sure, in some instances they sent patients to the city hospitals. They delivered all the babies and that was their training and that’s the way they understood it. When they began to get some of the details of what was going to go into our training program, they were uneasy. Probably the biggest thing was they could see there was going to be a threat to their surgical privileges and their privileges in the hospitals. They were not enthusiastic. Gradually there were some of them who could see what we were doing. When the guidelines came out and the specialty was recognized, it became a lot easier for those of us who started program so early, I don’t think any of us really anticipated that there would be this much difficulty. It really wasn’t surprising because they didn’t understand what we were trying to do. It was a Catch-22. The same thing was true for money except for places like the University of Minnesota. After it became obvious what the directions were, monies began to come in. \n\nLooking back, if you could start all over again, would you do anything differently? Or what would you change from that experience?\n\nIn the way that I started the residency?\n\nYes.  \n\nWell, in the way that I started the residency, I would have done it, I suppose, just the way I did except for the interaction with people. I was definitely, I would say, just borderline in my ability to sell the program to individuals. I did not do as much networking as I could have. I suppose in a certain sense, we would have been more successful if we had started the program a year later. To answer your question, what I would do differently, I would definitely be much more patient in helping people to learn what the program was about. I’m talking about the practicing physicians and the faculty at the university. At the university particularly, they were leery of the whole thing. Some of them did not believe in the idea of primary care at all. They thought they should continue to turn out internists and pediatricians and obstetricians and they could give the primary care. There are plenty of people who still think that’s the way it should be done. That mindset was not easy to overcome. In that respect, to state it once again, I should have been more skillful in my relationships with the faculty. They were pleasant to me and they ultimately helped with the teaching program, but it took some doing to get there. With the family doctors, I did the best that I could. I talked at various meetings and things like that but that was simply going to take some time. I guess if I had to do it over I wouldn’t be able to do it much better than I did for our particular setting or area of the country. \n\nLet’s talk a little bit about what was your greatest satisfaction from your experience in working in this program.\n\nI’ll tell you one thing that was a surprise and it took a little experience before I recognized this. Gayle Stephens and Gene Farley are still around, they may have experienced this too. I’m talking about the grandfathering in of the practicing physicians. That was a great handicap for us in the early years of the development of the residency. Let me explain that. Here are these folks out there that are doing this yeoman’s job of taking care of people for decades and now here’s the specialty. What are you going to do with those folks that are so important to us and doing work so skillfully in most cases? Are you going to leave them out of the certification? The Board of Family Medicine developed the plan by which a person who had a history of a rotating internship could get credit for that, that’s one point. Then they needed two more points if they had some other graduate medical training. But basically it was this: for every three years of experience in general practice with good continuing medical education they could get another point and so the doctors out there had one point for their internship and then two more points for six years of practice experience accompanied by documented CME. They, of course, had to take the examination and pass it. But they could become board certified that way. Well, that affected us in the residency because here’s what happened: Our early residents all had their rotating internship before they started with us at the second-year level. They had, we think, a pretty good year of training in that second year. Then for the third year, about half of the residents that we were getting felt, “Well, this one year has been good enough and that gets me two points. I’ll pick up the extra point by going out into practice. I don’t need to take the examination early. In three years I’ll take the examination, I might as well make some money while I’m doing it.” They had the start of a residency so they opted out of the residency after finishing the second year and went into practice. We thereby lost half of our residents. That phenomenon, of course was soon obliterated. It wasn’t long before the Board said the practice option was no longer viable. I can tell you that was a disappointment that was difficult to handle. There was really nothing that I could do to convince them that they should stay for that third year.  \n\nHave we covered the Oklahoma years well enough? Are you ready to move on to when you went to Alabama or is there anything else we need to address during that period?\n\nLet’s see. One thing that we were proud of is that our program was known enough so that people came to look at what we were doing and to use that as a guide for what they were developing. Like Ed Ciriacy, for example, came from Minnesota. Ed had moved in to take over from Ben Fuller, an internist, and really moved the university program right into solid activity. He came down and visited with me. Gayle Stephens visited with me to look at our program and there are a couple other people that did the same thing and of course we shared it at the Education meeting of the AMA in Chicago. This was the AMA. I gave a talk on our family medicine program and described how we were running our program. I did that at the request of Bill Ruhe who was the head of the educational part of the AMA at that time. \n\nSo in the space of six years you had become essentially a national leader in family medicine residencies.\n\nWell, I was one of the people who were recognized for having a model clinic. Other people were able to move their programs faster than we did because of our problems with money and the old ways…the traditional turf protectors, both in the university as well as out in practice. It was a significant uphill battle here. Oklahoma is rather conservative and we had significant problems because of our family. Those are rather lengthy stories but suffice it to say that our children got into difficulties that made the front pages of the newspapers because we were a family from the north coming into the community and acting in a more liberal way. That’s related to an unfortunate embarrassing encounter for the police that ended up with their planting drugs in our children’s house. That ended up eventually as a procedure that the police undertook in order to save face. They made some serious mistakes and I can’t go into the rest of it except to say it was difficult for us to go through that when the charges were completely phony. The police detective in charge at that time was later removed from the force. Then our daughter received national fame when she was a student in college at the University of Minnesota. We were down here and she was up at the University of Minnesota. She came out with a simple statement to the editor of the university daily newspaper about some rules to curb activities of the girls in the dormitories, cutting their curfew hours and so forth. Our daughter objected that it was discrimination. It was interpreted as advocating free love and she made the newspaper front page throughout the country, courtesy of the Associated Press. Jim Dennis had to make sure that he had my letter of resignation in his drawer in case people gave him too much trouble. Again, our family was a little bit ahead of the times. However, I want to emphasize that support for the program gradually improved through the years leading up to the present time. The total number of employees is now about 200, including the professional and the support staff. The residency is an unusually fine residency. It is now the most popular clerkship in the whole Health Sciences Center. However, to this day, there is still opposition because some people still can’t get the message. And they’re not happy with the new legislation that will likely shift more and more care into coordinated primary care plans run by family doctors, internists, and pediatricians. \n\nMaybe we can get now into when you went to the University of Alabama at Huntsville and what led you to go there.\n\nAt one point at the University of Oklahoma, it was felt that my effectiveness as head of the residency was in question and I agreed with them. They wanted me to step aside and let somebody else run the residency, or part of it, and I was asked to go across the street and start developing an undergraduate family medicine program. That was one of the hardest decisions I’ve ever had to make. I decided that even though this would guarantee an academic life forever, that wasn’t where I thought I was the most capable. My teaching interests and my teaching methods were related to practicing medicine and modeling that as my main tool of teaching. I think I was a good teacher – on-the-job teacher – and I was a pretty good administrator. There were a lot of things that I did that brought the program along but they needed something else and I agreed it would be better if they had a new residency program director. I went out into practice but was quickly found and recruited down to Alabama where I started the Family Medicine Program in Huntsville as part of the University of Alabama Medical School. Gayle Stephens came as the head of the medical school within the Huntsville branch of the university. He also directed the family practice residency until a new director came to fill that position. I recruited the first residents, and the Huntsville program was in operation when I moved to Anniston, Alabama to start a new program there. That was a typical private hospital-type residency. But it soon affiliated with the University of Alabama and became one of the branch residencies in the state.\n\nThat’s the program in Anniston?  \n\nYes. And that program was later discontinued…I think they had a couple of recruiting problems…I don’t know the whole story. I developed the patient base myself in a couple years from ’73 through ’75 and had the program ready when I recruited three residents, getting them started at the first-year level. Then I decided that I didn’t want to spend the rest of my life in academic medicine and to live in that part of the country. So we came back to Oklahoma City. \n\nAt that time you went back into private practice, is that right?\n\nThen I went back into private practice and I did that for the rest of my career. I had a solo practice in Oklahoma City from ’77 to ’83. And then I was asked to move into the large hospital in my area and develop a family practice clinic right in the hospital. They carved out an area in an unfinished part of the hospital and made it into a good clinic. That was still going when I retired in ’89…but I really didn’t retire. I retired up to the Indian reservation where my wife had been doing fieldwork for her PhD in anthropology. We decided to live there the rest of our life but it turned out that the clinic in the community near the reservation needed a doctor and I said I could help out part-time. They said, “We don’t have any part-time work here, we just have an opening for a full-time doctor; could you do that?” That’s what I did for a couple of years. I practiced rural medicine full tilt for the last two years of my career. \n\nThat was from ’90 to ’92? Was that the Cook County Community Clinic in Grand Marais, Minnesota?  \n\nRight. That’s the community in the county that contains this small Indian reservation of the Ojibwe tribe. \n\nYou practiced there until you finally retired from practice.\n\nYes and at that time we already had a house which we’d had for a long time in the Indian village, and we had decided that we wanted to live there for the rest of our lives and proceeded to do that until 2004 when Nancy’s dementia developed to the point where I could see that it was going to be too hard for me to continue her care there in that remote village. We moved back to Oklahoma City where two of our kids were still living. That was in 2004. That’s where I am now. \n\nAt this time we might want to turn to a couple of other things that maybe we haven’t talked about yet. One was, you could talk briefly about the fact that you were a charter member of STFM. Can you tell us a little bit about how you got involved with that organization and why?\n\nI think I was probably geographically somewhat removed from it and I just don’t remember doing very much except talking with people when I would meet them at meetings or something like that but I was not active in the mechanics of setting up that organization even though I became a charter member of it. That’s a little bit fuzzy in my memory. I don’t remember doing too much. This is one of those areas that, inasmuch as it’s been about forty years since that happened, I can’t remember every bit of it.  \n\nThe primary purpose sounds like it was to network.  \n\nYes.  \n\nI thought that was important to note though, that you were a charter member of that organization when it was established in 1967.  \n\nRight. \n\nIf I could backtrack just a little bit. One of the start-up obstacles was…in addition to helping the public as well as the private and academic physicians to learn about the new family medicine and how it was going to be taught, it was difficult to recruit the first residents because there wasn’t anything to show those possible candidates. All they could see was what I said to them and what I had written on paper. The other part of it was to get faculty people who were qualified because there weren’t any programs around that any practicing family doctor had worked in and the prospects didn’t come from an academic background. Virtually all of the family doctors were general practitioners who had their rotating internship and their continuing education. But they were not a part of the ongoing academic scene. So they didn’t have a background and they couldn’t understand – literally couldn’t understand – very much about what the new residency training program was going to be like. Even though on paper we would get enthusiastic applicants for positions on our faculty, they had no teaching experience. They were well-meaning, but they didn’t understand what it meant to actually teach family medicine. One person – for example, our first faculty person – was an outstanding practitioner in his small city in one of the northern states and he had been president of his state medical association. So he had the political tickets and he knew how to practice but he didn’t have the fundamentals of academic teaching and he wasn’t aware of the psychological dynamics of what he practiced. That brings me to the extra point that I want to make – which is a very strong point. That is, that we are still handicapped severely in the development of primary care by adhering to the now outdated notion that there are two parts to family medicine, one being the scientific part and the other being the “art of medicine.” We now have clear evidence of all kinds that what doctors have been calling the art of medicine is actually part of the health care process. Many of those doctors had years of experience…they were good-hearted and compassionate…they were caring and had a good bedside manner…they adjusted the care to fit what they knew about the patient. In general, those doctors and their patients referred to that as the art of medicine – separate from the science of medicine. We now know that much of that is actually a big part of the science of medicine, it is the basis of psychosomatic medicine that has been demonstrated in thousands and thousands of articles and research projects. It’s been shown very clearly that what happens in people’s lives has a huge impact on what happens inside the body. That’s the kind of material that can now be taught as part of the integral whole of the science of family medicine. That is still in the process of being developed. It’s being recognized somewhat by the government’s move just a year ago to give more and more weight to what the primary care doctor does and that’s one of the most exciting things on the horizon right now. For example, there are already a few programs called the patient-centered medical home. People are beginning to understand that primary care has many dimensions and needs to be the center of a family’s health care. \n\nThat’s a good point and considering that, you’re looking at the state of health care in America today, what is your sense of where the specialty is going to go in the future?\n\nNow that we’re understanding more about what is happening to people when they think they are sick and what dynamics are really operating out there, there’s more and more respect for what the family doctor does. Thank god we have a specialty status and we can now take advantage of that and develop our teaching programs more appropriately geared to the actual clinical practice. It’s clearly recognized that the family doctor can still provide much care himself. With this enhanced arrangement through the patient-centered medical home – a larger team than just the doctor and a nurse. The family doctor can coordinate care and give more care and better care and there will be a change in the way it’s going to be paid for. The quality is going to improve: same-day appointments are going to be easier to arrange; we’re going to be able to give more care by email and more care over the telephone so that we can use our time more efficiently. The family doctor will continue to not only be looked to as a patient’s doctor, he’s going to be the center of these teams that are going to be formed in one way or another depending upon geography and demographics. There are going to be different forms. Primary care has also been given more political attention recently. One of the leading research people in the Department of Family Medicine here at Oklahoma had a lot to do with literally writing the legislation that was passed last year to support this new development in family medicine.\n\nThe federal legislation?  \n\nThe federal legislation. He’s active at the Washington level. \n\nIt sounds like overall you’re optimistic about the future of family medicine.\n\nI am. I am optimistic about it and I have a greater understanding what the family physician is able to contribute to patients’ health. Some of the increasing presence of family medicine is going to be supported by legislation. \n\nAnything else that we need to cover that maybe we haven’t talked about? Any thoughts you’d like to add? This is your opportunity to share your thoughts with future generations listening to this tape. To set the record straight on anything, what would you like to add?\n\nI have the general impression that there’s greater awareness of what we’re doing. The research and gathering of information and top-level discussions are encouraging. I just think there are so many exciting things that are happening that were just not there in the past. We were stuck at a level that was romantically attractive and was adequate in a certain sense for a time. But then, with the amazing growth of technology there has been a narrowing of the science of medicine… more focus on diseases and problems rather than on the whole person. That has pointed out the need for a larger view of health care and I think we’re beginning to get that. Even though I’m not actively associated with medicine now, I can see there’s a greater awareness at the level of our federal and state governments, and the corporations are needing to deal with the problems of providing health care for employees. \n\nOne other question I’d like to ask is, what advice would you give to future generations maybe who would be listening to this tape who are interested in or involved or getting involved in the specialty of family medicine? What kind of advice would you like to give them?\n\nI think it would be helpful for them to have a chance to talk with people who are involved in the educational process because there are quite a few now who are quite sensitive to it. In this state alone, a lot of teaching of the medical students is being done by physicians throughout the state and there’s close collaboration constant collaboration between the faculty of the Family Medicine Department and these teachers in their offices throughout the state. It’s phenomenal, and the feelings are so good. Students can find out who those doctors are by just getting in touch with the Family Medicine Department. Or they can come to the Family Medicine Department and talk to people there. I think it would be very helpful for people who are considering family medicine, to talk with these people who have some kind of academic connection because those people know what’s happening now. \n\nOne other question, I wanted to backtrack just a bit. When you were talking earlier about the difficulty you were having in getting qualified faculty when you were at Oklahoma, I failed to follow up with you on that and ask, how did you overcome that?\n\nIn my time there, what happened is that our own residents finished and we began to get instructors from our own teaching program. These were effective doctors and teachers. By the time they finished our residency, they knew how to practice medicine because that’s what they’d been doing throughout their residency, in an academic atmosphere. They had a lot of practical experience and they had good connections with people. There were good relationships with other family physicians and with other specialists. When these residents finished and began to instruct in our program, they were comfortable and respected doctors. So a number of our graduates went on to teach in our program or went elsewhere to start or work in residency programs. Then the school’s administration recruited into the Oklahoma program a particularly strong person, Christian Ramsey, who was able to get a new Family Medicine Center built right in the middle of the Health Sciences Center. It’s right there with all the rest of the hospitals. It’s a big building. There’s a lot going on in it. They handle the student health care and they also run the Physician’s Assistant Program. Chris Ramsey had a lot to do with that. The present head of the Department of Family Medicine is even more outstanding in my estimation. He continues to practice medicine as a model physician and yet he directs that program in the most sophisticated and compassionate way. He’s one of the finest people I’ve ever known in the field of family medicine. \n\nWho is that?  \n\nThat’s Steve Crawford. I think he’s been there for about fifteen years now. \n\nNow you’re in retirement, what are the kinds of things you like to do now?\n\nI’m enthusiastic in what’s happening in the field of health and in my personal life. Nancy died of a stroke as a complication of her amyloid angiopathy dementia about two and a half years ago. About a year after that the department here decided to create a history of the Family Medicine Department. One of the Department’s assistant professors, a PhD in educational psychology, was asked if she had enough time to coordinate the development of that history. She said she’d give it try. She took it on and I was the first person she got in touch with to interview. That made sense…I started the program, was still vertical and well, and lived in the city. We’ve become good friends. I actually share a house with her at this time. Another connection: I am having conversations with Jim Mold. He is the person whom I referred to that is active at the national level. Jim Mold is the head of the Active Research Division in the Department of Family Medicine here. He wanted to talk with me to get my slant on my basic ideas and theories of family medicine. He has written many fine papers. He’s been very active in other states and he’s an outstanding person in my estimation. We have thought that we might put together some kind of Grand Rounds or other presentation…or a journal article. So, here I am, back into some sort of connection with the basic thrust of what’s happening in family medicine. \n\nAny final thoughts you want to add?\n\nNo, except just to say once again, Don, I admire what you’re doing and I admire the Academy for doing this kind of work because I think it’s so important for medical historians and scholars. It’s going to always have an important place in the further development of our programs. \n\nDr. Lienke, I want to thank you for taking the time to talk to us today. Very valuable, the information you’ve given us and thank you very much for your willingness to do this.\n\nIt was a pleasure and an honor for me. \n\nThank you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281720#t=0.0,3578.77929"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281719","type":"Canvas","label":{"en":["Media File 2 of 2 - Lienke_Rogers_10_b.wav"]},"duration":3090.0456,"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/153063/file/281719/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281719/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/719/original/Lienke_Rogers_10_b.wav?1752093128","type":"Audio","format":"audio/wav","duration":3090.0456,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153063/file/281719","metadata":[]}]}],"annotations":[]}]}