{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/696zw19s7p/manifest","type":"Manifest","label":{"en":["Dr. Matthew Nix"]},"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":["2022-04-05 (created)"]}},{"label":{"en":["Format"]},"value":{"en":["video"]}},{"label":{"en":["Keyword"]},"value":{"en":["Arkansas","family doctors","rural family medicine","physicians"]}},{"label":{"en":["Subject"]},"value":{"en":["Arkansas Academy of Family Physicians (corporate 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/collection_resource_files/thumbnails/000/196/781/small/Nix_Matthew%284-5-2022%29.mp4_1689092518.jpg?1689092519","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/99089/file/196781","type":"Canvas","label":{"en":["Media File 1 of 1 - Nix__Matthew_(4-5-2022).mp4"]},"duration":8318.31,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/196/781/small/Nix_Matthew%284-5-2022%29.mp4_1689092518.jpg?1689092519","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/99089/file/196781/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/99089/file/196781/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/196/781/original/Nix__Matthew_%284-5-2022%29.mp4?1689092503","type":"Video","format":"video/mp4","duration":8318.31,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/99089/file/196781","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/99089/file/196781/transcript/45027","type":"AnnotationPage","label":{"en":["Transcript of Dr. Matthew Nix interview [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/99089/file/196781/transcript/45027/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Dr. Sam Taggart:  Good evening, my name is Sam Taggart.  This is 4/25/22 and we are in the office of Dr. Matthew Nix in Texarkana, Arkansas at the UAMS Family Medicine Clinic part of the Family Practice AHEC....not called AHEC anymore, but Area Health Centers or whatever they are called now.\n\nDr. Matthew Nix: Regional Programs; UAMS Regional Programs.\n\nDr. Sam Taggart: We are here to interview Dr. Nix about his life, about the practice of family medicine, and especially about his experience of being on the board of family Medicine and president of the Arkansas Academy of Family Physicians.  We are going to go back and go through a whole bunch of stuff if you don’t mind and have the time to do this because it takes about an hour and a half from start to finish.\n\nDr. Matthew Nix: Oh sure; we have the whole afternoon.\n\nDr. Sam Taggart: Ok good; the best place to start is at the beginning: When and where were you born?  Talk about the circumstances of your birth.\n\nDr. Matthew Nix: Well, I was born in 1977 on August 26th and I am actually from Texarkana; so, I was born at one of our local hospitals here, Wadley Regional Medical Center.  There are two hospitals here in Texarkana and have been for a long time; St. Michael, which is Christian St. Michael, and Wadley Regional Medical Center....which I was born at Wadley.\n\n  \n\nDr. Sam Taggart: Was there another smaller hospital here at one time?\n\nDr. Matthew Nix: There was Medical Arts Hospital at one time, but it closed.  I’m not sure; I think Wadley...St. Michael just celebrated like maybe 150 years or something in this area.  At the time that I was born, St. Michael did not deliver children; they had stopped doing that, so only Wadley delivered children.  When St. Michael moved to its current location, they started delivering children again.\n\n   \n\nDr. Sam Taggart: Talk a little bit about your mom and dad; when were they born and where were they from?\n\nDr. Matthew Nix: They were both from Texarkana as well.  My dad was born in 1951, so he just turned 70 years old.  My mom was born in 1952 and she passed away at the age of 62; so, she passed away in 2014. My dad graduated from Arkansas High and mom graduated from Liberty-Eylau, which is on the Texas side, and somehow they crossed the state line and got married.  I have one older brother, Curt, who is two-and-a-half years older than me; he was born in 1974. He is a pharmacist and lives in Florida now.  My dad was a...he had all kinds of jobs; he was in the Marines during in the Vietnam War and when he got out of the Marines, he had several jobs but wound up being a paramedic.  Then, he became a firefighter; back then you could switch between being a paramedic and a firefighter fairly easily and he stayed on as a firefighter.  I think he retired after 35 years as a firefighter and battalion chief.  My mom went to...when we were young, she went to nursing school and became a nurse; an RN.  I remember her being in nursing school and working nights trying to, I guess, work her way up the RN ladder where she could work the day-time shift or day-time job.  She was a nurse...I don’t know; I guess for almost 30 years, 25-30 years, before she retired.\n\n \n\nDr. Sam Taggart: Do you know much about your extended family; where they came from?  Were they English, German, Scotch, Irish?\n\nDr. Matthew Nix: I have dived into some of my genealogy and of all my family trees, my paternal grandmother is probably the most well documented and they actually....most of them actually came from around the area of the English Channel; so either Normandy, France, or there on that side of England.  They came over; I think they came over and they were....there was actually that branch, but then there was this Germanic branch....the Germans came over and went through Pennsylvania and came down to Tennessee.  This English-French branch came into the Carolinas, across Georgia, and into Tennessee; that’s where they kind of met up and came through Alabama, Mississippi, and made it to Arkansas.\n\n \n\nDr. Sam Taggart: About when?\n\nDr. Matthew Nix: Um...that’s a great question; I’ll have to go back and look that up, but we’re talking about the late 1700s or early 1800s.  Actually, one of my grandfathers was an assistant surveyor to.....was his name George Conway, the first Governor?\n\nDr. Sam Taggart: Yeah....\n\nDr. Matthew Nix: His plantation, his home, is south of here and....have you ever heard of Bradley, Arkansas?\n\nDr. Sam Taggart: Uh huh...yeah, sure...\n\nDr. Matthew Nix: His wife’s, Governor Conway’s wife’s maiden name was Bradley. So, his homestead, or whatever, is right near Bradley and that was her family. But, my grandfather was one of his assistant surveyors and he was commissioned by one of the president to survey Arkansas when it still Indian Territory; so, they got to choose any land that they wanted and the future governor chose this land down here on, I guess, the east side of the Red River and my grandfather chose the land on the west side of the Red River...around Doddridge....and that’s where my family, I guess, settled.  That branch of my family settled and have been here ever since.\n\n     \n\nDr. Sam Taggart: Now, there is a generation-and-a-half there; what did they do?  Were they farmers?\n\nDr. Matthew Nix: Farmers; yeah......famers and then they operated a mule driven ferry across the Red River there; that was a money maker, I think, for them because a lot of the crops and things from Texas got to New Orleans and the east, Pittsburg and stuff, across that ferry. Then the Civil War came and that was captured; they maintained that ferry until like...my family maintained that ferry until, I think, the 1960s.” \n\nYeah, I remember crossing that ferry going to Texas.  I remember crossing as a small child; I had family members who live in Midland, Texas and we’d leave Augusta up in the northeastern section of the state and we’d come to the Red River and cross on a car ferry.\n\nDr. Sam Taggart: Uh huh...\n\n \n\n Dr. Matthew Nix: I’m not sure, but it’s got to be the same place....\n\nIt’s got to be; they have now....I don’t know maybe in the late....in the 1990s, they built a bridge finally across there and they retired the last gas driven, gas engine, ferry.\n\nDr. Sam Taggart: Is that the one going towards Stamps and Lewisville?\n\nDr. Matthew Nix: No, it’s not that one; it’s further down around Doddridge and Bradley....\n\nDr. Sam Taggart: Ok...\n\nDr. Matthew Nix: Where it crosses there; closers to Shreveport or the Louisiana line and I think they even have a park there that has the old ferry there where you can go look at it.\n\nDr. Sam Taggart: Yeah, I’m fascinated by that kind of stuff; so, I probably will at some point....\n\nObviously, you had a fairly substantial extended family...\n\nDr. Matthew Nix: Uh huh...\n\nDr. Sam Taggart: Grandmas and grandparents; did you have a lot of cousins in the like and around this area?\n\n\n\nDr. Matthew Nix: Yeah; typical Arkansas, people don’t go very far a lot of times, so all four of my grandparents lived in Texarkana.  I even had a set of great grandparents that lived in Texarkana that I knew growing up.  I actually still have two grandparents that are still alive; they are both 92 or 93, I think, which is a little bit unusual...from different sides of the family.  But, I had...my grandparents and all their children all lived here; so all aunts and uncles lived here and no one moved away....and all their kids growing up.  So both sides of my family; there were...I don’t know, I’d have to think about it....but probably eight grandkids; so, eight cousins on either side.\n\n   \n\nDr. Sam Taggart: Were you close to them?\n\nDr. Matthew Nix: Yeah; for the most part, yeah....We spent every holiday together for sure and then some of  them....none of us went to school together...but several of my cousins, we’d still hang out and do things. \n\nDr. Sam Taggart: A bunch of the kids were obviously raised out in the country, but you were raised in town; is that correct?\n\nDr. Matthew Nix: Uh, well....both; I’m trying to think who all....pretty much everybody was raised....all of my first cousins were raised in the city.  We lived in the city up until I was in the 4th grade and then we moved to the country not far from my grandparents.  I mean, it was the country...dirt roads and I had to walk half a mile to get on the school bus kind of thing...but, we lived there until I was in the 10th or 11th grade.....I think 11th grade...and then, we moved back to town.\n\nDr. Sam Taggart: Where did you go to school; your early primary school education?\n\nDr. Matthew Nix: I went to Fairview Elementary, which is now burned down, but was an old, old, school building here in town.  I forget how old it was, but it was really old; I mean, it was like... all the light fixtures had transoms and you know...built in the ‘30s kind of school.\n\nDr. Sam Taggart: Do you remember much about that time in your life; the kids you ran around with and the things that you did?\n\nDr. Matthew Nix: Yeah, I think so; I have some stories, but I’m not sure anything in particular.  You know back then where I lived in the city at the time, which was about six blocks from the elementary, we walked to school or rode our bikes to school....which my kids never did. But, we had neighborhood...a whole bunch of neighborhood kids that were all the same age and we rode our bikes everywhere...around the city and to each other’s houses to play and stayed outside until the sun went down or supper was ready.  So, I’m old enough to have those experiences that my kids have never really had because times have changed and things have changed; so, I’m kind of in this....I guess, we’ll talk about this later as far as medicine goes...but I’m kind of in this transition age where I still remember how things used to be before computers or whatever and now I’m having to use all this stuff now.....but yeah, we definitely had, I guess, a classic childhood.\n\n   \n\nDr. Sam Taggart: Idyllic...\n\nDr. Matthew Nix: Yeah, you know...\n\nDr. Sam Taggart: Were you involved in sports: football, basketball, or baseball?\n\nDr. Matthew Nix: I tried, but I was not.”  (Laughing)...\n\nDr. Sam Taggart: (Laughing)....It wasn’t your forte...\n\nDr. Matthew Nix: I played baseball for a couple of years: tee-ball and pee-wee and had very little talent.  So, I got out of that; now, my brother was quite athletic or at least a lot more than I was.  He played several sports: soccer, basketball, and I think he even ran track.  But, I did not.....so, I was more of a nerdy-book worm.\n\nDr. Sam Taggart: When did you start thinking....”I like this part of school” or “I don’t like this part of school”...things that you enjoy or subjects that you enjoy?\n\nDr. Matthew Nix: I don’t really know; I guess it’s that you gravitate to things that you’re good at maybe.   I didn’t have a great experience in 1st grade; my teacher and I didn’t mesh.  A lot of it, I think, had to do with probably me being a very shy child with social anxiety being in a brand new school.  My teacher had; we were talking about this the other day, my wife and I, but my teacher actually had some kind of surgery and she had to....she wasn’t there very long in the year as a first grader and she had to leave for six weeks; so, we had this substitute and I won’t say her name on here, but she was awful and it really kind of stressed me out.  But when I got into 2nd grade, I had the best teacher, Bobby Dowdy; she was an older lady, one of a grandmother type figure, and you know, she really worked with me and realized, “Oh, this kid is pretty smart.”  I remember her testing me for various things like reading levels; back then, I guess, I was at a basic reading level and she said, “you can read so much better than this; let’s move you up” and she kept doing that until I was eventually moved to a 3rd or 4th grade class and reading with them.  So, she really kind of saw that I had some potential there and kind of fostered my academics.  It’s funny and this is pretty classic Texarkana and Arkansas; her grandchildren went to school with my son and so, they all grew up together and I would still see her even as an adult.\n\n          \n\nDr. Sam Taggart: Did you ever take care of her as a patient?\n\nDr. Matthew Nix: I did not, but I have taken care of several teachers as patients or their family members.\n\nDr. Sam Taggart: Were there any other people in that time frame of your life, up until the 6th grade or so, who had a big impact on you?  Grandparents, mother or father, teachers, preachers, business leaders; anybody who had a big impact on your life and maybe turned you in one direction or another? \n\nDr. Matthew Nix: I’d have to think about that a little bit.  Of course, your parents are going to have that effect on you.  I think I spent a lot of time growing up with my maternal grandmother quite a bit.  I definitely had various teachers; I think my 2nd grade teacher...you said up until 6th grade?\n\nDr. Sam Taggart: No, anytime.....I’m going to ask you about it again in a minute....  \n\n Dr. Matthew Nix: I had a teacher, which I just told you that I didn’t have a very good experience in first grade, but my first-grade teacher was a lady by the name of Carrie Mackey and I encountered her again in 6th grade because she had moved from teaching 1st grade to the librarian.  Then in junior high...for us that was the 7th, 8th, and 9th grade...she was the librarian in my junior high and one of the electives that you could take was being a library aide.  We actually...I didn’t really like her much in 1st grade and in 6th grade and in junior high, we spent a lot of time together because I worked in the library and she really became probably one of my favorite teachers overall. She really spent a lot of time just talking to me, talking about careers, and giving me books to read....\n\nDr. Sam Taggart: What age is this now?\n\nDr. Matthew Nix: I was in junior high; so...12, 13, 14.  She really helped, again, kind of foster my interests in academics and you know, making it possible to be a physician....you know what that like. So, I would probably say of all the teachers that I’ve had; I’ve had...I’ve been very blessed.  I went to public schools my entire....1st through 12th grade...and I would be hard pressed to find or think of any teacher that was a bad teacher. I was really blessed and always had good teachers.\n\nDr. Sam Taggart: Were there subjects in that timeframe that ....in junior high and high school...that you were particularly interested in?\n\nDr. Matthew Nix: No, I really liked everything.   I don’t know if I was particularly interested at that time... I don’t think I was particularly interested in any one thing.  You know, I didn’t like enjoy necessarily one subject versus another; I liked history just as much as I liked English or even like science.  It wasn’t until I got into college with a goal of getting into medical school that I really kind of focused more on the science classes.\n\nDr. Sam Taggart: We’ll come back to that in a minute and we’ll spend quite a bit of time on that.  But what about high school; were there any teachers, people, or did you have an extended group of friends that you ran around with or anything that you really enjoyed about high school?\n\nDr. Matthew Nix: Um...so high school, I had a pretty...again, I’m kind of nerdy guy...so I had a pretty small group of friends that we’d share similar interests with.  A lot of us were in the same kind of group as far as like people taking more advanced classes; so there may have been like 15 or 20 of us that pretty much had all the same classes and so, we’d just kind of move in this small group together in high school.  I mean, I wouldn’t go back to high school.... (laughing)...for anything; especially today; but high school was fun.\n\n    \n\nDr. Sam Taggart: Where did you go?\n\nDr. Matthew Nix: I went to Arkansas High and that’s actually....you know, my grandmother graduated from Arkansas High, my dad did, I did, and my son did; so, we are four generations of Arkansas High graduates.  At least at the time, it had a pretty rigorous curriculum for those who wanted to go to college or a graduate school; it had those goals and so, it really prepared me to go to college.\n\n   \n\nDr. Sam Taggart: Was education a big deal with your parents or your family?\n\nDr. Matthew Nix: You know, I didn’t have anyone in my family that really had a high education; my mom was an RN, but back then it wasn’t like a BSN or anything like it is now.  Both of my parents had Associates Degrees, but my parents....\n\nDr. Sam Taggart: Did your father get his degree after he came back home from Vietnam?\n\nDr. Matthew Nix: Yes, but education was extremely important to my parents.  They wanted my brother and I....they wanted to make sure; I mean, it was always drilled into our heads that our education, our academic career, was number one...that wanted to make sure that we were doing that.  They both wanted us to have jobs in which we were more professional with a more advanced skill that we could use.  My dad would say... (Laughing)...well, my dad didn’t want us to be a fireman like he was, or a logger, or whatever.  I don’t think that he necessarily wanted us to a physician or a pharmacist, but he really just didn’t want for us to have a job where we would wear our bodies out early, which is what he....it’s kind of what he did with his job as physically demanding as it was.  He’d always say that he didn’t want us to have to work out in the freezing temperatures or the sweltering summers; you know, be able to go inside and have a job because it’s a lot easier on you, which is true.\n\nDr. Sam Taggart: My father’s version of that was, “I don’t want you to end up in your life pushing somebody else’s mud around”....\n\n(Both Laughing)....\n\nWe were rice farmers....\n\nDr. Matthew Nix: Ok...same thing...\n\nDr. Sam Taggart: Did you write down any of your memories when you were a kid or did you make notes?\n\nDr. Matthew Nix: Well, I don’t ...I know at times I did and I saw that question; but I’d have no idea where any of those things are.  When I was in 11th grade, my English teacher at the time, as a project, made us do a family-type genealogy book where we would write down stories of our family; stories that our grandparents told and different things and she said it would be something that you would cherish as you got older....so, I have that and it really is something that...you know, my grandfather has passed away now and I actually did this; when I went and interviewed him for this project, I recorded him telling these stories that he’d been telling all his life about his time in the navy and his kids early lives and you know now that he has passed away, that is a great treasure to have.\n\n      \n\nDr. Sam Taggart: Yeah; are there any of those stories or tales with or without a moral, it doesn’t have to have a moral; any of those tales that stand out in your mind?\n\nDr. Matthew Nix: Maybe, I’d have to think about it and go back and read my own writing.  A lot of his stories were growing up during the depression, being poor, and just the things that he had....my grandfather had 12 brothers and sisters and so, just all the trouble and shenanigans that they would  get into.\n\n Dr. Sam Taggart: You went to Arkansas High and graduated when?\n\nDr. Matthew Nix: In 1995.\n\nDr. Sam Taggart: At some point during this process, everybody starts thinking about what they are going to do when they grow up; do you remember when that first occurred to you because at some point, you were going to have to start making some decisions?\n\n\nDr. Matthew Nix: Yeah; you know, I was thinking about that and I’m sure you’ll ask me this later; but I did grow up with my mom as a nurse and so, I grew up with her coming home telling stories about the hospital, patients, and doctors.  We didn’t have internet and we had three channels on T.V, so I found a lot of those to be entertaining and interesting.  I had, and still have some of her nursing books and with nothing to do; I would read anatomy and physiology and so, all those things kind of peaked my interest early.  My mom eventually stated working in the GI lab and she’d be on call; so on the weekends or at night, she’d get called in sometimes and she’d carry me or my brother with her and we’d have to go sit at the hospital and wait.  I never minded it because I liked being at the hospital and being around all the equipment and just looking at things that were unusual to me.  She would let me; you know, she would talk with the doctors and tell them that I had an interest and they would let me come watch a procedure or just talk to me...that was kind of my introduction into medicine; it was kind of through her job.....that was back; that was probably...that probably started when I was about 8 or 9 years old.  Eventually...I remember one summer, we didn’t have anything to do and my mom suggested that I come and volunteer at the hospital; they called them “candy stripers” then.  I didn’t really want to do that because I thought that was something that girls did; but this was at St. Michael and one of the nuns there at St. Michael, who I later developed a good relationship with over the years, said, “Oh no, come...come and we’ll change the name to junior volunteer from candy striper, so that way it won’t sound like that.”  So, I guess that was my place in history; I was the first male...” (Laughing)...\n\nDr. Sam Taggart: Junior Volunteer...\n\nDr. Matthew Nix: Junior Volunteer at St. Michael and I did that for at least two summers when I was in late junior high or high school.  So, it was kind of the same thing; yes, I was a junior volunteer, but my mom and Sister Damian, Sister Damian Murphy, knew that I was interested and they would get me in to watch a procedure, talk with this doctor, or go and check on this patient and talk with them, and stuff.  I don’t know if you can do that anymore with HIPPA, or anything these days with the laws; but back then, it was a much smaller...smaller town and smaller hospital.  So, I think all those things kind of built my interest into doing it and going into medicine. Now in answer to your question, I was kind of side tracked...but I remember being in high school and trying to figure out, “Am I going to go off to college,” “Am I going to stay here”, “what am I going to pursue” and I remember being really torn; I wasn’t sure...I was good at science, but I was good at other stuff too. I thought about “Maybe I should go to law school” or “maybe I should be a teacher” or “Maybe I should”...I had no idea.  I was interested in so many things and I felt like I was good at so many things that I had no idea.  I kind of had this thought in my mind about being a physician, but part of me kind of thought that I didn’t know if I was smart enough or good enough to actually do that.  I knew based upon my experiences with my mom and I would talk to my mom about it; she didn’t discourage it, but she also knew the sacrifices that physicians have to make in their time and their life, their personal life, and so he would say, “I don’t know; you really ought to think about that.  I’m sure that you can do it, but that doesn’t mean you should do it.”  I remember talking to my granddad, my dad’s father, one day and ...I remember he was eating an ice cream cone watching the news or something; we were over at his house and I just kind of brought it up and he asked me what I was going to do and I said, “I don’t know.”  Then, he just said, “Well, you should be a doctor” and I said, “Ok, sounds good.” (Laughing)...I wanted; we never talked about it before and he didn’t know I was even thinking about it, but I felt like I was kind of struggling with the idea of whether I should pursue that or not and he said it so nonchalantly, like...”Yeah, that’s what you should do”...you know; so, I said, “ok.” \n\n                  \n\nDr. Sam Taggart: What informed your decision about where you would go to college?\n\nDr. Matthew Nix: Well, it really just came down to money; I wanted to go off to college just because I really just wanted to get out of Texarkana.  I wanted to leave my home and do something different, but that was expensive and my parents could not afford it; so, I really just applied for scholarships.  I thought going off to college at that time would give me a better education to increase my chances of getting into medical school; so, I really didn’t care where I went.  I just really applied for scholarships and UCA in Conway was...they basically gave me the best scholarship. I got full tuition with room and board paid for; so that’s where I went.\n\nDr. Sam Taggart: You started there in what year...’95?\n\nDr. Matthew Nix: I started there in ‘95.\n\nDr. Sam Taggart: Did you go a full four years?\n\nDr. Matthew Nix: I finished in’99.\n\nDr. Sam Taggart: Did college turn out to be what you thought it would be?\n\nDr. Matthew Nix: College was great; I would go back to college.  I told you I wouldn’t go back to high school for anything and I wouldn’t go back to medical school for anything, but I would go back to college.\n\n(Laughing)...\n\nUm, it was just...it was independence, but not too much; I still had meals being prepared for me in the cafeteria and I still had a roof over my head, the dorm....but, I didn’t have as much parental control.  I was around a bunch of people at college that was very different from me.  I was around a bunch of people in college that had very similar interests to me...my interests and things that I like to do; things that I was interested in...those nerdy things in high school all of the sudden wasn’t so nerdy in college and there were people in college who also wanted to go to medical school, or wanted to do this, or wanted to do that; so there were a lot of goal directed people.  I was very blessed and got in with a great roommate who was very studious; he was a science major, like I was, and so we helped each other out a lot. I had a fairly small group of friends, but very supportive; we didn’t get into any trouble.  We weren’t...thankfully, we didn’t have the college party-life, which is a good thing in my mind; but, we still had a lot of fun and I would go back in a minute.  You know because I’m so interested in everything, I would just love to go and take classes just for fun.\n\n   \n\nDr. Sam Taggart: Back like we were talking earlier...in elementary, junior high and high school...were they any teacher or people in college that had an impact on you during that time frame? Your organic chemistry teacher or those kinds of people...\n\nDr. Matthew Nix: Yeah, I can’t...I mean, I have some people in my mind that I’m never going to forget, college professors and stuff, but not any one person made a definitive difference or whatever that I keep any contact with.\n\nDr. Sam Taggart: Did you work during high school or college?\n\nDr. Matthew Nix: I did not work in highs school; in college, I did work several jobs.  My tuition and board was paid for, but I did have to pay for my car insurance.  My car was paid for, but I still had to pay for my car insurance, my gas, clothes, and entertainment...whatever little entertainment that we did. So, I actually worked...I worked there; we had a food court at the student center that had various places to eat there and so, I worked there for, I think, a couple of years to make extra money.  Then, I actually got on...there was an academic study tutoring center there and so, I was actually hired to teach biology and chemistry to anyone that wanted it basically. So, the university paid me for tutoring.\n\n     \n\nDr. Sam Taggart: So, basically, these kids were taking chemistry or taking biology....\n\nDr. Matthew Nix: Uh huh and they needed help; they would just come up there at nigh to get help and they paid me to do that.\n\nDr. Sam Taggart: Yeah....right....\n\nDr. Matthew Nix: So, I did that for probably at least two years and eventually got busy enough after that that I stopped working at the food court.  I worked there a couple of nights a week and it was a great experience because it really got me...you know, you don’t know something until you teach it oftentimes and it really got me feeling like I had a gift for teaching.  I really enjoyed teaching and for a while there in college, I thought, “Man, should I go off to medical school or should I actually go and be a teacher?”  I enjoyed it so much and I thought, “well, do I need to be”....my roommate and one of my best friends in college were both going in college to be teachers, high school teachers, and I thought, “Should I be a teacher?  Maybe I should get a PHD and be a college professor?  Should I go on to medical school?” So, there was a little point there were I was kind of debating on what I wanted to do.\n\n     \n\nDr. Sam Taggart: When point in your college career was that?\n\nDr. Matthew Nix: That was probably in my third and fourth year.\n\nDr. Sam Taggart: Somewhere along this time, you had to...even if you just chose not to....you had to get serious enough to take the MCAT test...\n\nDr. Matthew Nix: Yeah....yeah...\n\nDr. Sam Taggart: And start going through the application process for medical school...when did that happen?\n\nDr. Matthew Nix: I mean, I was always serious; when I showed up on day one of college, I had that single-mindedness of, “I’m here to prepare the way for medical school.” So, everything that I did was pretty much geared towards taking that MCAT, keep my grades up, taking my pre-regs, and trying to get into medical school. A lot of people don’t have that experience as far as not knowing what they’re going to do when they get to college; but I was pretty hyper focused on that.  Not to say that there weren’t times when I didn’t have doubts; you know; there were times where I thought, “what if this didn’t work out?” or “What if I don’t get in?”....”what if I don’t do well on the MCAT?”...you know, those kinds of things or “would I be happy doing that?”...”should I be doing something else instead?”\n\n    \n\nDr. Sam Taggart: At some point in everybody’s life, they get romantically involved; did that come during college, medical school, or after medical school?\n\nDr. Matthew Nix: This maybe a sore subject....(Laughing)....\n\nDr. Sam Taggart: That’s ok.....\n\nDr. Matthew Nix: So, I actually... in my senior year of high school, I probably just had a few months left of my senior year, I started dating someone that was two years in school behind me.  So my first two years in college, this was a long distance relationship that part of it, I didn’t think was going to work out; but it worked out and she actually came to UCA when I was in my third year.  We wound up getting married after I graduated; so the summer between...I went straight from college to medical school...so, that summer in between, we actually got married.  We stayed married for 11 years and then, we got divorce and I have since remarried.\n\n \n\nDr. Sam Taggart: Did you have any children by that first marriage?\n\n\nDr. Matthew Nix: Yes, two children by that first marriage.\n\n \n\nDr. Sam Taggart: How old are your children and when were they born?\n\nDr. Matthew Nix: Um...my first child, Nathan, was born in 2001.  He was actually born....I was just talking about this last night too; he was born at the end of my second year in medical school.  We got married and at the end of my first year in medical school, we found out that she was pregnant ....talk about stress.\n\n(Laughing)...\n\nWe didn’t have jobs, you know, and I think she was finishing up college.  I remember being terrified to tell my parents that that had happened; I remember laying on the couch in our living room at our house, our little rent house near UAMS, and staring at the ceiling, I think, for hours just thinking, “What am I going to do?”  But, we told my parents and it was fine; it was stressful.  I have a friend whose son is in medical school right now and he is finishing up his second year and he’s taking his step one exam’s; he is studying, studying, studying and I told my wife last night, I said, “you know, I remember being at his point, but the only difference was...I had just had a baby.”\n\nDr. Sam Taggart: Yeah....\n\n Dr. Matthew Nix: I was trying to study for step one and I had a brand new baby in the house; so stress is relative right?\n\nDr. Sam Taggart: Yes, absolutely....\n\nDr. Matthew Nix: So that was my first child and then my second child was born....I had just finished my residency in 2006 and just started my practice; she was born that September.  My wife was pregnant with her during my last year, the third year, of residency.\n\nDr. Sam Taggart: I’m going to come back to this in just a minute; but, where did you do your residency?\n\nDr. Matthew Nix: Here...\n\nDr. Sam Taggart: Here, ok...alright, you came back here...\n\nDr. Matthew Nix: That’s a story too.... (Laughing)....”\n\n\nDr. Sam Taggart: We’ll get back to that in just a few minutes.... (Laughing)...back to the acceptance process in medical school; carry me through the steps on that.  Was that hard for you?\n\nDr. Matthew Nix: Uh, you mean as far as just the applying, interviewing, and....?\n\nDr. Sam Taggart: Obviously, there are a few things that you to do; but were you worried about it?\n\nDr. Matthew Nix: You know, I was worried about it; but in my position now as a faculty member and having interactions with the students....not only the medical students but the people who are applying to medical school...I don’t think I was as nervous as I should’ve been.  I don’t think I was as nervous as a lot of people are; I think I just kind of felt like...”if this is what I’m supposed to do with my life, it will happen and I will do my best.  Obviously, I’m nervous about it, but if this is what’s going to happen...and if it doesn’t, then I’ll do something else.”  I kind of already resigned myself to...”If I don’t get in my first year”...a lot of people don’t get in their first year...”I’ll just regroup and maybe try again next year.”  That’s not to say that it’s not nerve racking and not a lot of high pressure; because, it really is. You know, one of the highest pressure things about is and I tell people now, “You know when you’re young, you put all this pressure on yourself that you think other people are putting on you”...like if I wouldn’t have gotten in, I would’ve felt that my parents were so disappointed or my grandparents were so disappointed.  Now as a parent, I wouldn’t feel that way if my kids....you know...so, I don’t think my parents would’ve been near like/or a fraction of disappointment compared to what I thought they would be.\n\n           \n\nDr. Sam Taggart: You said money played a role in where you went to college and you got a bunch of scholarships; did you end up with much debt after college?\n\nDr. Matthew Nix: I was very blessed and had no debt when I left college.\n\nDr. Sam Taggart: Ok; Medical school is a whole different ball of wax...\n\n(Both Laughing)...\n\nTalk about that a little bit...you got accepted....\n\nDr. Matthew Nix: Yes and I am ashamed to even probably tell you some of that; you know, I was accepted... things have changed a little bit, I think, the way they do some of this now...but back then, you know, part of taking out loans was for living expenses because they don’t expect you to work and go to medical school.  They may allow you to take out more now depending on your living situation, but I had a wife and eventually had a child; so I definitely took out the maximum amount of loans that I could and then, we took out other loans too just to keep the rent paid, food on the table, and have things for the....all the sudden you need cribs, diapers, and all this kinds of things which a lot of that we were able to get because people either gave them to us, or the garage sales that we went to, or whatever.  So, we definitely scrimped, and saved, and tried to make things meet; but, it was financially very difficult and I wouldn’t go back to that for anything.  When we started residency; at the time when I started my intern year, our salary was $36,000 a year, $3000 a month, and I thought I was rich.  I didn’t know what we were going to do with all this money; $36,000 a year was a lot...especially when you went through your years with no income.\n\n     \n\nDr. Sam Taggart: Negative income....\n\nDr. Matthew Nix: Yeah and of course, it has taken a lot of work and a lot of time to pay off all that debt.\n\nDr. Sam Taggart: So, did you do rural health classes?\n\nDr. Matthew Nix: You know, I did not.  When I went into medical school, I had....I’m sure you’ll ask about this later...but I had no intention of doing family medicine or practicing in a rural area.  I actually wanted to be, when I went into medical school, an oncologist and then as I went through medical school and my experiences I had, it kind of evolved and I actually wanted to do family medicine. So, I actually got... I think when I was in my third year; I went ahead and was able to get a rural loan for two years and that was what I was going to do at that point. I did get a scholarship, a private scholarship, based upon that as well; a Dorothy Schneider Foundation Scholarship.\n\nDr. Sam Taggart: You started medical school in ’99...\n\nDr. Matthew Nix: ‘99...\n\nDr. Sam Taggart: And you finished in 2003...\n\nDr. Matthew Nix: 2003; yeah...\n\nDr. Sam Taggart: Let’s back up just a little bit; talk about those first two years of medical school.\n\nDr. Matthew Nix: Terrible... (Laughing)...they were awful.\n\nDr. Sam Taggart: Had UCA prepared you for it?\n\nDr. Matthew Nix: Yes, UCA prepared me for it.  I mean, I thought I was well prepared and was as well prepared as you could be; it just simply the growling schedule as far as the amount of material that must be covered.  Looking back, if I could change something about that experience...I wouldn’t have been popular with my parents...but, I actually probably would’ve stayed out a year between college and medical school.  I think that...you know, I went straight from high school to college and was very driven and then from college to medical school without a little break ....I think I was burned out; so, I think if I would’ve taken a year off and worked and just kind of got refreshed, I would’ve been better prepared mentally and emotionally for medical school.  But, I went straight through and especially that first year, you just get burned out so fast; so, I think I struggled with that.\n\nDr. Sam Taggart: Was there a time in that first year where you looked up and said, “Oh me, this is dreadful”... was it the first half of the year or the second half of the year?\n\nDr. Matthew Nix: You know, really, I don’t remember the first year being as bad in some ways as the second year; you know, I struggled for some reason.  Well, I struggled with physiology for some reason and I remember getting an “F” on a test and then the second test, I got an “F” on ....and I thought, “Oh my God, I’m going to flunk out of medical school; I don’t understand what I’m doing wrong.” I was talking to some of my friends and said, “how did you; we’ve taken this test and I don’t know where some of the material came from, so I wanted to let you...I didn’t know...” and they were like, “Oh, that was on an old test.”  I said, “What do you mean an old test?”  I really wasn’t; I was studying for medical school the way I studied in college...\n\n   \n\nDr. Sam Taggart: Right...\n\nDr. Matthew Nix: And it did not hit me...at a certain point it clicked that I could not study for medical school the way I studied for college; I’ve got to do this differently.  So once I got it figured out; even to me in my first and second year, my first year I studied different than my second year...but once I got it figured out, “ok, I just got to study the way everybody else is studying and doing well” and things got better.  But, you could see the light at the end of the tunnel.\n\n   \n\nDr. Sam Taggart: In those first two years, were there any people, teachers, who stand out in your mind either in a positive or a negative way?  You don’t have to say their names, but...\n\n (Both laughing)...\n\nDr. Matthew Nix: Well, positive and negative; again maybe I shouldn’t say this, but when we got to medical school, they told us numerous times, “We’re so glad you’re here”... “we want you to be part of the process”...“if you have any ideas how we can improve medical school or your curriculum, please let us know”...blah, blah, blah....well, I remember giving an opinion one time to a professor through an email and it probably wasn’t worded as diplomatically as I would word it today...but, he told the Dean and I remember the Dean brought me in and basically told me that in reality, they don’t care what my opinion was (laughing) and that I could keep it to myself and he didn’t want to see or hear from me again.  It really...honestly, it really scare me because I thought,”are they fixing to kick me out of medical school?”  You know, I didn’t realize that I had really basically pissed somebody off and irritated them; it made perfect sense once I saw it from his standpoint.  I really...I can name the Dean if you want me to, but I really appreciated him bringing me in, sitting down and talking to me, and saying, ”you did this and I don’t think you should have; this is way and we have to have an understanding”...it felt like something; it was exactly what my dad would’ve said to me.... (Laughing)... and it’s like “Oh, ok...well, this is how this needs to play; now, I understand. You’ll never see me again I promise.        \n\n(Both Laughing)\n\nDr. Sam Taggart: What about that second two years?\n\nDr. Matthew Nix: You know, it was...I’m sure that everybody says this, but it was a lot better....a lot more fun and a lot more interactive.\n\n  \n\nDr. Sam Taggart: This is about 2002-2003...timeframe?\n\nDr. Matthew Nix: Yeah....and not that it wasn’t difficult, but it made more sense to my mind how things worked and it was easier to study things with a clinical background; so, I really enjoyed...it was difficult at times and I didn’t enjoy every rotation, but for the most part I did.  That’s kind of what again led me further to doing family medicine when I was in my third year; I kind of liked everything and kind of saw the value in everything; you know.  I mean it wasn’t....when I was on one rotation doing something, I was still thinking about everything else. \n\nDr. Sam Taggart: Other than the crisis of having a child without having any money; where there any other crises along the way that pushed you, or could’ve pushed you, in one direction or the other?\n\nDr. Matthew Nix: Uh....no, I wouldn’t say crisis; I remember our first and I don’t know if it was....one of the things that I remember about that time and I don’t know if it was the fact that I had a new born child...I don’t know if it was the fact that I was just starting my clinical rotations and I was at the VA and Children’s Hospital a lot; but my family had...I think my family doctor counted and we had like, In a year’s time, we had like 10 stomach bugs.  I don’t know if it was my son bringing this stuff home or if I was bringing it home from the hospital, but we were just seemed like all the time having diarrhea and throwing up.  We’d get so sick and we’d have to call my mother-in-law from Texarkana to drive up and take care of the baby because we’d be dehydrated and sick; but, I’d still try to go to my rotations.  That’s the thing that I remember happening and causing...other than like you said, “the child and the finances”....but other than that, everything was really ok.  I mean, there were no real problems with my rotations or interactions with anybody; it was all positive.\n\n  \n\nDr. Sam Taggart: So you begun leaning towards family medicine...\n\nDr. Matthew Nix: Uh huh...\n\nDr. Sam Taggart: As opposed to oncology....\n\nDr. Matthew Nix: Yeah...\n\nDr. Sam Taggart: Were there any “Ah ha” moments or times when....at this point, you had to start thinking about residency programs....\n\nDr. Matthew Nix: Yeah....\n\n  \n\nDr. Sam Taggart: What informed your decision, kind of like going to college, on where you would do your residency?\n\nDr. Matthew Nix: So, I’ll tell you...that’s a long story, but I get asked this a lot by medical students who rotate...”How did you choose family medicine?” I went in and I was going to do oncology, I was set on that....at the time, they were doing some kind of research project at UAMS and what they told us, this is through the psychiatry department, was that they were measuring how things like...personalities change through medical school...how your compassion, for example, changes through the course of medical school...and every year, they gave us an exam and asked us a bunch of questions on this computer.....at the end, it would give a prediction of what field you were going to go into; I’m a firm believer that certain personalities gravitate towards certain fields.  The first time I took this, after my first year, it said...maybe we took it at the beginning of the first year and at the end of the first year...but, it said family medicine.  I just thought that that was the stupidest program, because I was not going to go into family medicine; that was the furthest thing from my mind.  I was going into oncology, maybe internal medicine, or do something different...maybe be a GI doctor or something; I didn’t know.   My second year, it said family medicine ...it just kept saying that ....so, even early on, I was thinking, “Why is this personality test saying family medicine?”   Then between my second and third year, I did a rural preceptorship through the AHEC program and they basically paid you like $600 and I think it was 4 weeks long; you went two weeks with a private practitioner in a rural town and I think you went two weeks at one of the AHECs.....they paid you $600 and I desperately needed $600; so, I signed up for it.  I went and spent two weeks at the Pine Bluff AHEC and then, I spent two weeks with a doctor in Sheridan, Arkansas.  I cannot remember that doctor’s name.....\n\n     \n\nDr. Sam Taggart: An older guy...?\n\nDr. Matthew Nix: He was younger at the time; he was probably....\n\nDr. Sam Taggart: Highsmith....?\n\nDr. Matthew Nix: Well, that sounds familiar....\n\nDr. Sam Taggart: I bet it was Highsmith; he was the only one of those guys who was young.\n\n \n\nDr. Matthew Nix: Yeah, he was probably fairly fresh out of residency then; of course, that was almost 20 years ago.\n\nDr. Sam Taggart: Yeah....\n\nDr. Matthew Nix: But, again I didn’t have any real true interest in going into family medicine at that point, but I went down to the Pine Bluff AHEC and saw some patients in clinic with them and we’d do...I worked with Dr. Justice in his private clinic in Pine Bluff and saw patients with him and would do like a noon conference there at the AHEC and met all the residents.  Then in Sheridan, I just drove down every day from Little Rock and spent every day in this guy’s clinic and I just really enjoyed it.  I didn’t really have much of an understanding at that point of what family physicians did; what they do every day and it was one of my first true clinical exposures to that and I thought, “Well this is something that I kind of think I might want to do.”  So, I think that really started it and then...of course this seems so insignificant, but it’s a huge deal....you know, we had an FMIG, Family Medicine Interest Group and I don’t know if you knew Yvonne Lewis or not; Yvonne Lewis was the DIO, designated institutional officer, for UAMS AHECs.....so, she kind of ran the AHECs as far as education accreditation with the ACGME or what-have-you.  She was kind of in charge of the FMIG and so, she always arranged, at least once or twice a month, lunches where we got free food and there would be some program in medical school starting at year one; well, I didn’t go to those because I wasn’t interested in family medicine.  Some friends of mine, though, who were going to go into family medicine invited me and said, “Hey come along; you get free food.”  Well, I was hungry, free food and I was poor; so, I just went to have free food during lunch.....then, they had various programs about procedures, cases, or just family physicians talking in the community, or from the AHECS, or residents come...you know, over time just listening to these people talking about their experiences, I thought, “Well, that seems like something that I’d want to do” or “these are kind of my people; I’m kind of thinking like they think.”  That’s where I first heard about the summer preceptorship; Yvonne Lewis was saying, “Hey, I have a summer preceptorship; y’all need to apply.  $600 if you do this“...so, I got into that.  When I got into my third year, I had all of my rotations...my clinical courtships...except for family medicine; that was my last one of the year and it was in June.  So, I went through all of those....which I thought was good for me, because when I hit family medicine, I had exposure to everything else...again, I went this whole time kind of thinking, “Maybe I should do family.”  I hadn’t done family yet...I really enjoyed pediatrics, I really enjoyed internal medicine, I really enjoyed psychiatry....but then, I hit family medicine and I did it here at this site, Texarkana; I chose Texarkana primarily because...\n\n        \n\nDr. Sam Taggart: Were y’all already in this building?\n\nDr. Matthew Nix: No, we were in the old building downtown.  I primarily did it in Texarkana just because I wanted to come home for a month; you know, the grandparents wanted to see their grandson and I thought it would be cool just to hang out in Texarkana again. Well, I loved it and so then, I really started struggling.  My wife said something to me that was kind of profound as I was talking to her about it; she said, “Well, you know, I have been with you for three years now in medical school and the only time you were ever happy was when you were on your family medicine rotation.  That was the only time that you got up, went to work, wasn’t complaining about this or that, and you came home talking about things; you just seemed generally happier there than you were anywhere else. So, maybe, you should do that.” So, I thought about it....\n\nDr. Sam Taggart: So, a whole bunch of things were kind of turning.....\n\nDr. Matthew Nix: Uh huh...and thought, “yeah, well, maybe I should; that’s what I enjoy doing.”  There is a lot of pressure in medical school and in life, I think, on a lot of people to not do family medicine; you know, it’s ...our system isn’t geared to necessarily encourage family medicine, even though that is probably what we need to be doing; that’s why, I think, things like the FMIG are so important. Summer preceptorships are so important....it’s so important to get students out of a tertiary center, where they are surrounded by sub-specialists constantly, and get them in the real world to show them how medicine in really practiced by family physicians; they have to have those experiences early on or they’re not going to have that chance for it to work on them.  You come into college and medical school with these preconceived ideas and theses biases, which I had...I thought, “That’s what I want; I want to be an oncologist and I bet you all the money in the world”....Then, I’m not... (Laughing)....\n\n \n\nDr. Sam Taggart: It did not work out...\n\nDr. Matthew Nix: It did not work out.\n\nDr. Sam Taggart: So at some point, you had to start thinking about  where you would go to do your residency program......by this time you are getting into your senior year now ....\n\nDr. Matthew Nix: Uh huh...yes and I...I decided that I wanted to stay in Arkansas and I wanted to do an AHEC residency; I really didn’t know where.  I had done my clerkship here, I was from Texarkana...I really...when I went off to college, I had no intension of ever coming back to Texarkana...”\n\n(Laughing)...\n\nI was 17 and I wanted to get the heck out of dodge and never come back; life changes, you know and I was really concerned, because I was afraid....and my wife had the same mentality and I really struggled with that...because I had such a good time in Texarkana and as far as my senior electives, I came back here and did an acting internship; I may have done something else, but I just seemed to connect with the facility.\n\nDr. Sam Taggart: Who were the teachers at that point?\n\nDr. Matthew Nix: At that point, Russell Mayo, Michael Downs, Jerry Stringfellow...who are all still here   Stan Collins was here and some other people who I can’t remember off the top of my head; but those were the main ones. You know, Stan Collins has now passed away.  But I just connected with those people and I felt like ...unlike other rotations that I’d had...I felt like I could ask any question that I wanted to ask and nothing was going to be considered off limits or stupid and I could get anyone to help me.\n\nDr. Sam Taggart: Was there anything about their personalities; the people who were your teachers?\n\nDr. Matthew Nix: I think its all personality, you know; I think it’s a very family medicine mindset approach to problems...which I shared; my personality was family medicine, so, our minds all kind of worked the same.  But just personality-wise, background, and stuff...I just kind of felt like, you know, this was a place where I could thrive.  I wasn’t...I didn’t feel intimidated; I just felt like I could learn.  I was in medical school and sometimes the medical school environment isn’t necessarily great for learning, especially different learning styles, and I really wanted to go to a place where I felt very comfortable and at ease, because I feel like I learn better if I have that kind of support. So, I was leaning in that direction, but I was scared to death to bring it up to my wife because I felt like she was going to say, “Oh no, I’m not moving back to Texarkana”...you know; but I wound up approaching the subject one day and she was like, “Oh, I’m glad; I want to go back to Texarkana.  That sounds like fun.”... (Laughing)...From her standpoint...and mine too...she was looking at, and I was too, at grandparents; grandparents being here and able to help.\n\nDr. Sam Taggart: To support the family; yeah....\n\nDr. Matthew Nix: Because residency is hard; I mean it’s a huge time commitment as you know and it is...\n\nDr. Sam Taggart: Did you apply anywhere else besides here?\n\nDr. Matthew Nix: I actually suicide matched…(Laughing)...\n\nHave you ever heard that term “suicide match”?\n\nDr. Sam Taggart: Uh no; but, I can calculate and guess what it means..... (Laughing)...\n\nDr. Matthew Nix: Looking back at my ignorance and being naïve, that probably wasn’t the smartest thing to do; but, you know, I had decided that that’s where I wanted to go.  Medical students, medicine, and residents were different back then than they are now; you know, now we have...and I understand it; I’m not knocking it, it’s just a different world...applicants will tell us, “I want to come here as my number one choice” ....which is good to know and then they wind up not even matching in family medicine; a complete different specialty.  I didn’t...I wasn’t smart enough to even be deceptive; I didn’t know that was even a part of possibility when I was at that age.  I just told Dr. Mayo, “Dr. Mayo, I really want to come to Texarkana and I’m going to rank y’all” and he said, “Sounds good; we’ll see you in July.” So, I just thought.....\n\nDr. Sam Taggart: So you just put down the one school....\n\nDr. Matthew Nix: I just put the one school; that’s where I wanted to go, so that’s where I put.\n\n(Laughing)...\n\nI got to thinking about it later and listened to other people talk, my classmates, and I got really worried; I remember calling Dr. Mayo, seeing him, or something and I said, “Dr. Mayo, we’re looking at buying a house or something; are we sure that this is going to work out?” and he said, “Oh no, it’s not a problem; don’t worry.” ... (Laughing)....     \n\nDr. Sam Taggart: Most studies...and these go back to the ‘20s and ‘30s...suggest that people go into practice close to where they were raised or trained; do you think that is true with you?\n\nDr. Matthew Nix: Yes...definitely; of course, I’m a faculty member in my original program site, so that’s....those studies are why we exist; really.  And I do think that’s true, not only in my personal life, but I’ve seen it time and time again.  Especially where you train; I think they felt like where you train is more important than where you are from.  Where you train is where you start setting, at that part of your life especially, you start put down roots...you start knowing the medical community... you become very comfortable where you are at ; it’s hard to leave that.  If you look at the family physicians in our area, the vast majority trained at this site and they’re not even....many of them aren’t even from this area.\n\nDr. Sam Taggart: Yeah....\n\nDr. Matthew Nix: They are from all over the United States or even outside the United States and they stayed; they stayed right here.\n\nDr. Sam Taggart: Talk about the residency experience here; three years, two hospitals, outpatient setting, obviously good staff....you already commented on the fact that you were pleased with that staff here.  Talk a little bit about what you felt like your experience was here as opposed to had you been at the family medicine center in Little Rock, up in Fayetteville, in Fort Smith, or Jonesboro....  \n\n  \n\nDr. Matthew Nix: Well, I mean, overall it was a really good experience.  I was, in my perspective, a little unique because I grew up here and my mom was a nurse who worked in the hospital here; so, a lot of the specialists that I worked with...either rotated with them or we shared patients through consultations...if I did not...I mean, I didn’t really know any of them on a personal level, but I knew their names; I’ve heard their names all my life and some of them, I did know; my dad’s doctor or I’d seen them at some point.  I’m from here and so the patient population, I knew I guess on a more intimate level.  A lot of the people...a lot of the patients I may not know, but I did know their family members and that made it much more personal to me.  I just wasn’t here as a resident for three years and I was going to leave; a lot of these people in my mind that I took care of a resident, if I didn’t take good care of them, if I didn’t treat them with the upmost respect, or give them my attention...it’s a good possibility that I was at risk that my grandmother is going to hear about it on Sunday school, you know, because there are only 2 or 3 degrees of separation of everybody here.\n\n   \n\nDr. Sam Taggart: Right...\n\nDr. Matthew Nix: So, I felt like at least I held myself to a little bit higher standard because I didn’t want to embarrass my mom or my grandparents and I also had intentions of really staying, if not here, somewhere close to practice.  So, I really wanted to have a good reputation with the other doctors in town; not that that should matter, but it does matter in reality.  My experience being from Texarkana and coming back here, that was a huge pro and con in coming back here; it was a pro because it would make me work harder and be a better doctor ...but, it was a con because I recognized that I didn’t know anything and I was afraid that I would mess up, I would look ridiculous, or do something silly, and then everybody was going to know about it.  So, it’s a give and take relationship.\n\nDr. Sam Taggart: So now, three years and you’ve got all this money.... (Laughing)...\n\nDr. Matthew Nix: (Laughing).....I’m filthy rich...\n\nDr. Sam Taggart: You’re filthy rich, (laughing)....you had to start thinking about what you are going to do at the end of your residency program; talk about that process just a little bit.\n\nDr. Matthew Nix: Well, I didn’t... (Laughing)....I didn’t think that much about it.  It’s such a different... medicine is so different now than it was even back when I was in this process.  You know, now almost all of the residents are employed when they leave; they are employed physicians and they pretty much have to make a decision between, “I’m going to be all outpatient” ....”I’m going to be all hospital”... “I’m going to do the ER”....or whatever that is and that’s it; if you go all hospital, you don’t do any outpatient or vice versa.  When I...that transition was just starting when I got out of residency; you know, we’d heard of some hospitalists around here, but we didn’t have any...you know, but that was a thing that we’d kind of heard about.  I did want to go to a rural area and practice and I wanted to practice as true-blue family medicine as I could; in other words, I wanted outpatient, I still wanted to do hospital work, I didn’t want to do OB...But the rest of the whole gambit, I wanted to do.  A resident one year ahead of me, a guy by the name of Dean Bowman from Ashdown, had opened up a clinic in Ashdown; we were friends and he basically told me, “If you want to come up here and join me in practice, you can.” I just thought, “Well, Ashdown is like 20 minutes from Texarkana, we can live where we are at now and not have to move, and I’ll just drive to Ashdown. It’s a rural area and they have a little rural hospital, a critical access hospital there; Little River Memorial Hospital.  It was a fairly new clinic, a brand new clinic”...so, it seemed good to me and so, I did it.  People don’t do that anymore; so when I went up there, there was no salary guarantee...there was no nothing.  It was just he and I would agree...I essentially rented space from him and rented the equipment; I basically halved harboring expenses.  We just made money and in Ashdown at the time....        \n\nDr. Sam Taggart: This was in about 2006?\n\nDr. Matthew Nix: 2006 and my wife was_______; so, in Ashdown at the time, things had not evolved and still the way they were...what I mean but that, in order to have hospital privileges at the hospital, you had to be in the ER rotation. So, the family doctors in town...there were 6 or 7 family doctors in town and all but 2 of  them had hospital privileges; they all were in the ER rotation and so, we didn’t have like an ER doctor, someone who was moonlighting, or a staffing company...none of that was heard of at the time.  So when I started practicing in Ashdown, I got in the ER hospital rotation and at least once a week, I did a 24-hour shift to cover in the emergency room and the hospital paid us an hourly rate.  That was my income guarantee; my salary guarantee was I had to work one 24-hour shift a week in the ER and you’d essentially function as a hospitalist/ER doctor during that time and while I built my practice.\n\nDr. Sam Taggart: Had you done moonlighting when you were in your residency?\n\nDr. Matthew Nix: Yes, I had; I had moonlit in residency in Magnolia, Arkansas and Nashville, Arkansas.  So, I had pretty good experience in the emergency room at that point and I was able to pay off some of my debt through my moonlighting activities.\n\nDr. Sam Taggart: Yeah....\n\n\n\nDr. Matthew Nix: So, I practiced up there and it took me...in my clinic, I did not make a dime off my clinic in a little over two years; I think it took two years to build my practice enough to have the income coming in to cover my operating expenses and you know, pay off some of that debt it took to get that started.”\n\n  \n\nDr. Sam Taggart: If you don’t mind me asking...you don’t have to answer this if you don’t want to...how much debt did you have after medical school and your residency program?\n\nDr. Matthew Nix: So, that’s a good question; I had....I don’t know off the top of my head at that point, but I think I probably had between 90-100 thousand dollars of student loan debt and I had probably between 70-80 thousand dollars of just personal loan debt.  Then when I opened up my practice, I took out about an 80-90 thousand dollar business loan. So, it was probably around $270,000 total debt.\n\n   \n\nDr. Sam Taggart: Yeah...\n\nDr. Matthew Nix: (Laughing)...Which seems like a lot of money, you know; but, a lot of the students now seem to have that much or more debt depending on where they went to medical school.\n\nDr. Sam Taggart: Yeah.\n\nDr. Matthew Nix: You know, they seem to have a lot more debt than I did.\n\n \n\nDr. Sam Taggart: Was private practice what you thought it would be?\n\nDr. Matthew Nix: Um, yes and no; I mean I enjoyed private practice, but, it’s actually lonely in private practice. That’s one thing that I didn’t realize it would be; it’s kind of lonely.  You know, I mean, I had a partner, Dr. Bowman; he practiced a year before I did and he’d tell me how lonely it was.  What I mean by that is that you’re there and you’ve got a patient you’re seeing, but there is no one to like bounce an idea off of someone’s head or say, “Hey, will you look at this x-ray” or “what would you do next?” or whatever.  It’s kind of the same thing; when I was in clinic, I had him to talk to or just communicate with somebody about being a doctor...when you were in the hospital there, you were on call and you were literally the only doctor in the county because everyone else left and so, you really didn’t have anybody to talk to.  That’s a very different feeling than it is here; where I’m around 30 different doctors everyday and know that I have several colleagues here all the time.  Even at the hospital in Texarkana, you know, there’s...you’re covered up with doctors and you can just grab a specialist if you want to or call and talk to them; they’ll say, “Oh yeah, I’ll see so-and-so; that’s no great problem.”  Rural medicine, you don’t have all those safety nets; you know you don’t really have anyone that you can necessarily talk to and get their ideas.  So that’s one thing about private practice, especially in a rural community, that was a little frightening...you know, a little different.  Numerous instances when I worked in rural ERs; “if I can’t get this person intubated, there was no one to help and they could die” or “if I can’t figure out this diagnoses and get the appropriate treatment”...”if I can’t whatever it is”...that’s a lot of pressure.  That’s a lot of pressure and I don’t think a lot of people really recognize what the rural physicians really have to struggle with.  I think the other thing about private practice too is you know, you just...you don’t realize or I had no idea when I was in medical school until later on... how much we don’t know. (Laughing)....You know, you watch T.V. and you think...you go to the doctor and you watch T.V. and you think, “I guess we’re more advanced than what we really are” and then you start practicing medicine and you realize that a lot of this is really more art than it is science; I don’t...I mean every day, I just don’t know and no one else does either...\n\n           \n\nDr. Sam Taggart: Any big time crisis during that time...?\n\nDr. Matthew Nix: No, no big time crises; do you mean during private practice?”\n\nDr. Sam Taggart: No; just with you, your life, your practice, the ER...anything....\n\nDr. Matthew Nix: (Laughing)....“There are always crises with patients; lot of those.  In, probably not at that time, but my practice was hindered from the beginning in Ashdown; there is a paper mill there in Ashdown and my partner and I could not get fully on under their insurance program.  They ran their own insurance program; but that is the largest employer there in Ashdown and that really hindered us from what patients we could see.  They had different tears of employees to their insurance programs and there were certain tears that we could see; but the largest tear of those patients, which is basically like your hourly workers or non-administrative people, we couldn’t see.  So, I spent four years in Ashdown and that just wasn’t going to work out eventually; I was always kind of promised that we’d eventually get onto this program and then, they’d wind up switching insurances.  Being in a small town like that and it being their largest employer, it’s a big deal.\n\nDr. Sam Taggart: It’s a big deal...\n\nDr. Matthew Nix: And I didn’t want to sink anymore money into it without some type of insurance that I was going to be able to not only make ends meet, but be financially successful in that market; so, I actually decided in 2010 to close my practice down.  The other thing with that was ...we practiced at Ashdown, but we actually covered three hospitals; we covered the two hospitals in Texarkana, so we had admitting privileges here, and in Ashdown...and two nursing homes.” Some other doctors had left; two doctors had retired by that point and one had just left and moved....so, I was doing a 24-hour shift in the emergency room once a week and it became two and three times a week.  Again, at the time, the hospital did not want to do a staffing company or bring an ER physician in and so, the pressure was on us to continue that. I was exhausted; you know, I was having to work at least two 24-hour shifts in the emergency room every week, maintain my practice 5 days a week, round at three hospitals..I just couldn’t.  I just couldn’t do it anymore.\n\n       \n\nDr. Sam Taggart: So in 2008-2009, you started thinking about making a change.\n\nDr. Matthew Nix: Well, really...yeah, 2009, I started thinking about making a change and in 2010, I did.  In 2010, I just decided that I was going to do something different; I had always thought that I would practice for maybe 15-20 years and then teach.  I thought I’d maybe try to find a residency program and teach; semi-retire and teach. I told you before that in my experience in college, I always enjoyed teaching.  When I was a resident, I was actually chief resident and one of my primary jobs was making sure that the interns were taught properly and I really enjoyed that. When I finished residency, I didn’t think I knew enough at that point to be anybodies teacher, so I decided that I couldn’t become faculty anywhere at that point; but that was kind of a thought that I had that I would eventually do that.  When I closed my practice down at Ashdown, I thought, “What am I going to do now?” and so, you know, I just cold called Dr. Mayo and said, “Listen, I kind of want to teach; I really enjoy it.”  We’d have medical students come up to rotate with us at Ashdown and the nurses would say, “You’re the happiest when there is a medical student here and you teach somebody something and there’s somebody to talk to about medical things” and I thought, “yeah, I know.”  So, I called Dr. Mayo and said, “Hey, I don’t know if you have any openings or not, but I’m kind of thinking about this”....I didn’t know it, but they had just...I think a faculty member had gotten sick and someone had to quit; so, they were hurting for faculty.  I think they had two full-time faculty at that point and one part-time.          \n\nDr. Sam Taggart: How many residents?\n\nDr. Matthew Nix: 24.\n\nDr. Sam Taggart: Wow; that’s a big load.\n\nDr. Matthew Nix: They were hurting and he was like, “YES.”\n\n(Both laughing)...\n\n“You’re the answer to my prayer”...so, I came on in 2010 and I’ve been here ever since.\n\nDr. Sam Taggart: And you’ve enjoyed it?\n\nDr. Matthew Nix: I have enjoyed it.\n\nDr. Sam Taggart: Yeah...and you continue to enjoy it?\n\nDr. Matthew Nix: Yeah, I continue to enjoy it; things have changed, you know.\n\nDr. Sam Taggart: In what way...?\n\nDr. Matthew Nix: Just everything has changed.  You know, we...medicine has changed, the local community, the local medical community, has changed.  You know, we have hospitalists now and a lot of the specialists that I grew up with and trained with are now gone.\n\nDr. Sam Taggart: Retired; yeah....\n\nDr. Matthew Nix: It’s crazy to me that we have specialists coming in who are younger than me now; I still think of myself as really young and I am young, I’m 44.....but, I think of myself as like 28 or 29. ”\n\nDr. Sam Taggart: Yeah...\n\nDr. Matthew Nix: In my mind’s eye....and I’m not; it’s hard for me to fathom that I’ve been practicing medicine now for really almost 20 years...that seems strange to me.  So, things have changed; technology has changed.  You know, I learned on...we had paper charts; the clinic and hospital had all paper charts and we wrote all the prescriptions out.  We had real x-ray films.  The residents now, when I bring them in, have no idea how to write a paper prescription; they’ve never even seen one.  They don’t know anything about a paper chart; they’ve never seen one before.  Everything is now electronic; no one has seen an x-ray film in I don’t know how long.  No one knows about chasing down the hall to find the x-ray film to look at it.\n\nDr. Sam Taggart: Right...\n\nDr. Matthew Nix: Just things like that; I’m telling things to people now and they don’t have any idea what I’m talking about.  Even old treatments that were state of the art 20 years ago are now somewhat barbaric; I guess.\n\n \n\nDr. Sam Taggart: Right...\n\nDr. Matthew Nix: So, I’m starting to have, at 44, these experiences... especially with these brand new doctors coming out of medical school.\n\n\nDr. Sam Taggart: You realize that you are the age of my youngest son....\n\n(Laughing)...\n\nI’m serious; I don’t know why I threw that in, but I just think that’s...\n\nDr. Matthew Nix: How does that make you feel?\n\nDr. Sam Taggart: It’s just interesting...it’s fascinating; it’s absolutely fascinating to watch the torch being passed.  \n\nThere are a couple of other things that we need to start thinking about because there is one subject we haven’t approached at all; the Arkansas Academy of Family Physicians, the National Academy of Family Physicians, and organizations...not just them...but the Arkansas Medical Society, the County Medical Society; does Miller County even have a county medical society anymore?\n\nDr. Matthew Nix: No.....so, you know, it used to; they had a......the county is Texas is Bouie County and at one time, I think there was a Bouie-Miller County Medical Society, but I don’t think that exists anymore.  I never, since I’d been practicing, ever heard anything about it.\n\nDr. Sam Taggart: When did you start getting involved with the Arkansas Academy of Family Physicians? Obviously, you are on the board and have been President.\n\nDr. Matthew Nix: Yeah; when I was in practice in Ashdown, you know, I had the journal sitting right over here next to me.  I would get....I was a member just because of my...really because of my membership to the National Academy.... and I would get the journal and I would just thumb through it some; there’d be some interesting things in it, but I had never been to a meeting.  I really didn’t know anybody in the Academy and in my training, that wasn’t really talked about or really wasn’t a big deal; but in practice, some of those issues that we think about....you know, things related to medical practice; whether it be scope of practice, insurance companies, all those kinds of things, legislative issues, and whatnot....it became more important to me because they were effecting me more there than they were when I was in residency; so, I just started paying attention.  When I came on here as faculty in 2010...I’m not sure what year it was; it may have been in 2011 or 2012... But somehow, I guess, I got out on the email lists and she just sent me an email...maybe it was a blanket email and asked; they needed a board member and asked if anybody was interested in serving on the board.  I said, “You know, sure; I mean, I’d love to know more about the academy and get more involved.”  I was kind of peripherally involved in reading some of their literature, but I never was really involved or knew exactly the scope the academy had or where its inter-workings were.  I was just interested in knowing more...one was just for my own gratification and education and the other is that I really thought that if I knew more about it and was more involved, I could transfer that down to the residents that I was teaching and get them more involved so that when they got into practice, not only would they be better prepared, but they would know what resources to reach out to if they needed something.  So, that was my mindset for when I got involved and basically.... \n\nDr. Sam Taggart: So you were already working here?\n\nDr. Matthew Nix: Yes, I was working here.  Carla said, “Well, you know basically, I think I can send something in.”  She, I guess, asked the President and the board and they thought it was a good idea; I don’t think we had a lot of representation at that time in this part of the state and so, that’s how I started.  I just got on the board and started going to the meetings; I started meeting people, learning things, and eventually became an officer, and then President. \n\nDr. Sam Taggart: Was that in 2017 or 2018; somewhere in there?\n\nDr. Matthew Nix: I was just looking; I was President in ‘19 and ‘20.\n\nDr. Sam Taggart: Ok....\n\nDr. Matthew Nix: ...Which was a rough year.... (Laughing).....\n\nDr. Sam Taggart: Ok, now, that was one of the things that I was going to ask you ....what were the pertinent issues that were going on Involving the academy either in your time on the board or especially during your time as President?\n\nDr. Matthew Nix: Well, by far, the most pertinent issue in my tenor as a board member always seems to have been the scope of practice.\n\nDr. Sam Taggart: So privileges...?\n\nDr. Matthew Nix: Yeah; with nurse practitioners having independent practice, that has seemed to be the biggest umbrella-type issue that has caused most of the conversations about... obviously especially during legislative years...and in non-legislative years, we are talking about various things about that to prepare for the legislative years.  There’s agreements on both sides and at this point...I was President during a non-legislative year, which was by design”.... (Laughing)... “I did not want to be President during a legislative year; I don’t particularly enjoy talking to legislators. There are some people who are so skilled at talking, specifically to legislators, and I can name some remarkable people that I met at the board.\n\n    \n\nDr. Sam Taggart: Who?  Please, name them; if you don’t mind naming them...\n\n(Laughing)...\n\n I mean, if you don’t mind naming them....\n\nDr. Matthew Nix: Uh, I mean, the first person on the top of my head is Lonnie Robinson; do you know Lonnie?\n\nDr. Sam Taggart: Yeah, I know Lonnie.\n\nDr. Matthew Nix: I wish I could...I wish that he could give me some of his authoritory skill; especially talking to legislators.  He is just very levelheaded and knows exactly how to brace things, say things in such a way that they can understand, and say it in a very succinct manor. He’d be, by far, probably the best in my mind anyway someone to speak to legislators.  I don’t really have that gift and so, I became President in a non-legislative year.  Now, I thought it was going to be a pretty good year; but, a couple of things happened....one was Carla Coleman, who had been the executive director for 30 years, retired and so, it was......I was the president and I always say that I felt like...this is probably not true...but I feel like she had enough faith in my abilities as President to feel confident to retire while I was President; right.   \n\n(Laughing)...\n\nIt was difficult because we needed to basically replace her and it’s hard to run a search committee and do interviews and stuff while we are all spread out across the state; but I had a great executive leadership team, an executive committee/search committee...a great board and lead that effort and we were able to hire somebody in that position and that they were going to start...so, we started in September or October in 2019 and we got somebody hired and they were going to start on January 1st, I believe.  Then on January 2nd, I was walking into the movies with my son...I was off for Christmas break and on this persons day one or day two...I guess, day one of the job, because January 1st was New Years Day; on January 2nd his first day on the job,  he called me and quit.  So, we had to start over” (laughing)....”and we hired Mary Beth; whose last name I can’t remember right now...\n\nDr. Sam Taggart: Rogers....      \n\nDr. Matthew Nix: What is it?\n\nDr. Sam Taggart: Rogers....\n\nDr. Matthew Nix: Rogers...Mary Beth Rogers; I’m so terrible with names.  She’s been absolutely fantastic; I’m so glad the other person quit, because I think we had made a mistake.  Sometimes you get a second chance in life; right.....and I’m married for the second time too.”   (Laughing)....I got remarried in 2012, by the way, and we’ve been married for almost 10 years.\n\nDr. Sam Taggart: No additional children?\n\nDr. Matthew Nix: None of our own; I did get a stepchild who is 23, Morgan.  My youngest daughter is 15 and her name is Nora; I had to make sure that I name these people.\n\nDr. Sam Taggart: Yeah, that’s a good thing.\n\nDr. Matthew Nix: Now another thing that happened in early 2020 while I was President was Covid.\n\nDr. Sam Taggart: Yeah...\n\nDr. Matthew Nix: Covid hit and of course, we wound up cancelling our annual scientific assembly and all the things that year; so all the things started to fall out from Covid and everything had to be done different...all that happened under my watch as President, but we made it.  We became much stronger in the end; it was...it was a good experience.  There was a lot of tough times and I always wanted to give some type of recognition to the President that preceded me, Scott Dixon, who helped out tremendously with just letting me...maybe complain or you know, shook him with ideas and maybe bounce ideas off of him....he was a big help during  that year. But, it was...I was glad to give it to somebody else.\n\nDr. Sam Taggart: We are....the book that I am writing is called, “For Every Family, A family Doctor” and it’s about the history of the modern family medicine who have been in Arkansas and the Arkansas Academy; so, I’m dividing up those two things.  I considered stopping it in 2000, because it’s really hard to write history....that’s kind of my forte now.....it’s hard to write history about things that haven’t actually played out yet.  But in 2002, the Future of family Medicine Collaborative occurred and they started promoting things...something they called the new practice model; obviously a major part of that was the Patient Centered Medical Home.    \n\nDr. Matthew Nix: I’m familiar...I’m very familiar.”   (Laughing)... \n\nDr. Sam Taggart: That’s the part I want to ask you about; do any of those terms.....the new patient model, the patient centered medical home...any of those terms have any meaning for you as a teacher or as a practicing physician in 2022?\n\nDr. Matthew Nix: Very much so; how much time do you have?\n\nDr. Sam Taggart: As much as you want to spend; seriously... \n\n\nDr. Matthew Nix: So in 2010 when I came on as faculty, it was about that time...maybe 2009...’08,’09, or ’10 when we started hearing about all this that you are talking about; the triple H...PCMH and all those things.  We didn’t know what that meant, but we kept hearing about it and it was getting pushed from various organizations to us, whether it be insurance organizations or the academy...when I was actually hired in this position in 2010, my director at the time..that was his first charge to me; he basically gave me this notebook and said, “I need you to turn this into a certified PCMH; that’s you’re project.”  We had this mandate from basically UAMS that we needed to be a certified PCMH; I literally didn’t know what that meant either.  So, I started digging into what that meant, how you get certified, and really at that moment started, at that time, started reforming our clinic and our processes...\n\nDr. Sam Taggart: Was this before Affordable Care or after?\n\n   \n\nDr. Matthew Nix: When did Affordable Care come in?\n\nDr. Sam Taggart: It was around 2010 or 2011; somewhere along there...\n\nDr. Matthew Nix: Yeah, along that time; exactly....I was reforming our clinic and our processes and stuff to basically meet some of those requirements of the Patient Centered Medical Home, which really wasn’t very different than the way that I was trained to practice medicine...which was basically me and my nurse; we took care of everything. Of course, that model had evolved over time; different layers have been added in or pulled out because things didn’t work.  It’s been changing and then, I can’t remember what year it was...maybe 2012 or ’13...UAMS wanted each of its clinics to have a medical director and I’m currently the medical director and have been since that time.  That’s really one of my primary goals, quality improvement; taking a lot of those acronyms: PCMH, Triple H, and all those kinds of things...and making them happen in the clinic. To me, there is quality metrics in those kinds of things and that is just one of the ways that this whole business has changed dramatically.  It would be so hard to do that in private practice; you know the way my office was set up in Ashdown and the requirements that are now in place for us, it’s not impossible; but it would be really hard and I think that’s why a lot of physicians do become an employed physician or do go into large groups; so someone could be doing that in the background or helping them with it, because it’s a lot.\n\nDr. Sam Taggart: Yeah...\n\nDo you see the Patient Centered Medical Home being transitioned from an academic center or a corporate center like Baptist or maybe somebody like that...do you see that transiting into private practice offices?  Do you think your students who leave here are doing that in their offices?\n\nDr. Matthew Nix: So, I do; I think that more...I guess its several fold; one is: I think that in the way that residents here are at least trained, they leave with an expectation that their practice is going to run a certain way...because that’s how they are trained; they don’t know any different.  One of the biggest hurdles we had to get over as practicing physicians was “this is not how we were trained to do things”... “this is not how I learned it”...”this is not going to work”.  It’s funny because I see residents every year and when this stuff...when all these things were visually started, I had so much push back from residents...a lot of pessimism and over time, that’s gone away because the new ones, they don’t know anything different.  Their exposure in medical school was as-is now; sometimes, some of them are a little ahead of me...they’re like,”Well, basically, that should be...why is that not done or whatever”...So, I think as residents are trained differently, their expectation is different.  They go into a practice and they’re going to expect these things to be done because they don’t know any different.  A lot of older...a lot of private practitioners that are older in the state have recruited residents in their practice for this very purpose; to help them in these transitions...because it makes perfect sense to them and to help them with that.  Another thing that I think happens is that...EMRs are becoming; I don’t want to be...or commit harasser, but they are getting better.  They are doing a lot; they are made better... the software is better.  At the beginning of this process, they wanted us to do these things and the software wasn’t made to do that....so we struggled, struggled, and struggled for years.  I spent a lot of my career fighting EMRs and now, the software is kind of caught up and a lot of the things that they wanted us to do...like at PCMH that I did, the software can now do for us or help us do it instead of fighting us; that has made a huge difference in making that possible. EMR is a huge investment; I mean, it’s a huge infrastructure investment and there are a lot of doctors, as you are aware in the state, who are still on paper.  I actually had a resident this past year that graduated and went into a rural practice in the state and they’re on paper; he doesn’t know...I mean, how does that work if they don’t know how to do it?\n\n \n\nDr. Sam Taggart: Yeah...\n\nDr. Matthew Nix: I don’t think though that that is a feasible model at this point; they’re going to have to become electronic because the insurance companies now are increasingly tying your reimbursement to all these things.\n\nDr. Sam Taggart: There was a physician in the late ‘80s or early ‘90s who still kept his medical records on 4x6 cards.\n\nDr. Matthew Nix: Wow; I’ve heard of that, but never seen it.\n\nDr. Sam Taggart: When I first started practicing medicine, my first practice that I was in was in Smackover and we had medical records on 4x6 cards.  But what ended up happening with this guy was that the medical board censored him twice and then took his license...because he would not make the transition to paper records and that’s the same kind of thing that is going to happen with this.  \n\nDr. Matthew Nix: I think we’ll see an exodus, you know....when the hospital went to full electronic medical record, several older physicians who were not near retirement...they were near retirement, but they still had several years in them... they were good physicians who were out and I can’t blamed them.\n\nDr. Sam Taggart: Right...I started practice in ’77 and I retired in 2012 to do this kind of stuff.  We went full EMR in 2008...or 2007...and I was just excited about it.  I was really excited about it and we only had one doctor that almost quit and three nurses; but, I think it has to do....like you already said...with these kids who grew up with a computer in their hands.  They wouldn’t know... \n\nThe next piece of technology information...any ideas and thoughts I want you to comment on...telemedicine; the idea of telemedicine has been around forever.  It’s just gotten functionally realistic in the last 10-15-20 years; the med center did some...Rick Smith the psychiatrist at the med center in the ‘90s did some.  How did your practice here handle the concept of virtual visits by telemedicine and increasing the technology that is in the home so that you can monitor and do more...I still can’t say the initials; the patient centered medical home...how did y’all make that transition and has that been met with hesitation or has it been embraced?\n\nDr. Matthew Nix: Yeah, it’s been complex.  As you know, Covid eased a lot of those restrictions that we had with HIPPA and that kind of stuff.  We didn’t do...we offered virtual visits during Covid and what I mean by virtual was video and audio at the same time....but, it didn’t go well because of technology on both ends; our technology was kind of shoddy and a lot of our patients, especially our older patients, couldn’t work their technology on their end.\n\n         \n\nDr. Sam Taggart: Right...\n\nDr. Matthew Nix: I do....it has gotten....you know, people were really excited about it at first and I do think it has its place; but I lost a lot of my excitement when I realized everything that I lost in a face to face visit.  I realized quickly how much information that I got, diagnostic information, from a patient from just being in the same room and those nonverbal cues and all those kinds of things; I think that really became important.  But, I do think that it has value and since then, for example: our EMR...before we had to like go outside our EMR to do the virtual visit, which was problematic...I never could get; the technology, things just never could get synced up.....well now, they’ve embedded the technology within the EMR that we use and it’s gotten a little bit better.\n\n      \n\nDr. Sam Taggart: Which EMR system do you use?\n\nDr. Matthew Nix: We use Epic.  I think it will continue to get better; I don’t think we know exactly how to use it.  You know, I see it....I see mental health still embracing it and it has done really well with that.  I would like to use it more in that capacity; just to check in on someone that I put on an antidepressant.  Check in with them in one to two weeks and just say, “hey, is everything ok?” I use our patient portal a lot, which is basically where patients have access on their phone and computer to their medical records and they basically send me messages through the software; essentially email back and forth; I use that all the time with my patients and I really embrace that and the patients really like it.\n\n\nDr. Sam Taggart: How important is the portal to the Patient Centered Medial Home?\n\nDr. Matthew Nix: It’s a requirement.\n\nDr. Sam Taggart: Isn’t it an essential part of that?\n\nDr. Matthew Nix: Yeah...\n\nDr. Sam Taggart: Ok, alright; I’ve heard that people complain, patients and doctors, a lot about the portal.  ”It’s very impersonal; I don’t...” \n\nDr. Matthew Nix: Yeah, it’s very...I don’t want to sound like an IT person, but it was so software driven.  Our previous EMR, the portal was awful; it was hard to use and you had to do a lot of double documentation...it was awful.  In Epic, they modified the portal where it was easier to use and I would rather get someone’s lab work back and send them a quick message that say, “hey, your lab work looks great” or “you’re still a little anemic, do this”...or whatever and then, they can read it on their own time as opposed to me trying to call them while they’re at work and I can’t ever reach them, or I stay on the phone with them for 20 minutes maybe, or we’re playing phone tag, or I got to write them a letter that takes 7-10 days to get there.  They’ve already looked at their results now because that’s also part of the PCMH regulations; people have to have instant access to their records and they’ve already seen all that.....so my ability  to communicate with them through the portal or if they just simply want to ask me a question...if it’s a simple question, that ‘s fine and if it’s a long question, I just say, “hey, why don’t’ you come into the clinic at you’re next convenience so that I can have some time to take a look at you.”  I’ve really enjoyed it and I think that’s step one; I think we will get to more virtual visits.  I think the reimbursement issue is still there, because we don’t get paid much for a virtual visit still; since all those Covid mandates have been receded.  But I think we will use that more in family practice again as technology gets better.  I have a lot of patients now who are on continuous glucose monitors and I download that information onto my computer from their Iphone.  We have a program here where we do ambulatory blood pressure that again comes through our....So, I can see the technology......people can send me pictures and stuff too now.; so, as the technology gets better, the software gets better, I can see us doing more of that.\n\n      \n\nDr. Sam Taggart: Have you ever had any contact with Steven Caldwell; the cardiologist, in Little Rock?\n\nDr. Matthew Nix: No, but I know the name.\n\n\n\nDr. Sam Taggart: He’s been involved in this process now for 8-10 years, I think he works through Baptist, but he’s been looking at various technologies that can be placed in the home: continuous blood pressure monitors, blood sugar monitors, and.....\n\nDr. Matthew Nix: We have INR machines now to be placed in people’s homes.\n\nDr. Sam Taggart: Yeah, yeah really very interesting stuff; these are the subjects that I told you in writing this history that it’s hard to write the history because by the time I give a talk in August, everything that I say is going to be dated....(laughing)...everything is going to be dated, but I want to go onto another subject....\n\nDr. Matthew Nix: But, I think it’s important though to go ahead and record that transition.\n\nDr. Sam Taggart: I think it is too.....I think it is too and that’s really an interesting ...engaging part of this. Another piece of information, another subject really, the Arkansas Academy of Family Physicians, the National  Academy of Family Physicians, the American Medical Society, the Arkansas Medical Society.....particularly the first two....their bread and butter the last 70 years was providing good, ongoing, meaningful, continuing education to its members; which was one of the sticks that got people to join.  They would have a good meeting and they’d show good.... now, you can go on the internet and get two hours worth of credit; some of it really, really good.   I did a thing on narcotics with the New England Journal Medicine here about a year ago; if you ever need any continuing education for narcotic usage, it’s really great....but anyway, in an hour or two hours, you can get 20-25 hours...how is the academy going to stay pertinent to the practicing physician?\n\nDr. Matthew Nix: That’s a great question. (Laughing).....That’s the million dollar question.\n\n           \n\nDr. Sam Taggart: Yeah...I’m talking about the American Medical Association...all these organizations; do they have the potential of going the way of the County Medical Society?\n\nDr. Matthew Nix: I think they definitely....there is no doubt that that is a definite risk and we have struggled with that.  We’ve been struggling with that for years; talking about getting new blood into the academy.  I don’t have an answer; I think we have to be...if we’re not relevant for today and for tomorrow, then we will go the way of the do-do and should.  Because, it’s a....\n\nDr. Sam Taggart: Yeah, why have another organization that doesn’t accomplish anything?\n\n\n\nDr. Matthew Nix: Yeah and I mean, I get it.  We are definitely struggling with and have struggled for a long time I guess.....”What or how do we need to change to stay relevant to our members, especially new physicians, what do they want out of their academy?”  We are supposed to; the academy is going to have a strategic leadership meeting in June, the National Academy is going to come down in June to meet with us, the state academy, and we are going to discuss that very issue. We recognize that your point is valid and we‘ve got to come up with a strategy... “What is our game plan for that?”  I don’t really have an answer; Covid prompted a lot of this.  We definitely pivoted with our scientific assembly this past two years, or this past year, we did offer it virtually and we recorded it.  There were some great lectures there, but we were trying to tell people, “if you want to come in person, that’s awesome; but if you want to do it virtual, that’s fine too.” So, we’re trying to do hybrid meetings every year as much as we can; but you’re right about the CME, I mean, you can get CME anywhere.  I will say though, I don’t think that you can get...the best CME that I have is CME that is given to me by another family physician.  I think that is something that we will continue to shine in and maybe we need to exploit it a little bit; we try to do that, you know; but a cardiologist talking to me about heart failure is one thing...a family physician talking to me about heart failure in his patients in his practice is the thing that oftentimes is more clinically relevant and useful to me in what I do every day than maybe someone in Boston. So, I think that is something that we...it’s still a strength for us, but I think that we definitely need to branch out.  I think one of the things that we tried to branch out...in the National Academy as well...you talked about PCMH and its transition to this new model of care, the Academy has tried to help physician in that process and it hasn’t been real helpful I don’t think over all; I don’t think..I think; I want the academy to be something of a resource that you can go to to help with all these kinds of items.  You know, that’s why it has its legislative arm, it has its CME arm, and all these things that we try to do; but I think we are definitely going to have to see what’s coming on in the future and you know, beef that up for sure.  One of the things that we’ve heard from our members is getting help with things like new technology and new procedures.  The big thing right now in medical education is point of care ultrasound and we’ve had a lot of interests in that; so ,we have practicing physicians who don’t have access to those kinds of things, but want to incorporate point of care ultrasound....how do they do that or where do they start?  Well, I think they should go to the academy and the academy say, “Hey, this is what you’ve got to do. These are some opportunities”....I think that’s how it stays relevant; as kind of a one stop shop.  Your Google of medicine; this is where you go or we can point you in the right direction if we don’t have the recourses.  That’s where a lot of our...as a doctor, I’m indebted with information; I mean, I can get lost with information.  I’ve got to have a way to pair that down; you know I need someone to help me with that from a family physician’s standpoint, not just as a physician.  I kind of think that that’s where we differ from the AMA and the Arkansas Medical Society; those are just physicians, not family physicians, and I think that our viewpoint on things, the way we look at the world, and what we need from the world are very, very different than other physicians.  I think there is value in that and that there is still a need.\n\n   \n\nDr. Sam Taggart: Do you know who Gale Stevens was?\n\nDr. Matthew Nix: Nu uh.\n\n\nDr. Sam Taggart: He is probably one of the.....the reason I know or have this on the top of my mind is because I have been reading a lot about him; he is probably one of the founders of the modern family medicine movement.\n\nDr. Matthew Nix: Ok...\n\nDr. Sam Taggart: He is originally from Kansas and moved to Alabama, but he discussed family medicine as a counter-cultural movement that began in the ‘60s.  He’s writing in the ‘70s and ‘80s...he’s the guy in the Keystone Conferences. \n\nDr. Matthew Nix: Oh yeah...\n\nDr. Sam Taggart: He was the leader behind that; he talked about...I forget where I was going with that...but he talked about family medicine believes in science, works with science, uses science, but science is not to be all....its start and then the end of all.\n\nDr. Matthew Nix: Yeah.\n\nDr. Sam Taggart: And I think that’s some of what you’re saying...\n\nDr. Matthew Nix: Exactly..\n\nDr. Sam Taggart: Now, I’ve got two more questions; unless there is something that you would like to throw in...\n\nDr. Matthew Nix: (Laughing)...No..\n\nDr. Sam Taggart: I have two other questions that I’d like to throw at you....you are 44 now; in 65 years from now, you’re going to be a picture on the wall.  \n\nDr. Matthew Nix: Yeah, probably...\n\nDr. Sam Taggart: Yeah, you’ll be a picture on the wall; what do you want your great, great, great grandchildren to know about you?  \n\nDr. Matthew Nix: I’m not the type....\n\nDr. Sam Taggart: This wasn’t in here...\n\nDr. Matthew Nix: No, it wasn’t; you should’ve at least warned me so that I could’ve thought of something...\n\nDr. Sam Taggart: (Laughing)....I wasn’t going to....\n\nDr. Matthew Nix: I don’t know......that’s a big question.\n\nDr. Sam Taggart: Sure it is....\n\nDr. Matthew Nix: I don’t know; you know, I would definitely...I hope when my ....when that time comes and I pass away, I hope that when people give my eulogy... my kids, my wife, grandkids, or whoever....I hope the first thing that think of, or first thing they say about me, isn’t that “he was a good doctor”.  (Laughing)....I mean, I am a doctor; I am a physician, but that’s not the title that I actually like the most.  I don’t want my life to be defined by that title.  I think that’s...if someone says, “He was a great doctor” you know, that’s almost insulting in some way; especially if my child or grandchild is sitting there.  I want to be a good father first, a grandfather first, a good husband first...and I think that’s definitely a change from maybe a couple of generations ago.  I mean, I would like for them to say, “He was also a physician and cared a lot about people, worked really hard, did a lot of good in his life to help other people and be an example to them.”  But, I wouldn’t want them to; you know...I don’t want my life to just be a physician.  I would like to have a lot of stuff in that eulogy or that obituary before that get to the part about where “he was also a family physician and practiced for 40 years.”  \n\n        \n\nDr. Sam Taggart: Right...\n\nDr. Matthew Nix: Or something; that’s really hard because it takes up so much of our time to do this.\n\nDr. Sam Taggart: So, this is my last question; again, unless you have any other questions... What do you want for them?  \n\nDr. Matthew Nix: What do I want from them?\n\nDr. Sam Taggart: No, for them...your great, great, great grandchildren who may get a chance to see this video.\n\nDr. Matthew Nix: Well, I want for you to come back sometime and let me give you a better answer..\n\n(Both Laughing)...\n\nNot on the spot...well, I would say that I want happiness for them; I want them to be happy and whatever that means.  You know, I always joke that when you take your marriage vowels, there is no vowel for happiness...that’s not even in the equation.  But, I would definitely want them to be satisfied and live a fulfilled life.  I’d have to think about it some more; maybe I’ll go home and write my own eulogy.\n\n \n\nDr. Sam Taggart: You can go home, send it to me, and I’ll put it in here; ok....if you decide something, I will put it in the transcript.  I won’t be on video, but it will be on the transcript.\n\nDr. Matthew Nix: I’ll think about it though.\n\nDr. Sam Taggart: Thank you, Dr. Nix; I appreciate this.  It was great fun and I have enjoyed it.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2312/collection_resources/99089/file/196781#t=0.0,8318.31"}]}]}]}