{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/804xg9h63w/manifest","type":"Manifest","label":{"en":["J. Thomas Koch"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Description"]},"value":{"en":["\u003cp\u003e\u003cbr\u003eIn this oral history interview conducted by Sandy Panther, J. Thomas Koch, former President of AAFP Insurance Services, Inc., reflects on his personal background, career trajectory, and long-standing involvement with the American Academy of Family Physicians (AAFP) and its Foundation. Koch discusses his early life, education, and unexpected entry into the insurance field through his father’s work, as well as the historical development of the Breckenkamp Agency and its pivotal relationship with the Academy. He provides a detailed account of the legal and organizational challenges that ultimately led to the Foundation’s ownership of the insurance business, and the subsequent growth and transition of operations to Kansas City. Koch also shares insights into leadership within the AAFP and Foundation, the evolution of member insurance programs, and the importance of professional relationships in sustaining organizational success.\u003c/p\u003e (summary)"]}},{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2008-07-09 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Sandy Panther (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["American Academy of Family Physicians","family medicine","Member's Insurance - Medical","Member's Insurance - Life"]}},{"label":{"en":["Subject"]},"value":{"en":["J. Thomas Koch (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"summary":{"en":["\u003cp\u003e\u003cbr /\u003eIn this oral history interview conducted by Sandy Panther, J. Thomas Koch, former President of AAFP Insurance Services, Inc., reflects on his personal background, career trajectory, and long-standing involvement with the American Academy of Family Physicians (AAFP) and its Foundation. Koch discusses his early life, education, and unexpected entry into the insurance field through his father\u0026rsquo;s work, as well as the historical development of the Breckenkamp Agency and its pivotal relationship with the Academy. He provides a detailed account of the legal and organizational challenges that ultimately led to the Foundation\u0026rsquo;s ownership of the insurance business, and the subsequent growth and transition of operations to Kansas City. Koch also shares insights into leadership within the AAFP and Foundation, the evolution of member insurance programs, and the importance of professional relationships in sustaining organizational success.\u003c/p\u003e"]},"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156784/file/286731","type":"Canvas","label":{"en":["Media File 1 of 1 - Koch_J_Thomas_08.wav"]},"duration":5152.18659,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156784/file/286731/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156784/file/286731/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/286/731/original/Koch_J_Thomas_08.wav?1755095089","type":"Audio","format":"audio/wav","duration":5152.18659,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156784/file/286731","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156784/file/286731/transcript/82477","type":"AnnotationPage","label":{"en":["J. Thomas Koch Interview Transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156784/file/286731/transcript/82477/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Tape One, Side One of the historical interview with J. Thomas Koch by Sandy Panther.   \n\nWould you please give me your name in full? \n\nJames Thomas Koch.\n\nAnd your present title? \n\nPresident of AAFP Insurance Services, Inc.\n\nWhen and where were you born and your parent’s names, please? \n\nJuly 10, 1949, West Palm Beach, Florida. Mary Waithman Bailey Koch, Robert Russell Koch.\n\nWhat did your family do for a living? \n\nI do not know, specifically much about the family history as far as employment was concerned prior to World War II.\n\nWhat did your father do for a living? \n\nVarious jobs prior to World War II. I had a brother that was born in 1941 before the war. I believe at that time they actually had a paper route in suburban Philadelphia. After the war, my dad didn’t have a job when he came back and ended up going into the insurance business in Florida, which is obviously where I was born in West Palm Beach in 1949.\n\nYou are currently married? \n\nYes.\n\nAnd your wife’s name and your children’s and grandchildren’s names? \n\nYou’re kidding.  \n\nNo.\n\nDoes anyone get through all these names correct?  \n\nNo.\n\nSharon Barnes Koch. We’ve been married since July 29, 1972. I have a son, Jonathan Thomas Koch, born January 22, 1975. He has, by his wife, Jill, two children, both boys, Jayce Thomas Koch, born in…age four. Another son, born in 2007 in December, Kellen Joseph, I hope, Koch. We have a daughter, Rebecca Lynn Earhart. Her husband, Thane, they’ve been married long enough to have a four year old son. They live in Wichita and my oldest grandson is Alexander Gabriel Earhart and my two year old grandson is Anton Ezekial Earhart. Clearly, Sharon and I had nothing to do with the naming of the grandchildren.\n\nDid you have any role models when you were young? \n\nThat’s a good question. I can think of three, one being my father, of course. My parents in general, but my father. A seventh grade science teacher, of all things, and Roger A. Sanborn, Sandy Sanborn, he and his wife started Sanborn Western Camps in Colorado.  \n\nDid you have any dreams or goals when you were young, or did you end up going where you thought you might go? \n\nNo, not at all. I didn’t end up going where I thought I might go at all. Very much interested in politics, in government, public administration. Everyone always thought I would end up being an attorney or running for some sort of political office.  \n\nLet’s go to your education then, and what led you into either what you wanted to do or what you ultimately did. Where did you go to high school? \n\nWebster Groves High School, suburban St. Louis.\n\nThen you moved from Florida to…?\n\nTo West Virginia. Actually my dad started in the insurance business in Florida with American Fire and Casualty Insurance Company, which I don’t believe exists anymore. Learned the business from the ground up from the claims side and at some point, managed to land a job with American Casualty Company, which is important down the line as we talk about the insurance agency that will come back into play. It was with American Casualty Company that we moved to Charleston, West Virginia in the early ‘50s. From there to Philadelphia by 1957 and from Philadelphia to Reading, Pennsylvania, which was the home office of American Casualty Company, and then to St. Louis in 1961 when he moved from the company side to the agency side. That would be the origins of the Breckenkamp Agency that is now AAFP Insurance Services, Inc. \n\nWe’ll get to that.\n\nBy that time we were in St. Louis and I graduated from Webster High in 1967. Went on to Vanderbilt University, Nashville, Tennessee. Graduated with a degree in Political Science in 1971, fully convinced that I was going to become a city manager or some comparable type of position with a city government or state government, only to find out that in the interim period of years while I was in college, the city management landscape had changed from hiring people with political science backgrounds, which of course would make sense, to hiring engineers so that they could kill two birds with one stone and get a city engineer as well as a city manager. So the opportunities for employment were extremely limited in the field that I wanted to go into. My options were to go to KU, perhaps for an advanced degree in Public Administration, which didn’t really appeal to me. To go to Colorado and stay there in the mountains and never come home, or to accept the job at the last minute, offered to me by my father to join him in the insurance business with AAGP Group Disability Plans, one of the predecessors of AAFP Insurance Services, to run the claims department. At that time we paid the claims on the disability and the hospital indemnity program for the Academy’s policy.\n\nYou had mentioned before, and I think I’ll take you back at this point in time, you had mentioned before that your father moved to St. Louis to go to work for the Breckenkamp Agency. This has a great deal of history for the Academy and the Foundation. Would you now, do your narrative, both from a historical perspective, both fact and hearsay, about what occurred with the Breckenkamps and the Foundation? \n\nYes. A. W. Breckenkamp, August W. Breckenkamp, was a journalist for the St. Louis Post-Dispatch in St. Louis, quite an accomplished writer, was famous for writing stories about the Depression, going out in the field and staying with the hobos and the train people as they were trying to get across the country, and wrote under the byline, Breck in Camp, which of course was a play on his last name, but he was in camp with the transients, the hobos, whatever. Not sure exactly what the specific timeline was, but for whatever reason, he was well-positioned to get involved with an emerging part of the insurance industry, which was association group insur-ance, which really developed and burgeoned after World War II. It was a new area of being able to offer insurance programs sponsored by associations, being able to offer programs to their members on a voluntary basis. Breckenkamp had an affinity and a love affair for doctors. Again, don’t know the origin of that specifically, but he was genuinely interested in physicians and in advancing physicians’ causes, so he ended up starting an insurance operation known as Professional Men’s Insurance. That’s an interesting side that we should talk about too. Professional Men’s Insurance in St. Louis, and that organization was able to, in addition to the American Academy of General Practice, he also had agreements with other medical organi-zations, one of which was the…if not all, it was part of the ACOG, the American College of Obstetricians and Gynecologists, which has its own interesting historical insurance past. Breckenkamp at one point, had part of that business. In any event, he, in 1951, started an insurance operation in St. Louis for the sole purpose of marketing voluntary purchase, associ-ation group insurance products to organizations that had physicians as members. Within a very short period of time, the Academy sought to make that arrangement exclusive and they asked him to divest himself of any other medical associations and concentrate solely on general practitioners, at the time, later to be family physicians.   \n\nAt that particular time, in the early ‘50s and into the late ‘50s, my father, Robert Koch, was working for American Casualty Company, and I mentioned that previously, and had, by the later part of the ‘50s, relocated to the home office in Reading, Pennsylvania. ACCO, as it was known, American Casualty Company, was one of the pioneers in the association group business and Breckenkamp’s agency and the Academy’s account was one of his accounts, so he called on the Breckenkamp Agency to help support the solicitation and servicing of the Academy’s program with American Casualty Company, and did for many years. Breckenkamp also had agreements with Continental Casualty Company, out of Chicago, to write other programs with the Academy. Breckenkamp essentially had, and Professional Men’s Insurance, essentially had the rights to write health insurance, which would be disability income, office overhead expense, known in the business as BOE, business overhead expense and any kind of hospitalization program. He did not have the contract or the agreement with the Academy for life insurance, which the Academy did separately, or for any other benefits such as retirement programs or anything of that nature. Breckenkamp changed the name of the agency to AAGP Group Disability Plans, Inc. at some point in time in the 1950s, I’m not sure exactly when that took place. That was with the permis-sion of the Academy and to underscore and emphasize the exclusivity arrangement that he had for the group disability products. At that particular time it was a competition, so to speak, or whatever, between Continental Casualty Company and American Casualty Company. They both had this broker, Breckenkamp in St. Louis and this physician’s account, American Academy of General Practice and my father, as I said before, was the representative from ACCO.  Breckenkamp, as time went on, into the latter part of the ‘50, it became clear, had a problem with alcohol, and in fact, was an alcoholic. He was approached by the Academy and essentially told in no uncertain terms that he needed to bring someone else on board that could succeed him and assist him with the business and be the spokesperson and be the out front person, representing the agency as far as the Academy was concerned, or he was going to lose the business. The person that Breckenkamp focused on was my dad, Robert Koch, but of course my dad really didn’t know or understand what the circumstances were. Breck kept making offers to my father to come over to the agency side and to leave American Casualty Company and come to St. Louis. My parents were born and raised on the East Coast, they were from that area, from the Philadelphia/Reading area. That’s where they wanted to live. They had no reason to move to the Midwest. Breckenkamp kept making offers. My dad couldn’t quite figure out why but he wasn’t going to deter him, and eventually he made him an offer he couldn’t refuse, literally. I can re-member very clearly my father coming home one evening and announcing that we were moving to St. Louis and that he was moving right away and my mother and I could follow in the spring of 1961. By the end of the ‘50s and the beginning of the ‘60s, by 1961, my dad had joined the agency and had the title of Administrator, which at that particular time was really recognized as the operative title to have in the association group area. Breckenkamp, of course, maintained his overall control of the operation.\n\nAs time went on, and the relationship continued between Breckenkamp and the Academy, for whatever reason, the Academy wanted to form a foundation. Had the idea of creating a chari-table, eleemosynary, if you will, foundation, which again, is not uncommon for associations to want to do, but didn’t have the means to do that, didn’t have the wherewithal to do that and Breckenkamp was approached and asked if he would fund or make an initial contribution to fund the formation of a charitable foundation. In fact, he did, to a significant extent and I’m not sure exactly how big that initial contribution was, but it was enough to at least establish the foundation as an entity in fact and get it started.  \n\nAs part of that arrangement with the establishment of the Foundation, Breckenkamp had some very, very good legal and financial advisors working on his behalf in St. Louis and he was not a young man at this point. He had a high-maintenance wife, Kathryn, and a daughter who as time would tell, later on, proved to be a total nut case, in more ways than one. He wanted to make sure that they were provided for after his death and demise, and he wanted to make sure that the relationship with the Academy endured. Since he had taken the business risk of giving up other lines of business, he wanted to make sure that relationship was solidified and there would never be a reason for the Academy to get rid of him or discontinue the relationship. So he was willing to give the money to establish the Foundation and he went beyond that and set up, through his will, a series of trusts that would come into being upon his death, which would continue and perpetuate the business for the benefit of his wife, Kathryn and would also see to it that his daughter, Gretchen was provided for financially. This was a very unusual and creative solution, which the Academy readily agreed to, because ultimately, the way Breckenkamp set it up, the Foundation would win the insurance operation after his widow died, after Kathryn died, the plan was that the agency would pass to the Foundation. The Academy’s charitable foundation would eventually own a for-profit subsidiary, the profits of which could be used to support the pro-grams of the Foundation. It was an absolutely brilliant, creative idea. There was one small hitch in that whole structure, among other things, and that is he could control what happened as far as his estate was concerned and everything else, but he could not control what happened as far as his wife’s will and estate was concerned. Upon his death in 1967, the Breckenkamp estate, the trust, began to come into play. My dad began to succeed in running the operation for the benefit of the trust and Mrs. Breckenkamp, Kathryn, was not directly involved in any specific way with the business, although she had the title as President. She had the ability to sign checks, things of that nature. The real control of the operation was through the attorney, Norris Allen, in St. Louis and through the accountant, H. Lee Schnur, who was a partner in one of the prominent account-ing firms in town. Really, they were the ones that oversaw the trust and the operation of the business. The Foundation, during the life of Mrs. Breckenkamp, had a residual interest in the trust. It sounds really silly, but it was like a one-sixteenth…I believe it was a one-sixteenth, so whenever there was a financial distribution out of the profits of the insurance operation, Mrs. Breckenkamp, of course, would get a portion of that and through these various funds that have been set up, one of which was to take care of the daughter down the line, and also a portion of those funds were distributed to the Foundation. That was kind of just letting them know, yes, this is working as we had planned and here’s an indication that there will be funds coming to the Foundation and this is working and ultimately you will own the entire operation and it will be good. As I said, it wasn’t possible for one to dictate what one’s spouse would do or how they would establish their own wills, etc.  \n\nAfter Breck died and after Mrs. Breckenkamp had an ownership interest and as time went on, I joined the agency in 1971, right out of college. So for the next about ten years, my dad and I continued to run the operation through the trust arrangements and through the estate arrange-ments. During that period of time, the Foundation would periodically come to St. Louis and their attorney, Gerald Gorman from here in Kansas City, who represented the Foundation’s interest and also was the attorney for the Academy, would come along and the whole purpose of that was to just kind of build the relationship and maintain the relationship directly between Mrs. Breckenkamp and the Foundation and the Academy. For the Foundation to be able to reassure themselves that Mrs. Breckenkamp had not changed her will and she did fully intend to leave the business upon her death, to the Foundation, and that she acknowledged that her daughter, Gretchen, had been taken care of separately very well and everything was fine. We did this year after year after year and she would smile benignly and say, oh yes, everything is fine. Through-out that entire period, the daughter was systematically working on her mother to get her to indeed, change the terms of her will, such that the daughter ended up with everything and would succeed in ownership of the agency and the Foundation would essentially be left out in the cold. Again, that part could not be guaranteed, it could only be promised from Mrs. Breckenkamp. Of course, the attorney, Norris Allen, had drawn all that up, provided for all that and it was beauti-ful, assuming that Mrs. Breckenkamp didn’t change anything. Unfortunately, upon her death, and I’m getting foggy, but I believe was 1981, lo and behold, surprise, surprise, she had been coerced, if you will, by her daughter, to change her will. The Foundation was cut out, the daught-er believed she was to be in charge and have control over everything. For lack of a better term, all hell broke loose. My father was approaching the end of his career. I was just getting started with mine in my early 30s and we’re the ones with the insurance knowledge and the insurance background and the ability to run the agency. Unfortunately, we don’t know who we’re running it for. We know who we want to be running it for and we know what we want to ultimately happen, but we’re not in control of that because neither one of us ever owned one scintilla of the operation. We were strictly employees. The Foundation quickly sued to enforce the previous will that Mrs. Breckenkamp had written and I believe, and I’m sure at some point in time, you will probably interview Gerald Gorman, but I believe the assertion was that there was a contract to make a will. That terminology sticks in my mind, for whatever reason, but that was her constant reassertion over the years, that this is what was going to happen and that’s the way she saw it and everything else and she intended it to be that way. That, indeed, was definitive and was a will and it did supersede anything the daughter may have gotten her to do after the fact. Of course, the daughter hired the absolutely number one law firm in St. Louis and secured, perhaps their nastiest personality to represent her. For the next year, at least, or so, my dad and I ran the opera-tion with a court-appointed administrator, pendente lite, which was someone designated by the court to say, okay, you’re now in charge of this, you keep it going, you preserve everything until we figure out who’s right and who’s wrong or this thing gets resolved. It’s a very strange way to operate a for-profit business when your whole focus is to simply preserve assets and preserve something. You’re not supposed to be taking any business risks, you’re not supposed to be doing anything that could shrink the size of the operation. In other words, you are in a holding pattern. This is not good for viable profit-oriented organizations, but we had no choice because ultimate-ly we wanted for the Foundation and the Academy to succeed, but we had to go through the process.\n\nFrom the very beginning, from day one, it was clear to me and it was also clear to my father and to most of us that the whole relationship was controlled by the Academy. They controlled who was going to be their broker, their third-party administrator, who ultimately could deal with their members. Unfortunately, the daughter never really could understand that, that the agency did not own, really anything. There was no value to the business. There were some desks, some file cabinets and things of that nature, which of course, Gretchen could have, if need be, but the business itself, was simply the relationship. It was the agreement that the Academy gave, which was yes, we designate you to be our third-party administrator for insurance programs to our members. In reality, that endorsement could be withdrawn, it could be changed at any time. The Academy was very careful, as was the Foundation, to try to work through all this without dis-ruption to the membership, without any, to my knowledge, the membership was totally, and the people we had insured, the thousands of members that we had insured, were totally unaware of any of the turmoil that was going on behind the scenes. We were able to maintain and to keep going and to keep running the operation with the court’s administrator throughout this period, and ultimately, finally, cooler heads did prevail and a settlement was reached and with any settle-ment, no side gets everything they want. Of course, the concern for the Foundation and the concern for the Academy was the insurance operation itself. As part of the settlement, indeed, the Foundation did get the insurance business, which was the original plan and there was a sizeable other asset to the estate, well in excess of half a million dollars, which was a considerable chunk of money, which was also supposed to come to the Foundation, but that went to the daughter as part of the settlement. There was a remaining fund from the old, original A.W. Breckenkamp estate, which was still there and producing investment revenue or whatever, to the daughter, which upon her death, would pass to the Foundation. Years and years later, and in fact, 2000 and something, Gretchen finally did die and that additional, I believe it was close to half a million dollars, also passed to the Foundation.\n\nIn the long run, the grand scheme, which was set up way back in the ‘50s, did come to pass but we had to get past the daughter in the whole process. It’s remarkable, when you think about it, that a growing, viable entity could survive that and could indeed continue on.  \n\nAfter the settlement was reached and the Foundation owned the insurance business, I had kind of swapped roles with my dad and took over as President of the new corporation, which at that time was named AAFP Members’ Disability Insurance Services, Inc., to which several of our valued insureds called in and said, could you possibly make a longer name to have to write on checks? In any event, the choice of the name was not ours, it was chosen by committee as a result of the settlement of the lawsuit. In any event, we lived with that handle for several years, then ultimate-ly we were able to get it to AAFP Insurance Services. We’ll talk a little bit more about that as time goes on.\n\nIn 1981 or 1982, as the Foundation was gaining ownership, the goal had always been to move the operation from St. Louis to Kansas City and to have everything connected with the Academy in the Kansas City area. I knew this years in advance so it was not a surprise to me. However, it was clear, and this was something Roger Tusken, in particular, was very clear that he wanted the insurance operation to be in Kansas City. The Foundation quickly moved in that direction, to have the operation move over here. At that particular point in time, the Foundation I believe, had just hired a new full-time Executive Director, so it was a threshold point for the Foundation, as well as for the insurance operation. As I say, my dad was phasing himself out of the business at that point and I had taken over the day-to-day operations. My father’s approach had always been to attend state chapter meetings, and to promote the insurance programs that way. He attended tens, if not twenties of them each year and was very good at that approach. That was consistent with what the Academy wanted to do, not necessarily consistent with what the Foundation, as far as a new ownership was concerned, saw as necessary or valuable because of the incredible expense involved in travel and attending those meetings. We did continue to do that for several years thereafter, but gradually phased that out. My father ultimately retired completely, I believe right around 1983, somewhere in that area, ’83 or ’84 timeframe. It was in July of 1983 that we physically moved the agency from St. Louis to Kansas City. Again, it’s amazing that the organi-zation survived. We moved a business that had been up and running for 30 years and had a full staff, had thousands of members as clients and for whom we had to provide a high level of service and I can’t get anybody to move with me, except one person. What we decided to do was to implement a new computer system and to use the computer system itself, kind of as the mech-anism by which we would make the transition. The tool for us to move so that we would be training new staff on a new system, which was going to be new to everybody anyway, and we would attempt to perpetuate what we were doing that way. I’d love to say that was just a stun-ning success and everything worked smoothly and there were no problems. The truth of the matter is, for the next two years, at least, well into 1985, we struggled to hire a staff, to train a staff, to find the right people, to find the right combination of people, to work through all that needed to be worked through with the computer systems and everything else. It was quite a decision actually, for my family to make when the Foundation did ultimately gain ownership, to decide whether we wanted to move. We thought we did, we liked Kansas City, we’d been over here frequently, but we had children of our own. All of our family was in St. Louis, but really came down to looking at it from a business standpoint and what was the best business oppor-tunity and was there something that I thought at that point, made more sense for us? By then, I had fallen in love, myself, with the business, the organization, the relationships, the association, all of it and really did not want to consider doing anything else. Had I been asked that question again two or three years after the fact, my answer may have been different because things may have looked different to me if I had any idea of what was really going to be involved. Frankly, and certainly not as a criticism of the Foundation Board at the time, but just a statement. They were incredibly naïve about what was involved as well. Working through that, I had presented to them on several occasions, a study or an evaluation of what would be involved in moving the business and everything else. Unfortunately, the Board came to the conclusion that I was trying to not move, to stay in St. Louis, to stall, whatever, that I wasn’t committed to making the move. That was not the case. What I was committed to was trying to make sure they understood exactly what the impact of that relocation would be, and in particular, not the direct costs of the reloca-tion, but the opportunity costs. That’s a concept which ultimately few, if anyone, ever realized. It was the loss of time and the fact that we consistently made mailings, that we were consistently out there in front of the membership. We lost all that, so there was a dead period that we had to recover from and we had to rehire, retrain and reenergize the organization, and that took several years. So the early years in Kansas City were not highly successful or productive years. Frankly, what evolved after that was, in 1985, we picked up the life insurance plan, which had been separ-ately administered. It was with Principal, which at that time was Banker’s Life and we had trans-ferred our insurance coverages to Principal, Banker’s Life, back in the ‘70s, so we had an ongoing relationship with Jack Lawrey, the representative here, the group person.  The Academy had always separated the administration of the membership programs, the life insurance, retire-ment and investment program, which was Jones and Babson, here in Kansas City, the Babson Fund, and then the disability portion, which was us. Naturally, once the Foundation had owner-ship of this insurance operation, both the Foundation and the Academy, was interested in helping build that and definitely wanted us to have the life insurance program at the earliest opportunity, so in 1985, we did indeed pick up that piece of business. It turned out it was a completely undeveloped program, which…\n\nThis is Tape One, Side Two of the audiotape interview with Tom Koch by Sandy Panther. \n\nTom, will you please continue? \n\nSo in any event, in 1985, we picked up the life insurance program and it was an undeveloped piece of business, that as I say, had previously been with New York Life and then passed to Banker’s Life, whose name changed to Principal. It was an outstanding opportunity for us to begin to build new business and to increase profits, and thereby increase dividends to the Foundation and we set about doing that. Historically, with an association program, you use your life insurance plan, that’s your lead plan, so it was a very unusual arrangement that we’ve been operating under because we were kind of selling disability and other products with one hand tied behind our back, where the logical lead product would have been the life and you would have sold the other products subsequent to that, or in addition to that. There’s a natural synergy that perhaps exists and that was not the case, so we were very excited about picking up the life plan and we were able to build that significantly, almost immediately and to increase the revenue stream.  \n\nSubsequent to that in the ‘80s, we added a comprehensive major medical plan, which grew tremendously and which also produced additional revenue. It was a very, very complicated and administratively-intensive program to handle and we struggled with that, because again, we were struggling with a new staff and new systems and everything else. We definitely were growing and expanding and thriving by the latter part of the 1980s and that continued well into the ’90s. We ultimately had to get out of the comprehensive medical business and shrink our coverage, if you will. That was a financial negative, or financial hit at the time, but it freed us to concentrate again, on our core products and shortly thereafter, we moved those products from being under-written with Principal, to New York Life, which we did in 1997, a little over ten years ago. The growth in the programs and the development of the programs since the move to New York Life has continued to be, each year, better than the one before and tremendous growth, both in terms of participation and in terms of premium and as a result, in terms of support for the Foundation.\n\nGive me the relationship with the Foundation and all of the different CEOs that you have been involved with. \n\nI won’t comment on present company, of course.  \n\nThank you. \n\nI remember the Foundation when it was the Family Health Foundation of America. I think it was actually Family Health Foundation to begin with, or was it AAGP Foundation to begin with? AAGP Foundation I think. But way back when it was nothing more than a couple of file folders in Helen Cobb’s desk drawer, Helen Cobb being the secretary or administrative assistant to Mac Cahal, and of course that evolved into Char Martin, who I think was really the first dynamic person involved in the advancement of the Foundation. Char was on board right up to the early ‘80s. By the time the agency was coming over to the Foundation, I believe Char was phasing out. At that point, the Foundation had hired a full-time Executive Director, Gary McMahan. He came on board in 1980, just a little before the transition to the ownership of the insurance company to the Foundation. That’s who I was working with when that transition occurred in 1983. At that time, I think the assets of the Foundation was over $2 million. I don’t think it had reached $3 but it was over $2 million. At that time, not much was being done. The Foundation was there, it existed, it had some assets that it had developed over the years, a lot of it through support from the insurance operation and from other sources, but really was not a viable entity, so to speak.\n\nWas it not the dividends off of life insurance policies…?\n\nThat’s absolutely correct, and I’d forgotten that, thank you. Yes, the life insurance was set up such that if there were a dividend declared, those dividends were automatically assigned to the Foundation. That was another reason why the Foundation was interested in getting control of the life insurance program, they wanted to see that develop and build up so that more people parti-cipated and there were more dividends assigned to help support the Foundation. I believe the model for that was the ABA, well, the American Bar Endowment, which had established that that could be done and that the membership could take a charitable contribution for the amount of that. Consequently, we had the same arrangement in our disability program with Banker’s, ultimately Principal, if there were a dividend, it would be assigned to the Foundation. In the ‘80s, that’s my first recollection of a full-time staff person.\n\nBy the mid to late ‘80s, I believe for better or for worse, under Gary McMahan’s leadership, the Foundation assets basically migrated someplace else. They weren’t there, they didn’t exist, and financially the organization kind of took a hit. At the same time, the Academy had been going through leadership transition, from Roger Tusken to Bob Graham. Dr. Graham, by position, was involved in the Foundation. I just recall being informed, basically, that Dr. Graham would hence-forth be the executive in charge of the Foundation and that Mr. McMahan would become Execu-tive Director instead of Executive Vice President and would fulfill a day-to-day responsibility, but not the head position. I think that continued for a few more years and then financially, the Foundation, for lack of a better term, failed again. I think that was 1988. Is that correct?  \n\n1988 was the first time, 1995 was the second time.\n\nYes, in 1995, a change in leadership was made. The Foundation basically started over again. Dr. Graham, I’m sure there’s others that could document that portion of it better than I could, but certainly worked closely with the people that succeeded Gary, and in fact, 1995 when that occurred, I approached Bob Graham and said, the Foundation owns a corporation that has significant knowledge and experience in dealing with money and finances and I think we might be able to provide some financial guidance and stability to our parent organization, which we have a vested interest in their survival as well, because it perpetuates the arrangement. In any event, we did, and Sandy, I believe that helped make the transition for both you and Pat, who for awhile, served as dual Executive Directors. That’s just not a good thing in any organization, as we all know, but something had to be done in the interim and something had to be put in place and that was the initial structure. At least we were able to step in and help with the financial aspects of it so that that was not an overbearing concern. I think that freed you up and it freed Pat up to concentrate on strengths that existed. Clearly what evolved out of that was ultimately your ascension to the position of Executive Vice President of the Foundation. It sounds egotistical to say, “and the rest is history,” but for whatever reason, from a coming together of all those things, the leadership provided by Dr. Graham, the leadership provided by the Foundation Board of Trustees, your leadership, the staff that you had was pulling together and working in the right direction. Our ability to help, not only with the management of the finances, but by increasing the amount of our dividends to the Foundation, revenue stream, from that point on, has been a…I don’t know how you could describe a healthier picture financially, as far as the Foundation is concerned. To the point where today, it is clearly established as, I believe, a solid, financially-viable entity, which won’t have to confront those types of issues again, and of course has evolved now into a situation where the staff is part of the Foundation…part of the Academy staff. An administrative agreement is in effect and the leadership position is really the one that you pioneered and thought was the one, and I’m putting words in your mouth, but I believe was the appropriate position, which is that of dual position of Vice President for Development for the Academy and Executive Vice President or Director of the Foundation. Those two things are tied together and need to be integrated at the staff level. I guess you could say I’ve seen the whole thing evolved from the bottom drawer of Helen Cobb to Craig Doane today.\n\nYou also worked with three CEOs of the Academy. Any reflections on that? \n\nFour.  \n\nOh, you worked for Mac too?\n\nNot for, but with.\n\nAny reflections on those CEOs? \n\nAmazingly interesting group of personalities. Mac Cahal, one of the most interesting, pheno-menal minds one could ever come across. Tremendous command of the English language, engaging personality. No doubt, the perfect person to be there and to create, from a legal standpoint and from an organizational standpoint, the original Academy. I came on board in 1971, my dad had worked with Mac closely and he was basically at the end of his tenure. \n\nRoger Tusken, who had been a significant member of Mac’s staff, was the designated person to kind of succeed that position and that was what the Board approved. Roger was the person that I thought defined the personality of the Academy throughout the ‘70s and well into the ‘80s. That’s the person I knew the best because he was there, for the most part, in charge, during my younger development years. The incredible talent that was around him and the stories that will always exist, Mike Miller, we could go on and on and on. Certainly when it came to communi-cation and things of that nature, Roger was equally talented. A very, very engaging person, who unfortunately had some personal issues and problems, which ultimately led to his demise, if you will, in terms of his leadership with the Academy and that’s to this day, something I think I will always not really fully understand and regret that it happened. Perhaps a classic example of someone who just didn’t know how to admit a problem and get help and solve it. Of course, we had been through a similar circumstance with Breckenkamp in the history of the insurance agency. It became clear, particularly as I worked through the transition from my dad to running the insurance operation, that Roger was becoming increasingly difficult to work with. It got to the point where no one ever wanted to have a meeting with him after lunch and sometimes even before lunch wasn’t real good. You kind of knew, if you had to see him face-to-face, you were probably going to get chewed out. It was not usually very pleasant. That’s unfortunate because that’s not the way things were early on. It’s not the good part, or the good side of Roger. Need-less to say, I was concerned, somewhat when that all took place because we had just worked our way through this whole thing with the agency and we’d been in limbo with the lawsuits and didn’t know and now I’ve got this Board the size of General Motors that’s advising me on run-ning the insurance company through the Foundation and the whole thing with Roger occurred. It just seemed like there was no stability at all and everywhere I turned it was chaos. The one person in that whole process that was as stable as a rock and was there, was Jack Stelmach. You asked me earlier…I wouldn’t say Jack was a mentor, but I would certainly say that he was some-one who had great influence on me, but also on the Foundation and the insurance operation and the whole relationship. For better or for worse, Jack was right there in the middle of it when it was all happening. I really have a tremendous amount of respect and admiration for him as a result of that.  \n\nI didn’t remember Bob Graham from being on the Academy staff. I would have not had any contact with him when he was. He, of course, had little to no knowledge of the insurance oper-ation, to my knowledge. He may have been aware of the fact that there was one out there when he was on the staff but certainly wasn’t on his radar screen. What an amazing transition or contrast, the years under Bob versus the previous years. I just cannot imagine anyone, except someone with Bob’s unbelievable personality and skills, being able to step into that position at that particular time and move the organization forward. He certainly grew the organization, that’s for sure, into…more than one headquarters change and large expansion of staff. I can remember early on, one of the meetings I had with Bob and my comment to him was, he was trying to get familiar with the insurance operation, how everything fit together and I said to him, “All a businessman wants is clear direction.” That’s what I got from Bob Graham. In a very quiet, but effective manner, we got clear direction and we knew what our role was and we knew what we needed to be doing and Bob was there to help make sure that happened and those were really, really, really good years. After some very difficult years, those were some really…we expanded, we grew, we addressed problems and issues. That was just a good time.\n\nThen Doug, that’s my fourth. And Mike Miller was interim. Of course I knew Mike from day one because he joined the Academy staff on the legal counsel side, not too long before I came on board. I think he might have come on in 1970 or late ’69, early ’70 and I came on in ’71. Not the Academy, but came on in the insurance, so I certainly had worked with Mike and knew him for many years.\n\nDoug Henley, what a great circumstance for the Academy to be able to have as its Executive Vice President, someone who is a physician, is a member and actually had a practice and a practicing family physician for all those years and what a great transition or evolution, to follow a Bob Graham, who did not have the in-the-field knowledge, so to speak, of a family doctor, but had the policy side of it and the government side of it and the government relationship side of it, all that really under control, then to be able to pass the baton to Doug at such a critical time in the Academy’s evolution, to confront a different set of opportunities going forward.  \n\nI found all of them to be, not only interesting personalities, but terrific leaders in their own right and in their own way.\n\nWhat would you say is your greatest success in your career? What do you remember in your career best? \n\nHow does one answer that? I’ve never really focused on that or thought about that. I don’t know how to express this necessarily, but I think just being able to develop, maintain and continue the relationships that exist. The name Koch has basically been associated with, almost back to the very beginning, so even though we didn’t own it, we certainly have a family interest in it, vested interest in it, but just watching the association grow and develop and being a part of that and being able to contribute in some way, working with family docs. The organization is unique, in that today, you don’t see those kinds of proprietary relationships where an association has its own controlled insurance operation, exclusively for its members. I don’t know, from a personal standpoint, from an insurance standpoint, I was one of the founding organizers of PIMA, Pro-fessional Insurance Mass Marketing Association, now called Professional Insurance Marketing Association, originally called Professional Independent Mass Marketing Administrators way back in the early ‘70s. I’m proud of that. I think I’m more proud of being able to continue for all the years that we have, we successfully worked with the changing Academy leadership and the changing membership and still made that work. I don’t know, probably silly, but…Don’t ask me questions like that.\n\nAside from the Foundation and Academy personnel, who are the people you worked with most closely who have impressed you and what is your impression of these individuals? More along the line, I’m thinking of your own organization. \n\nTo answer that, I would go back to Norris Allen, Reese Neur (?), my dad. Having those indivi-duals, interacting with them at a very early stage, those are people of great accomplishment in their senior years, if you will, but they helped instill a sense of, do it right the first time, there is a right and a wrong way, if you make a mistake, admit it and fix it and go on from there and don’t worry about it. One of my philosophies is always to build an organization where, and it sounds funny to say, this is a place where you can fail and still be accepted. We don’t want that to hap-pen. We try to make sure that doesn’t happen but if it does, that’s okay, we can get beyond that. I would say Roger Tusken, I would say Gerald Gorman. Gerald Gorman has played a significant role. I’ve worked with him in all different kinds of ways for almost 40 years. Several people from the insurance side with Continental, CNA, in Chicago, in my younger years. Bob Miller would be one I would mention that won’t mean anything to anybody but 100 years from now when someone listens to this tape they’ll recognize it. But then there were significant staff folks as well in the agency. I worked for many, many years with Mabel Rich, who was the one person that made the move with me from St. Louis. Mabel was an absolutely fascinating person. She was a graduate of the General Motors Accounting School. She didn’t have a college degree but she was the epitome of a full-charge bookkeeper and believe me, she knew what a 10-column ledger was and she knew how to make it work. She had a great mind for administrative tasks and details and organizing. My father, fortunately had the great wisdom to hire her and when I came on board, his first instructions to me were, “You can change anything you want to but don’t mess with Big Mabes.” Big Mabes was Mabel and I wasn’t allowed to mess with anything that she was in charge of. Over the years, we developed a very strong working relationship and the success, the viability of the organization as much a result of her grit and determination as it is mine because had it not been for her accompanying me, good heavens, I don’t know how we would have survived. Mabel and I then tried to systematically build a staff going forward and I now have one employee who next month, will celebrate 25 years with us, which means she was hired the month after we came over here. I have two others who are rapidly approaching their 20 years, or better. Twenty-five years is Carolyn Leehy, who was that first group, most of whom we had to go through like crazy to find anybody who could do anything and she survived.  We strug-gled for many years to get customer service representatives, people who we could have on the phones, who could handle stuff and work with the members and everything else. Noreta Johnson and Chris Dillon have been on the staff for almost 25 years. Then when Mabel retired, the major development that occurred there was bringing Rick Marsh on board. Rick is now Vice President. We were able to really solidify the organization and clarify its structure by having Rick as the administrative person and Betty Freeman, who interestingly, her husband, Bill, was one of the principals in Jones and Babson that had the Academy’s retirement programs. Years ago when we would come over to Kansas City for SOC, which is now called whatever it’s called, ALF, the insurance folks and different organizations would host things and we got to know him. Unfortu-nately Bill died very young of a heart attack and Betty, who we knew, wanted to work and she called me and said, I’d like to work for you. I said, “You have no way of knowing that.” She said, “Oh, I think I do.” All these years later, Betty is still there and has won every cotton pickin’ marketing award there is to win that PIMA can give out and has endeared us to every insurance company we’ve ever worked with as far as our marketing and relationship that we have, which is always a difficult one. I’ve been fortunate as the years have gone by and as years have devel-oped, to have two key people and then to have additional strong staff. We’ve added some new folks along the way, not too many, but one of the things we need to look forward to is how we continue that transition and that evolution. Did I answer the question?  \n\nYou did. You’re not ready to retire yet, I understand that, but philosophically, when your career comes to an end, do you have plans for retirement? Things that you really want to do? \n\nIsn’t that a great question? I don’t know. I am a history buff, I’m still a political nut, I love to get in the car or truck or whatever vehicle and drive, so I would look forward to that as a time to get involved in perhaps some mentoring programs. There are some entities out there, they’re on the East Coast, but I haven’t been able to find any connections here, where you actually read books and you record those books so people with visual impairments can listen to the books. I’d like to find ways where some of the interests that I have might be put to good volunteer use. I’ve never been a hobbyist. I’m not a golfer. I like to swim, I like to hike, I like to do things like that, in a casual way, but not really interested in retiring to a golf course or something of that nature, but would like to travel and volunteer in some fashion.\n\nAny last thoughts you’d like to add? Areas that we didn’t cover? \n\nHave we gotten to the end?  \n\nWe are at the end.   \n\nOh my. I don’t think so. I think we’ve pretty well hit enough of the high spots without boring everyone to death. Did we cover everything on your notes?  \n\nWe’ve covered everything and in fact, most of the questions I asked, you covered in your narrative. It’s been a pleasure, a historical pleasure to get down on tape some of the things, for which there is no one other than you who could convey those thoughts. \n\nI’m sure everyone will remain totally and completely confused after listening to it.\n\nThank you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/156784/file/286731#t=0.0,5152.18659"}]}]}]}