{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/gf0ms3n01b/manifest","type":"Manifest","label":{"en":["Dr. Gerald Keller"]},"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“I have spent 40 years of my life being involved with the Louisiana and American Academy of Family Physicians (AAFP), says Dr. Gerald C. Keller. During those years, he served in every position for the state academy. At the national level, he spent time on the Resident and Student Affairs Committee as well as chairing the Rural Health Committee, which allowed him to testify before U.S. congressional hearings. Then in 1991, he served as vice-president. In 1993, he became involved with AAFP Foundation Board where he chaired the Commission on Public Health and Scientific Affairs, served as treasurer and president. He was also privileged to travel to Uzbekistan and the Russian Siberia with the Physicians with Heart missions to educate physicians about medications. While serving as the only physician on the American Dietetic Association Board, he was instrumental in the Nutrition Spokesperson Project which was a joint effort with AAFP. He has been honored with the Academy’s President’s Award.  \u003cbr\u003eAlong with this New Orleans-born native’s national involvement has been his community attachment to Mandeville, Louisiana, where he and Dr. Roy Gregory began a general practice in 1963. During their 22 years there, they founded a health clinic which they considered “… a service to the community”. Additional service was rendered during the aftermath of Hurricane Ka In return, the community awarded him the A.H. Robins Award for Community Service, the Junior Chamber of Commerce Distinguished Service Award and the Mandeville Chamber of Commerce Outstanding Businessperson. From 1968 to 1980, he served on the Town Council and was the Mayor Pro Tem for eight years.  \u003cbr\u003eBy 1986, Dr. Keller, the father of ten children, joined Ochsner, a multi-member specialty clinic where he worked for 22 years. He jokingly says, “I’m now officially retired for the third time…still working for Ochsner one or two days a month.”  \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":["2008-09-16 (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","family physician"]}},{"label":{"en":["Subject"]},"value":{"en":["Gerald C. Keller, MD (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"summary":{"en":["\u003cp\u003e\u0026ldquo;I have spent 40 years of my life being involved with the Louisiana and American Academy of Family Physicians (AAFP), says Dr. Gerald C. Keller. During those years, he served in every position for the state academy. At the national level, he spent time on the Resident and Student Affairs Committee as well as chairing the Rural Health Committee, which allowed him to testify before U.S. congressional hearings. Then in 1991, he served as vice-president. In 1993, he became involved with AAFP Foundation Board where he chaired the Commission on Public Health and Scientific Affairs, served as treasurer and president. He was also privileged to travel to Uzbekistan and the Russian Siberia with the Physicians with Heart missions to educate physicians about medications. While serving as the only physician on the American Dietetic Association Board, he was instrumental in the Nutrition Spokesperson Project which was a joint effort with AAFP. He has been honored with the Academy\u0026rsquo;s President\u0026rsquo;s Award. \u0026nbsp;\u003cbr /\u003eAlong with this New Orleans-born native\u0026rsquo;s national involvement has been his community attachment to Mandeville, Louisiana, where he and Dr. Roy Gregory began a general practice in 1963. During their 22 years there, they founded a health clinic which they considered \u0026ldquo;\u0026hellip; a service to the community\u0026rdquo;. Additional service was rendered during the aftermath of Hurricane Ka In return, the community awarded him the A.H. Robins Award for Community Service, the Junior Chamber of Commerce Distinguished Service Award and the Mandeville Chamber of Commerce Outstanding Businessperson. From 1968 to 1980, he served on the Town Council and was the Mayor Pro Tem for eight years. \u0026nbsp;\u003cbr /\u003eBy 1986, Dr. Keller, the father of ten children, joined Ochsner, a multi-member specialty clinic where he worked for 22 years. He jokingly says, \u0026ldquo;I\u0026rsquo;m now officially retired for the third time\u0026hellip;still working for Ochsner one or two days a month.\u0026rdquo; \u0026nbsp;\u003c/p\u003e"]},"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281715","type":"Canvas","label":{"en":["Media File 1 of 3 - Keller_Gerald_Pt1_08_a.wav"]},"duration":2588.77009,"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/153060/file/281715/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281715/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/715/original/Keller_Gerald_Pt1_08_a.wav?1752092309","type":"Audio","format":"audio/wav","duration":2588.77009,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281715","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281715/transcript/81620","type":"AnnotationPage","label":{"en":["Dr. Gerald Keller Interview transcript  [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281715/transcript/81620/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Tape One, Side One of an interview with Gerald C. Keller, MD by Sandy Panther. Dr. Keller, how are you this afternoon? \n\nI am fine this afternoon, thank you.\n\nYou are aware of and have agreed to be audiotaped for use in the Center for History of Family Medicine, is that correct? \n\nThat is correct.  \n\nThank you. Would you please tell us a little bit about your, or a lot, your choice, about your early life. Where you were born, when you were born, your family, what they did. \n\nI was born in 1934, April 24th of 1934. My parents were Dewey and Oralee Weber Keller. My mother was a housewife, my father started out as a jack of many trades but eventually owned his own Ready Mix concrete business but died at a young age of 64. I am married, her name is Joan Arnold Keller. I see you asked, how did I meet my spouse? Well, her father was Chairman of the Department of Biology at Loyola University where I was attending school. I cut my hand in the lab, he was also sort of a doctor even though he was a PhD in Medicine, not really an MD so I went to his office to get a Band-Aid and to clean up my cut and his oldest daughter was there, whom I met and from then on we eventually married.\n\nI’ll get into the children and test your brain power in a minute. Where were you born? \n\nI was actually born in New Orleans, Louisiana.  \n\nAnd have been there all your life. \n\nBeen there all my life. I went to school there, married there. When I returned later from the military I moved to Mandeville, Louisiana.\n\nHow many children do you have? \n\nI have ten children and I think I can tell you even their birthdays if you really want to know that.  \n\nI do want to know that.   \n\nMy oldest was Sharon, who is now deceased and she was born April 19, 1959. I had my first son, Chris Keller, he was born in Europe when I was in the military and his birthday was November 28, 1960. John, my second son was also born in Europe when I was in the military and he was born April 26, 1962. Both of these boys were born in Wurzburg, Germany and enjoyed German citizenship until they were age eighteen. My second daughter, Jennifer, was born April 15, 1964 in Mandeville, Louisiana, as was Jodi, my third daughter, who was born August 27, 1965. Then came my third son, Dan Keller, he was born December 27, 1966. Scott Keller followed, born November 13, 1968. Roger, my fifth son was born on May 12, 1971 and Joani, my fourth daughter, was born on March 27, 1974. Last but not least came Gregory Keller, the spoiled brat of the family, was born December 14, 1978. That’s pretty good, isn’t it?  \n\nThat is very good. I’m not going to ask your grandchildren’s names but how many grandchildren do you have?   \n\nI have 25 grandchildren and two great-grandchildren at this time. Nobody’s pregnant that I’m aware of.\n\nDo you have any special stories about your childhood that were particularly interesting or memorable to you? \n\nNot particularly. I had a very normal childhood, happy childhood, nothing traumatic and nothing unusual during that time.\n\nDid you have any role models when you were young? \n\nI guess I really didn’t. I had a great uncle who was a general practitioner and he was the one who always came and took care of us. I didn’t like him because his usual prescription was castor oil, whether I was having an asthma attack or a sore throat so I don’t think he was really a role model for me at that time.\n\nDid you always want to be a physician or did you have other goals when you were young? \n\nI always thought that I would become a priest. I went to Jesuit high school and was very impressed with the Jesuits. I felt I had a calling at that time. My problem was, I also wanted to have children so at the last minute I pulled out of going to the seminary, like in August and quickly enrolled to go to college at Loyola University.\n\nDid you do both your undergraduate and graduate work at Loyola? \n\nI did my undergrad at Loyola in three years, going to summer school and then went to medical school at LSU Medical School, which is also in the city of New Orleans.\n\nThen your internship? \n\nInterned in 1959 at the Madigan Army Hospital in the State of Washington. By that time I was in the military.\n\nDid this occur during a war? \n\nNo, this was between the Korean War and Vietnam.\n\nYou mentioned that you were stationed, at least part of the time, in Germany. Was that a good deal at the time when you were in the service? \n\nIt was one of the highlights of my life, really. When you’re in medical school and you’re in pre-med, you’re associating most of the time with people who are also in that field in one way or the other. Even my wife’s family was very oriented toward the medical field. My wife is a blood bank technician med tech and so all my interaction, or a great deal of it, was in the medical field. When I first went in the service, of course I interned at Madigan Army Hospital and from there I went to Germany for three years. There, my first assignment was a battalion surgeon, meaning I was the only doctor in a tank battalion. I knew nothing about tanks, they knew nothing about medicine and so we had to interact at a common ground and I did get used to the military that way and they got used to me as a doctor. Formed some very close relationships, fantastic, out-standing people. We’re still friends with many of them, we still get together every two or three years, in fact, with [Hurricane] Katrina, I actually went to one of their homes in Montgomery, Alabama where myself and my wife and two grandkids who were with us at the time and my daughter, all five of us went to their home in Montgomery. I formed many good relationships and it was a break from having that strict medical environment. It also gave us the opportunity to travel and see parts of the world that I’d never seen before so it was really a great experience.  \n\nMy second assignment overseas was I was Medical Director in the outpatient department, 130th Station Hospital in Heidelberg where [    ] headquarters was. Old Heidelberg is a beautiful, charming old city and I’m sure you’ve been there. It was just a great place to end my career in the military. Again, made very good friends and it was very good medical experience.  It pre-pared me well after spending a year and a half with the tank battalion seeing mostly men, not that many dependents. Young men with not too many health issues. I then went to an outpatient department where we had patients of all ages. It sort of prepared me to come back and go into, at that time, general practice in Mandeville.\n\nWhat made you join the military? \n\nI’d like to tell you it was dedication to my country but actually in those times you had compul-sory military training and so I had to go into something. I married when I was in medical school, had my first child when I was in medical school and I was concerned about whether my wife was going to be able to support me in the manner in which I was used to when she got pregnant and had the baby so I joined the military while I was in medical school. I was on active duty for my senior year of medical school so I was able to receive compensation during that time, when I was a senior and to finish medical school without getting a loan, which I know nowadays is unheard of.  \n\nAbsolutely right. When you ended your service career, where did you go then? \n\nI then went to Mandeville, Louisiana. In medical school I had a good friend, we went over a cadaver in my freshman year and we were very close friends all through our medical school career and we decided that we wanted to go into practice. He’s a little bit older than I am and had been in the military as an enlisted man before he ever went to medical school. He took an intern-ship and a one-year, what they called then a general practice residency, mostly for surgery pur-poses and then he came to Mandeville in 1961 and opened up a practice. We had both picked this area. We didn’t want to live in the city of New Orleans, we wanted more of a rural practice to raise our kids. He started the practice in 1961 and I joined him in 1963. We’ve been together ever since.\n\nWhat was the world of medicine and particularly, family medicine, at that point? \n\nIn 1963, as you know, there was no such thing as family medicine, it was general practice. There were no residencies, it was not a specialty. It wasn’t until 1970 or 1969, the first exams were 1970 so it was really a general practice. When I came here there was no hospital emergency room to call, we took our own calls, alternating every other night. We delivered babies, we took care of children, we did appendectomies, tonsillectomies, set fractures, really the whole medical parameter we took care of. It was our own guts that get you through it I guess, starting a practice. When I got here, charges were $3 an office visit. I think deliveries were $125; that was total OB care. Things have really changed in that regard. But it was a lot of fun, formed a lot of close rela-tionships with your patients. The town was only 1,200 people so your patients were also your friends, you knew everyone and they knew you. They knew who your children were. If your children were doing something wrong they would call your wife and tell her. It was a lot of hard work, a lot of long hours. Compensation was fair, certainly not what it is today but very satis-fying. It was what I wanted to do when I joined medicine.  \n\nI’ll tell you a story about why I picked medicine. Like I said, I was going to be a priest and at the last minute I turned it down, went to Loyola, signed up to go there. They asked you, what do you want to do? Gee, I’m not really sure. Well what do you like? I guess I like science. You’ve got to pick out something. I said, well, you know, I always liked people and I always wanted to help people so let’s go into medicine, pre-med. That’s how I picked that, while being interviewed about it the first time and it was, luckily for me, a very great choice and one I’m happy that I made.\n\nHave you held positions other than private practice? \n\nIn 1986, joined Ochsner, which is a multi-member specialty clinic, which had just embarked on its own HMO product and was after to get an administrator who said he would actually come and work with that group to form the HMO if they would hire family physicians to work the clinics. Having some association with them before, they came to Dr. Gregory and myself to ask us to join them. Actually I turned them down for several reasons that would be a very long story, for six months, eight months and then finally went with them. I thought the managed care was really here to stay so I might as well take advantage of it and work with it. Also, in those days we didn’t think very much about our retirement and retirement benefits and with ten kids there wasn’t money left over, really, to invest at that time. It was a good way to get retirement benefits also. It since has worked out very, very well for me to join Ochsner.\n\nAnd it still allows you to practice in the same building? \n\nYes. To be honest with you, I’m officially retired now for the third time. They say they’re not going to have another party or cake for me so this next time I just walk off and say goodbye. Yes. They allow me to continue an association with them, mainly because I wanted to continue my malpractice [insurance] so if I wanted to do any community work after that, I would be in-sured while I was doing volunteer work. They very willingly continued to carry my malpractice. To do that I had to work for them at least one or two days a month, which I do very willingly at this time.\n\nWe’ll go on a little bit now with your political structure and your political background. At what point did you become involved with the Louisiana Academy of Family Physicians? \n\nI knew Ralph Sanchez, who had been part of the movement back in the ‘50s and ‘60s to develop the specialty of family medicine and he was very active in the Louisiana Academy. In fact, he did my physical for admission to medical school. After I’d been in practice a year or two and I met him on several occasions after that because he was a friend of my wife’s family, he talked me into going ahead and joining the Louisiana Academy and the American Academy of Family Physicians. That’s how I first started becoming involved, probably 1966, 1967, with the Academy. I really didn’t do very much in regard to working with the Academy until the early ‘70s when I went to a meeting and was given a job, I can’t remember what it was. I enjoyed doing that and I must have done a good job because then they wanted me to be alternate delegate to the national meeting. Went to my first national meeting, I think it was in Chicago, it was either 1974 or 1975, fell in love with what was going on and have been going every since and started my activity. I then became a delegate to the national Academy. I became Treasurer, Vice President and then President of the Louisiana Academy in 1980. Then became much more active in the American Academy.\n\nIn all of the things that you have done, I’ll get into the American Academy in a moment, what was the toughest decision you had to make in your career? Or was there one? \n\nThe two toughest decisions I have made, in 1963 when I had to make a decision at that time whether I was going to get out of the military and go to a… at that time the Army had a two-year residency in general practice, this is 1963. I could have taken that residency program, studied there and then make the Army my career. My wife loved the Army, she really did, she was an excellent Army wife. Functioned well in it, was not overwhelmed and I really had no complaints, I enjoyed it too, very much. The big decision was, should I stay in the military or should I get out? There were two things that made me go ahead and leave the Army and go into practice. Number one, we had three children at the time, we both had wanted to have a very large family and I thought moving with children every two to three years would be a problem and so we probably would be better to get to one place and stay. Secondly, I really had sort of committed myself to Gregory that partnership so I felt I had to fulfill that obligation. He would have under-stood if I hadn’t. That was the first big decision.\n\nThe second decision actually was when I joined Ochsner. By this time in 1986 I had been in private practice for 23 years and you’re your own boss and do your own thing and you’re the guy telling other people what to do in your office and you will have to do certain things to conform with the overall business that you’re in. Did I want to give up that complete independence at that time? So that was a decision that I hemmed and hawed about for, as I said, six to eight months. It was a big decision. Both times, I think I could have been happy in the military as well as I am happy here. I know I’d have been in group practice as I was in private practice. Luckily, when I joined Ochsner, we were the only physicians on the North Shore associated with Ochsner and they knew I was enough of an independent individual that they really weren’t going to try to tell me what to do all the time so it worked out very well.\n\nWhat did you enjoy most in your career? \n\nThe thing I enjoyed most in being a physician is really the relationships that you make, being a physician. The respect you get. Sometimes you wonder whether you really deserve it or not. The challenges that you face, the decisions that you can make. All that was just most, most meaning-ful to me. It’s very meaningful to me now to go to a grocery store in my area and see two or three people that I treated for 45 years and they all say, gee, we miss you Dr. Keller. It does unbelievably good things for your ego and makes you feel great. That satisfaction element there is just tremendous.\n\nWas there anything you least enjoyed? \n\nGetting up in the middle of the night. As I said, when we first started there was no emergency room coverage. In fact, you had to alternate. Every physician on staff was on call for his own patients but for any person who came to the emergency room without a physician, they rotated the physician on call so there was no doubt that you got up at 3:00 in the morning and drove miles to the hospital and took care of that patient. That part was pretty hard, especially if you had to get up at 5:30, 6:00 the next morning. That’s probably the part I didn’t like.\n\nThe other part is, you know when you treat a patient for long periods of time and you know the family and you know them well, when they die, you lose a friend.  \n\nThat would be a hard part.\n\nSometimes that’s what’s hard to take.\n\nIn which of the positions, including the Army and private practice and Ochsner, do you feel you accomplished the most? \n\nI guess I’d have to say private practice. I guess the reason I say that is because when we founded this practice here in Mandeville, it was a small community with a rather large community around us. We were the only physicians in the town at the time so you felt you really were truly doing something for the community. Bringing medical care within five or ten miles of a circumference around you, people didn’t have to drive to New Orleans to get medical care or Slidell, which is 20 miles away. Even going up to Covington, which is 12 miles away. So in their community we founded for them, a clinic that they can come to without having to run everywhere in the world. And giving them the whole spectrum of medical care that we took. I don’t mean we treated everything and never referred anything, that’s not what I’m trying to say. Certainly we sent people for certain types of surgery, serious heart problems, we referred these people to special-ists, either in New Orleans if they didn’t exist on our side of the parish. Being able to feel like you did a real service, not only satisfied yourself, you actually did a service for the community. That’s why I guess I feel the private practice part, which we did for 22 years, I guess contributed most to the community and made us feel good about that.\n\nThis is probably a silly question but if you had it all to do over again, you could wipe the slate clean, would you still do what you did? \n\nExactly. I know that sounds silly in a way, there are things you wish you’d done but no, I’ve been blessed.\n\nYou mentioned a few people who were really integral to what you did and made a really deep impression on you. Are there others that have done so? \n\nI have mentioned Roy Gregory, we went to medical school together and he was really someone who has been my best friend as well as my compadre in medicine. He was the one who certainly I can most remember as all good. There was a surgeon, Dr. Pat Hunter, who we worked a lot with and who enjoyed the same church I went to and same morals, the same feelings, the same feelings about patients and he was also a very, very good friend of mine and I respected him and what he did for me was great. Ralph Sanchez, who I mentioned before, was a great role model for me and getting me involved in the Academy and I guess the person who really got me rah, rah, rah about the Academy was Gerry Gehringer, who was President of the Academy in 1980 or 1981. He was the one who probably really stimulated me to become more active in the American Academy.\n\nI understand you were in the Louisiana Academy and held every position there. Let’s move onto the American Academy and what were your interests when you served on the Board there? \n\nBefore I even got on the Board, I can remember being on a committee, it was the Resident and Student Affairs Committee. I remember the first meeting I was going to attend, I had to leave the same night as a carnival parade that I was in here in my end of the parish. We’re all carnival freaks here and certain priorities we have and I just couldn’t miss this carnival parade so I hit the carnival parade, rode the float and then hopped one of those midnight flights. I think we ended up in Phoenix. I got off in Phoenix but my clothes didn’t and all I had on was a pair of jeans that had been with me on a float underneath my costume and an old, smelly shirt. The next morning I got up and went to the meeting in my jeans and smelly shirt, my clothes had still not arrived and they really attached themselves to me. They thought I was one of them because they had jeans on too. I never had worn jeans to a meeting before. That was the beginning of my experiences with committee meetings.  \n\nBefore I got on the Board I really was very, very interested in continuing medical education and enjoyed that tremendously. Also worked on the committee that planned our national meeting and I found that was very exciting to do because it tied in sort of with continuing medical education.  Once I became on the Board, I chaired the Commission on Public Health and Scientific Affairs. That was something new to me insofar as that particular aspect of medicine but it was very enjoyable, very educational. It sort of really fit in with continuing medical education also, so coming together, that worked out very well for me.\n\nAlso became very involved in, the Academy at the time was becoming very interested in rural health so I chaired the Rural Health Committee. Even though by this time, where I lived was no longer rural, it was now really a satellite area of New Orleans, it was a rural practice when I started and so I had a very big interest. Louisiana is really a rural state and so because of that I was interested in rural medicine, why doctors were no longer going to rural areas to practice medicine, how can we get them to do that, how can we entice them, what are the problems of keeping them from going into rural health. I enjoyed that and with that, I enjoyed going to testify before congressional hearings concerning rural health as well as Medicare reimbursement for physicians in rural areas. It’s a little frightening the first time you go to a congressional hearing. There’s this big room with congressmen sitting up there looking at you and you’re looking at them and they have TV cameras looking down on you. You get used to it after awhile. It was quite challenging but I enjoyed it. There were some really important issues at that time.\n\nWhen you came up through the ranks and served as Vice President, wasn’t it awesome? \n\nI was Vice President in 1991 and 1992 and that also was a good experience. I’ve had many great experiences. President at that time was Mo Mellion and he really shared with me the visits to state chapters for their installation and the opportunity to talk to chapters concerning what was going on in the national Academy. I was able to visit many of our states, many of our chapters, talk to them about family medicine and what was going on at headquarters so that was a very great year.  \n\nYou asked me about what other things happened to me, disappointments of things you really wanted. I did run for President of the American Academy. When you’ve been in the Academy and you’re going up from one level to another, you know everybody and you become personal friends and you’re running against some of your very closest friends when you’re running for office. It took me a lot of decision to whether I really wanted to run or not run. It was a feeling that you would like to be President of such a national organization, the prestige is phenomenal. You want to do whatever you can for the specialty which you love but you also have to weigh that against what does this mean to your children, your wife. I still had young children at the time and what effect that was going to have upon them. So I have a tremendous ambivalence about it when I ran for President. Certainly when I lost it I was certainly disappointed but at the same time I knew the person who won would be a great President and it gave me the opportunity to get back with my family. I guess the importance of that came to mind when my youngest son grad-uated from high school, at one of the dinners they usually ask a couple of the boys to get up and give a talk about their parents, their father in particular. My son, Greg, got up and gave a very nice talk and in the talk he said, my dad ran for President of the Academy and he didn’t make it and that was very happy for me that he didn’t because I really didn’t want him to win. He wanted me to win but he was glad I didn’t win because he felt he got his father back. Things work out for the best, they really do.\n\nYou received the President’s Award. Was that from Gerry Gehringer? \n\nThat was from Gerry Gehringer, right. Gerry and I were very close friends. He supported me and I supported him when he was President of the Louisiana Chapter and then of course, as President of the Academy. He and his wife became very close friends to Joan and myself.\n\nAt what point did you join the Foundation as a member of their Board? \n\nI had served on the Foundation Board as representative from the [AAFP] Board my third year as a Board member and then as Vice President, I was on the Board. So I had become more familiar with the  Foundation even though I was not that active with it. I guess in ’93 when they appoint-ed someone to the Foundation, the American Academy Board asked if I would be interested in serving on the Board of the Foundation. This was really, I guess, I keep saying one’s better than the other, I don’t know, but it was an appointment I really thought, gee, what am I going to do here? Is this really what I want to do? Is this going to be fun, satisfying? Turned out to be an absolutely tremendous experience and grateful [    ]. It was 1993 when I became on the Board there. I served on the Board for a couple of years, at that time I got to know someone who was actually President my second year on the Academy Board, got to know Jim Jones very well during that period of time. A fantastic man, fantastic President of our Academy. Likeable, devoted, good, just a real professional, lovable-type guy. So I was happy when I got on the Board and he was there and got to know him better.  \n\nI then became Treasurer, unexpectedly to the Foundation. I guess so many accomplishments I think I have done for the Academy, probably my greatest one was for the Foundation. The Foundation was in bad financial shape, monies had been somewhat cheated, don’t get me wrong, or stole but just did not handle the affairs well. Much to my surprise, all I saw was red and very little black. We had to accept the resignation of Executive Director at that time and I felt bad about that but I felt that was just very, very important. We went through a time of picking an Executive Director and went through a trial and Sandy Panther became Chief Executive Director or Chief Vice President of the Foundation and with her great ability to raise money and my ability to really watch how money was spent and how we got the best deal for what we had, we brought together the Academy [sic] out of the red and into the black. Since then it has grown I think, very, very well. So I’m very proud of the work I did with the Foundation, working with Sandy Panther.\n\nTape One, Side Two of the historical interview with Gerald C. Keller, MD by Sandy Panther. \n\nWe were talking about the Foundation and what you were proud of. Would you like to continue with the Foundation and some of your accomplishments further? \n\nBeing President of the Foundation, as I said, I think we increased the contributions, both from our membership, as well as the corporate membership. I enjoyed developing memberships with corporate members. I even enjoyed going to pharma meetings where CEOs of various pharma-ceutical companies gather and discuss the issues that were hot at the time. I also particularly enjoyed going to mission trips, Heart to Heart [Physicians With Heart]. We went to Russia one time, the other time to Uzbekistan, which I had never heard of particularly before. Missionary trips were not missionary trips in the sense that we think about other mission trips I’ve taken where I practice medicine when I’m doing types of trips but this was a trip where we were educating physicians in these lands to the medications that we were bringing. It was sort of an educational chance for us to talk and lecture to physicians in Russia and Uzbekistan because you’re bringing a lot of new medicines into them and what are they used and how to use them and so forth. It was interesting to talk to them and to realize that they were all well-trained in these countries. They were poorly-paid, poorly-reimbursed for the work that they did, willing and eager to learn and talk to you. I guess going to Russia was an experience because you hear so much about the problems or the competition between Russia and the United States and what they have accomplished and the power they had and I was just surprised that there was no competition …I shouldn’t say no competition but they had many problems in the country, problems paying their physicians, problems with their hospital personnel, problems with their supplies. One CAT scan in a city of a million people was available. One monitor was in the ICU in Russia that we visited. It made me feel good that we were so much more advanced and had so much here in the United States but it was interesting to see what was really available in other countries.  \n\nUzbekistan was a completely different type of experience. This was real poverty, poor people who lived in unhealthy manners, food out to be sold with flies on it and so forth. It was a reve-lation to me that this existed in the world today. It was a good feeling to go, a good feeling to bring supplies to these people that were badly needed, however, in Uzbekistan, all my group who went – because somebody named Sandy Panther picked that place to go and it was in the desert which you could only reach by plane. All my group got sick, violently ill and we had to also eat the head of the lamb, either the eye or the tongue or the lips so that was an education also. These are experiences you never forget. It teaches you so much about what medicine is like in the rest of the world. We’re so lucky here in the United States.\n\nAnd potentially what the lack of sanitation can cause a group of people who are not used to it. \n\nRight.  \n\nAs I recall, we also went through a bout of either fleas, bed bugs, or mosquitoes, something in our mattresses. \n\nYes we did. It also made us realize for the first time on a mission trip of this nature, we have to make sure that those people who go on these type of things are healthy people without severe chronic illnesses such as severe hypertension, heart disease. One of the doctors, who was a surgeon there, who was even older than I am, he and his wife, who was a nurse, made this trip and she was one of the people who got sick, he was and when his wife came to get me, I went to see him in his room and I wasn’t even sure he was alive when I walked in his room and I wasn’t sure he was going to make it through that trip. He did. I passed out more Cipro on that trip than I think I’ve ever passed out in the rest of my practice. I did bring a great deal of Cipro with me, fearing that anything like this might happen and I think that’s what really got us all through that situation.\n\nGoing back to Russia, we actually went into Siberia, even though it’s Russia, but on that one we had another wonderful experience going from the Yekaterinburg into Novosibirsk, Siberia. The Trans-Siberian Railway. \n\nYes. We actually went from Yekaterinburg and then we were going into Siberia. We decided we wouldn’t fly, we wanted to see the countryside so most of us were in staterooms on the train. The train was very slow, we stopped in many small towns, we experienced poverty. We saw people trying to sell bread and dried-up smelly fish from the trains to people on the trains. I guess it was interesting to see the countryside but it was uninteresting, to be honest. It was a very different experience. Once we arrived there, then we went actually over to Akademgorodok, which was the area or the city that Stalin had sent all the scientists so they could live there secluded and not particularly escape to the Western world. These people were all either MDs or PhDs and they lived in quarters that I could compare to, what would you say, Sandy?  \n\nBoxes, crates, one room.   \n\nVery, very small rooms. They had a kitchen, a living room and one bedroom and no matter how many children you had, you had one bedroom. It was a little like projects.  \n\nYes.  \n\nVery bland, very boring looking and they were at that time, three months they had not been paid whatsoever. They all planted their own plots of ground so they could raise their own vegetables. We actually went to dinner to one of these apartments and this woman, who is a PhD, was also the mayor of the city and this is what she lived in. It was really eye opening that all of the people …they just wanted medicine. There were engineering schools there, all the various professional specialties out there, all represented there the way you would expect everything to be perceived and they would be living well. They were not.\n\nYou were fortunate to do the trips right after the Wall had come down. On those early trips, that is when we particularly saw people with absolutely nothing. It is not that way anymore. \n\nI was very fortunate when I was in the military, that the one I guess when the Wall first went up, I was in Wurzburg in Heidelberg, Germany. My tank battalion was the backup to the tank battalion that rolled down the highway daring the Russians to stop as we rolled into West Berlin. We all sat on chairs and didn’t sleep until that last tank got through into West Berlin so I was there when the Wall went up. What was going on in the military at that time was rather frighten-ing. We thought we might be going to war with Russia over that. I did go back before I left Germany, I did visit West Berlin and go into East Berlin and that was also an interesting experi-ence to go from East to West, where in West it was sort of a bustling, active, people running around, doing things, sort of happy. Sort of like what you expect here in the States and you went into East Berlin and it was sort of somber and dead, buildings that you saw, the facades looked great and if you went behind them you realized they were all facades and nothing behind. A lot of the destruction caused by the war had not been removed and rebuilt as it had been in West Berlin. It was interesting to see the difference between the two sections and the Wall. It was an eerie feeling going through that Checkpoint Charlie. Am I really going to get back or not?\n\nI have a question on both the Academy and on the Foundation side. Were there any particularly difficult decisions that you were part of on the Academy side during your tenure on the Board? \n\nProbably with the Academy was the time we started talking about the high number, I can’t remember exactly, it was like 35 million Americans were uninsured and no way for them to be getting medical care except for paying for it cash. This was the problem. At that time we drew up a plan that we presented to the Congress of Delegates. The plan was based mainly upon the federal government urging employers to carry insurance for their employees if they were of a certain size, number of employees. If there was a lower number of employees then the federal government would help with tax benefits and so forth so people could buy their own insurance or if they had a group policy, we would help give benefits so that it would be easier for the employ-er to carry insurance on these people. We felt that we still wanted to privatize medicine. We did not want the government to develop the same systems they had in Canada and Germany and England because we felt Medicare was really not a star in regards to problems we encountered in Medicare. We felt the federal government should not be the one who actually runs the medical care of the nation but we were trying to stay at the private by giving tax incentives as breaks and so forth so people could afford to buy their own insurance. That was a very, very important thing.  \n\nThe Foundation, the position I had was, as I said before, when I became active in the Foundation and I became Treasurer, the person I worked with most closely my entire time was Sandy Panther. She is an excellent Executive Vice President and we had a very close relationship. I got a call from Dr. Graham Monday saying Sandy was interested in moving on and I couldn’t believe what I heard so that was very difficult for me to take and accept and yet, I respected Sandy enough that whatever she really wanted to do, she felt was best for her and Dick, then that’s what it had to be. It really was very disappointing to me and I felt, God, I’m going to have to do this on my own, I’ll never have a good relationship with another person of that nature again in the short time left for me to be with the Academy [sic]. So we went through a lot of negotia-tions, a lot of talking with the Foundation and the Board members of the Academy, Dr. Graham and Sandy and Sandy came around and saw the light and she agreed to stay with the Academy [sic] and then I was overjoyed that she did. That’s why I think the Foundation continued to build after that time. That was the most difficult time I had.  \n\nYou were given an award in 1985, you were made Alumnus of the Year, is that correct? At Loyola? Either Loyola or LSU.\n\nI was honored by Loyola at one time and once by LSU. At that time, it was not only for medicine. I served for 12 years on the Town Council of Mandeville and so I was involved in that political aspect of my life. That was non-medical. I was very active in my church and in some other community affairs here so I was very honored to be recognized by both of these groups.\n\nYou also, and I’m looking at a newspaper article, were appointed to a federal substance abuse steering committee. Do you want to tell us a little about that? \n\nI’m not sure what you’re reading. I don’t remember being appointed to that.  \n\nIt says here it was the U.S. Public Health Service and it was to develop national policy between primary care providers and treatment systems for alcoholism, drug abuse, mental health, and HIV infection.   \n\nAs Chairman of the Commission on Public Health, I did attend some meetings but I hate to tell you, I’m drawing a blank. Certainly what I did at those meetings was really never significant I guess, to me at the time. I was attending a lot of different meetings. My biggest thing during that time was really nutrition. I was lucky to be involved in studies that were going on in regard to nutrition in the elderly and we developed, the Academy, the American Dietetic Association, one of the senior citizen organizations banded together to develop a screening technique for screen-ing the senior citizens to see if they were eating adequately. What led to them not eating ade-quately, what we could do to improve their diet or to change the circumstances in which they were living. Tips to give family members so they would recognize that there was not weight loss but malnutrition in what their family members were eating. In that way I did become more involved in nutrition, which I enjoyed. I was later appointed to the board of the American Dietetic Association. I was the only male member of that board, which was intriguing but also, very educational in regards to nutrition.\n\nWere you the only physician involved in that board also? \n\nI was the only physician. Since that time, we have had a couple of physicians from the Academy who have served on that board. I think being on that board and having a physician there and realizing that we wanted to work together and not compete against each other, they felt it helpful to have a physician on the board.\n\nYou were integral, were you not, in starting that Nutrition Spokesperson Project, which was a joint effort between the ADA and the AAFP? \n\nRight. The ADA had a spokesperson project going on before, which was being available to speak, talk about, write about, nutrition when called upon, make TV appearances, interviews on radio concerning nutrition. We, even though I don’t make any claims that I know what the dietician knows, a lot of times we add credibility as a physician to what is being said because patients still look to us as experts in some things that we may not be expert in as we would like to be. We can’t be experts in everything. So working together as a team and backing each other up in interviews and appearances was a project that we shared with the American Dietetic Association and the Academy and I think worked very well during that time.\n\nDid you also co-author a book on nutrition? \n\nWe did write several books that I was consulting on, not writing but consulting in regards to nutrition. That was also sort of tied in with the project we did on nutrition in the elderly.\n\nAny particular organizations, either civic or professional organizations that you’re particularly proud of, having served upon? \n\nServing on the Town Council of Mandeville, I think that was from 1968 to 1980, was an education also. I just happened to run because I think I wanted to do something about the lakefront here in Mandeville but it was, again, another aspect of my life that was different but was very educational and is very satisfying to be able to lead a town that was small and learn about sewerage and running trucks and hiring people and making sure you have a good police department. I served as Mayor Pro Tem for eight of those twelve years too. You don’t recognize the municipal problems that occur in a town or a city and actually we have 12,000 people in the city now so it’s a little more complicated. That was a learning experience.\n\nI’ve also been involved in the food bank here in the area, even though part of my area is fairly affluent, we do have a large indigent group also in our parish.  It became necessary for us to have an active food bank, which I’m still involved in, going to a meeting tomorrow night.  We try to say it’s mostly for the working poor because the real poor have food stamps but there’s those that falls through the cracks.  In medicine, Medicaid is there for people who have a low income, handicapped, etc., but there’s people that do work but just don’t have enough money to buy health insurance.  We need to fix that crack that people fall through.  You see this in food also.  We did start a clinic.  In the food bank following Katrina, we had many displaced persons here after the devastating hurricane that hit south Louisiana, particularly the New Orleans metro area.  We ran a medical clinic for over a year, taking care of these displaced persons as well as people seriously affected by the hurricane and couldn’t afford medical care.\n\nOur latest project now is to form a community health center in St. Tammany Parish. This is a federally health qualified center we’re talking about. We worked on this for two years and fortu-nately we know now that we did not receive the $650,000 grant that we had hoped for but now we’re presently working on bringing the community health center in as a satellite of another parish and then later becoming more autonomous and hopefully have one both in the east and west end of our parish. These are clinics that probably anybody can come to. There is a fee but never is there a question that you’re going to force payment. There’s no sending second, third, fourth, fifth bills or things of that nature. We see anybody who walks through the door when we open this clinic. Hopefully we’ll get that done by the first of the year. I’ll be happy if we can say we have a federally qualified health clinic as a satellite of another and then hoping through the years we’ll apply again and be accepted that time by the federal government and we’ll have financing to do it on our own.\n\nYou also did a project for Pfizer, did you not, or helped with a project during the Medicare transition period? Or am I thinking of a wrong state? Where I came down and Pfizer came in and you actually showed people how to sign up for Medicare. \n\nOh yes, right. Actually what it was, the pharmaceutical companies had all developed programs whereby if you had limited income or didn’t have insurance, then you could sign up for their medication benefits and they would either send the medicine to the doctor and the doctor would then give it to the patient or sometimes some of them would send it directly to the patient them-selves. The problem was that every company had its own way of people signing up. Different form…many of these people were on six, seven medications, all coming from a different com-pany. Pfizer started out by having a project, whereby they would fund and advertise people to come into an area and they would help them sign up and we did this where we had an LSU residency program in family medicine in the City of New Orleans. I went over and helped them organize that program here in the City of New Orleans. I think one of the things that we did, remember when we went to the pharma meeting together, we brought this up and this was discussed, asking, pleading with the pharmaceutical companies to develop one form they all could use that a patient would not have to sign up with three, four different types of forms. Well, they have simplified it now but they still haven't developed that one form yet, unfortunately. Many of us in my clinic, hire somebody who usually does nothing but fill out these forms for the senior citizens so they can get their medications in this manner. This is somewhat simplified now under Medicare, you can actually get a benefit, you can sign up for the pharmaceutical benefit. It’s a great program, it certainly helped a lot of patients who could not afford to get their medi-cations but it was more complicated. We tried at the Academy, we tried when I was on the Foundation, we met with all the CEOs, we’d meet once a year, the Foundation organizes the program and we meet with CEOs of pharmaceutical companies trying to get them to work harder to develop this one form.\n\nI just wanted to highlight that you have been the recipient of several awards during your career, some of which we’ve talked about. The A.H. Robins Award for Community Service, Junior Chamber of Commerce Distinguished Service Award, and the Mandeville Chamber of Commerce Outstanding Businessperson so it’s obvious you have been very involved in your community. \n\nI’d like to go back to the hurricane a little bit. Obviously Katrina and you and I were part of the one year anniversary of Katrina. Have you been in more than one devastating hurricane in your time and could you explain at least, Katrina to us and what it did to the healthcare system. \n\nKatrina certainly was the worst I’ve dealt with since I’ve been back living in this area. We did have a hurricane back in 1967 or 1969, shortly after I arrived here that particularly affected the Mississippi Gulf Coast and we are within 40 miles of the Mississippi Gulf Coast where we live. The devastation there was tremendous and just completely wiped out the first two to three blocks from the coastline and including a lot of the clinics. A lot of people were living in schools, café-terias, things of this nature. Very worried about tetanus, people were out digging in debris and so forth. That was my first experience with going down and doing some volunteer work, doing immunizations, giving tetanus shots, taking care of cuts, injuries from people who were mostly going back and trying to retrieve whatever they could out of their homes. We thought that was bad and that was, in retrospect, nothing compared to Katrina.  \n\nKatrina, as everyone probably knows from some of the news reports in the past, left the city of New Orleans nearly completely flooded, a 100,000 homes nearly destroyed, everybody had evacuated along with the professional people had evacuated. The hospital, except for Ochsner, East and West Jeff had been closed because many of them were flooded and there was no personnel. One bit (?) hospital, Touro, did not open but did have patients still in the hospital and I’m sure history will tell the tale of patients dying and a physician and two nurses being charged with mercy killing of several patients, which really upset the medical community. They gave them medication that probably caused their demise eventually but these people were suffering and they were given medications to calm them down, to keep them stable the best they could. They had no electricity, no water, no sewage, nothing. They weren’t able to get the helicopters in there to get them out. It was very, very poor. There are some interesting pictures even in St. Bernard Parish that Sandy, you saw, which the water was totally up to the first floor of a hospital in St. Bernard Parish. You could actually get off a boat onto the second floor. Again, no water, no electricity, no air conditioning, no oxygen, and trying to get these patients…they finally got them out with boats and helicopters in that particular parish. The only dry place was the jail. I don’t know why but it was high enough. That was the first time they could render any medical care. Medical care was very, very sporadic in the city after that. First of all, there was probably none except at Ochsner, as I say and West and East Jeff Hospital. Their emergency rooms were overwhelmed with people who were sick or injured. All these people came into the city to help rebuild, of course they had no money, no medical care. It inundated the emergency rooms. A lot of these people came over here and lived in the area in which I live and that’s when we opened up a medical clinic at the food bank to try to take care of these displaced people. You’ve got to realize they thought they were leaving town for a day or two or three or four so maybe they had medicine to last them a week. They came without their hypertension medication, their cardiac medication and there were no drugstores open anywhere within 100, 150, 200 miles. I had some on hand that we could give these patients, at least to tide them over so I was able to get in touch with a national organization that ships medications overseas and I was able to plead with them and it was the first time they actually shipped the medicine in the States and they finally just shipped me loads of various and sundry medications that I collected and that I could use at the clinic. It was a very difficult time. It was very, very taxing on the hospitals that were open. They each lost about $150 million within a year, work that they were not compensated for. This went on for more than one year so all of them have some very serious financial problems because of this devastation.\n\nWe did have one of our Academy members who reopened his clinic right in the center part of the city as quickly as he could. How he did it was really a miracle because he had water three-quarters up to his roof. He was able to clean it out, get an air conditioner going and started seeing patients. Dr. Bertucci in St. Bernard Parish, they brought in some trailers and opened up a clinic in trailers to take care of those people. You’ve got to realize, you say how many people were there? They may have lost 75% of their populations. St. Bernard must have lost 75% of their homes. The place where I was raised, now gone, flooded, flat now. And then we also had the Family Physician Department at Tulane open up a clinic across the river shortly afterwards. That was an interesting experience. Sandy and I and the President of the Academy went to see that particular clinic, the Academy was giving awards to those people who had done outstanding service to the community during that time. We went to see the clinic in Algiers. It was something they put together but they did a great job. It was divided by curtains and so forth. They were using some medications that had been donated and brought in by some of the companies. Just an awful lot of volunteers, all volunteer work.\n\nThe person who was sort of running it administratively was a young woman who had actually no transportation there except riding a bike and she had ridden the bike over and opened the clinic and gave us a tour. When we went to leave, her bike had been stolen. You’ve got to realize at that time there was a lot of theft going on, which is bad, but you’ve got to realize what people were living through. We all looked at each other and we all felt so bad so we got in the car and the first thing we did, let’s go find if there’s a Wal-Mart open and get this girl on a bike. We were very proud that we were able to get her a nice, new bike and a very secure lock, hoping that it wouldn’t get stolen again.  \n\nWe opened Ochsner Clinic two, maybe three days on the North Shore after this happened. We actually worked with a generator in the clinic here on the North Shore for about two weeks. We had no electricity in my house for over a month. It was four to six weeks, I can’t remember. We ran two generators 24 hours a day. Had 13 trees on top of my house. It took us about two years to get it looking like it looked before Katrina. \n\nMedical care, if you wanted to open up hospitals, you really didn’t have the medical personnel to open them. Some physicians had left and said, I don’t want to go back to that again. They had to, in the meantime, find work elsewhere. Nurses had left the area and a lot of them decided they weren’t coming back. To this day, a severe shortage of nursing, paramedical personnel – the hospitals. It’s slowly coming back but it’s taking a lot of time.\n\nTape Two, Side One of an interview with Gerald C. Keller by Sandy Panther. \n\nWe were talking about Katrina and what it has done and has it come back. My question to you is, have any physicians returned now in the subspecialty groups? \n\nYes, they have. At Ochsner I’ve been very lucky to entice physicians back and we’re back up to about 460 physicians in our group alone. I think the North Shore has done well. It always has because it’s just a great place to live, where I live. The city is becoming more and more full. Another hospital has opened, that’s Touro and Ochsner has bought three other hospitals, one in Kenner, one across the river on the West Bank and one right in the uptown part of New Orleans. We have opened those hospitals too so people now, medical is available to them. St. Bernard is getting a lot of FEMA money to build a new hospital down in St. Bernard and that’s where Dr. Bertucci was, as you remember. New Orleans East is the one area that was most devastated and there was a Methodist hospital there and that has not been reopened. They’re trying to entice there. Tulane and LSU have both started clinics down in those areas to help take care of those people. I’m not going to say we’re back to where New Orleans was prior three years ago but it’s getting that way slowly. The city has done better with tourist trade now, still having Mardi Gras, more conventions are here and I hope the Academy in the future again comes back to the city of New Orleans.\n\nNext I’d like to do your philosophy and then end up with a lighter side to your career. How have you seen family medicine change over the years since you’ve been in practice? \n\nWhen I first started practice, as I said, the town was only 1,200 people and we were the only docs in my immediate area, we had no subspecialists in my immediate area and so it became necessary for us to do many things that you don’t see people doing today. Things that really were fun to do, to be honest with you. I remember the first time I had a pericardial effusion and this guy couldn’t breathe and I had to call somebody in New Orleans and he said, take a spinal needle and go into the diaphragm under the last rip, the first pop you’re going to hear is you’ve pene-trated the diaphragm, the next pop, you’ve penetrated the pericardial sac and drain that thing. I thought, he must be crazy but then I had a patient that was going to die on me and I did it. So those things made it very, very interesting. Things were done out of necessity because there was nobody else to take care of it or do it. Evacuation was 35, 40 miles away and without the ability to transport so easily as it is today. The scope of practice is so much more confined now than it was when I was in practice. The big thing to me, the difference I see is more fun. It was more fun to know the whole family. We didn’t have pediatricians in the area, we didn’t have geriatricians in the area, you really saw from birth to death patients and you treated the full constellation of medicine. And we did a pretty good job, don’t get me wrong. And we weren’t trained as well. I had no residency in family medicine. I interned and that was it. There were a few residency programs that mainly taught you more about how to do some surgical procedures, as I mentioned my partner did when I was in Europe. I took my own X-rays with an old X-ray machine that we got secondhand from someone and we had our own lab eventually where we did…my wife is a med tech and so we were able to do those types of things. I think we miss many of the things that I thought were challenging and important for us to do. I’m afraid we’ve given up too much to the other specialties.  \n\nThe family physician today is much better trained than I was when I went into medicine. Students are better trained. They amaze me because we still have students in this office nine, ten months out of the year. They’re very well-educated, very knowledgeable. By the time they’re a senior they have much more clinical experience than I ever had and much more qualified. It’s just that the spectrum now is so much more confined now. I think starting the medical records, the computerized medical records is great but time-consuming in a way. It has its benefits, don’t get me wrong, it’s nice to be able to print that prescription, you know it’s in the computer and that knowledge is there all the time, doesn’t eat up a certain time that I can spend with a patient. Dictating long notes to prove that you did something so that you can justify the charges that you made, just those notes take a lot of time. Now that time is so precious, which it wasn’t… time was precious, don’t get me wrong when we first started practice, wasn’t as important but we had more time to spend with the patient because all these other things didn’t have to be done. Our notes were short, concise, to the point. Since there were only two of us and we saw each other’s patients, we were really pretty knowledgeable about the past history because we had been treat-ing this patient for years and years and years. There are good points to what’s going on, I think the physicians are better-educated now than they were. I’m afraid money may be a little bit more important but then if you’re going to have $100,000 to $200,000 debt facing you, you become very aware of what you have to earn to pay off that debt, buy a house and a car and start a prac-tice. The most important thing to me is, you don’t have the time with the patient that I used to have with my patients, you don’t get to know the patients you don’t get to know the whole family because you go to the pediatrician, you in between and sometimes some will go to geriatricians. I guess I really became a geriatrician in the last three or four years of my practice because my patients had all aged with me and I was still seeing the same patients but they were getting older as I was also. I think you missed something. Some of that satisfaction that we got before. I think we knew our patients better than they do now.\n\nDo you see it getting any better in the future or potentially worse? \n\nI haven’t seen it get any better. I’ve only seen it get worse, to be honest with you. Maybe if we get to the point where the reimbursement is going to be able to justify you spending more time with the patient, I think you will get more out of medicine yourself when you can sit there and talk to the patient for twenty minutes, then knowing you have fifteen minutes to do the whole thing, not just see the patient but write the notes, print the prescription and make the charges on the computer. And I do all those things now, which I never thought I’d be able to do but I can do it. I know I could do it much faster if I wasn’t spending the time…in fact now my nurse, since I only work one or two days a week, the nurses will finally come in and say, Dr. Keller, you’re really behind time because they know I’m going to get in there and start talking about things that probably had nothing to do with that patient’s complaint at the time.\n\nOn the lighter side and sort of to end this up, tell me, were you King of Mardi Gras at one point? \n\nI was not King of the Mardi Gras in New Orleans, I was King of the Mardi Gras on the North Shore.\n\nHobbies are? \n\nMy hobbies are tennis, which I play about three times a week, at least two times. I ride my bike…we’re very lucky in my area, we have a Trace that goes from Slidell to Covington now. Mandeville is in between those two towns and Trace is probably totally about 35 miles, 40 miles and so I ride probably, when I do ride, maybe four or five times a week I will ride about 25 miles at a time. I also say, God, if you take me right now, why am I doing all this exercise? I do it because I like it, not just because I guess I want to stay healthy. I do a lot of gardening and I enjoy that also. Had to do a lot of gardening post-Katrina and then Ike didn’t help me any at all. I’d just finished cleaning up one and today I’m just cleaning up from the second one. At least I don’t have any more trees, they’re all down now except for some oak trees. I did plant oak trees because they don’t come down as easily in the yard. That’s mainly my hobbies. I am still active with the food bank. I’m going to see St. Tammany Parish gets a Community Health Center before I do.  \n\nAnd undoubtedly you will. Is there anything else you wanted to add before we close? \n\nThere are many things that have been good in my life and hard to pick one or the other but certainly the time I spent with the Academy, starting with the Louisiana Academy and ending with the Foundation, was certainly a big part of my life. It went from 1967 or so to 1998 when I left the Foundation. It was a long, long time, 40 years of my life being involved with the Academy and it was a wonderful, wonderful experience. Met a lot of nice people. I think a lot of good things for healthcare and the country, not me personally but as a group.  I think we advanced family medicine and got the specialty, which was really a big, big deal and I’m proud of that time and also can say it was just a great, great experience being involved with the Louisiana and the American Academy of Family Physicians and the Foundation.\n\nThank you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281715#t=0.0,2588.77009"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281714","type":"Canvas","label":{"en":["Media File 2 of 3 - Keller_Gerald_Pt1_08_b.wav"]},"duration":2541.5379,"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/153060/file/281714/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281714/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/714/original/Keller_Gerald_Pt1_08_b.wav?1752092308","type":"Audio","format":"audio/wav","duration":2541.5379,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281714","metadata":[]}]}],"annotations":[]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281713","type":"Canvas","label":{"en":["Media File 3 of 3 - Keller_Gerald_Pt2_08_a.wav"]},"duration":882.52859,"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/153060/file/281713/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281713/content/3/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/713/original/Keller_Gerald_Pt2_08_a.wav?1752092265","type":"Audio","format":"audio/wav","duration":882.52859,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153060/file/281713","metadata":[]}]}],"annotations":[]}]}