{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/m03xs5mf3h/manifest","type":"Manifest","label":{"en":["Dr. Brent Smith"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer: The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2020-12-03 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["oral history"]}},{"label":{"en":["Agent"]},"value":{"en":["Annette Routon (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["video file"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","family physician","American Academy of Family Physicians","AAFP President"]}},{"label":{"en":["Subject"]},"value":{"en":["Brent Smith, MD FAAFP (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/295/885/small/Dr.BrentSmith%2812-3-2020%29.mp4_1761149929.jpg?1761149930","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885","type":"Canvas","label":{"en":["Media File 1 of 1 - Dr._Brent_Smith_(12-3-2020).mp4"]},"duration":3340.44,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/295/885/small/Dr.BrentSmith%2812-3-2020%29.mp4_1761149929.jpg?1761149930","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/295/885/original/Dr._Brent_Smith_%2812-3-2020%29.mp4?1761149928","type":"Video","format":"video/mp4","duration":3340.44,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522","type":"AnnotationPage","label":{"en":["Dr. Brent Smith interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Annette Routon: All right. Good afternoon Brent. To confirm for the record, please, that you are aware that this is being recorded and you have signed the consent form with the Center for the History of Family Medicine, and you are giving your permission or have given you permission to do this interview on Wednesday, December 2nd, via Webex.\n\nBrent Smith: I am aware, have done so.\n\nAnnette Routon: Okay. All right. Well, let's get started. Brent, where do you currently work and what is your title.\n\nBrent Smith: I am clinical physician, practicing physician, family medicine, Cleveland Medical Clinic in Cleveland, Mississippi. Northwest Mississippi, it's a small rural town, about 12,000 people, if you don't count our college, and if you count the college, it's about 15,000. Rural community in northwest Mississippi, the same community I grew up in.\n\nAnnette Routon: Okay. And is that where you were born?\n\nBrent Smith: Yeah. I was born and raised in Cleveland. Lived here for 18 years, went of to college and higher education and then came back to practice.\n\nAnnette Routon: Can you tell us, where did you attend college and residency?\n\nBrent Smith: I did my ungrad at Ouachita Baptist University in southwest Arkansas. I graduated there in 2005, came back to the University of Mississippi Medical Center and medical school in Jackson, Mississippi. Ouachita Baptist is Arkadelphia, Arkansas. University Medical Center is the only Allopathic Medical School in the state of Mississippi. It's a branch of the University of Mississippi, but it's located in Jackson, Mississippi. I did my medical school and residency training there. Medical school, and then, residency in family medicine at the University of Mississippi Family Medicine Residency Program, and did a year of fellowship in sports medicine at the University of Alabama in Tuscaloosa, and then came back to Cleveland.\n\nAnnette Routon: Tell me about living and practicing in your hometown of Cleveland, Mississippi.\n\nBrent Smith: It's a bit of challenge, more so than I ever expected to practice in your hometown. Several things, number one, it's a very small town. Small town, in the sense that it's rural and it's only about 12,000 people, so there's not a huge population of patients that I'm not associated with. The average panel for a family doctor is supposedly 2500 to 3,000, and there's only 20 or 30,000 people in the county, so there's a solid chance that I've seen or evaluated one out of every seven or eight people I've seen, in some setting. So the challenge is, how to live and practice in an environment where your exposure to everybody is pretty wide open, and most people know you. It makes it somewhat hard to separate the work/life balance.\n\nBrent Smith: I tell people all the time, \"The place I like to go the least is the grocery store.\" Because it's just hard to be there and be a simple guy trying to get your groceries, you end up being asked a lot questions a lot. What you accept coming back to a small town, especially a hometown, to practice, is that that's going to happen, and you have to make it part of the reason you're here, and it is. I very much value being a resource to people I grew up with and that I know. The trade-off is, two things. Number one, the absolute lack of anonymity. And number two is the sense of familiarity that sometimes makes it challenge to keep the proper patient/physician relationship.\n\nBrent Smith: I have people that, they have my cell phone number, because I grew up with their children or they were my elementary school teacher. I have football coaches that have my phone number, because I take care of their athletes. And inevitably, I'll get a message about something completely unrelated to the reason... The best example I have is I am divorced and dated a girl here, when I came back to town for about a year, and her mother has my cell phone number. And despite the fact that I've been broken up with this girl for six year, her mother-in-law still texts me whenever she needs something medical. It's hard to come back and say, \"Look, this is not appropriate.\" So, that's the challenge.\n\nBrent Smith: The other challenge of a small town is that as evidence by the COVID pandemic we're in, you have to do a lot here. You have to... I cover ER one weekend a month, sometimes a little more than that. I'm a hospitalist and a clinic physician, and I cover high school sports, so you have to be able to stretch and right now, we're all very, very stretched with that. Because, as in today, today, we're interviewing about [noon o'clock","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=0.0,302.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] here, I've been sick, so I didn't go up and go to the hospital this morning. I'll go as soon as I finish my clinic this afternoon, and probably be there for a few hours. So it's just... it's small town living. The benefit though is I'm very close to my family and I'm around them. I get to see my niece and nephew grow up, and be close to my brothers. There's the positives of it. I know I mentioned a lot of the hard parts, but the positives are the community, the sense of engagement in an area where you know your people and having resources to help me.\n\nAnnette Routon: Okay. So how many brothers do you have? Do you have brothers and sisters or just-\n\nBrent Smith: Two older brothers and an older half-sister.\n\nAnnette Routon: Okay.\n\nBrent Smith: I'm the youngest.\n\nAnnette Routon: You're the youngest.\n\nBrent Smith: Mm-hmm (affirmative).\n\nAnnette Routon: [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=302.0,349.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] okay. You kind of answered this other question but I kind of want to ask this instead, you worked... Instead of working for a bigger healthcare system, you opened your own practice, so why? You didn't open your own practice?\n\nBrent Smith: When I first came back to Cleveland, I actually joined a practice of six or seven other physicians. It was more of a loose partnership than it was... We basically pooled resources and said that part of your expense were the front desk and the rent and things like that, but there was no overarching ownership. I left that practice after nine months for a variety of reasons, most of which were business related, and joined the practice I'm in now. And in the practice I'm in now, I'm employed by another physician. And so, I went from practicing with six or seven positions and probably four nurse practitioners to I'm with one other physician and three nurse practitioners. It's a smaller practice, but the ownership structure is way more clearly defined.\n\nBrent Smith: We're all employees of the physician that owns it, and it, to me, has made a lot more sense, because everybody has the same incentive. We're all paid on a production basis, but there's more than enough patients to go around, and we all try to look out for each others workloads, and we try to overdo it. So it's just been a different... much more pleasant environment. In this group I'm with now, I've been here for over six years.\n\nAnnette Routon: Okay. I don't know why I thought... I must've had... obviously, I had the wrong information, so sorry.\n\nBrent Smith: Well, I'm given a lot of independent for what I do, work schedule wise, and so, it probably seems like I'm, either independently practicing or own my own practice, but the truth is the physician that owns the clinic, he's very much in the mindset of, give everybody the opportunity to work as hard as they want and take care of how much they want to make, and as long as you're pulling your weight, and we're all... There's nobody in my practice that's there just to milk it can coast through the day. We all want to be productive and have a busy practice, and so it's never been a problem of needing to be reminded of, we have to work this much. I did build into my contract when I came here, that I need to have a set amount of days off a year to be able to go and do organized medicine/vacation time, and that's... As long as I keep it... And I try very hard to keep in those days.\n\nAnnette Routon: Okay. All right. Well, let's talk about your decision to go into family medicine. You mentioned that as a medical student, attending national conference played a role in leading to you a career in family medicine, please, expand on this.\n\nBrent Smith: I was an athlete growing up, I went to... First off, I'm the son of a coach, so I've been around sports, literally, since I was old enough to walk. Now, sports have always been a part of my life. I grew up playing sports and as not a high level football player, but I was competitive enough to get a college scholarship football player. I got injured the Spring of my senior year, and it kind of derailed the thoughts of playing college football, but I went and was on... still took my scholarship and sat a semester and then went out for Spring and decided I was never going to be a professional football player, so perhaps I needed to focus on school, so that I could... I knew, even then, that I wanted to do medical school, and instead of transferring or just getting completely away from sports, the way I kept my scholarship was to work for the football team, so I did some supervision of the other student workers, I was in charge of a lot of the equipment and budgeting and some of the film things and some of the travel stuff. I had a pretty broad portfolio of things that I was asked to do.\n\nBrent Smith: But what it really did was keep me involved with sports. I stayed associated with the football team for the rest for the rest of my time in college. And so, I still had that connection. So I went to medical school, and my first thought was to try to do orthopedic surgery, because that seemed like the most connected way to stay involved with athletics. The problem was, when I got to be a third year medical student, I did not like surgery at all. I didn't like the environment. I didn't like being locked in a room all day. I didn't like the long procedures, any of those things. I didn't like the mentality. There was just so much about it. I carved the ability to connect with people and then move on. I also like a more fast paced world, where you spend 10 or 20 minutes doing something and then you go do something else. And that's what kind of life is for me. I have a 10 or 20 maybe 30 minutes with a patient and I go see another patient, so it's turning over fast.\n\nBrent Smith: Once I realized... And it happened very early that I realized that surgery was not going to be the option for me, and spent the rest of third year, trying to figure out what the heck I wanted to do with my life. And by the end of the year, I looked back and I thought, \"Man, the one thing I enjoyed the most was family medicine.\" It let me go back... I did my rotation in a smaller town, got to do a lot of stuff, a lot of procedure in the clinic and things like that. And what I realized was, originally, I thought I'd enjoy the rotation as much I did, because it was my very first rotation, and I thought I was just happy to be out of the classroom. But it also, turned out to be the thing I enjoyed the most. So, this was toward the end of third year, I applied for a scholarship to go to a national conference, because our school gives a certain number of scholarship... our family medicine interest group, and our family medicine department, gives a couple, and it was too late to get into those, so I applied for a first time scholarship through the foundation, ended up going to national conference, got really excited at national conference, ran for a student delegate role there, got it.\n\nBrent Smith: And so, from not knowing what I wanted to do to being fully engaged with family medicine, within about four months, and then, actively involved with family medicine. Since then, I have increasingly become more in tune with why I made that decision. A lot of the things that I enjoy about being in a small town, are the same reasons I enjoy family medicine. I treat everybody. There's not much that can come in the door that I can't work with them. My patient load this morning. I had a four year old with a humeral fracture and I had a 67 year old with a reoccurrence of Lymphoma, who needs a PET scan but can't get a PET scan because she recently flared her diabetes up. I've had COVID patients. I've had upper respiratory infections. I've got a farmer that had a scratch on his eyeball from working in a grain bin today. There's so much there that you have to be willing to be able to bounce back and forth and do.\n\nBrent Smith: And it's, one, very challenging, but two, it's also very rewarding to be able to do that. And it's also, doesn't get boring. I don't do the same thing all day every day. There are days where I do nothing but diabetes and hypertension all day long, but days like today that's a good mix, it's a pleasant mix.\n\nAnnette Routon: So then you touched upon kind of an athlete your whole life, and your father was a coach, so then, I'm guess, that kind of lead you into the sport's medicine, specializing in sport's medicine.\n\nBrent Smith: Yeah. I knew I wanted to do family medicine, and I wanted to be able to still be a resource, and so I learned, sometime, probably, the second year of residency about primary care sport's medicine fellowships. And what primary care sport's medicine is, is essentially the primary care for athletes. I've explained it to my coaches a lot, \"I do family medicine for athletes.\" They have some unique things we need to be aware of, but it really strengthens your ability to provide orthopedic and muscular/skeletal care for setting, and that's where I get the most out of it is, is I practice in a smaller town, there's an orthopedist that comes here two half days a week, otherwise, the patients are looking at a least a 45 minute drive to see an orthopedic surgeon, but most of the time, it's actually a two hour drive, to go see one of the bigger orthopedic groups.\n\nBrent Smith: So the ability to provide that in this area, is important, but, also, it helps me take care of the high school teams, that their athletes need that level of care to keep them from missing a lot of time or missing injuries.\n\nAnnette Routon: Okay, great. All right, well, so you've been a practicing physician for more than seven year? Six, seven years?\n\nBrent Smith: Yep, [crosstalk","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=349.0,904.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] seven years.\n\nAnnette Routon: How has the health landscape evolved? And how has it influenced you? Wait, gosh, how did I write this question? And has it influenced how you practice medicine? Gosh, [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=904.0,918.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"]-\n\nBrent Smith: The health landscape in Mississippi has evolved in a very interesting way in the last 10 or so years. So I came into medical school and graduated into residency right at the time of Obamacare. And so, we went from having a fairly significant portion of our population, that had no insurance coverage in Mississippi, to a lot more coverage, but it's coverage with some restrictions. And a lot of what we call Obamacare plans are high deductible plans, but they cover a lot of primary care services, so it really emphasizes the ability to take care of things without ordering some tests that are high cost tests, and it makes you very focused on what medicines the patients will actually be able to get.\n\nBrent Smith: And I think it challenges you to be able to provide care as much from a mental standpoint... We have to be able to provide things without relying on tests, on relying on the ability to get every medicine that you'd ever want, and still find a way. It challenges you to be very intellectual about the way you practice medicine.\n\nBrent Smith: The other thing that's really changed the landscape in Mississippi is along with Obamacare plans the state, five or six years ago, it's been a while, sold their state Medicaid program into managed care. They started with all children, and it's kind of progressed now to people that are on Medicaid in the state, I want to say, 50 or 75%, are on the managed Medicaid program now, a third party managed program, either United or Magnolia or Molina. And they essentially have the same practice model, which is, they make it very hard to get an ancillary test. They have a restrictive formulary, they're not going to do a lot of extraneous stuff. So the good is, is that people have some coverage. The bad is, it's very restrictive, and sometimes very frustrating coverage.\n\nBrent Smith: So that's how it's evolved. We've got better coverage in some ways, but a lot of the extra work and stress has been shifted into the physician and provider area more. I do a lot more paperwork than I did probably five years ago, just to get stuff that makes no sense, and some of it's very frustrating. And I have days where I'll spending 20 minutes on a phone call, knowing that the call is going to go the same way every time, it's just that they want to take up 20 minutes of my time to try to keep me from getting what I want, which is usually to get an MRI or extra test or something like that. So that part has been a struggle.\n\nBrent Smith: But the side benefit is that we see a lot less patients that do not have any form of insurance, that are covered. And we're in a state that didn't expand Medicaid when Obamacare passed, so it's gotten somewhat better here. It's just been a challenge for practicing in that environment.\n\nAnnette Routon: I'm sorry, so did you answer the second part, where has it influenced how you practice medicine, did you answer that part?\n\nBrent Smith: Yeah.\n\nAnnette Routon: Okay.\n\nBrent Smith: It's influenced it in several ways. It forces all of us to practice very... as far up to our extent of our training as we can, because it's just too hard to get somebody in to see some other things. But it's also limited your ability to innovated, because there are a lot of new medicines out that I would love to try on patients, that their insurance is just not going to cover. If they do cover them, they're going to put them in a tier of their formulary, where it makes it so expensive they just didn't cover it. And so, it forces you to be really sharp about managing things. Also, you have to be comfortable with the fact that you're not going to have access to some things that other place would.\n\nAnnette Routon: Okay. All right, well, we're half way through, I think, we're almost half way through. All right, so let's talk about you serving in multiple positions with AFP, including resident member of the Board of Directors, Mississippi AFP Board of Directors as well as other professional organized memberships. In what way have these elected positions shaped you as a family physician and leader?\n\nBrent Smith: So I've always been of the mindset that if you want to live and work or do something, then you need to be prepared to try to [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=918.0,1213.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] issues that come across or make changes. I've never been the kind of person that can accept an environment where the only thing I can do about something that bothers me is complain. And that sounds a little worse that what it means, but there are a lot of... And I've told you several of the things that frustrate being able to practice in the state of Mississippi managed care Medicaid is one, Obamacare and the limitations there. And so the way I chose early on to address that, was to try to be as involved as I could in organized medicine, because the only way physicians are going have an impact on the system is through their communal voice.\n\nBrent Smith: And if you chose not to be engaged with communal voice, either have to be very, very in [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=1213.0,1263.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] with your local politicians or you have to run for office yourself. There are other venues, but the venue I chose is to try to stay involved with organized medicine. And what that's forced me to do is, I have to understand what's going on in my practice, both from a sense of what insurance is doing, what payers are doing, what the system is asking, how the government is coming to its decisions about how to do this and that, so that I can fulfill my roles where I'm representing other physicians. So it's forced me to be more... to be aware of what's going on beyond what's right in front of me with seeing the patient. So I can't just say, I'm seeing patient A, and patient A has this insurance, and this insurance only allows me to do this and this. I have to understand that patient A insurance is a large private care insurance governed by these regulations, and that if we want to change that, we need to get this aspect of the state legislature to address that.\n\nBrent Smith: And the way I need to do that is to carry that to our board meeting for the state academy and move forward from there. The involvement with the national academy came from being very excited to have found a place where I felt at home and comfortable in wanting to be engaged and wanting to know, and that really it had a life of its own there for about seven or eight years. Like I said, I started out running as a student delegate, just at the very first meeting that I'd ever been to. And from there, I held some form of organized medicine position with the academy or the academy foundation for the next 10 years. Fourth year of medical school, by the time I was a third year resident, I was the resident board member on the Board of Directors. Literally, as I was finishing my board term, I was approached by the foundation to join the foundation board, and then moved through the officer track for that one. I was doing foundation activities as I was moving back to my home state, I got involved with our state academy some too, and have been on their board for a few years now.\n\nBrent Smith: And also did a thing with the National Resident Student conference, where I was a delegate for new physicians. So it's influenced my mindset with how I practice. It's both made it a lot more interesting to know, really, what's going on. I feel like I know why things are the way they are more than the average physician. The challenge is is that I also see why things re the way the are, and in some ways, you recognize things that there's just nothing you can do about and you just have to accept. And you recognize that there are things that could change, but it's going to require a special set circumstances or the right mindset to address it too. The short answer-\n\nAnnette Routon: [crosstalk","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=1263.0,1441.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] question-\n\nBrent Smith: ... to the question is I wanted to be able to make some changes where I saw problems, and that's lead me down the path of just staying involved in things outside of just focusing on what's in front of me.\n\nAnnette Routon: Okay. So my question center rather... they do focus a lot on the board of trustees, and you touch upon it, someone approached you to be on the foundation board, so why did you then decide to get involved with the Board of Trustees for the foundation?\n\nBrent Smith: The tricky thing about being involved at the national level for family medicine is that you grow a group of friends and professional contacts that you never, otherwise, would have had. I know physicians in Washington state, I know physicians in Southern California and Colorado and Vermont and New York, and I never would have had contact with them otherwise. And once you've established that connection, not only do you want to continue seeing these people, so that you can maintain your friendships, but you grow to appreciate the perspectives they bring.\n\nBrent Smith: I live and practice in a very rural and conservative area, and my exposure nationwide is all the way from ultra-conservative to the most liberal mindsetted people you'll ever see. And I enjoy having that perspective, I enjoy being able to see both sides.\n\nBrent Smith: So once I moved up through the academy and had that exposure at, what I consider the highest level, on top of that you get to be involved in decision making and leadership at that level, and you really learn to appreciate what it takes to do that. I was at a bit of a loss as that year came to a conclusion, because the resident and student and new physician members of the board only serve a one year term. Elected members out of the body of the academy get a three year term and then get the option of running for the presidency, so you feel like things are super engaging, but they go away very quickly.\n\nBrent Smith: And I was kind of at a loss for what to do. I was moving into my fellowship and didn't know... figured I would just be going back to my home state after fellowship. And then I got approached by both Brenda Cherpatil and Phil [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=1441.0,1590.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] at the last the congress delegates meetings I was at as a board member. And for some reason between them and Craig Doane who was the executive director of the foundation at the time, they felt like was a candidate for the Board of Trustees for the foundation. They had been making a conscious effort to get younger people from a different practice environment on the foundation Board of Trustees, and I think they saw me as a step in that direction, and, hopefully, they saw something they liked from a personal standpoint.\n\nBrent Smith: But we've had a very significant... Both in the few years up before mine and in the years since I've been on the board and moved on, there's been a very significant transition in the composition of the Board of Trustees, I think, I was kind of the second or third step in that, from a younger Board of Trustees member. The trustees for a long time had been a place for older retired, semi-retired physicians, physicians that were coming off of the Board of Directors for the academy, things like that, so I think it was an important step for them to get people in their actual Board of Trustees a little younger, that could speak more to what the actual practicing [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=1590.0,1672.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"].\n\nAnnette Routon: Okay. So before we focus on your time as foundation president, so you are the youngest officer to be elected to the Board of Trustees, why were you interested in the officers track, knowing that's another four, is it four more years?\n\nBrent Smith: That was actually... It was interesting, so when I ran for the board, it was a four year time commitment, and then literally, the first or second meeting I had, we were having a discussion to finalize a plan to shorten the board terms to three years, and so, I immediately found out that I was on there for three years not four. And then at the end of my second year, just out of the blue, because I honestly did not expect this, I was approached by Craig Doane to run for the officer track, which was a year early. Typically, you see people run in their third year, as they're finishing a term, and the way our foundation Board of Trustees works, you have the option of running for a second term. So you have some people that have been there for six or eight years before they run for the officer track.\n\nBrent Smith: The office track used to be very different as well. It was a much longer period of engagement in the iteration before I joined. You could be in each spot in the track for two years, sometimes even longer than that. And so you had people that had been on the board and in the office track for 10 or 15 years, and that was changing, so that we could have more turnover on the board and get new ideas. And that essentially was a result of things weren't moving fast enough. We were very much being trapped in the same way of thinking, because we weren't getting enough turnover. And I also think that the length of time we were on the Board of Trustees, prior to my being involved with it, was allowing people a sense of complacency that you were going to be here for 10 years, you didn't have to getting anything done.\n\nBrent Smith: So they elected me when I was younger, and then they'd asked me to move into the officer track, and I told them, even in running for the officer position that, \"Guys if this is something you want, be prepared for me to be here for four more years, but be prepared for me to push you to do things for four years, because I sense this as a call to action. We need to be growing and innovating and changing our model.\" I guess the board felt like that was what they wanted at the time. They elected me after just my second year, and then I moved into a four year officer track.\n\nBrent Smith: Why I wanted to do it was because I recognized the role the foundation had in giving me the opportunity to find what I consider my passion in family medicine, and wanted to give back to that. But then in the two years I'd been on the board, I saw so many programs that were doing such good work that we could really grow those. And this was at the time, the Emerging Leader Institute was getting off the ground, and that was another program that I had a personal connection to, because it was mentorship for residents and students. And one of the things I felt was very lacking in my time at my residency training site was mentorship. I felt like I was doing a lot of things that, I will arrogantly say, were pretty impressive for someone my age and there's only one resident nationally elected to the board, and I was doing it. I was the only person from the state Mississippi that had ever done that, and then I would go back and I would just have no support in my residency program.\n\nBrent Smith: Trying to implement change there and I butted heads with my faculty and butted heads with my program director and chairman, and it was very, very frustrating, and I felt like, if I had the opportunity to be engaged in things like the Emerging Leader Institute that were providing an alternative to that, then that would be another great place to be involved. So I recognize the trend of the board to a younger, more rapidly turning over, more diverse Board of Trustees that truly reflected what our membership was going to look like, as the academy and the donors to the foundation. And I just felt that I needed to embrace that and help be a part of it, and I've never regretted that decision. I had second thoughts about it my president year, but I've never regretted making that commitment.\n\nAnnette Routon: Okay. All right, well, let's just get into your time as foundation president. What did it mean personally for you to hold such a prestigious role at such a young age in your career?\n\nBrent Smith: I'm very proud to have done that. I recognize being the youngest person elected to the board period, and I recognize that effectively made me the youngest president in the history of the board, and that that showed that there were people that had confidence in my leadership capability even having seen just a small window of it. So there was very much a pride in that. But firmly for me, I have come to believe that you are put in the position for things at a time where your skillset is needed. And what of the things that I have come to be, what I consider, very good at, is small group leadership [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=1672.0,2032.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"]. Meaning, board level interactions and being able to understand the current of a room and the flow of people's thinkings and conflict resolution in a small group setting, and understanding how to get the most out of a small group of people.\n\nBrent Smith: I learned that the hard way from a great year on the Board of Directors for the academy, where I saw that modeled by some great leaders there, Jeff Cain, Reid Blackwelder, Roland Goertz, who I will always look towards as a way of leading small group dynamics, Glenn Stream was great there, and then I saw it at other boards that I was serving on. And specifically at our state level with our state medical association. I saw how small group boards can be lead in a way where power is centralized and people aren't engaged. And so, having seen both sides of that, I feel like I was pretty prepared for what would be a challenging year. My year as foundation president was very challenging, be it, we had essentially crises come up that year that needed to be address.\n\nBrent Smith: The first was, I remember this very distinctly, January 9th of my... Our Board of Trustees years beginning the calendar year, and so, literally, the ninth day I had been on the job as president, I got a call from Doug Henley. And I'm recognizing that I was the youngest to do this, and still having a young person's mentality of when somebody of a higher authority calls you, you're first reaction is, \"Oh, crap, I'm in trouble.\" I was like, \"What have I done? I've been here for nine days, we haven't had a meeting, we haven't even had our first officer's call.\" And he said, \"We're going to make a change at the Executive Director position.\" And that meant a change at a Vice President level at the academy, and begin the Executive Director for the foundation was just a part of that responsibility as a Vice President for the academy.\n\nBrent Smith: And so, I immediately realized that my year was not going to be engaged with dynamic changes at tinkering with the way the foundation board was doing things, it was going to be about providing leadership in a time of transition, so that we don't complete lose our barring for what we were... of the very difficult things we were already working on. And to be steadfast in keeping the board engaged, and also being prepared to welcome a new executive director. So that was challenge number one.\n\nBrent Smith: Challenge number two was one of the reasons we had to make a transition in our Executive Director leadership was difficult with getting our third signature program going and off the ground. And one of the reasons we were having difficulty with it was, the last vestige of the old model of thinking with our Board of Trustees not being open to new innovation and once you get attached to an idea, kind of forcing it through. And we had been on this cycle with our, what we called at the time, research signature program. We had had some research grants we were doing, we were going to basically repackage them and call it a research signature program. And it would have been very, very easy to do that as a leadership and say, \"Hey, this is great. We're doing a brand new thing.\" But knowing inside that all you're really doing was repackaging something you already have done.\n\nBrent Smith: And then from a standpoint of philanthropic leadership, we recognized that we weren't going to be able to generate a lot of new income because of that, because it wasn't new or innovative. And this is not... I don't mean to make it seem like I came to that conclusion independently. Hughes Melton was very good at asking questions that people needed to ask, and he was never one to avoid asking a difficult question for fear of what the answer would bring. And so for the entire year... his year of leadership, we had been kind of examining that, and then even for the year before with Evelyn Lewis \u0026 Clark, there had been some pushback on that.\n\nBrent Smith: So when I entered the year, almost immediately, I got hit with, we're going to be searching for a new Executive Director. We don't know how long this is going to take. We don't know who that person's going be, but we still have to carry on, we still have work to do. And then, also, in the back, there's this other program that's hanging and there's several options for how to address that issue. The first would be to push forward with what we've been thinking, knowing it wasn't probably the best thing to do. Or second would be to say, \"No, we're just not even going to worry about that this year, and we're going to push it back a year.\" But that ignored the fact that we were cutting out a part of our foundation legacy being a host for research grants that people had become dependent on. They had become very much reliant on. And so we took the challenge during my year of getting that program going, even without the Executive Director position filled, we... and this is...\n\nBrent Smith: I'm proud of two things. I'm proud that our board was as good or better picking up a new Executive Director as we had been at the meeting before the old Executive Director left. I'm proud that we got through what could have been a very rough transition. But I'm also proud that during that year, despite everything else that was going on, we finished our signature and launched a program that was distinct and new and innovative, when we had every opportunity to just kind of put it on hold for a year. And I'm proud of that because it ran the risk of tearing our board apart.\n\nBrent Smith: We actually lost a board member during my year, over that issue. It was a man named David [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2032.0,2424.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"]. He was a very intelligent... I don't hold this against him in any way. He was involved with the research subcommittee that was doing the research grants, and he was passionate about making it a bigger program, and when we took the decision to step back and say, \"No, this isn't what we want to do.\" He very much was the voice of opposition, saying, \"Look, guys, you can't do that. You can't change willy nilly like that.\" And it was one of the hardest decisions to make from a leadership standpoint, because it was something that had been going on my entire three years as an officer, but it was still the right thing to do. And he chose to resign over that, a decision I respect very much as standing for what you believed in, but it also crystallized the fact that we need to make some very difficult decisions at the same time as we could not accept making the easy decisions.\n\nBrent Smith: The easier things to do in that situation were not the right things to do, no matter how much it upset some people. And I think that getting through the year with that, those two big challenges, I think I was the right person at the right time, because I was willing to step in and make difficult decisions, because that's just my... I've always been of the mentality of you've got difficult choice, A, B, or C, that choice is going to be difficult in a month, it's going to be more difficult in two months. It's hard now, but it ain't getting [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2424.0,2527.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"], and I think that was what reinvigorated that year. And I think if you look at the way our course of officers on both preceding and me and then Doug Spotts and Julie Anderson, since then, but Hughes was very good at saying, \"Yeah, we got a problem. We need to figure out this problem.\" But my job was to step in and say, \"All right, we know the problem, now, let's fix it. And I know that in fixing it, we're going to create hard feelings.\"\n\nBrent Smith: There was hard feeling over Craig Doane's departure and there was hard feelings over David [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2527.0,2571.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] resigning. There was hard feelings over the research signature program becoming the RapSDI program for our scientific signature program. My job was to make hard decisions and try to get everybody to stay engaged and stay onboard. [Linda","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2571.0,2590.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] Hooks position turned into reestablishing this [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2590.0,2594.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] at the foundation board, and getting things going back into that direction. I think we were all where we needed to be at the right time.\n\nAnnette Routon: So then you have these challenges in your presidency, did you actually have any goals? Or did you accomplishing any of your goals that had for the year?\n\nBrent Smith: One of my goals was always getting the research signature program issue resolved, and we did that. I had some other things with how we were addressing the [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2594.0,2628.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/17","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] thing and things like that, but it quickly became apparent that that wasn't going to be where we needed to be that year. So my goal after that was to resolidify the good feelings of the board, and get us into a new Executive Director. And so the two goals I had, we accomplished.\n\nAnnette Routon: Cool. All right, well, we four questions left I think. So, okay, you continued to be involved and volunteered for the foundation, but you're also a generous donor. In 2017, you created a fund to help residents and student attend the family medicine Emerging Leader Institute and the AAFP National Conference, why was the establishment of this fund important to you?\n\nBrent Smith: So I touched on this a little earlier about I had some issues with the mentorship at a fellowship level going [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2628.0,2687.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/18","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"]. I recognized that if I'd have had a different opportunity there, things may even be different for me. And I wanted to be able to provide others with a different options, and so it was important for me to get involved both personally with the program but also financially. I think you have to put your money where your mouth is, and the thought that after this year, somebody will go to the Emerging Leader Institute every year based on the money I've given means that if I practice for another for 30 years, that's 30 people during my lifetime that I have [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2687.0,2728.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/19","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] for a mentorship experience that I didn't have. And so that was what made it worth it to me.\n\nBrent Smith: The second part of it was it turned into, for me, a very meaningful way that I could honor Hughes Melton, so we changed the name of the [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2728.0,2743.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/20","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] that I did to him. What I'd never realized about Hughes, until after he had passed away, was how much mentorship he was giving me, personally and professionally in the time we spent together, so meaning for him too late.\n\nAnnette Routon: You answered my sixth... That was my next question, so thank you. That's exactly what I was going to ask, so you really did answer that, thank you. I have a bonus question, based on your resume, so you received a Bachelor of Arts in History, what was the original plans with this degree?\n\nBrent Smith: So when I was undergraduate, history has always been the thing that I enjoyed as a divergent from medicine, and my father was a history teacher and a football coach, so obviously, I'm very involved with sports, and football in particular. I share a love for history with him, and I CLEP'd... There's a program called CLEP, College Level Exam Programs, I CLEP'd a lot of their basic stuff, college algebra, English composition, things like that, I just took the test and got a credit for the classes. So I needed to fill extra hours during the four years I was at Ouachita, and so I would just take history classes. I enjoyed them. It was a diversion, and to be honest with you, I could do it without really having to study as much as I did for biology and chemistry and physics. And I looked up at my last semester and I was 21 hours away from graduating with two degrees. Both my BS in biology, but a BA in history, and if I had not already been accepted to medical school and if calculus did try to kill me my last semester of college, I would have finished with that.\n\nBrent Smith: But I quickly realized that if I was going to finish calculus, because I needed calculus as a prereq for medical school, that had to take some time and focus on it, so I had to cut my hours back. And low and behold, what, I was 12 or so hours short with my degree in history, and I graduated with a BS in biology. So during my intern, after I finished medical school, I just on a whim one day, emailed the director of the department, who I had spent some time with while I was there. Certainly, did not form an intimate connection with him, weren't deep personal friends, I didn't feel like he's even remember me, but I explained the situation to him, and I said, \"Look, I'm, I think, 12 hours away from graduating with this, I would really love to do it, but I'd have to do it, basically, distance learning, and the classes I need are ones that are more focused on research and doing a paper, things like that.\" And he worked with me. He said, \"We'll make it work.\"\n\nBrent Smith: And so, during my intern year, my distraction from the stress of internship was to finish that history degree, which turned into finishing it, and during fourth year of medical school I had done a thing called a medical scholars travel award, where I, using my love of history, looked into what the history of medical education was. Which is, in itself, a fascinating evolution over the course of six or 700 years of western medicine. I turned it into a travel project. Through my travel project I met the Director of the Masters program at the University of Edinburgh, Edinburgh is a university that has a direct connection for the foundation of medical education in the United States, and as soon as I finished my history degree, I began a Masters in Science in history, distance learning through the University of Edinburgh.\n\nBrent Smith: So I've always felt like things kind of fall in place and you've got to keep eyes open for what the next opportunity is, took me getting through medical school, which was a huge challenge, lead me to wanting to get back and stay engaged, and the Masters program showed up as basically my next step in doing that. So while I was a second and third resident and my fellow, and the first six months I was back in practice, I finished my Masters program.\n\nAnnette Routon: Okay. I thought there was going to be something more off the wall that you were going to do with it, but that's okay, that answer was okay.\n\nBrent Smith: So one of the challenges that... One of the realities you have to face when you're applying for medical school is you may not get in. It doesn't matter if it was the thing you enjoyed... I have known since I was little I wanted to be a doctor, and they are very blunt about, \"You need to have a back up plan, and you need to be able to talk about your back up plan.\" Because it's a sign of maturity for you to be able to say, \"I have thought about the reality of the situation, here's what I would do if I didn't get into medical school.\" And my plan always was to teach history and coach football, if I didn't get into medical school.\n\nAnnette Routon: Okay.\n\nBrent Smith: I still would love to be able to teach history somewhere, I don't know that I would enjoy coaching football, seeing how frustrating that could be. When I was finishing undergrad, we had to have a meeting with our professional programs committee, so medical schools, either require two or three letters of recommendation from faculty members or if they have a committee, you have to submit to the committee to write you one letter. And I was told they might write it, I said, \"If I don't get into medical school, recognizing that I'm the first person in my family to ever apply. If I didn't get in, I would try do what I needed to strengthen it for a year, and if I didn't get in the second time, I would teach history and honor the legacy of my father in a different way.\" And that was always the plan, if I did get in.\n\nBrent Smith: But I got into medical school, and if I want to be able to lead the [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=2743.0,3128.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/21","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"], to me understanding the history of medicine as a practice, as a profession, and of medical education for how we evolved to where we are now, makes it easier to connect with the residents and students, because we kind of have an insight in why we do some of the things we do.\n\nAnnette Routon: So how many times can you apply for medical school? Until they're like, \"No, [crosstalk","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=3128.0,3151.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/22","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"]-\n\nBrent Smith: You can apply as many times as you want.\n\nAnnette Routon: Oh, you can, okay. I know with like the bar... because like the bar you... Oh, I guess you can apply for the bar multiple times, right?\n\nBrent Smith: Yeah.\n\nAnnette Routon: Okay, I was thinking there was a cut off, where they said, \"Okay, you've tried four times, it's not going to work.\"\n\nBrent Smith: No, what their rule is is that your prerequisites have to be done with in a certain amount of time for you to apply. So if you apply for 10 years straight, they may say, \"Now, you've got to go back and redo your prereqs, it's been too long.\"\n\nAnnette Routon: Oh, my gosh.\n\nBrent Smith: Then considering the application process is... You do have to put some money into it, you have to go interview. We're all type A personalities, none of us like to get rejected, and if you do it two or three times... I know people that it took them three or four years to get in. But if you do that more than your ego will allow, eventually, [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=3151.0,3207.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/23","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"].\n\nAnnette Routon: Okey doke. Well, Brent, your achievements and leadership at such a young age was truly inspiring, and will have lasting effects on your career in the specialty of family medicine. Before we conclude, is there anything that you'd like to add that we didn't cover?\n\nBrent Smith: One of the things that changed over my time at the foundation, was the way we approach giving as a whole. For a long time, giving was viewed as something you did after you lived or towards the end of your career, and it was basically legacy giving or giving once we were established. And one of the things I hope that I have modeled, was that as a younger person you can give as you go, it may not be the amounts that others would give, but if you do it consistently over a long enough time, it can have as much or more impact, because you're doing it earlier and allowing more money.\n\nBrent Smith: And the reason for that, for me, was very personally, my dad passed away when I was 14, he was 44. And so, I have had a very constant reminder, since he was young, that you're not guaranteed to reach retirement, that you can say, \"Yeah, I'm going to give it all to when I get done,\" but you may not be there. Me, I'd rather give it now, and then when I've retired, live off what I have got, and feel very comfortable from within, and see the impact of what I've gone. I'm very much looking forward to being able to retire and see 30 years of people that have had an opportunity to benefit from my work at the foundation.\n\nAnnette Routon: Well, I appreciate this opportunity to interview you, and with that this concludes our interview. Thank you very much.\n\nBrent Smith: It's disconnected, and I'm assuming you [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=3207.0,3333.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885/transcript/85522/annotation/24","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"].\n\nAnnette Routon: Oh, can you see me now? Uh, oh.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2376/collection_resources/162456/file/295885#t=3333.0,3340.44"}]}]}]}