{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/s756d5rh05/manifest","type":"Manifest","label":{"en":["Dr. Mark Belfer"]},"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":["2010-08-23 (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":["family medicine","family physician","American Academy of Family Physicians"]}},{"label":{"en":["Subject"]},"value":{"en":["Mark Belfer, DO (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: \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/154888/file/284063","type":"Canvas","label":{"en":["Media File 1 of 1 - Belfer_Mark_H_10.wav"]},"duration":6070.97196,"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/154888/file/284063/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154888/file/284063/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/284/063/original/Belfer_Mark_H_10.wav?1754505631","type":"Audio","format":"audio/wav","duration":6070.97196,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154888/file/284063","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154888/file/284063/transcript/82293","type":"AnnotationPage","label":{"en":["Dr. Mark Belfer Interview Transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154888/file/284063/transcript/82293/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is Tape 1, Side A of the oral history with Dr. Mark Belfer, DO, recorded on August 23, 2010 by Sandy Panther. \n\nIf you would, please start out with you giving your full name, date of birth, where you were born, who your parents were, what they did and then we can move from there through the progression of your family.\n\nMy name is Mark Harris Belfer. My present title is Chief Medical Officer of the St. Vincent Physician Network in Indianapolis, Indiana. I was born October 7, 1952 in Grand Rapids, Michigan. My parents’ names are Gerald and Sylvia Belfer. My father went in with his father in the late 1940s, right after World War II and started a steel drum reconditioning factory. They started out very small, just a little family business and by the 1980s or 1990s it was one of the largest in the six states surrounding us, with several semi-trailers; in 1974 it was offered to me on a gold platter but instead I wanted to be a physician. My father retired at age 50, fully retired and gave the factory then to my two younger brothers, both of which retired before they were 50, so it was a very good business. It was steel reconditioning and basically I did not have anything to do with it.\n\nI am currently married, I’ve been married for 36 years and my wife’s name is Nancy Lynn Belfer. I met her in high school. Wouldn’t say we were high school sweethearts, in fact she was dating a friend of mine in the junior and senior year of high school and I actually dated a friend of hers in junior and senior year. We broke up and she and her friend broke up and Nancy and I got married and the other two actually dated and got married. It actually worked out for the best. We were married in Grand Rapids, Michigan, June 9, 1974. That day has special significance also because it was the same day I graduated from college, but I went to the wedding instead. I didn’t go also, I missed my own graduation to get married. I have three children, all grown up, Rachel, age 33, she was born in Grand Rapids, Michigan, approximately a month into my internship, a son Aaron. Aaron is 31, was born when I was in Germany in the Army. He was born in Nuremberg, Germany. My youngest is Brett. Brett is 28 and was born in June 1982 at Fort Benning, Georgia.\n\nI grew up in Grand Rapids, Michigan. I was there right until I went to college at Michigan State University in East Lansing, Michigan. Did I have any role models when I was young? Probably the biggest role model I had was my own father. I had a science teacher in physiology in either 11th or 12th grade of high school named Mr. Quist. Mr. Quist probably was one of the role models. He seemed to really kind of take me under his wing and I really enjoyed that course. I think that probably helped me attain my goals as a physician.\n\nDid I have any special dreams or goals when I was young? There’s a picture of my class in fifth grade and every child in my class in fifth grade had to say that they had a special job and my job was class doctor. I believe in fifth grade, I was fascinated by the field of medicine and the human body. I remember writing a paper in the fifth grade on the spleen and I remember it very well. I can remember actually using Dr. Morris Fishbein’s book. He had a big book that he had written on the human body and I remember looking at that and getting a lot of information on the spleen, outside of say World Book Encyclopedia. So I think I can relate that I wanted to be a physician …that’s the earliest recollection I have when I was probably ten or eleven in fifth grade.\n\nIf I could go back please, you mentioned you had two brothers. Were they your only siblings? \n\nI have two brothers. Scott is my younger brother and Paul is my youngest brother. I have an older sister named Karen, who is married to Barry Steinway in West Bloomfield, Michigan. Both my brothers live in Grand Rapids. My dad died in December of 2009, the week of Christmas and my mom is still alive and actually doing quite well. She’s independent and she still lives in Grand Rapids, Michigan.\n\nYou’ve touched on your education so far. Again, you went to Grand Rapids High School? \n\nNo, I went to Ottawa Hills High School in Grand Rapids, Michigan. At that time, high school was grade 10 through 12, we had junior high before that, grades 7 through 9. My early years in school, I played football in high school. Broke my arm about three days before homecoming, which was the end of the season. I probably wasn’t all that great in football. I was on the team and I enjoyed it. I also played a lot of golf in my high school years. When I started out in high school I was an okay student and as the years went by I became a better student. I found that I could almost memorize things fairly rapidly and I felt I didn’t have to do a lot of study at night because I could memorize things quite well and when I would look at things in the books, I was able to actually remember whole pages I think that probably helped me quite a bit.\n\nAfter high school I went to Michigan State University in East Lansing, Michigan. My major was zoology with a minor in psychology. I actually had more hours in psychology than I did in zoology. It was for pre-medical. If I hadn’t been a physician, I was thinking, maybe I’ll end up being a park ranger. I really didn’t want to take over the family business. Who knew I could have been a multimillionaire? Who knew? Some days I just have to have my head examined I guess.\n\nDo I have a story from my undergraduate years that I want to share? Well, since that was in the early ‘70s, I’m not sure I want to share them. Let’s just say I enjoyed it.\n\nYou had a good college career, I take it? \n\nHad a lot of fun in college. I was in a fraternity, Sigma Alpha Mu. I had a lot of friends that I still have, I still keep in touch with several of them. I went to school during the Vietnam era and I can remember getting tear gassed one day just outside of the main campus on Grand Avenue. It was May 1972 or 1973 when President Nixon mined Haiphong Harbor. A bunch of students went and started rioting. Actually, when I went down to see what was going on, I just went to basically take pictures. When I had the pictures developed, they never were ever developed, they probably turned those into the FBI or something. I never did ever get my pictures back but I took pictures of police gassing students, students throwing tear gas canisters back at them. It was an interesting time during Vietnam. Other stories, none that I think that I could relate.\n\nWhat made me decide to take a career in medicine? As I mentioned, I always wanted to be a doctor. My dad, as I mentioned considered having me take over the family business in 1974 but I really wanted to be a physician. Interestingly, in Michigan, I had grown up knowing DOs as role models. My own family doctor, his name was Joe Belsito, he’s still alive, he was a family friend and he was our family physician. He was a [    ] physician. The only kind of doctors that I knew at that time were DOs and at that time, I think about 50% or 60% of all primary care in Michigan was done by DOs so it was a big DO state at that time. Actually I only applied to five different DO schools. My intent going to school, I think when I was growing up, I always wanted to be a country doctor. I can remember watching the TV show Marcus Welby, M.D. I can also remember Father Knows Best, I think he was also . . . maybe he was a doctor, or maybe Donna Reed Show and I can remember those people playing doctors on TV. I really wanted to be a family doctor. If I had to do it over again, I would absolutely do the same thing. The only regret I have is that I kind of wanted to be a country doctor in the form of say, the movie Doc Hollywood, that’s probably the only regret I ever had because I never did that.\n\nAs I mentioned, I grew up only knowing DOs and that’s why I applied to five DO schools and I got into Des Moines College of Osteopathic Medicine and Surgery in 1974 and went through an accelerated program where we basically went to school on Saturdays and all through the summer and graduated in June of 1977. Medical school, I think the first year was all the prerequisites, all the basic sciences. They were difficult but I thought I had a pretty good background from Michigan State and as I went forward in medical school, each year seemed to get easier and easier for me. I’m not sure I have any special stories from my years in med school. I was freshly married about two or three weeks before med school started so I had a brand new wife. Nancy worked as a secretary, and interestingly, she was secretary of the hospital foundation executive director in Des Moines, Iowa Mercy Hospital. That was her main job. She enjoyed it a great deal. I was on the US Army scholarship program so I received $400 a month as a stipend, which occasionally the government would take away or start taxing, they’d give it back you just never knew year to year what you were going to get. We did not have a lot of money. I was too proud to ever ask my folks for any money. That’s why I went in the Army. My father was offering to pay for medical school for me and I flat out refused because I didn’t want to feel like I owed anybody anything. I think that’s just how I grew up, just wanted to be on my own, wanted to be my own person I guess. We struggled during medical school, at least financially. She did not earn a lot of money, I certainly didn’t. We rented an apartment first. I saw my first cockroach at that time. I can remember that. It was $160 a month and we moved out of there fairly soon after we got there and lived in a little home in Des Moines that we rented. The guy who owned the home was the guy who just did his own carpentry on his own so it wasn’t anything fancy, but it was home for us for a few years. I really enjoyed medical school, we had a lot of parties at our house. We would go to a lot of parties, we had a lot of friends. Interestingly, I have not kept in contact with just about anybody from medical school except one, a guy who is currently a rehab specialist.\n\nFrom medical school I did an internship in Grand Rapids, Michigan at Grand Rapids Osteopathic Hospital. It is currently known as Metropolitan Hospital. It’s much larger now than it was when I was there. It probably had about 300 beds when I was there, it’s much larger now, so I did a rotating internship at that time. I got the nickname during that period, of “Paddles” because I wanted to be the first person up at any code so I would run up and down the stairs just to get to a patient’s room first so if anybody had to be resuscitated, I would be the one who got to kind of lead the code. I got a nickname from a couple of my colleagues as “Paddles.” I’m not sure if that’s good or bad but I was very assertive, I was aggressive as an intern, I really wanted to learn everything I could. Back then we did day shift on, another day shift on and then 24 hours and then another day shift on, so you did basically 12, 12, 36, 12, 12, 12, 36. I can remember one week when I was actually in the hospital for over 115 hours and to be honest with you, I would do that again because the way I felt about my internship and later, my residency, this was the time in my life that I could absorb the most knowledge and to this day, I still feel the same way. I really enjoyed my internship. I got to know a lot of the physician attendings. I was a hometown boy so everybody treated me very well during my internship and I just learned a lot.\n\nAfter my internship, that kind of segues into the next section here about military service. I owed the Army three years, a year for a year in med school. As soon as my internship was over, just before it was over, the US Army sent me papers to go active duty. I was going to enter into the US Army as a captain in August of 1978, almost a year to the day that Rachel was born. So I went in August 1978. I decided to join, only so I didn’t have to borrow any money from my family, basically. To be honest, I would have preferred Air Force but the only scholarships that were left at that time was for US Army. None of my friends who I was in college with could believe that I actually went in the Army. I was fairly liberal at that point in college but I did not find it a problem going in. Probably owe most of my career to the Army, at this point. So I went in August ’78. Before I went in though, they sent me paperwork about where I’d like to go. I only had an internship so I knew I’d be going in as a general medical officer. What they did is give you all these choices. My first choice was Hawaii, which I think they’re still laughing at. My second choice I think was Alaska, which I’m sure they’re laughing at. My last choice actually was Europe and the first place they sent me was Germany. I didn’t know any German, neither did my wife. We had a brand new baby and after three weeks of basic training at Fort Sam Houston in San Antonio, in late August, they send us over to Charleston, South Carolina and we took a plane from there to Frankfurt, Germany. I was stationed for three years in Bamberg. That was a wonderful tour, actually. We spent three years there, two of which I served as a brigade surgeon, which is a title where I was in charge of the health of 3,000 soldiers and their significant others and their families. I was on the colonel’s staff. It was a really neat position to have because I actually learned what it meant to be a physician in the Army rather than being a physician at the hospital like most physicians are while they’re in the Army. I got to learn more about infantry people and tankers and everybody else by doing that so I have no regrets, actually. I got to fight in a tank, I got to drive a tank, got to fire a missile, a tow missile, just had a great time. Got to shoot guns at targets and play war. There were times when I was in Germany, since it was the middle of the Cold War during Carter and Reagan era, we would go on alert in the middle of winter or at any other time and Nancy wouldn’t see me for four to seven days and had no clue where I was. I wasn’t allowed to contact her, so we would actually go on alert. We lived only about 26 miles from the Czechoslovakia border and because of that, that was the other side and it was real interesting. Nancy used to say, she would wear a babushka if the Russians came across and she’d serve vodka on the street if need be. We lived pretty close to the other side.\n\nI became fairly conservative, almost immediately when they took me to a border tour. I went to see the border between Czechoslovakia and East Germany and West Germany at that time and when I saw how the other side lived compared to how we lived and saw what the actual border looked like with the concrete and barbed wire that was utilized to keep people in, not keep us out, I pretty much became a hawk almost immediately. I knew that our society was worth fighting for, I still believe that. I went from being a fairly liberal person, I was against Vietnam because all my peers were and I couldn’t see a reason for it and I became a hawk when I lived in Germany and probably have remained kind of hawkish. I went from Germany, I completed my residency at Fort Benning, Georgia, became Chief Resident in my last year, had a great time as a resident again. I felt the same way about wanting to work long hours, putting in the hours so that I could build as much knowledge as I could.\n\nSo you served three years as brigade surgeon before you entered residency? \n\nYes, before I completed my years two and three of residency.  \n\nIn other words, did you have to apply for a residency then? \n\nYes. To be honest with you, I had a role model there too, in Germany. When I was in Germany, my intent was to go and practice with my family doctor, Dr. Belsito that I talked about earlier. I grew up knowing and he knew that I was going to end up going into practice with him and then he could retire when his own son completed medical school, which was I think a year later. He was going to retire. My intent was, do my three years in Germany and then get out, go back to Grand Rapids and work with him and be one of those so-called one-year wonders where they just do one year of internship and then go into practice. That was absolutely my intent. I am so happy and grateful to a family doctor in Germany who I actually I think last talked to in about 1996. His name was Dr. Frank Cherry Leitnaker and you’ll remember that name, Leitnaker. Remember that name?\n\nNo.\n\nOh, you were not [    ] with us. There’s a woman in Kansas City on the Overland Park side who worked with Heart to Heart last year when we went to Kyrgyzstan a little over a year ago, her name was Vicky Leitnaker. Her husband was related to this gentleman. Dr. Leitnaker was prob-ably, I don’t even know if he’s still alive. He was an older man, he was a full colonel, smoker as I was at that time and Dr. Leitnaker convinced me near the end of my tour to complete my resi-dency instead of just going into practice. I absolutely owe my entire career to him because of it. He convinced me, he said you’re good but you’ll be better if you do this. I said, “Why do I need that? I’ve got a license, I can go in now and start earning money.” He said, “Mark, I’m telling you, this is what you need to do.” He was probably a one- or two-year trained person himself. He was older at that time before they really had family medicine residencies so he probably had done a year or two on his own but he knew that getting further training in a residency was the right way to go and it was before the [     ] even had family medicine residencies. He convinced me to do that. It was absolutely the best thing I ever did and that’s why I ended up going to Fort Benning. They only had a couple of spots, residency-wise, Fort Benning had one and I think Fort Bragg had one. They didn’t have an internet yet but I checked it out and found Fort Benning was the first Army family medicine residency so it was the oldest one, I figured that’s probably the right one. I knew nothing about it, never interviewed for it. When I got there I found it to be the hottest place on earth. Fort Benning, Georgia, it’s in Columbus, Georgia.\n\nWhen I was Chief Resident, one of my interns was a guy named John Bucholtz. I probably should talk a little bit about Fort Benning for a second or two. Fort Benning was very interesting. You’ll like this because you’re going to know everybody I’m going to talk about. I got to Fort Benning and my boss was a guy named Larry Fields. Larry was the chief of the department and we all know Larry became, both the Kentucky, President of the Kentucky Academy [of Family Physicians] and then he became later the AAFP President and he and I have remained good friends ever since residency. Another person on that hallway was a guy named John Saultz, that’s another pretty famous name in family medicine. John, eventually was an Oregon [AFP] President, he also was head of the ACGME, he was head of the ABFM when it was called ABFP. He’s done about everything. I think he is still the Chair of Family Medicine at Oregon State University, College of Health Sciences and also, I think he’s an associate dean as well. He went places. Another guy on that hallway was a guy who was an intern when I was chief resi-dent, his name was John Bucholtz. I think most people know John from the Academy. John was President of the Georgia Academy. He has been serving most recently on the American Board of Family Medicine on the Board [of Directors]. He also was President of AFMRD a few years back as a program director himself. There were other people who were on that hallway, I think Mike Bradley who eventually became President of the Delaware Academy. Another gentleman was Ed Friedler who was my advisor. Ed, I think did some things on the Virginia Academy Board. It’s interesting how everybody on that hallway seemed to do something in organized medicine or in education and none of us knew that the Army was training us to be leaders at that time. But to have one hallway where all those people were on there all at once, none of us knew that years down the road that we would be in the positions we’re in.\n\nAfter the couple of years at Fort Benning, I was Chief Resident, I was allowed to go to Honolulu for three years so I actually went from owing three years to owing a total of eight. They sent me to Hawaii where I was teaching at the family medicine residency. I was a faculty member, I was junior faculty at that time. Three months later they basically made me the medical director of the clinic so I was responsible for a lot of the administrative work at the clinic. My chief was a gentleman named Ken Steinweg. Most people thought Ken was going to become a general and he was very good at what he did. He was a real good administrator. Ken eventually got out, sur-prising a lot of us, he got out and became Chair, I believe, of the Department of Geriatrics in East Carolina University. At the same time I was in Hawaii, let’s see, who else was in Hawaii with me? Chuck Henley was the program director at that time and Chuck eventually went to Oklahoma University or Oklahoma State University first and then Oklahoma University in charge of all their research. I became very good friends with a gentleman named Paul Evans. Paul took over as a chair then as assistant dean at the Oklahoma State osteopathic college after he was in the military. He served I think for 20 years in the military, or 22 years, got out as a colonel. Paul then left Oklahoma, became the first dean or regional dean of the Georgia campus of the Philadelphia College of Osteopathic Medicine. I just learned within the last month that Paul is now coming to Indianapolis to become the very first dean of the new Indianapolis school at Marian University. We’ve remained good friends ever since then, ever since we were in the Army together and I’ve already had dinner with him here in Indianapolis. \n\nAmazing how people come around, isn’t it?           \n\n      \n\nBut I’ll tell you, seeing how the people who were on my first hospital residency, how everybody almost did the same kind of thing but in different places and I was President of the Ohio Acad-emy, I then became President of the AAFP Foundation. To think of the different organizational things that we have all done and we were all on one hallway together. To me it boggles my mind, it really does.\n\nThat was basically my career when I was in the Army. I didn’t do the Persian Gulf War and the Iraq War. I was not in either of those. I got out in August 1986 and Nancy really wanted to settle down. We had three kids at that time, we’d already done two overseas tours and she wanted to settle down and we ended up, I interviewed pretty much in Michigan, one place in Ohio and I think in Illinois or Indiana and I settled in northeast Ohio, much to the chagrin of my family. They all wanted me to come back to Grand Rapids to start a practice.\n\nLet’s continue on with your first position and what you did in Ohio and then just sort of go through your transition from…\n\nMy first job was a staff model family doctor in Warren, Ohio. It was a group of probably about 20 docs in pediatric family medicine and internal medicine who worked for a company called Health Maintenance Plan, HMP. It was an HMO and I worked there for about a year and a couple of months. I rapidly realized after about six months that that was not the right practice for me and there were two other family docs at that time, one was trained in the Air Force and one in the Navy and the three of us actually graduated at the same time. Actually the three of us decided it wasn’t the type of practice that we wanted. So the three of us decided that we would go into private practice in Warren. Basically the three of us went and borrowed almost a million bucks basically just on our signature and built a building and started our practice. We practiced from November 2, 1986 until we closed the practice, basically, in. . . this was the saddest part of my life, I think. We closed it in September of 1994. I had a partner at that time who was getting very involved with insurance company work and was medical director for one of the insurance companies. We would have doctors in Warren constantly calling us, upset with us because of what one of my partners was doing. He was the doctor who would have to refuse care, refuse procedures and things like that, for the insurance company. I started feeling as a partner, I just wasn’t enamored anymore in that practice and decided to start looking else-where. That was probably in early 1994 and actually I was offered a position at Wright State University as an assistant professor. I had had the history of teaching before and I had always liked to work with residents and medical students. At the same time, they wanted me to be asso-ciate director at Good Samaritan Hospital, a family medicine residency in Dayton. Both Wright State and the residency were in Dayton, Ohio. I left practice in 1994, in September of 1994 and one of my partners ended up buying us out. He kept the practice going for awhile then I think he totally closed the practice. It was just a bad part of my life, I think because it was such a good practice and my other partner and I both missed that practice immensely. We still have friends who both were patients and were not patients in Warren, Ohio. We still see them. So I went to Wright State to the residency. For about six months being at the residency, now I just had started getting involved in the Ohio Academy of Family Physicians around 1988, 1989 and was actually and I can tell you how the Board worked and what my positions were. I’ll tell you that later. Anyway, I was starting to get involved in that and it was taking me out of practice also, so going into an employed position like a faculty position did not seem unreasonable at that time, although I really missed the private practice. About six months after being at Wright State I was starting to get offers actually, to be a program director. In Youngstown, Ohio, St. Elizabeth’s Medical Center actually contacted me. A couple of the faculty there knew who I was from [    ] Ohio AFP and they knew I was working as an associate who was in Youngstown, which is just near, it’s kind of a sister city in Warren, Ohio and I thought gee, if I go back I might be able to still see a lot of my old patients because part of the sadness that I felt was because I didn’t know where all my patients were going when I left them back in ’94. Actually I jumped at the [    ] and left Wright State, lost a lot of money on my new home and went to Youngstown, Ohio to St. Elizabeth’s to take over the family medicine residency which did not have a director for about a year and a half. They still had faculty, still a young faculty but they needed some leadership and I learned how to be a director quite rapidly, actually. I took that over in late 1995. I was at Wright State just about a year and I could say [    ] about that amount of time.              \n\nThe St. Elizabeth program at that time had four residents each year. I was there for three and a half years and we did very well. St. Elizabeth’s, like most places, had difficult time recruiting residents but we actually recruited some really good residents and a lot of people actually stayed in the area, which we liked. I found that I really enjoyed trying to get the financial picture of the residency improved and academically making the residency as stellar as possible and we did that in a program that had struggled for at least a year and a half without any significant leadership. After about three and a half years I was starting to think about, what do I want to do from here? I had done basically everything I wanted to do at St. Elizabeth’s and wanted a bigger program, started looking around and got an offer from Kansas City, Missouri to go to a program that I felt like I was going to be there forever, at a hospital called Trinity Lutheran Hospital. Trinity Lutheran, when I interviewed there, it looked like [    ] they had beautiful furnishings, a beautiful clinic, it had 24 residents, it had 10 faculty. They had so many staff it wasn’t funny. I had no idea at the time that it was struggling financially because they didn’t show that to me. I learned a lot about how to interview at that point. I went to the place and the campus and the paperwork said it was 751 beds, which it was in fact licensed for. The problem is, when I got there in late March or early April of 1999, I got there and they took me on another tour and I saw a lot of beds that were empty and I was asking them, show me where all the patients are. She said, we’re here. I said, okay. She showed me the surgery suite where they were doing like four surgeries and I said, show me the actual surgical place. This is it. Then she showed me ICU. They had a few patients in there. This is crazy. This is a 751 bed hospital, where are all the patients? She started laughing and she said, we only have 115 patients here. I wanted to die. I thought, oh my god, what hap-pened? First of all, you have to have 130 patients to even have a family medicine residency and here I was, I left everything in Youngstown to come to a residency where the hospital only had 114 patients. That worried me immensely. They had a very committed faculty and what I started thinking about within two or three weeks of being there, was how do we move this residency to the mother ship, so to speak, at Research Medical Center? We started having rotations at Research and starting some alliance there. That was probably the smartest thing I could have done. In 2001 the hospital really was struggling financially. It was part of a large system called Health Midwest, which now is defunct but Trinity was part of a large system. There was another family medicine residency just down the road in Kansas City called Baptist Medical Center. Baptist had a good family medicine residency, in fact, we were definitely rivals. Their program director was Larry Rues, a good person. Larry and I would basically compete, both for good residents as well as reputation of having the best residency. Trinity was really doing very well, residency-wise. Academically when I took over it was okay, it was doing well but when I left it was doing great. Financially, we had an almost two million dollar turnaround in the last year I was there. The residency when I took over was losing over a million dollars a year. When I left it had actually made $912,000. We were real creative. When I had a faculty member decide to leave, because we had so many faculty, they were crawling all over each other, if one left I didn’t necessarily find a replacement. I became a pretty good administrator as far as genuine health care when you try to do more with less people and we did. We did a whole lot more for a residency with less people than when we had more people. Our residency really ranked quite well. I learned a lot and basically did a lot in that residency. In 2001, the hospital system decided it was going to close Trinity just due to financial reasons. Kansas City at that time was over-bedded, they had definitely too many hospitals in Kansas City at the time I was there. There were a lot of empty beds and Health Midwest was struggling financially at that point. The big competition at that time was St. Luke’s Medical Center with its hospitals that it owned. At that time I think they had a system called St. Joseph and they were doing quite well I understand but they were a smaller system. Health Midwest was struggling and they closed Trinity and announced it was going to close it in the fall of 2001 and the problem is, they announced it without sending in paperwork to both Medicare and to the ACGME saying they were going to move the residency over to Research Medical Center. When they did that, Medicare makes them close the residency and the ACGME couldn’t do anything about that. So here I was in charge of a residency that had actually done very well, we had already moved most of the rotations over to Research Medical Center, which didn’t have any residencies over there except ours. Here everything was coming to a grinding halt because of that. I came up with a plan, much to the chagrin of Larry Rues that Health Midwest should combine the programs, should combine both Baptist Medical Center and Trinity Lutheran to have a combined program at two sites. I basically came up with a plan and I did not consult Larry regarding that. He was pretty much taken aback by that and wasn’t terribly happy about it but he eventually acquiesced and said, okay, we’ll do those. So the residency of Trinity hadn’t actually [    ] after three years. I find it was one of my proudest moments, to be honest with you. I knew that I could not be co-director of that combined program because Larry had the seniority, certainly and my program was closing and I certainly did not want to move down, take a downward job in my own career progress. I didn’t want to become a plain faculty member, I wanted to stay as a director so I knew I couldn’t do that, but on the other hand, I did not want any residents to leave, I didn’t want any faculty to leave or staff to lose their jobs. I can tell you that no person left. No residents left, the residency continued doing very well for those three years of [    ]. No faculty were let go, all the faculty remained and interestingly, no staff were let go so everybody kept their jobs. There was only one person who lost his job and that was me but I knew that going into it. I knew making that plan, that I would be the one to lose my job. It really mattered to me that nobody else did and that’s why I came up with that plan. [    ] the phone call to the ACGME, Medicare would not back down regarding allowing the residency to live on because that was at the time of the balanced budget that the Clinton Administration came up with. Basically, I was having to look for a job and to be honest with you, I never intended on doing that.\n\nI was offered a position at Ohio State under Mary Jo Welker as Program Director and I turned that down. I also was contacted by a hospital called Akron General Medical Center. I really enjoyed fixing things. I was able to have academic and turnarounds in the previous two pro-grams. I felt like hey, I know what I’m doing and I interviewed at the Akron General Medical Center position. Interestingly, Akron General had a whole faculty and program director and a whole class of residents who leaves a year and a half before I got there. They left because they did not like how administration was holding them to task and responsible for some of the pro-ductivity that they had. They didn’t like the new contract. I personally looked at the contract, it was one of the fairest contracts I’ve ever seen and people actually could make a lot of money, probably more money than if they were just on salary and in fact, that was true. I took over the Akron General job, called it my Phoenix project because it was a dead program. If I had been the CEO of the institution I might have closed it because they literally had no faculty. They were hiring all brand new people from around the area to become faculty members with no education backgrounds. They could not recruit residents, in fact, they had never had a full recruiting class probably in about 15 years. They were really struggling. Financially, they were being given an injection of money from the institution but they had no leadership whatsoever, all brand new faculty. They had interviewed several people for the program director position and every person said, kill the program, it’s not worth saving. I look at that as a great challenge and turned down Mary Jo at Ohio State because it was already a program doing well and I said, I think I can turn this program around. I went to Akron General in April of 2002 and I immediately started with a strategic planning session with the faculty. Sent all faculty to academic fellowships. One person actually went to Michigan State to do a fellowship in research. The residency had never, ever done any research. They had never presented at the annual research day at the hospital. They were the only residency that didn’t, in fact. People all thought of the residency as kind of a ter-rible residency. They had a terrible reputation when I took it over and to me that was the greatest challenge. I took it over, sent everybody out for extra training, started remediating residents who were struggling, in fact, many of them were. It was the same remediation program I had utilized in other residencies. Turned it around within a couple of years. Financially it was doing much better. I actually had a full recruiting class my very first year there and for the six years that I was program director, I think I had full recruiting classes four out of six and the two that I didn’t fully fill, we filled that day, it was a match. I had really good residents. I had wonderful faculty, very committed. We came in very well and everybody was doing research. I think out of all the 25 residencies in Ohio, Toledo Mercy, who was probably number one or two with the amount of research it was doing. Had several publications come out of it, several national and statewide presentations. We actually were winning awards at the hospital and at the medical school at [    ] in research and they were very proud. They had never done that before I got there. They had never done the research, they had a terrible residency. If I was a medical student I wouldn’t have gone to that residency when I first got there. Within a couple of years it was on its way to being a stellar residency. For me, I just thought that was a phenomenal turnaround and I’m very proud of what I accomplished there. What we accomplished, I should say because it really took the whole faculty’s dedication.\n\nAfter a few years of being in Akron, I really found that I enjoyed turning things around. I had done that in three programs and was actually getting consulted with my different residencies around the country about how do you do this, how do you do that? Financial things, economic things, how do I do a remediation program? I started a practice management elective, that be-came a requirement and I was consulted around the country from some of my program director peers on my own programs that I instituted and still remains. I still occasionally get phone calls, even though I haven’t done program director type of work in the last couple of years. After about 2006 I was already thinking of leaving and going to another program.\n\nMark, may I interrupt you? \n\nAbsolutely.\n\nAre we moving to a new position? \n\nYes.\n\nI need to turn the tapes over. This is Sandy Panther, interviewing Dr. Mark Belfer. This is Tape 1, Side 2. Dr. Belfer, please continue. \n\nI think I was at the point of I was thinking of leaving Akron General, that was about four years after I was there and my CEO, who I really respected and I felt he was the most ethical, good person I’ve ever worked with, unusual for a doctor to say that about a business person but he just was. To this day I feel the same way about him. He asked me to stay on as program director and I was moving up in the leadership at the hospital, we had a great deal of respect in the residency, in fact, my last year there they became the Department of the Year. Things were really going well at the residency and my positions in leadership and he asked me to stay on so I did. But around 2006, 2007, I again was thinking of moving on and he said, I think we have something that deserves your attention. I said, what’s that? They had a new group, multispecialty group of employed physicians that were employed by the system and very few primary care people and they offered me a position as president and chief medical officer to take that over. They had 42 doctors at that time, this was in 2008. My task was to lead that organization and to grow it. By the time I left, two years later, the group was 108 doctors, almost 50/50 primary care specialists and financially doing well, meeting our benchmarks and very respected in the community so that basically took me to, I guess more recent times. The hospital was struggling financially over the last couple of years and I really didn’t know how long things were going to continue at the same pace. I would be told at times not to recruit people because of financial implications and at other times I was told to recruit. I became aware that things weren’t doing great, financially, at the entire health system. At that point, I was starting to get recruited as a chief medical officer. I guess the internet has done that, where your name gets around there pretty rapidly and I was invited to interview here at St. Vincent Health System as a chief medical officer of a 200-plus person multispecialty group that’s employed by the system, called St. Vincent Physician Net-work. I came over to Indianapolis to interview around April, I believe, of 2010 and really more just to see what they had to offer. I had a good job already at Akron General, was both president and chief medical officer, in fact, I was one of four presidents in the entire system so I had a pretty good position. I was also vice chief of staff at Akron General when I ended up leaving and I was due to be chief of staff of 1100 doctors right after I left. It was a very difficult decision for me to consider leaving Akron General but what I found at St. Vincent was something I had never seen anywhere I’d been, where every person I met talked about values and mission. They all seemed to not only talk the talk but actually walk the walk and I had not ever seen that anyplace I’d ever been. I did my homework, found out the system was doing fine financially in an era where health care is killing hospitals, this hospital system seems to be doing well, in fact I think they were up to 26 or 27 hospitals now. I am responsible for about 224 physicians currently, although it’s growing, and provide other providers with nurse practitioners and PAs. In an employed system network that consists of about 60 offices in 46 counties, so much of my job is actually on the road, meeting physicians and other providers in different venues. I actually get to truly be a chief medical officer, not just the president where I was so much administration in Akron and recruitment, putting contracts together, putting deals together, that I didn’t have the opportunity to do as much of what I wanted to do, which was CMO, Chief Medical Officer. Here, I get to actually do the chief medical officer, which really acts as a liaison between the network and their offices. I really am doing the kind of job I’ve always wanted to do as a CMO. That’s why I left Akron General. Akron General is a wonderful place to work, in fact all the places I’ve worked have been wonderful but now I’m at another place. I’m hoping I can be here a long, long time.\n\nNancy was not crazy about me leaving Akron because it’s not like I had to leave. She really wanted to stay there. I have two sons that live in Akron and I have a daughter who’s only an hour and a half away in Columbus and Nancy, my wife, really did not want me to leave, but I found this is a place where they really believe in the mission and values and that led me here. I can honestly say that. I just hadn’t been in a place that felt that way. It was just really something to see when I interviewed and they offered me a position and I took it.\n\nCan you tell me which positions in your career you most enjoyed? Obviously discounting this one at this point. \n\nIt’s not chief medical officer or president. Those gave me probably the highest positions of lead-ership but to be honest, boy, it would be a toss-up between being in private practice where I really got to know my patients really, truly well, or being a program director where I got to take a medical student whose edges were all square and round them out as a resident. To me there was nothing more fun than that. Being a program director, I got to do some administrative work, which is what I do almost totally now. I see some patients but not a lot and I got to work with medical students and residents to teach them to be good family doctors so it’s really kind of a toss-up between being a program director and being in private practice. My private practice years were absolutely wonderful and when I left it I think I was probably a little depressed for about six months, really worried about where did my patients go after I left. That was a very hard time in my life, trying to figure that out. That’s one of the reasons I wanted to go back to Youngstown and then when I went back to Youngstown to become a full program director I actually was able to . . .they advertise in Warren which wasn’t far away and many of my old patients actually came back to me.     \n\nWhich was your least favorite? \n\nIn my career, I would say the eight years I was in the Army. When you’re in the Army you don’t think about what they’re really doing for you so I would say the eight years I was in the Army, I probably could not enjoy while I was in it, except when I was a resident. In retrospect, they were absolutely wonderful years. Now living in Hawaii was not as wonderful as people who hear this or read this might think. Living in Hawaii was not a wonderful place. Going there on vacation is very different than living there. I have not gone back. I don’t care if I go back to Hawaii. It just was not a wonderful place to live, to me.                                    \n\nDo you have a particular position where you feel you accomplished the most? \n\nBoy, that’s a toss-up too. Probably either at Trinity, like I said, my crowning achievement was being able to salvage all the residents and faculty and staff at the end and I think I feel the best about what I did there than any other place. I certainly revived the program at Akron General to the extent that it’s on the map now, where it was totally dead. It truly was a dead program, so it would be a toss-up probably between the Trinity program which I guess I became a closer on and salvaged everything, versus reviving or turning around totally a program that was dead at Akron General. It would be a toss-up between those two as far as what I really should be known for.\n\nUnless you have other reflections on that, why don’t we move on to your volunteer leadership activities? \n\nI did a few things. Boy, oh boy, oh boy. In 1987. . .I got to Ohio in August of ’86. I think it was 1988 actually, I was invited to a dinner meeting for the Trumbull-Mahoning Medical Group and I had actually no career aspirations to do anything in organized medicine, to be very honest with you. In 1988 I was in private practice already and we were doing well and like I said, I got this dinner invitation and all my partners, to go to this meeting for this Trumbull-Mahoning Academy of Family Physicians and since I was a family doctor, said, you ought to go to that, so I did. There were probably about 10 or 12 of us in that group who had dinner, and I met some folks from Youngstown. I was in Warren at that time. They made mention of this Ohio Academy of Family Physicians, which I had no clue what that was. I was in it because I joined the OAFP and the AAFP while I was a family doc but I had no idea what the organizations really were or what they were about. In 1988 they had somebody who was heading up that from the Mahoning Academy. “We need three people to be alternate delegates to the House of Delegates for the OAFP meeting in August of that year.” They wanted volunteers so I said, “Okay, I’ll do it. What do I have to do?” I literally asked, “What do I have to do?” They said, “You have to go there and represent us and hear what kind of things are going on throughout the state and you’ll be voting on some things as well.” So I went as an alternate delegate in 1988. In 1989, I went again, this time as a delegate. The Ohio Academy at that time had an actual house of delegates, they had several different academies from around the state and I was representing Trumbull-Mahoning. In 1990, I again went as a delegate. Actually I may still have been an alternate in 1989. In 1990, I believe, I went as a delegate and there, Bill Gillanders had been a delegate and [    ] was a delegate and I settled down and nobody wanted to be a Board member representing District 6, I believe it was at that time when this was done. That was my district. Nobody wanted to be on the board at the Ohio Academy and represent that district. Bill Gillanders kept saying, “Mark, why don’t you do it?” I said, “Listen, I’ve only done this a couple of times, I have no clue what the OAFP does.”  He said, “Oh yeah [    ], just do it.” So, nobody else would do it from the whole district so I just volunteered: “Okay, I’ll do it. What do I have to do?” So I met with somebody named Jady DeGiralomo, who was the Executive Director at that time before Ann Spicer. I met with people who were going to be Board members or who were already sitting on the Board of the OAFP. There was a young woman there named Mary Jo Welker, there was a guy named Ross Black who were on the Board at that time and they were already starting to move up. I’m sitting as just a Board member and a guy named Ken Bertka was basically one of my young colleagues at that time. These were all people who eventually went further up in the Academy. Glen Aukerman had already finished his term, I think as President, at that time, or was already on the Board [of Directors of AAFP].  I had not ever gone to an AAFP delegates meeting, Congress of Delegates at that point, so in 1990 I sat on the Board. I sat on it for basically two years and I started always going to the OAFP meetings because I was not a Board member. In 1991 maybe or 1992, I went to Toledo, Ohio for the annual Ohio Academy of Family Physicians meeting and when I was in the hallway, both Mary Jo Welker and Ross Black walked up to me and said, “We want you to run for Vice Speaker of the OAFP.” I said, “You people have to have yours heads examined. I’ve only sat on the Board for two years. I was a delegate for a year or two. You’ve got other people who are way ahead of me who should be going on.” They said, “You speak up at the Board so much, we want you to do this.” They were already moving up. I think Ross at that time was like a Vice President and Mary Jo might have been Vice President or something. I said, “Listen, if you guys can’t find anybody to do this, I’ll do it but there are a lot of people better than me.” Well, I ended up being Vice Speaker. I was Vice Speaker that year. Normally Vice Speaker would either stay in that position or move up to Speaker. The following year I was asked to move up to be a Second Vice President. When that happened I thought, gee, if I do this, there’s a big chance I’m going to end up moving all the way up to be President of the OAFP. [    ] in that kind of position and I thought there are a lot of people who are ahead of me. Burt [    ] was ahead of me and doing things. There were other people on the Board that were ahead of me. They had been there longer than I was and I felt that they should do it. People were walking up to me going no, we want you to be Second Vice President and move up, so here I was, only on the Board for a couple of years and Vice Speaker for a year, all of a sudden I get put in the position of Second Vice President, now I’m starting to move up in leadership and a couple of years later, President or what? In 1996, August 1996, I got installed as the President of the Ohio Academy of Family Physicians and really enjoyed my year. It was a year where I helped to work out the line item for family medicine in Ohio. It was a year where we were talk-ing about nurse practitioners doing independent prescribing, collaborative agreements. I have to say I was against that at that time. I learned to live with it but I have to admit, I was against it at that time. I thought if they do that, where’s primary care going to go? It was an active year and was before the Ohio legislature quite a bit. I also went to one of the state meetings in Washing-ton, DC and did a lot of lobbying. Met John Glenn and Sherrod Brown and some other folks, William Simpson I think I got to meet. [Max] Baucus from Montana I met, so I actually got to do a fair amount of lobbying for the AAFP at that time. I wasn’t all that active in the AAFP at that point. I think my year as President-Elect is when I met you. I met you, I believe, Sandy, in Mich-igan, at a Michigan Academy meeting where I was representing Ohio. I think that’s shortly after you took over, I believe, probably about ’95 I think.\n\nIt was. I took over in ’97 but I think I met you a little earlier. \n\nYou also came to a meeting where I got installed as president by Pat Harr in the Ohio Academy meeting. You came that year and that was also the year where they came up with an acronym that was going to be what I was going to do for the year and it was called FPSLEED. Don’t ask me what each letter stood for but the “P” stood for Philanthropy, you may recall that and I talked about philanthropy and how Nancy and I had put the OAFP in a will which we have always done since then and we believe in philanthropy. You heard that and I think that was before the Legacy League, actually.\n\nThat was. \n\nWe were some of the very first people in the Legacy League and that was one I think we had done. I was a firm believer in philanthropy, so was Nancy and I know I got to sit on the Ohio Foundation Board, I think since probably 1994, 1995, something like that and we did a lot of things for the Foundation, the OAFP Foundation.\n\nWhen I became Past President of the Ohio Academy in 1997, I ran for the alternate delegate position for the OAFP to the AAFP and won. It was actually a contested election. Another Past President ran at the same time and I was the one that won. I was very happy. I then became an alternate delegate to the AAFP. In 1999, as I mentioned earlier, I went to Kansas City. All along, I was applying for Commission on Education or Commission on Public Health from Ohio during the years I was an alternate delegate and even when I was President of the [Ohio] Academy. I called myself the Susan Lucci of the Academy because for five or six years I was applying for a commission and never got it. Even in Kansas City, I kept dual membership with both Missouri and with Ohio, I paid two sets of dues because I really did not want to give up my Ohio member-ship at the same time I was in Missouri. In late 2000 or 2001, I heard that I was selected for Commission on Education and later in the day I got selected for the AAFP Foundation Board to sit on the board. I want to say that was November 2000. That was at the same time our hospital was announcing it was closing, by the way. No, it was the year before that, I’m sorry. Instead of one commission, I got both the commission and the Foundation Board and I was really excited that I was going to get to serve in two different areas. I believed a lot in the Foundation. The year before that, in 2000, I was Philanthropist of the Year for the AAFP [Foundation]. The year be-fore that, Nancy and I were Philanthropist of the Year for the OAFP so it was really neat, being able to get a chance to serve for both Foundation and the Commission on Education. I got to travel to Kansas City, meet a lot of new people, both in leadership and the Academy and on the Foundation. I got to work on both areas, both the Commission on Education, which at that time was a very, very busy commission, one of the busiest, I think they had, and work for the Foundation. I enjoyed my years on both. After four years on the Commission on Education, I was selected to be the Chair of the commission and after just three years on the AAFP Founda-tion, some crazy woman named Sandy Panther and a couple of guys, Jerry Rogers was one of them, asked me to throw my hat in the ring for Treasurer of the Foundation, as you recall. You remember that?\n\nI do remember that well. \n\nActually Ross Black, he’s on the Board, he and I had the same year, I would have thought that Ross wanted to be Treasurer and said [    ] said he didn’t want to be Treasurer so he encouraged me to do it so I did it and I was Treasurer for two years and then Vice President of the Founda-tion and then President of the Foundation. I ended up being President of the Foundation in De-cember of 2009. It was January 1, 2002 to December 31, 2009. Actually I had my dates wrong. It was 2002 I started on the Foundation so it was the year that our hospital announced it was clos-ing that I found out I was going to be on both the Commission [on Education] and on the Found-ation, so it was the same time so there were a lot of things going on in my life at the same time.\n\nI’d like to pursue the Foundation a little bit more, obviously because of my interest and yours here. Unfortunately, I wasn’t here when you were President. I’d like you to reflect a little bit on the Foundation and where you think it is and where you think it’s going or where it was when you first started in 2002 and where you think it’s going.\n\nWhen I first got on the Board, I got a whim when I was on the Board, I guess it was the first year I was on. Terry Promio (?) from the Division of Education came to me and asked me to kind of fight for a program that would get $50,000 in seed money to have an MBA program for residents around Kansas City. Actually, when I was a residency director in Kansas City, I actually was helping to develop that curriculum so I already knew about the program and I was very willing to fight for it. Got to have my first win against a guy named Doug Henley. You may remember that.\n\nI do remember that. \n\nDoug was dead against giving that $50,000, thought it could be better spent elsewhere and I con-vinced people on the Board to vote for it and like I said, it was my first win and Doug never for-gave me for it. I always get a kick out of that because Doug will occasionally bring it up. For the whole eight years I was in, he’d usually bring up “The crazy MBA program.” In retrospect it very well may have been, but it was seed money, that’s all it was used for and it was used well. There were several family physicians, residents and faculty that actually underwent the MBA program and graduated from it. I don’t know if it’s still in progress now but I know that it was for at least three years and they used it so it was a good program. I got to work with people like Mindi McKenna, who is currently with the AAFP, I think in the Division of CME, I think.\n\nYes, she’s Director of the Division of [Continuing Medical] Education.    \n\n \n\nI got to work with her, putting that MBA program together and worked with people like Terry Promio (?), who I had a deep respect for at that time. It was my first win, it was my biggest win probably. And Doug never forgave me for that. He was a good sport about it.\n\nWhen I first got on the Foundation Board, the thing that bothered me was, a lot of family physi-cians sitting on the Board, people who I wasn’t convinced were great business, including myself. I always felt that we needed somebody representing business outside of the four people who were serving from corporate, pharma. I really felt we needed people who were really noted in business to sit on the Board. I fought for that every year I was on the Board and another win was my last year on the Board when we got a Board seat for somebody to sit on the Board from busi-ness. I felt that was really neat.\n\nThat is and may I ask who that first individual was? \n\nI wish you hadn’t because I can’t remember.\n\nI did not realize that and that’s great. \n\nYes, they started this year.\n\nThat is a great accomplishment. \n\nI really felt that way. Every year I brought it up, why don’t we have business people and I was actually willing to have fewer family physicians and I wanted to see the Foundation grow further and I felt that we needed people who knew more about business and raising money and that’s what they did.\n\nThat’s wonderful. \n\nI felt really good about that, actually. Who was it? It was somebody who had done a lot of work in…it wasn’t Kenneth Moritsugu? \n\nHe was the Assistant Surgeon General. \n\nI think he was the one.\n\nHe is currently on the Board, I know that. \n\nAnd I don’t think he represents Pharma. I know he worked for Lilly but I don’t think he’s the one that represented pharma. I’m pretty sure he’s the one. He’s been a big addition and I just felt like we needed to have somebody who is business-minded, who has a wide breadth of experience to help the Foundation progress. That was one of the things I always wanted to do and we finally accomplished that. Another thing that got accomplished during the time I was there, I can’t say I did it but I can say that we were lucky that we had a stock market that was doing well. The en-dowment grew significantly. I remember shortly after I was there, they wanted an endowment with a goal of $5 million and I think by the time I left it was $11 [million]. \n\nIt was. \n\nI felt good about that too but that wasn’t my doing. That was the stock market. I had something to do with at least the assessment committees and things like that but it was still the market doing well. We outdid our goals.\n\nYou were a great asset to the Foundation and its Board, I will tell you that. \n\nI really enjoyed it.\n\nI think we’ve pretty well covered you. I’d like to just briefly get into some of the philosophical and I really don’t want to go by the sets of questions except for a few. Do you fell that there are any important issues in the specialty of family medicine we haven’t talked about? And this is very broad-based, much larger than you and I. \n\nYes. I think if family physicians continually quit going to the hospital I think we’re going to be relegated to nothing more than well-trained nurse practitioners. I have always felt strongly that family docs should continue to be visible to their peers in the hospital. I have seen it in the past where if doctors don’t communicate amongst each other, family medicine is going to continue to hurt. The other thing that I really do believe is hurting medicine in general, is lack of communi-cation among physicians. The Institute of Medicine came out with a report, talking about all the medical errors in the hospital and I don’t believe it’s because of writing of prescriptions, I be-lieve it’s because doctors don’t talk to each other anymore. I [    ] 30 some years that I’ve now been a physician, I can remember the days where I would go to the doctor’s lounge at breakfast time, both as a medical student and then as an intern, and I can remember how all the physicians of different specialties would sit around having breakfast and people would do curbside consults and they would learn from each other about taking care of a patient. That’s dead. That doesn’t ever happen anymore and I think that the one thing that has hurt patient care in hospitals is the fact that doctors don’t talk to each other. Doctors are so rushed now that they don’t even read each other’s medical notes. I’ve seen that in my career where one specialist writes a note, another \n\nspecialist writes a different note and they haven’t even looked at each other’s notes. I think their lack of communication among physicians is what has caused more medical errors than anything else and I’m hoping the electronic age might help that. I think electronic health records definitely helps with prescriptions. You get fewer prescription errors because people can read the writing now but there’s still a lack of communication among physicians. That is the one thing in medi-cine that bothers me the most, I think.\n\nSort of in lockstep with that, what is your opinion of the overall state of health care in America? \n\nI think it’s going to get much worse before it gets better. I think it’s hurting significantly today and just throwing Band-Aids at it, they are not involving everybody to improve health care. We need to improve insurance, we need to improve the legal side of it, we need to improve patient expectations of health care, we need to bring more physicians to the table and physicians who care about improving health care, not their bottom line. It’s true. I think we need to take all the conflicts of interest out of there and it should be physicians that care about improving health care for the masses and I think if we improve health care for the masses, physicians are still going to make a good income. The day of the filthy rich physician is gone but I think all physicians de-serve to have good incomes but they don’t necessarily have to [    ].\n\nDo you think health care reform, the current bill, will help or hinder the ability to…?\n\nI think all it really was, was insurance reform but it wasn’t enough insurance reform because they’re still jacking up the rates. They’re trying to make hay while the sun shines, the insurance companies are. So they’re still jacking up the rates. Every time this administration has…what they feel is reform, for instance, when they had banking reform, they just had an article in the Wall Street Journal today, how the credit card companies are jacking up the interest rates. They’re going to make money one way or the other so we call reform as just another way to start making more money. We did not have any true health care reform with this bill and all we have in both the government and our Congress and that’s on both sides of the aisle, we just had a lot of arguing and nothing good really came out of it. I feel very down on where government is going with health care reform.\n\nYou talked earlier and really throughout earlier, about those people who were role models to you or people that were very special. Is there anyone else that has sort of touched your life over the years? It could be in or out of medicine. \n\nYes. I think Mary Jo Welker was a role model. Ross Black I felt was a role model. Both those are family physicians. They helped me in the administrative side, in organizational medicine, so I felt they were good role models for me. Other people who were role models…\n\nOr just who touched your life. \n\nI think I hit on most of the people who did. You were a wonderful administrator, I really enjoyed working with you. I was in on picking your successor [Craig Doane] when you retired and I think he’s done a very good job as well. I think everybody in leadership, everybody is going to be remembered for things that they did. You’ll be remembered for a lot of things, I think Craig is going to be remembered for a lot of things. You surrounded yourself with people who were really good in your group, people like Lori Foley and I think Craig has done a good job contin-uing that. He’s also brought other people on who have done a good job, like Brenda Cherpitel. I think everybody with their leadership, they all leave something and hopefully leave something good. I hope I’m remembered for leaving some good things. I’ve tried not to be a wrecker, I’ve tried to be a fixer and hopefully I’ll be remembered as somebody that did that. I didn’t have to fix anything on the Foundation. My job at the Foundation was just to help lead but I was sur-rounded by good people too. Secrets of leadership is surrounding yourself by people better than you and I think I’ve done that in most of my career. I tried to put people in positions where I thought they would excel. I’m a believer in Good to Great philosophy where if you’ve got people who are in the wrong positions, try to put them in the right positions and I try to do that. Some-times I’ve had to take them off the bus, as they say in the book, but I’ve always tried to give people a chance by putting them in the position where they’ll actually excel and not fail. When that has happened, I think I became a better leader by doing that and I think the organizations that I led were better because of that. You’ve done that, Craig has done that and good leaders do that.\n\nIt was our pleasure. We’ve pretty well come to the end. Any last thoughts you’d like to add for people who’re maybe doing sabbaticals and listening to this tape ten years from now? \n\nPeople are going to hate this. They’re going to, this guy is a blowhard.\n\nNo. My true hope is when we have completed this series that there will be people in the future who will come into the Foundation on a sabbatical to learn firsthand, what those leaders that preceded them felt about the specialty and accomplishments and where they feel that it started and where it’s gone to. \n\nI think I’m just praying that this generation of physicians will be followed by another generation similar to mine and generations before me where people cared more about work ethic than any-thing else. Today’s generation of physicians, I’m a little discouraged by because they’re looking at medicine as shift work. I’ve seen that as a program director and also now in my position as chief medical officer, that physicians, and this is in every specialty, are [     ], they’re looking more at lifestyle and family, which I think is very important, but I think the job as doctor is be-coming relative to being on a shift, a 9:00 to 5:00 kind of job and that is really discouraging. I think that our society is going to suffer for that, I really do. I hate to leave on a down note but it does bother me. It worries me because I’m going to need those doctors.\n\nDr. Belfer, thank you so much. I thank you so much for what you have done and I look forward to seeing you sometime in the future. \n\nThanks Sandy. I look forward to seeing you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154888/file/284063#t=0.0,6070.97196"}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154888/file/284063/transcript/82294","type":"AnnotationPage","label":{"en":["Description of Interview with Dr. Mark Belfer [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154888/file/284063/transcript/82294/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Interviewee: Mark Belfer, DO\n\nInterviewer: Sandy Panther\n\nDate: August 23, 2010\n\n“When I was in fifth grade,” begins Mark Belfer, D.O., “my special job was class doctor…I was fascinated by medicine and the human body.” Today, he is fulfilling that “special job” as the Chief Medical Officer (CMO) at the St. Vincent Physician Network in Indianapolis, Indiana.  He serves as the liaison between 224 physicians and their offices. \n\nHis path to CMO began in 1974 when he entered the Des Moines (Iowa) College of Osteopathic Medicine and Surgery followed by an internship in his hometown of Grand Rapids, Michigan, at the Osteopathic Hospital. Then came six years in the US Army starting in Bamberg, Germany, as brigade surgeon responsible for 3,000 soldiers and their families. During his final three years, he served as the medical director of the clinic in Honolulu, Hawaii. From 1986 to 1994, he partnered with two other physicians to build a practice in Warren, Ohio. Next came the years when he became director of developing residency programs. These included  positions in Youngstown, Ohio, at Trinity Lutheran Hospital in Kansas City, Missouri, and General Medical Center in Akron, Ohio. He says of those years that he always “tried to be a fixer.” The record shows that he did just that by turning the programs into successes.   \n\nDr. Belfer has also been very successful in his volunteer leadership roles. He is the unique physician who has chosen to serve in two different areas: the Ohio Academy of Family Physicians (OAFP) and the American Academy of Family Physicians (AAFP). For OAFP he has filled the offices of Vice Speaker, Second Vice President, President, Past President, and Chairman of the Commission on Education as well as sitting on the Foundation Board.  In 1999, the organization honored him and his wife, Nancy Lynn, with the Philanthropist of the Year Award. The AAFP Foundation Board honored him with a similar award in 2000. He served on that Board as treasurer, vice president and became its president in 2009","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154888/file/284063#t=0.0,6070.97196"}]}]}]}