{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/sf2m61dr6f/manifest","type":"Manifest","label":{"en":["Dr. Kemp Jones"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Date"]},"value":{"en":["1989-11-28 (created)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["Society of Teachers of Family Medicine","Dr. Kemp Jones","family medicine","family physicians"]}},{"label":{"en":["Subject"]},"value":{"en":["Dr. Kemp Jones (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["english (primary)"]}},{"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"]}}],"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/3180/collection_resources/150641/file/277825","type":"Canvas","label":{"en":["Media File 1 of 2 - Jones_Kemp_1989.11.28_-_Side_1.mp3"]},"duration":3717.848,"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/3180/collection_resources/150641/file/277825/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/277/825/original/Jones_Kemp_1989.11.28_-_Side_1.mp3?1750277654","type":"Audio","format":"audio/mpeg","duration":3717.848,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825/transcript/81263","type":"AnnotationPage","label":{"en":["Dr. Kemp Jones Interview Transcrip [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825/transcript/81263/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is a recording of Kemp Jones on the 28th of November, 1989. Location is Chapel Hill, North Carolina.\n\nI guess the best thing to do would be if you could just tell me how it all started, how you ended up coming here and going into practice.\n\nDr. Jones: When I was in medical school and preparing for my future, the opportunity came up for an exchange in internships. I was at Duke Medical School and they had an arrangement in the department of internal medicine with the University of Rochester in Rochester, New York for an exchange of interns each year. One intern would go up   to the Rochester program and then they had a person who came down to Duke to the internal medical program. So I went up there in internal medicine and became very much interested in cardiology. And I figured that that’s probably the direction that I was going to pursue. When I finished up, about half of my residency up there, I had to go into the Navy with two years of obligated duty to pay back. I had gone through medical school as a Navy apprentice seaman. So they sent me down to the US Naval Hospital at St. Alban’s out in New York. I was there for a year in internal medicine. I was a ward medical officer. And then went on down to Paris Island for my final year. But I was at the Naval hospital, a very enjoyable experience. And one of the great things about it was the work in caring for dependents. They had a great big clinic area that we had to serve in. Everybody on the staff rotated through there and we took care of the children and the adults on outpatient basis. And I just became very much fascinated with family practice. You know, that aspect of it. So I had been accepted into an assistant residency over at Duke in internal medicine. And I road up to Duke and declined that and asked Dr. Davidson, he was the dean over there, if he still had a program that prepared people for family practice. And he did. He had a split one year deal that was six months of OB/Gyn and you just served in that just like an intern. Then you served six months in pediatrics. So I got into that program after my term down there at Paris Island, my tour of duty there, and came back to Duke for one year. And while I was taking that split residency to prepare for entrance into family practice, I began to figure out where I was going to settle down. My family wanted me to go back to Salisbury, North Carolina, my hometown, and practice there. And my dad had already bought a lot out near the hospital to build the office and so forth. And then at Thanksgiving that year we came to Chapel Hill from Durham. We were living in Durham. My wife and I came over here to a party. She had gone to undergraduate school here and one of her old college classmate’s family lived here and he was a professor in the English department here. They were having a party at Thanksgiving time, so we came over to that party. And at that party we met my future partner, Fred Patterson. He lived across the street from these folks and he said that he was just busy as he could be. He had been in family practice here. This was in 1949. He had been I practice here since about 1947 when he’s come back from the Army. And he needed some help, so I came over and road around and evenings on-call with him and we got acquainted. Then he offered me an opportunity to come over and join him in practice. So I came over in June of 1950 and joined him and we moved into Glen Lennox. Glen Lennox was the apartment complex out on the edge of town that had just been completed. And it was the first large apartment complex that had been built here and a really great place. Our neighbors were the people who were here getting ready for the hospital’s transition to a teaching hospital for a four year medical school. And all that started in ’52. So all the young, new faculty people were living out there. The dental school was going through the same transition. So it was just a fun place to live and very interesting and challenging young people, mostly young couples. So we lived there for a year and then moved over here to our present home. And our relationship, one of the first things that Fred Patterson did when I got to town to join him was to take me over to meet Dean Berryhill (?) at the medical school. And he assured me that he wanted us, our practice, to be a part of whatever went on over there. So that started that relationship that has existed since 1952. Our first appointment at the medical school was in the department of internal medicine, of course. And that continued until the early eighties as internal medicine. And then my appointment with the department of family medicine started in seventy, when the department was started and has continued since.\n\nWas it unusual to get into a partnership right out? Was that the norm for people, your contemporaries?\n\nDr. Jones: It was back in those days, I guess. People were beginning to do it. But as I recall, that was very unusual. There were some situations … I know some family doctors in Durham had begun, after the war, to take in new people coming back as partners. One of the early internal medical groups over there in Durham, a man who started it was, I think, really a family physician who chose to just stay with internal medicine. So when he began to enlarge his practice into a partnership group type thing, he brought in strictly internists.\n\nMy conversations with folks seem to show that the group practice approach was a relatively new idea.\n\nDr. Jones: It was.\n\nIn a lot of places it was kind of discouraged.\n\nDr. Jones: I know I made one trip down to Warsaw to interview a family physician down there. One of our friends at Duke, Dr. Medgerson (?), had identified this man as wanting an department. And it turns out the reason why he wanted a department was he had had a heart attack and he wanted some relief. But mostly fellows liked to go it alone.\n\nWhat made you decide that a partnership was the direction you would go?\n\nDr. Jones: Well, the opportunity to get to live in Chapel Hill. My wife had lived here, her father had the Methodist church back when they built the church, back in the twenties. And she had lived here then and she had gone to school here. I had gone to Duke all the way, undergraduate and medical school. \n\nYour loyalties have changed to here though?\n\nDr. Jones: Yes. (Laughter.) But I guess the main thing was opting to get to live in Chapel Hill. And I didn’t realize then how important it was to be in a partnership, from my point of view. I was going to go back to Salisbury solo.\n\nSo it really was a change not only in location. Decidedly. If you remember back to the first few years of practice, what was that like and what was it like to practice in this area? \n\nDr. Jones:  One thing that was unique about it was we didn’t have any hospital here. The infirmary at the university was the only medical facility. There were only about three or four physicians in town and family docs, we were really the only full time ones that were practicing. I remember house calls. We had a place over just beyond what is now the hospital complex called Victory Village. And we had all these veterans back here with their families pursuing their graduate degrees. And morning house calls, starting at, say, 8:00. We never did get to the office before","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825#t=0.0,600.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825/transcript/81263/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"because we would start, you’d go to Victory Village and you might make five, six house calls on a cold winter morning with the flu bug out or whatever bug was current among the upper respiratory and lower respiratory bugs. And then swung on around into the office. And, likewise, the various areas of town, everything was so close in the village that I could make ten or twelve house calls before","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825#t=600.0,600.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825/transcript/81263/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"without any trouble at all. And problems were pretty simple and straight-forward.\n\nSo what percentage of your practice would have been house calls in those days?\n\nDr. Jones: I think probably, we were such a high volume practice, we saw so many people at the office and on house calls, I’d say at least 25% in those days. You’d always end up with some house calls in Scarborough (?) and then we would swing through the predominantly black area in town, the north side area. There would be some there. And uniquely, the first part of our practice we didn’t bill any of our black patients because for most of them, the expense was a real problem. Of course, we charged $1 for an office visit and, I think, $4 for a house call back in those days. Went up to $2 five or six years later. And I think when the big inflation and all of the fees started in the early seventies, we were still charging $6 for an office call. We’ve always been on the low side there, but we’ve done, as I say, a fairly high volume. We’ve never had any hospital practice. That was one of the things about starting in the early fifties, we didn’t have any hospital beds locally. So that automatically eliminated OB. Fred didn’t do any OB and I was prepared to try it, but only had one case and that was out in the county, down on 15-501, down there on Manns Chapel Road. Got a call from a lady who said her daughter was up in the little loft above the living room, we’d call it a family room type arrangement now, they had downstairs there and was having a severe stomachache and they couldn’t move her. So in those days we made house calls, so I went out there. And back in those days, for instance, a lot of these were made on dirt roads, Airport Road, where you turn off to go into Horace Williams Airport now, at that point on was dirt. So you’d get out-of-town on some occasions and it would be a little muddy. Anyway, I went down to see this young lady and I climbed up into the loft and just observed my first home delivery. (Laughter.) The hospital had opened so that we called an ambulance and got the little gal into the hospital for the completion of the thing. I’m not certain whether or not the placenta had delivered or not. She didn’t know she was pregnant? She didn’t know she was pregnant. She was a teenager and had just developed this severe stomachache. But we got her in and things were taken care of. The baby did well and the mother did well. That’s the only delivery I ever participated in.\n\nWas the hospital in Durham?\n\nDr. Jones: Yeah, Watts Hospital. It was a big hospital that we referred to. And, of course, Duke Hospital was over there then. But Chapel Hill people were drawn to Watts Hospital and the Durham doctors. So if you needed to put someone in the hospital, you would send them over to … We would call over to Watts, to one of our friends, in whatever specialty applied. They had family practice folks in Durham, a pretty good community of them. And they had privileges at Watts and admitted there. And sometimes we would deal with them and other times with internists or surgeons or what-have-you. But we had a very good relationship. That’s when we had the … I remember we had the Durham Orange County Medical Society. People have always wondered why we had the combined situation. And one of the reasons that we always brought up was that it gave us a chance to meet and socialize, get together with our colleagues. And for those of us in Orange County, the people to whom we were referring patients most often. So we were drawn together that way. There was a meeting in the early fifties, a group of people from the School of Public Health mainly had sponsored it to split us off and have a  Durham and an Orange Medical Society separate thing. And we met at the Inn, I remember, and had a clear discussion of the advantages and disadvantages of it. And the big reason that won out was the opportunity to get together and fraternize with our colleagues. And that has prevailed, that feeling has prevailed. \n\nAnd it’s still a major function, I think, of medical societies and hospital staffing, is to get people together.\n\nTo get people together. Trade stories, in a sense, and catch up with stuff. I miss that a lot here compared to Wurster, where I used to practice, because I practiced at a community hospital there, the residency program was there. And we would have a monthly meeting and everybody would sit down and kind of tell stories about everything. And \n\noften, around here, it tends to be much more businesslike, which is a little unfortunate, but … \n\nDr. Jones: That used to be the big thing that we did at those meetings. That was fun. \n\nOne of the things that has come up, because most of the physicians I’ve talked to have been in North Carolina, is, as you mentioned, the whole issue of one doctor taking care of the whole community, the black community and the white community. Right. And in the times before integration started, to come about, the physician often played the role of being the person who kind of took care of everybody, regardless. Right. Was that ever difficult or put you in an awkward situation?\n\nDr. Jones: No, it really didn’t and it served me well. I was elected to the school board in the mid-fifties and that’s when we had the big push on integration. So I was chairman of the school board when we had our first hearings. I served on the school board about seven years. And we went through all the hearings that we had for integration when we first started. Person-by-person, there was no blanket thing. We had a very liberal school board, but everybody moved in step and that kind of thing. And I remember one of our first integration plans was to integrate the first grade and the second grade, third, and so on. But ultimately it all worked out. But this relationship that I had had with the partner before me that Fred Patterson had had, with the black and white community, it was all absolutely the same. Now, that served me very well in handling the problems of integration on that school board and dealing with these people because I was talking to people who had been our patients and I’d been in their homes, I’d known their mothers and grandmothers and taken care of them. And it just puts you in a very unique position because you don’t have any of the barriers there that other stuff does.\n\nWell, it’s very evident to me that the physician in a community like this, your role here is one where your status is not just that as another citizen. Right. You’re very special. And that kind of social role physicians play in their communities is something we don’t talk about very much now, but it’s very important.\n\nDr. Jones: It was absolutely, you became a member of the Civic Club and the Kiwanis Club and church. You were called on for leadership roles. I was chairman of the board of -- Methodist church and taught Sunday School. These are things that were just a part of what you did. And people turned to you, you know. They expected it.\n\nBefore you came into a community like this, did you realize it was going to be like that?\n\nDr. Jones: I did not, really, except from a role model view. And in my hometown of Salisbury it had been somewhat that way.\n\nBut Salisbury is a much larger town than Chapel Hill.\n\nDr. Jones: That’s right. Chapel Hill was really a little village then. Interestingly, on this integration thing, the little house that we practiced in was right down here on Franklin Street across from the Moorhead downtown parking lot. The little house that is next to the social studies building around --. That house had been a doctor’s office since the thirties, or maybe even before that. So it was set up so that the living room of the old cottage was now a waiting room. And then there was a corridor that ran down one side of the house, back to the back and the laboratory was back there. And then the examining rooms and offices off from there. And along that little corridor there were some benches. And in the beginning, black patients came in that side door, the one that we used mostly. But, anyway, and sat on those benches. So we had segregation there. And this was one of the things that really sort of bugged me when we got into this integration thing at the school. When I was chairman of the board, we did have segregation, but it was voluntary. I don’t think anyone would have objected if a black patient had sat down in that waiting room area, but this had just been traditional. But I was so happy when we moved into that new office in Glen Lennox in ’59. There were absolutely no racial lines drawn. You know, we totally integrated. 1959 was ahead of a lot of things that came along. But it was a real relief to me. And I know Bill Jorneau (?), another partner, was very concerned about this and this gave us a big push in the right direction, I think.\n\nIn some ways, I think younger physicians often don’t appreciate the importance of that social role that physicians play in small communities. That is so right. I think they shy away from it a little bit. And I think what we need to be doing is saying, somehow, that you have got to act responsibly as a … I mean your role is very different.\n\nDr. Jones: You know, it’s almost like responding because people come to you for their … In those days, at least, you know, they would come to you for medical advice and then when they looked for somebody to handle their school board or handle whatever, church, so on, they would turn to the physician.\n\nDid you ever feel that that was outside of your responsibility?\n\nDr. Jones: No, never. But I had always been into that kind of stuff, since a long time ago. I just felt I had some kind of obligation of that kind.  That was part of being a doctor. That’s one of the reasons I wanted to be a doctor. That’s really nice. Was to play that role. \n\nSomeone said to me one time that … he was the Minister of Health for Puerto Rico. He was a GP from a small town in Puerto Rico. And I said, what got you from being a small town doctor to the Minister of Health in your own country? And he said, well, it was a logical extension. He said if I was really concerned about the health of my community. And if some of the things outside the community were affecting their health, then I needed to do something about it. So responding to things was basically what he did. Again, I don’t know if that’s something that we even talked about as a kind of responsibility, but it certainly is a big part. If you’re going to practice in a small community, you can’t just hide out from people asking you to take some of the leadership role, which is how you husband that role in a way that’s good for your community and good for your own family. Did you and your wife, your family talk about your role in all of this as that went on? Was she supportive of you taking that role?\n\nDr. Jones: Yes, she really was and that meant a lot to me because whatever I wanted to do, she was perfectly agreeable and very supportive of my getting along with it. She enjoyed it, I think. Especially being a Carolina graduate, she liked being involved in lots of things around here? That’s right.\n\nSome folks who started practice really had to kind of struggle to build up their practice, but you were good in your own …\n\nDr. Jones: No, we never had that problem because Fred was so busy and that still was significant. When we started there were no pediatricians here. I think Bob Sr. came in the late fifties maybe. So on a given afternoon down at that office, we’d have a well baby exam scheduled every fifteen minutes for three hours every day. And we had well baby clinics at the health department that we conducted. And, of course, these were free clinics. But they, in turn, contributed patients to our practice. I remember one out in the country, a place called Terrells Creek church on what’s now the New Greensboro highway out there where Pat Guiteras lives. And we went out there. We had the immunization clinics and we would do well baby checkups. And looking out across the field, here they were coming across, you know, carrying the babies in their arms and on their backs. It looked like something from Africa, like out in the, you know, coming in there. It was real fun. We did that once or twice a month, we’d conduct these clinics. Sometimes at the health department, as I said. Now, at the health department a lot of our patients were those Victory Village babies that I was talking about, the graduate students’ children and so forth.\n\nIt still goes on the SHAC Clinic. I see kids that I delivered who, for their well child and their immunizations and stuff will go over to the SHAC  Clinic because their parents are graduate students and they’re on limited budgets and all that type of thing. So there’s a lot of that still goes on, I think.\n\nDr. Jones: How is that SHAC Clinic going?\n\nIt’s going well. It’s now been over twenty years. We had a twentieth anniversary celebration, the students had, last year.\n\nDr. Jones: Do they it off-site of the school?\n\nIt’s now at the health department. It’s been at the health department since I’ve been here and that’s been ten years now.\n\nDr. Jones: What’s its schedule? How many days?\n\nJust Monday night. It’s been going on every Monday night. I think it was two nights back in the late sixties. But it’s the longest continuously operating student run clinic in the country. That is great. It is. And Pat Guiteras is one of the students that got it started. So there’s some continuity there. But that whole idea of people trying to put their own medical care together is still going on despite the fact we’ve got all these doctors around here.\n\nOne of the things that comes up all the time for me in talking is the whole question of privacy for you and your family. And, as you say, when this was a village, every place you walked you ran into patients and so on. Was that ever something that you were conscious of? And how did you deal with that?\n\nDr. Jones: Well, we had a very active social life. I mean that’s the university community, you know, all the different departments and so forth. And these people were patients and friends and we were members of the country club and all of that was pretty open and above board. We didn’t have to worry about privacy though because people sort of respected that, you know, in the community. And we had no real problems with it. One thing that happened to us was a unique experience in the late fifties. We built, as a joint project with another couple who did not have children (we had children but they did not) a raft to put up on Kerr Lake. We built it in their front yard. You know, we used oil drums, pontoons originally. We spent that one whole spring building it, then launched it up there. So on weekends … By then there were three partners. I had two out of every three weekends off. So we built this raft, then eventually they got a houseboat and we would tie the raft and the houseboat together. So we had a sailboat and we had a ski boat. But it looked like urban renewal in the middle of Kerr Lake. (Laughter.) Two out of three weekends every summer we walked barefoot the whole weekend. That was really fun. And that gave us a lot of privacy and a lot of time with the kids and so forth. It was real fun.\n\nThere are lots of advantages and probably some disadvantages to group practice. Right. But I think the people, the folks who are in solo practice are so reluctant to kind of go away or leave town. Or some of them can’t if they’re the only doc in town.\n\nDr. Jones: And this really gave us that opportunity.\n\nSo, would you say,  for example, you would be in a social situation or church or things like that with patients of yours, if there was difficult as far as …\n\nDr. Jones: No, it never really created any problems that I can remember. And they respected our right to go up there to Kerr Lake to do our thing up there. That did take us away from church a little bit more than we had anticipated. But my wife had been a preacher’s child all of her … So she had a full dose when she was young? She had church three or four times on Sunday and a prayer meeting on Wednesday and innumerable church-related duties. So we didn’t  have any trouble soft-peddling that and going in for this time to get away, to get together with the family.\n\nThe other side of the privacy question, I guess, is, for me, the question of confidentiality. There’s not much written about kind of small town doctoring and some of the issues. But confidentiality is one that always gets brought up. Do you remember, over your practice lifetime, how did that raise itself for you or your family?\n\nDr. Jones: Well, I don’t remember that being a problem. I just did not discuss, ever discuss my patients’ affairs with anybody else. I didn’t even have to make an effort about that. It was just sort of like an unwritten law. And I never did discuss that. Of course, I have discussed some things with my wife, but she’s been very good at that, respecting that rule of confidentiality.\n\nDid she ever feel … I had one experience with a physician who said that his wife would always get approached in the grocery store and say something about, you know … Oh, yeah. How did that all work out?\n\nDr. Jones: She was very expert at handling that kind of thing. It did not bother her. She just played the part of the non-knowing person, you know, that she wasn’t really privileged to that information and we hadn’t talked about it.\n\nSo she didn’t end up coming home from the grocery store and saying something to you about …\n\nDr. Jones: No, I never remember much of that because of the way she is excellent about it. And her telephone diplomacy was even, I think, better than mine. You know, that telephone is an important part of a family doctor’s life. Sure, it is. And it starts early and ends up late. And sometimes you can get involved a little too much. You can overshoot things. But she handles the phone beautifully. Now, I think that’s part of the way she handles this grocery store situation.\n\nIs that something she just developed over a period of time or …\n\nDr. Jones: I guess it is. She’s a very easy going person. I mean she was president of the medical auxiliary early on, that type thing. But she’s never been a very pushy person in that respect and she’s preferred for me to do the civic things. But she was part of the auxiliary. I remember they went around doing the testing of the sight, the eyes, in school and so forth. And that kind of job – she did everything she was asked to do, but she didn’t surge to the fore in any issues. She did get interested in one local political campaign. It was funny, that’s an interesting thing about it. Early on, as I recall, doctors tried to remain pretty neutral in politics. But somehow we got interested in politics early on and found it was a lot of fun. And one of our friends was running for judge here and we had a big poll right across the street here. And we had a poll watching post here. My wife sat in the dining room and they would check them off as they came in and they would call people to get them to vote and all that. I guess the biggest move I made in that direction was when Richardson Pryor ran for governor in the primary. I was his Orange County chairman. And we won the primary, the first round. You know, that’s so often the way with it. And then Dan Moore beat us in the runoff. But, still, we won in Orange County both times.\n\nI’m a product of the late sixties and it was a very political time. I have two children who are products of the late sixties. But I think one of the difficulties for me … Again, your being a generalist is a different thing than being a \n\ncardiologist or a surgeon because when you’re a generalist you’re in the community … You have a different relationship than, say, when you’re doing a -- on someone. And I was careful, although it was a struggle sometimes, to in a sense appear … I mean I was clear about what I felt about that, the way I felt about local issues and so on. On the other hand, I had to be careful not to say it so loudly or in such a way that I would make people feel like they wouldn’t come to me because my politics would spill over into …\n\nDr. Jones: You’re right. I guess this was one reason why doctors were a little reluctant about politics early on.\n\nAnd Chapel Hills is a different community and you go to cocktail parties and things where you have a professor of history and professor of English and one of political science and every one coming from a different angle. And it’s fun to jump in and get in the middle of the conversation. And those guys don’t show any deference   to you because you’re a physician. (Laughter.) On the other hand, the fella we were talking about, who is the family physician in the small community, I think he does have to think, or did have to think, twice about expressing his political views.\n\nI think that those are the kind of keeping things clear. And I think patients, community people think it’s a lot easier for us than, at least, I’ve had the experience. Right. It’s a real struggle sometimes and there are people that … You know, how do you deal with patients who you don’t like? Right, exactly. You don’t like them for any number of reasons.\n\nDr. Jones: I’ll tell you a funny story about me in that respect. One of the first communists identified directly in this community was a man named Junius Scale (?). Sure, I’ve heard of that. You heard of that. They lived here in \n\n--. Junius lived there in a little former millhouse just about where OCCHS … And, by golly, Junius and his wife had a baby and I got called to go out and make a house call to see this child. The child was sick with a cold or something, so I went out there. And I went in and here’s this great big thing of Gus Hall, you know, the secretary of the communist party, on the wall. All these pamphlets around, the walls were plastered with these things. And I made the house call and he asked me what the charge was and I told him and he wrote me out a check. And I drove back from --, here to the house, and was thinking about it. And I got out of the car and I tore the check up. (Laughter.) I didn’t want anything like that, you know. I didn’t want any check from Junius. I mean it was that bad. It was so stupid, but … And I took care of all of his family and the mother and father of his wife moved down here and took care of them. And we knew that these people were related to the movement, but the practice of medicine, fortunately, was a little bit above all that.\n\nIt has to be. It’s like … In a funny way, I grew up in the Midwest and coming down here, it’s a different culture. And sometimes I’m really, I feel like if I had my choice I probably wouldn’t be taking care of some of the folks I take care of in a lot of different places. But, on the other hand, I said to myself, and I act on that, is the family doctor means … You know, I don’t make those kinds of discriminations, at least as much as I can control it. I mean it’s not something you can totally control, but you need to be always acting on their behalf. And I think we’re the only group of physicians who have that responsibility. Like I said, you can pick and choose a lot more easily if you’re the consultant somewhere. Yeah. But we can’t because we live with people.\n\nDr. Jones: And if you ignore … For instance, the black part of your practice, that just misses the whole point in practicing in this community because that’s such a significant part.\n\nI was really surprised, that’s something I had not heard. No one did it as formally as you did with the school board and so on. But I don’t think there’s an exception to any of the physicians I’ve talked to in North Carolina who always behaved equally to black and white patients. They would have the situation, perhaps, that your waiting room in your old building … It was more a custom. And I think somebody coming from another part of the country, who hadn’t lived here, wouldn’t understand that. I mean I’ve learned a lot about things, having been here as long as I have. But they’re kind of a force for change in a very understated, quiet way. And when the schools were integrated, I remember one doctor in the western part of the state, his wife was saying that their kids went to the integrated junior high school. And I asked him whether that was a problem for them. And he said, no, we felt like our kids needed to have an education that was more than just what they learned in school. And so, in a sense, their family became the folks who helped integrate that particular school. They didn’t do it in a big flag waving or a sign waving kind of way; they just did it. So doctors have special responsibilities in communities, I think.\n\nDr. Jones: I had, I guess, a professor in psychiatry talk to us in medical school about never differentiating among patients in that respect and always showing them proper respect and never falling into the vernacular in communicating with them. And I’ve always remembered that. For instance, on this thing dealing with black folks, negroes, I think I “yes mam’d” and “yes sir’ed” these people from the beginning of my practice, just as I did my white patients. And I think they understood that – because there was no difference.\n\nThe obviously trusted you as a more formal, public role and that really came to serve you and everybody else quite well.\n\nWhat have been some of the hardest things for you over the years, practicing in this town?\n\nDr. Jones: I’m just trying to think of that … I just can’t think of anything. Nothing really comes to mind as being difficult or hard in that sense.\n\nHave the changes in the medical community been …\n\nDr. Jones: I think that is it. But that had to come, you know. That’s inevitable. And the numbers things has been very difficult to cope with. We started out with a very small, local medical community and had very good relations. And then suddenly our ranks increased so that I don’t know everybody anymore. And I guess that’s the hardest thing that I’ve had to cope with. I don’t know them and I have a feeling that they don’t know me. So I inferentially conclude they really don’t understand what I’m all about and what I’m trying to do here. And you have a terrible fear in the back of your mind that they just say, that old such-and-such. And I don’t have any real reason or a factual basis for saying that, but I guess it’s the way everybody becomes introspective and wonders about that.\n\nI think that you’ve touched on what I think is the biggest issue, which is if you don’t know somebody, you really don’t know what they have to teach you or what you can work with them on. Right. And I’ve had that happen so many times in my life. You know, it surprises me that it doesn’t happen more because, in a sense, people are getting … I don’t know, it seems like there’s much more of a focus internally, particularly in medicine nowadays, it seems like. You know, people are…\n\nDr. Jones: Well, you know, for instance, recently … I’ve been, for about the last fifteen years, chairman of the underwriting committee for the medical liability insurance company in North Carolina. You know, the doctors’ company. And about five years ago when we suddenly had to charge the same premiums for our family physician OBs as our regular OBs and there was such an inflation in that charge that a lot of the fellas and ladies in family physician, OB situations, just had to give up OB. And this created a real flap and I took a lot of heat at our state family practice meetings when this all came up. They were saying that the insurance company was being punitive, punishing them for something, when we had the figures to prove that the OB people, in our company’s experience, were paying, say, 20% of our premium income and we were paying out 50% of our offices for these people.\n\nBut it’s hard for these folks to understand that, that we were not being punitive. But that was a very difficult time and period, going through that. That’s now all settled down. I’m going to go this weekend to the winter session, the continuing medical education thing in Raleigh. The first time in about four years. It got so hot over there. I mean they’d come into the meetings and call me out. I remember when we were organizing the house of delegates for the family practice group, I was on the initial committee, the initial group. And we were getting ready to discuss something about insurance in this little committee meeting and suddenly two former presidents of the Academy in that state (Laughter) … And I made my motion or suggestion and they jumped on the thing. It was part of that dialogue that was going on about insurance companies and this thing about their being punitive. And now it’s all come out and they see what all the insurance companies are having to charge because the law requires them to put up these reserves that these folks look upon as great profits. And they see that’s the way it has to be and that we were no more punitive, our company, than any other company in that respect. I remember that. I bet I know who the two former presidents were. (Laughter.) Not that particular meeting, but it was a … \n\nDo you feel like a lot of what’s been going on, particularly in the last ten or fifteen years, has affected the relationship not only … Well, it sounds like it’s affected the relationship among colleagues. Yes. But, also, if it’s affected your relationship with your community, with your patients?\n\nDr. Jones: Yeah, it has because we’ve had to … For instance, that one issue alone, we’ve had to increase our fees so that it’s just painful for us. I’m telling you. We’ve always operated on that medical economics theory that your overhead had to be at 50% or under. And whenever it began to sneak up above that, then you had to raise your fees. And we got one period here about three years ago where we walked around 70% to 75% overhead. I mean just all these different charges. So we just had to go up, up, up with our fees. And then when we would hit on the other side, that was a hard thing. This Medicare freeze. You remember when we went into a voluntary freeze one year at the AMA’s behest. And then the government came about four years ago and put us into this freeze now that is just … We’ve just had an adjustment of our fee schedule. And for a regular office visit, I think now our charge is about, for a usual patient, a non-Medicare patient, it’s about 80% more than what it is for Medicare. They have us seeing Medicare patients, in many instances, as you know, at below cost. Yeah. And our problem with that is about 40% of our practice now is Medicare. That’s right. And I think that’s what happens with physicians who are in communities for long periods of time. Generally their practice gets older as they get older. Old doctors have old patients. And in some ways, I’m a real believer, the more I talk to older people, that it’s good for them to have older doctors because there’s a certain kind of appreciation for the things that you have that I don’t, although I’m learning. Well, that’s true. But I think to penalize people for having an older practice is just …\n\nDr. Jones: This new pay arrangement, if it does hold, it will be great. But that repeal of that Medicare thing was so terrible because that hurts the one group of patients who need it most. That’s right. And these rich people who rejected that $1500 year increase in their taxes … As the vice presidential candidate, Vincent, said, that’s cheap insurance at that. And pay for all those medications, the way the cost of medicine has been going up. You know, it’s one of those things where they’re going to pay later in ways that they don’t understand right now. That’s right. Or I’ll pay later in the sense that … The indigent patients will be alright because the government will pay there. But I’m talking about that group of the working poor, they’re going to be socked with it. \n\nWhat do you think about the future? What direction do you think it should go in?\n\nDr. Jones: I’d like to see the present system preserved. I’ve enjoyed it so much. But, frankly, I think we’re headed into a state controlled medical system. I don’t know whether you saw this last month’s “North Carolina Practitioner,” that article about medicine in Cuba. That’s a very unique program they have there. \n\nI was there actually. I wrote a letter back to the editor. I spent ten days about two and a half years ago. Pat Guiteras and I went down together. Yeah, I remember when Pat went. And he and I were there together and we were incredibly impressed with what … And the irony for that whole thing was, and in some ways this whole project I got involved with started in Cuba because we were sitting on top of a mountain after having traveled for two and a half hours in the back of a truck, up a dirt road and bouncing,  to get to this clinic up there. We’re standing and talking to this young family doctor who his nurse was there. It’s like they were saying … They all live in the same house. He sat down and he showed me that they had a circuit that he rode on the back of a donkey. And he knew all the names of all the patients, about 800 of them or so, on all the mountain tops, all around him. And he had his clinic and it was very much of a basic practice. Some woman in the group asked him whether or not he would, given a choice, rather practice in a bigger city where he came from. And he just looked at us like that was the craziest question he ever heard. He said, I consider it an honor to be able to serve these people. \n\nDr. Jones: Oh, I love that. Do you remember when they’d have somebody to go into the tertiary clinic – he goes with them. Takes them in. That’s right. And that, to me, would be the ideal situation. \n\nHe really is a person who is a member of that community.\n\nDr. Jones: You know, I was on the medical school admissions committee … I was going to ask you about that…  Fifteen years. And one of the questions we always used to ask, what kind of doctor do you want to be …\n\nOne of the answers we always used to get was, I want to be a family practitioner in either east of North Carolina in the mountains. And then you would ask them to defend that and to substantiate it. And so often these folks would fall short. They really hadn’t thought very much about it. And they thought, the main thing that was obvious was that that was the correct answer. And that was about it. But when I read that article, that just seemed to me to be the ultimate theme of the whole way of doing it.\n\nSide 2: Dr. Jones: My goals, decidedly I’m going to keep it local and just work in the county medical society and do things I can do there to make a contribution and concentrate on practicing medicine. Because I have a feeling that if I got into that thing too much on a medical/political basis, that I’d be drawn away from my patients – and I didn’t want that. I liked the role that I was playing with my patients, first, and then all these other roles secondary to that.\n\nI guess the real question is, what’s kept you in this town over your life and what is it that … Did you ever consider leaving, moving? Were there ever any pressures from …\n\nDr. Jones: Well, I know early on Robert Smith offered me a position in the department of family practice. He wanted me to give up my practice and come there – and I declined that.  Do you remember why that was? Well, the main thing there was I was going to have to make a commitment time wise. And my other partner was, Fred was sick, he had open-heart surgery and I felt like I would be leaving the practice at an inopportune moment. That was the main reason.\n\nWere there any other times during the course of all the years you’ve been here that kind of you and your family or you just felt like maybe a change was necessary or something?\n\nDr. Jones: I just don’t remember. So the natural momentum of things has continued at such a rate that … I mean we had the children to raise. We had a two generation of family. My older two children, the younger was ten years older than the next daughter. So we had a long period of time there when parenting went on. And, you know, as a parent you make mistakes and you live with those and you get involved in your mistakes. Then some of the success … All of that gets so involved that it creates this momentum that I’m talking about that keeps things rolling along. So we’ve been involved in that so much that I hadn’t really thought about anything else. Always in the back of your mind you think about I sure would like to go to South Port and open a practice down there. And then when you think about that alternatively a little bit, as a family physician, when you’ve been here with all this wonderful tertiary care available and at your fingertips and at your beck and call. When you can call someone and deal with them on a first name basis about your patient, that’s the one hard thing, as we reviewed earlier … Is the way it’s grown now, I don’t know anybody. But put me down in South Port and have somebody come in, say, with an acute appendicitis, and I’m thinking about the possibility of their having that surgery there, which is perfunctory, I know, but things can go wrong in that little hospital – it’s scary.\n\nOne of the doctors I talked to was in a very isolated town. I asked him, did you ever kind of worry about all the things that would come in that you might not know about? He said, no, I had this sense of myself that I could just do anything. He said, I had more guts than brains. (Laughter.) He said I’ve learned to, but …\n\nDr. Jones: I’ve had two chances to learn that. One is practicing here, you know. And the other thing is being on that insurance board. I’m on the claims committee, too, and, man, we look at that and you can see the pitfalls of that isolated practice.\n\nWhat about mistakes? I mean I think that’s one of the things that …\n\nDr. Jones: Well, I know and you know that mistakes are a part of the game. I mean if you’re a good doctor, you’re going to run into a situation where you’re going to make a mistake. An honest mistake, we call it. And then when you see honest mistakes, what happens to some people because of those, it’s tragic. I, philosophically, can accept that. But I can understand how some people would have great problems with it.\n\nWhen things would go wrong or things would happen that felt … Whether they were mistakes, at least they felt that way, and sometimes I think there’s a big difference between … Right. How did that affect your practice or your …\n\nDr. Jones: Well, the one thing that you learn in a small community, and that’s where I’m from … Now we’re not, but … Is that if you’re honest and forthright and open with your patients and they understand what you’re trying to do, you can make a mistake and it will be accepted and understood.\n\nBut somehow knowing people in that long term way, that they’re more forgiving in some ways because they see … That’s right. It’s also been my sense that maybe they see us as being more human and less heroic, which I think is always a problem. Because that’s something that I think everybody, as you know, worries about, everybody agonizes about. And particularly doing it in a community where it may be so visible.\n\nDr. Jones: That’s where the rapport with the patient is the cornerstone of half the solution. Because if you have the rapport with the patient and there’s full understanding there … Another little side offshoot of that thing is casual remarks that physicians make that are so damaging. We’ve agonized about that in our insurance board meetings. We have some faculty members on our board. The head of the department of surgery of East Carolina is a member of our board. One of the chiefs of neurosurgery down there is on our board. I mean we have some people with excellent credentials. And so often a casual remark in the ER by a resident, you know, what in the world have they done to you, something like that, will just set a whole chain of reaction off that leads to disaster. Whereas if it had been properly handled … I’m not saying to cover up, but I’m saying just to be fair about it and recognize that you, first of all, when you see a situation you’ve got to be certain that everybody made the wrong decisions that you think were made at the wrong or right time. But a casual remark like that can do such great harm.\n\nIs your sense that there were fewer of those kinds of remarks and fewer of those situations years ago when everybody really knew each other?\n\nDr. Jones: Right, I think so. I think so, very definitely.\n\nAnd you probably realized the potential consequences because you knew the person?\n\nDr. Jones: Oh, I can remember when I was a medical student, the disregard, the low esteem that was apparent in some of my classes I had for the LEMD. On the other hand, there were those who respected and admired and appreciated what they did. \n\nThe issue also comes up for me, at least the way to put it would be why have you been able to do what you’ve been able to do for as long as you have and what’s kept you going with this?\n\nDr. Jones: Well, first of all, I have to do it. I wasn’t able to get far ahead enough ahead to even think about planning a retirement, you know. I suppose if I worked at it, if I had to, if I became ill or something like that, I could do it. But through the years I’ve managed to stay involved in enough things that kept me interested and stimulated me to go along. And the give and take with patients on a day-to-day basis has been very rewarding.\n\nAnd that’s been the thing that when you get tired or you say, well, I don’t know, that’s what keeps you going?\n\nDr. Jones: That’s what does it. \n\nDr. Jones’ wife: He’s very business-minded. He always has been. That’s something I guess I had not appreciated quite as much as -- … You know, he was chairman of the school board for several years. And at a particularly interesting time.\n\nAre there things that we haven’t touched on that you think would be important for me to hear?\n\nDr. Jones: Well, one thing that helped me tremendously from the beginning has been the support of my family and Salisbury always supported me. Even though you didn’t get back there? I didn’t get back there but it was automatically just understood that I was going to be able to go to college and they were behind me 100% in that. And whenever we got ready to do anything, they were willing to be very supportive. That’s why I‘ve always felt I had to be supportive of other people and to give something for what I was receiving. In a nutshell, I guess that’s where it all started. And that’s a quality, I’m sure … If you had a question, to get a potential medical student’s, to find out to what degree they believe that, then that would probably be the only question we needed to ask them, so … Yeah, that’s right. That’s the most interesting thing about medical school admissions process, was with all the tests and everything, they have finally been able to identify those students who will succeed in the first three years in medical school and that’s it. I mean you can’t identify on whether they’re going to be a good doctor. We still can’t do that. It’s a guesswork and it’s a matter, I think, of feel when you get there. I used to talk in the committee meetings about a diamond in the rough. You see somebody, some man or woman who just seemed to be not the type, so-to-speak, but something there was identifiable, to me, at least, that indicated they had a yen to do it the right way. That’s right, it’s so hard to tell. I have a hard time doing that with people who have already been through medical school and we’ve got lots of information on them and they all want to be family doctors. And it’s hard to … You can also come up with kind of clinker because you just didn’t perceive … \n\nI like the sense of service is one of those that if I had any criteria for somebody who I think would do well in family practice, it would be some sense of obligation. You used that word.\n\nDr. Jones: I think you’re exactly right. MCATs came up with an idea about twelve years ago of trying to identify the black student who would go back to his black rural community and practice. And they somehow came up with\n\nthe idea these were the students who were involved in their church community life very intimately. You know, in the choir and on all the committees and everything and put that foremost in their lives as they were coming up through school and so forth. And they felt that they could identify someone who had been that way with the church back in his community and his roots, that after all this medical school business, he would go back there. This man or woman would want to go back there to practice.\n\nNationally the rural issue still is there. And it’s going to be a bigger problem in five years than it was twenty-five years ago. And the irony for me is when you were around, when general practice was kind of going and family practice hadn’t come around and this whole question of every town in the Midwest advertising for a doctor – and we’re in worse shape five years from now than we’ve been ever …\n\nDr. Jones: -- thought they solved this problem with East Carolina Medical School. And that’s a dismal thing in that respect. It’s been great, don’t misunderstand me, but …\n\nThank you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277825#t=600.0,3717.848"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277824","type":"Canvas","label":{"en":["Media File 2 of 2 - Jones_Kemp_1989.11.28_-_Side_2.mp3"]},"duration":1012.448,"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/3180/collection_resources/150641/file/277824/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277824/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/277/824/original/Jones_Kemp_1989.11.28_-_Side_2.mp3?1750277647","type":"Audio","format":"audio/mpeg","duration":1012.448,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150641/file/277824","metadata":[]}]}],"annotations":[]}]}