{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/wd3pv6dd53/manifest","type":"Manifest","label":{"en":["Dr. Ross R Black II "]},"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":["2007-07-12 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Interview","Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Lindsay Young (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["American Academy of Family Physicians","family medicine","family physicians","Society of Teachers of Family Medicine","Dr. Ross R. Black II"]}},{"label":{"en":["Subject"]},"value":{"en":["Dr. Ross R. Black II (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/150963/file/278395","type":"Canvas","label":{"en":["Media File 1 of 2 - Black_Ross_17_a.wav"]},"duration":3770.9982,"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/150963/file/278395/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150963/file/278395/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/395/original/Black_Ross_17_a.wav?1750874786","type":"Audio","format":"audio/wav","duration":3770.9982,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150963/file/278395","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150963/file/278395/transcript/81411","type":"AnnotationPage","label":{"en":["Dr. Ross Black interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150963/file/278395/transcript/81411/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Tape One, Side One of the oral history with Dr. Ross Black, II, on Thursday, July 12, 2007, recorded by Lindsay Young over the telephone. Can I ask you again if I can record this over the telephone? \n\nIt’s okay that you record this over the telephone.\n\nLet’s start with some basic biographical family data. Would you give your name in full please. .\n\nMy full name is Ross Roland Black II. I go by Ross R. Black II, just plain Ross.\n\nWhat’s your present title? \n\nI don’t have a title…well, there’s an academic title, which is Clinical Professor of the Department of Family Medicine at Northeastern Ohio Universities College of Medicine. Otherwise my title for real life is partner in Millpond Family Physicians.\n\nWhen and where were you born? \n\nI was born in Cleveland, Ohio in 1948.\n\nWhat were your parents’ names? \n\nRoss and Joyce. I was named after my dad.\n\nWhat did your family do for a living? \n\nMy mom was a homemaker and by the time I got to my last year in high school she did work part-time as a secretary at a church for awhile. My dad was an electrician.\n\nAre you married? \n\nI am.\n\nWhat’s your wife’s name? \n\nLinda is my wife. We’ve been married 37 years this August. We met in college.\n\nDo you have children? \n\nWe have two grown boys.\n\nWhat are their names and when and where were they born? \n\nEric was born in Columbus when I was still in med school and Ed was born in Akron when I was in residency. They’re both married and we have five grandkids.\n\nWhat years were they born? \n\nEric was born in 1973 and Ed was born in 1975.\n\nWhere did you grow up? \n\nGrew up in a Cleveland suburb. Southwestern suburb of Cleveland called Parma Heights.\n\nDid you have any role models when you were young? \n\nMostly the role models were work ethic and that kind of stuff from my mom and there were some schoolteachers that were role models.\n\nDid you have any special dreams or goals at that age? \n\nNot really. As a young kid there were somehow or other, some discussions about maybe doing medicine but was never anything that was really long-term talked about. It was just sort of something that came up but I don’t remember even if I’m the one who came up with it or if someone else came up with it. Just something that’s a vague memory from being a kid.\n\nDo you have any other stories you’d like to share about your childhood period? \n\nI’m the third of three kids. Grew up arguing with my brother and hanging out and doing whatever you could and trying to stay out of trouble. Basically it was time well spent in terms of working on the yard or doing stuff with Boy Scouts or doing stuff with music in school.  \n\nDid you play an instrument or sing?   \n\nBoth. Played the trombone.\n\nWhere did you go to high school? You said you had some teachers that were inspiring. \n\nParma school system, which is a suburb of Cleveland and went to Valley Forge High School. Basically had the opportunity to watch my sister and brother go through a couple years before myself. My sister is three years older than I am, my brother is one year older than I am. I watched them do a little bit of stuff and took some lessons from what they did but basically went there and didn’t have any study halls because I was taking all the classes that were science and math and all the other kinds of things you could do along with whenever you had spare time you were doing a music thing.\n\nAny other stories from your high school you’d like to talk about? \n\nGot involved in a lot of scouting activities also. Was on the wrestling team and enjoyed doing that kind of stuff but otherwise it was just enjoying life, it wasn’t making any plans. Looking at college and all that other kind of stuff was like, what am I going to do and where am I going to go? I’m not sure what I want to do. I looked at places where my sister had looked and looked where my sister and brother were in college and said, well, let me try some other places. There were a couple of teachers from high school who had gone to Muskingum College and I thought, they’re nice people so I’ll look there. So I wound up going to Muskingum College for lots of no specific reasons.\n\nWhat did you major in there? \n\nMajored in Biology. Back in the old, old days and in a small little school like that there were 1,400 students in the whole place when I started. You didn’t have to declare until sometime in your sophomore year and I basically went there saying, I’m taking a lot of science and math and I’m not sure why but I know I’ve always done that and I’m not sure what I’m going to do with it and I really don’t know what I’m going to do with my life. Tried to do some music things on the side and some other things, didn’t have any time for some of them. Participated in some college plays just because it was something different to do. It was in a small little town of about 2,000 people out in the middle of a cow field in southeastern Ohio. You couldn’t have a car and there was no alcohol on campus so you did everything pretty much on campus. It was just enjoying life until you said, okay, what do you want to do with life? I had good opportunity with math and good opportunity with science but as my wife says, I was getting A’s in Chemistry and A’s in Math and I got a B in Biology so I picked Biology to major in because I wanted to prove I could do better. That was it. Finished at Muskingum and had a good time going there and doing all kinds of different things in the honors society in high school and in college. That was kind of fun. Then I said, I think I want to do medicine but I’m not really sure what that means because nobody in my family did medicine. At the end of my sophomore year I took a job as an orderly in a hospital and said, oh yeah, I like this so went back to college and said, okay, now I know what I want to do, I think. Went back and did an orderly thing the following summer and said, I really like this. Instead of applying to colleges, at the end of my junior year, for med school. They said, what’s your hurry? Because I want to go. Anyway, graduated in four years and got accepted to med school.\n\nHow did you get into family medicine? \n\nI went to Ohio State for med school and was going through all the kind of stuff there and experiencing all the different things you do and talked about, maybe I’d like to be like my family doc back home who was an old GP who had lots of good experiences and related pretty well to me as a kid. I didn’t have a close personal relationship with the guy, I never saw him unless I was sick. There was no specific preventive care that was done back in the ‘50s. Rotating through the various things and dealing with it was like, okay, I like surgery but I really don’t want to stand around and do surgery all day and I like delivering babies but I don’t want to do that all day. I like taking care of kids but I hate having to take care of sick kids all the time, I want to take care of well kids and I like some psychiatry but I got really tired of psychiatry or taking care of, my perception or my experience was, pretty much people who were really crazy or depressed housewives. When I was back in med school, that’s all the old people that were in the hospital. I said, I really think what I want to do is just family medicine because then I can relate to people. We also had the opportunity to spend time in people’s offices and I spent some time in some family doc offices and pediatrician offices and said, doing the family doc thing and that’s what I want to do.\n\nDo you have any other stories from your medical school training you’d like to talk about? \n\nThere were a ton of people and being a student you never are quite sure of what’s happening and the lowly student, as most students remember, you’re kind of in the middle of strange campuses and different settings and this was obviously a very, very large kind of get lost setting at Ohio State. But having the exposure to some really highly-renowned, world-renowned people like Robert Zollinger, who founded or discovered the Z-E Syndrome or some other kinds of things like that or some other opportunities where I made a diagnosis on somebody that nobody else could make and I just figured it out as a student because you go back to the basics of asking the right kind of questions. Those are neat kind of questions to get involved in. During that whole time Linda was a schoolteacher and we didn’t have a whole lot of money so I was moonlighting while I was a medical student, working, doing all the things I could do. I worked in the morgue and had all kinds of wonderful experiences in the morgue, learning anatomy and learning some pathology. Then she got pregnant during my last year in med school and at that time you couldn’t teach and be pregnant so I was moonlighting and selling my blood and doing research projects and whatever I could do on the side to make money so we could have some money to live off of. When I graduated from med school we had about $200 left to our name. The days of being poor. Linda, as a schoolteacher, had her purse stolen one day at school and they took $20, which was our whole week’s worth of groceries then. Popcorn made a good dinner for awhile.\n\nWhere did you do your residency? \n\nDid my residency in Akron at Akron City Hospital. The traveling tour of visiting people and doing different things, there were hospitals that would come around to the med school a little bit at that time and try and recruit people and trying to figure out what hospitals are like and what places you might want to go. Being very early on in the system of family medicine back in 1972, I wasn’t really sure what was going on in the world and so here we were in 1972 and I’m interviewing, I’m looking different places about possibly going to residency and not even sure what that all meant. Got exposed to some people from Akron City that talked about it and I’m looking about where Akron would be and my wife is from Cincinnati and that’s close to Cleveland but it’s not in Cleveland and there are no other places around so where do we go? We actually took three weeks off of med school for vacation and went around and for our vacation we traveled around the country visiting residency programs, what they were like and visited different places. Went to Rochester and went to Akron and went to places in Michigan at Michigan State at Sparrow Hospital. Went over to Minnesota and saw the hospitals and stuff up there. Came down to Dayton, Ohio and also went over to Indiana and saw a couple programs in Indiana to kind of get a feel for where different things were and what different opportunities were but also within the geographic region that I thought we wanted to be for family issues. Wound up at Akron City.\n\nDo you have any stories from your years when you actually were a resident that you want to talk about? \n\nMoonlighting and being a resident and working a lot and studying a lot and I would take my vacation time and I had a great experience where I would work in doctors’ offices for my vacation, I would cover their practice. Again, we had no money and now we had a second kid on the way so moonlighting in a doctor’s office was a great way to get exposure to what it was like in the real world of family medicine, not just working in the model family practice unit, as it was called at that time. So it was a good way to really see whether you had what it took to be a physician and where you wanted to go and how you wanted to do it. I also had signed up with the Navy when I was in med school because this whole thing with Vietnam and stuff was going on and as I was a med student I was watching half of the interns get drafted after their internship year. I said, no, I don’t want to do that so I signed up with the Navy in what’s called the Berry Program, named after one of the congresspersons who organized a mechanism to allow the military to get people to come in after some professional training. Signed up with that and somewhere between moving from Columbus to Akron the paperwork got all lost so I’m nearing the end of my internship and I suddenly get papers that say I’m going to be going to active duty as a physician in the Navy at the end of my internship year. I had just been to a meeting of family physicians across the country that we’ll get to a little bit later and met all kinds of people, including one Robert Higgins and a few others and was able to get a lot of support from congressmen and senators and whatever and went to the Navy and basically said, I never got the information that said I’m supposed to ask for deferral until I complete my residency program and I’d like to do that. They said, you didn’t apply for it. I said, well I never got it. That’s when I figured out they didn’t forward the mail. So I was able to get the deferral until the end of my full three-year period of time. Then I used the same contacts and said, where do I go and how do I think and wound up in the Navy and was stationed in Pensacola at a teaching program there. Half my time was in teaching, half my time was in patient care and we had a good couple years of experience in Pensacola, Florida.\n\nWas that the only place you were located during the Navy? \n\nYes.\n\nDid being in a military setting affect your outlook or your way of practicing or anything? \n\nNot really. It was interesting. In Pensacola there were a lot of retirees who were there so I got exposed to a lot of geriatric patients but at the same time, there were a lot of people who were in the military who were saying, we’re tired of going to the general medical clinic or seeing a different doctor every time we go in because you never know who you’re going to see when you see these things and also the fact of having a family practice center there, the military people loved having the ability to see the same doctor, them and their family all the time. They really enjoyed that, rather than going to different people. As part of that, I had a lot of the military people, their care was free but if you give them attention and take care of their needs and stuff, they go out of their way so I had a young Filipino family ask us over to their house and they made lumpia, which is basically their ethnic form of egg rolls and gave us tons of that kind of stuff. The retired Air Force colonel came over to the house and showed us how to prepare shrimp and freeze it so we could keep it for later on. I had a family who had a daughter who was retarded with Down Syndrome, spent some time dealing in the community with mental health issues. She made me a quilt and that kind of stuff so there were a lot of close, personal things that occurred because of the opportunity of something different that they didn’t always experience in a usual military activity. I’m not sure it tainted me, other than saying people really, regardless of where they are and where they come from, they really respond well when you give them the attention that they need and make it personal at their level.\n\nWould you say overall it was a positive or a negative experience? \n\nIt was very positive.\n\nWhile you were a resident did you become involved in the AAFP then? \n\nYes.\n\nHow did you become involved and what did you do? \n\nThe Ohio Academy had a lot of action and support with residency programs and it was a group of third-year residents that went off to a meeting that the Academy organized in January of 1974 and that was in response to the American Academy’s meeting in Denver in 1973. They came back from the meeting and said, we need people to…and I couldn’t go to the Ohio Academy meeting in January and they said, we need people to be able to go to another meeting that might be available in Kansas City sometime in April and all the third-years are saying, that shouldn’t be us because we’re leaving, we’re going on to practice, it shouldn’t be us, it should be somebody left in the residency program. They turned around and picked people who might be available in April and have an interest and there was one second-year and one first-year, myself that got the chance to go from our residency program that the program director said go, go to the meeting, take the time to go do it. Again, you had to have the support of the hospital and the program director to be able to go to those things. Got involved with both the Ohio and the American Academy then at the early end of my first year and early second-year residency, just kind of get exposed to what the world is outside of my own residency program. It was really eye opening. The activity in Ohio, at least I got to be on different kind of committees and meet with other people around the state and write articles for their newsletter and participate in their annual meetings and be a delegate to their meeting and all that other kind of stuff for a couple of years.\n\nWhat was the world of medicine and specifically, family medicine like when you were finished with your residency? \n\nMost family docs at that time could go anywhere they wanted to go. There were still a significant number of them who were setting up in solo practice at that time, back in 1976. A lot of them were saying, I don’t really want to do that. I want to join up with somebody so they were looking for other family physicians who had been in practice for awhile who had a practice they could join, not necessarily take over but join, or who would be in a setting that would be helpful for them. The concerns were, will I be having problems getting privileges? Will I be guaranteed to have privileges? There were a lot of arguments back at that time about who will be able to have CCU and ICU privileges, not delivery privileges so much. Or will we be able to have pediatric privileges because some of the pediatric hospitals were limiting who was going to give privileges at various locations. Those were the bigger issues about what’s going to do and how you’re going to be able to do things, not liabilities issues. The other thing was, what am I going to do when I get out and how am I going to take care of these things and who are my consultants going to be and where am I going to work and what comfort am I going to have and what’s my family going to be like? So that was the world of family medicine back then. Privileges.\n\nWhat was your first position out of medical school? \n\nWent to the Navy.\n\nWhen you came back from the Navy? \n\nWhen I left the Navy after two years I was thinking about joining a practice with a guy who’d been in training with me and actually had gotten down to some final issues, I was talking with him. I’d also talked about whether or not to return to a residency program and work there, then I got a call from Dan Ostergaard of Kansas City. By this time I’d been involved as a Delegate to the American Academy for three years as a resident and kept involved with them through the Residency Assistance Program afterwards. They were looking for somebody to come there and work so in 1978 when I left the military I wound up going to the Academy and working there for three years. Dan Ostergaard was the Assistant Director to the Division of Education and he left to go to Duluth, Minnesota to run a residency program up there. So I took that position for the next three years. While I was in Kansas City, it was like a fellowship. It was like a teaching fellowship that a lot of people would do because I did a lot of stuff with the residency programs and student programs around the country. They had a clandestine meeting in New York City with a bunch of medical students who were in medical schools in New York City and weren’t getting any support from anybody in their own institutions and there was sort of a local group of family docs who had this clandestine meeting where we got together and talked to them about family medicine. Went to Louisiana and talked to residents and students from around the state. Went to Michigan and they had a big meeting. They always have at their annual meeting, students and residents and there were about 300 people there, talked to them about the world of family medicine. Got to go to the World Medical Association Meeting in Caracas, Venezuela because Tom Stern was sick and couldn’t go so I got to go there and give a talk. Some great experiences like that.  \n\nI wasn’t sure that I wanted to lose my clinical experience so I spent some time down at University of Kansas and precepted students down there and residents down there every other week or so. I wasn’t sure about just those experiences because I only had two years out of residency, what do I really know? I moonlighted in a couple of hospitals. Did that when I was in the Navy too, I kept moonlighting when I was in the Navy. You still got bills to pay. So I did some moonlighting when I was working in Kansas City, worked in ERs in Kansas City. Kept some of my clinical skills up. So that was three years of great experience of learning about education, learning about educational criteria, learning about residency program coordination and running and activities and going to the Residency Review Committee and sitting in with the RAP program and that kind of stuff too.\n\nWhy did you eventually leave that position? \n\nI wasn’t sure I wanted to do administrative medicine all my life and I thought, okay, I’d learned a lot and I wanted to get back to a situation where I could do teaching and practice and so I looked for places that would allow me to do both and again, in 1981, as I left, there were a lot of programs around that had faculties that were doing pretty much nothing but teaching and administrative work. They would do very, very little practice. I didn’t want a university program because I’m not the research brain guy. I wound up back in Akron because it was one of three places that I saw that I looked at and interviewed that allowed me to have a significant amount of practice and still do the teaching and very little administration stuff. It’s the opposite of most people. Most people go into practice and after 20 years leave and go into teaching programs. I’m the reverse of most.\n\nDo you know why? Why were you interested in the practice and the teaching rather than the administrative? \n\nI didn’t want to lose the contact with patients. Administration is not a problem, I don’t have a problem with that but even when I was with the Academy as an administrator, when someone would say, I have this problem and I’d have to ask them what’s going on and I would try to deal with it. There was a lady there by the name of Betty who worked in the printing department and she was one of the first people I remember in 1979 or 1980 who was going to have cataract surgery and we were talking about doing lens implants, which was totally new back then. For other people who would have health problems or other kinds of stuff and I would talk to them about their health problems and I found that it’s that personal relationship that I couldn’t get away from and that I really enjoy. So when I looked at a residency program I wanted to be able to maintain some of that because that’s probably what I do best.\n\nThroughout your career, what unique challenges did you face or what barriers or obstacles did you come across? \n\nI’m probably my biggest challenge because I don’t shut up enough. The other thing is, I’m not sure there were barriers and challenges, it was more people encouraged me to try things and do things and deal with things and it was my own feeling of, I’m not sure I’m ready to do that yet, I’m still learning from other people. The concept of you’re here to learn something as you go through all of your life and school is usually, you’re learning something from somebody else and okay, let me try and do it in that way. It doesn’t always have to be that way, sometimes you do it your own way. But to be able, as a young kid, to feel comfortable doing it your own way or to step out of the routine or the norm or to try something totally different is not always easy when you’re a youngster. It’s the same thing of also saying, when we deal with our patients, analyzing the problem and trying to come up with, what does it really mean and how to answer, learning how to ask the right question, which in research and other places it’s the process of what is it that you’re really trying to learn, what are you really trying to know? In the education it’s the same thing, what is it we think we want them to learn? Why is it we want them to learn that and how do we get them to learn it? Not how do I teach it, how do I get them to learn it. The challenge of doing that was, not everybody was ready for that. A lot of the students and residents were, teach me what I’m supposed to know. Not, help me understand how I’m supposed to learn.\n\nOn the idea of learning, how did you learn what you needed as you were going along, to do what you needed to do in your work? \n\nProbably from what used to be called the school of hard knocks. Try something and see how it works and watch people do some things and think about, am I comfortable in doing it in that way and what is it they’re doing and why are they doing that and is that getting the best result? It’s sitting back and watching, as well as trying something and then being able to make change when it needs to be made.\n\nWhat was it like practicing while you were also teaching? \n\nI enjoyed that. The challenge was that the residents want your time and the patients want your time so there was no time. You had to make time for the residents so they would have their own personal time and also then you could do the patient care kind of time stuff and trying to help the residents to understand how to pay attention to the patients’ needs and to learn what it is the patients need. It was a good experience but again, as time went by, it became more and more apparent that residency programs and the hospitals were more accustomed to saying, well, we need you to do more administration and more teaching and less patient care. At that point in time I said, I can’t do that, I really need to do more patient care. So after seven years I left the residency program and went into a practice.\n\nDid you have more time when you were strictly doing practicing? \n\nI did, but also as my kids were growing up, if I want to take a Thursday afternoon and go watch their football game or their soccer game or if I would need to leave an hour early, when you’re at the residency program I couldn’t do that because I had other responsibilities or it was my afternoon to teach so I would try and switch with somebody, well, I couldn’t switch because they were with patients or it was their afternoon off or whatever. When I was in practice I could say, I need to be out of here by 3:30 and you can do that. So you can say, I need to be out by 3:30 and you just go. You can handle things by phone call or you can do other kinds of things to make sure things are okay and say, I just need to be gone by 3:30 today. It’s much easier to handle that when you’re in practice.\n\nIs that what you’re still doing now? \n\nI still am. I still have some students and residents come through here. I used to do some teaching in the hospital when they had a hospital service and over a month, would spend a couple hours in X-ray every day to spend some time rotating with the residents but they don’t have a teaching service anymore so I don’t do that. I had to stop delivering babies four years ago because of the liability cost issues so that was my other exposure to both family medicine and the OB residents to be involved with the deliveries so I’m not doing that anymore but still doing all the practice things. I also was a medical director for a nursing home for about twelve years so I got to do a bunch of that kind of stuff and be involved with some of the residents from that standpoint and with time and efforts and changes of life, I had to drop that also.\n\nWhen were you doing that? \n\nI did that from 1989 until 2001.\n\nOf all the different kinds of things that you’ve done, what’s been your favorite? \n\nPatient care, working in the office, taking care of patients.\n\nCan I guess that your least favorite had to do with administrative things or is it something else? \n\nAdministration wasn’t my least favorite.  \n\nWhat was your least favorite?\n\nI’m not sure there was a least favorite. It wasn’t as favorite as patient care. I enjoyed some of the administration because the issue of administration, likewise was, asking a question and get other people to make change. Probably the least favorite, in that it’s tough in an administrative environment to get change made. There are so many people who are used to the same routine issues, to get something to be done in a different manner is sometimes difficult.\n\nIn 1998 you were awarded the Ohio Family Physician of the Year Award and you were a finalist for the AAFP Family Physician of the Year Award in 1999. What sort of criteria is involved in those awards and then how did you feel when you won the Ohio award? \n\nDepends on who you pay. I’m not sure exactly what the listed criteria but primarily they’re looking for people who have done a lot of work and activity on behalf of their patients and in their community. So I got nominated from some people within Ohio for that. I was working in a free clinic, doing the stuff with the residency program, had been picked as a Teacher of the Year from the residents a couple of different times when I was in practice, had continued working with the local mental health society as well as years of activities within the state and national family medicine stuff so they just picked me that year. It all added up. Probably not a good year to do it because I was also elected to the Academy Board that year and the interesting thing is, it kind of raised some kind of major crisis because then as I got nominated for the national [award] it was like, well yeah, you really can’t pick somebody who’s on your Board because that wouldn’t look very good. On the other hand, when you look at the criteria or if you look at some of the people who have done other things and those who were awarded other things you kind of wonder how you even got nominated in the first place because some of those people who do some major community activities and involvement in supporting many of the people in their community, it’s like ooh, I’m surprised I’m even considered part of this group.\n\nYou also received the Summa Health System Family Physician of the Year Award in 2000 and Summa Outstanding Physician of the Year in 2001. What went into those awards? \n\nThat’s the city where I trained and then I taught, became as Summa Health System, that’s the same location. The Department of Family Medicine has an award they give every year to someone within the department who has been outstanding and so after four or five years they bring it out, they look around and say well, okay, he qualifies. It again, was probably because there were so many other activities I had been involved in and been on the staff for so many years and involved in the community activities. The other thing was, one was a department award, the other was an Outstanding Physician Award and that’s done more by the medical staff, where they give an award or two every year, looking at staff who give quality care to their patients and who have received outside recognition outside of the institution and are involved in the community.\n\nHow did you find time to do all those things? \n\nBy that time, by 1998 our last kid graduated from college so you do it when the kids are around and when they’re off in college, Linda says, you were home doing stuff with the kids, now the kids aren’t there so now you’re doing something else. Part of the community activities, Linda and I were very involved in our church and still are. One of the other things we did, even when the kids were at home is that we did some things where they do a youth work camp program with a national organization out of Loveland, Colorado called Group Incorporated. Work camp is where 350 high school kids and 50 adults go to some community and fix up homes and repair homes of the underprivileged. We’ve been doing that for ten or fifteen years so you have spare time because you take your vacation time to do that kind of stuff. That’s vacation time for us. As you say, in my spare time, and to go back to the first question about work ethic and what you do with your life and how you do it, that’s the stuff that mom and dad did and they were always involved as youth directors or working with kids or Boy Scouts or something else and it’s the kind of thing you did in your life.\n\nDo you find that a lot more rewarding than going on a normal kind of vacation? \n\nIt’s different. We went on vacations sometimes but sometimes on vacation we would go see family so if we did a vacation with the kids, it was as they were getting near the end of their high school year and we would take a vacation and do something with them but it would be a fun thing that would be a memorable kind of exposure. It wasn’t always something just to go relax someplace.\n\nDid you travel much within your career? If so, do you have any travel stories you want to share? \n\nWith the various committee and commission meetings and the activities of life within working with the Academy or being on some of their Board meetings or their commission/committees, sometimes I would travel with Linda. Also, when I was working with the Academy I was also on several committees for the Society of Teachers so I would go with their meetings. We went to Boston with the kids and did the Paul Revere walk and went to San Diego in May and had to wear sweatshirts and stuff walking around because it was so cold. Went to Orlando for a Society of Teachers meeting and took the parents, it was payback time. Flew my parents down to Orlando and paid for their time and their experience down there. It was a nice family time. I was in a meeting periodically when I needed to be there and the rest of the time was with the family but it was good family time. One of the memorable trips of life was when the kids were young and Linda would stay home and I went to a committee meeting, I’d usually leave late Friday afternoon and fly out late at night and get to town and then have the meeting all Saturday and Sunday morning and I’d fly back home and go back to work on Monday morning. One Friday afternoon I got to Cleveland a little bit early and was waiting for my flight to leave and it got postponed and I had to get out to Monterey, California or wherever the meeting was, someplace out there. Wound up getting bumped from one flight to another and finally flew into Chicago and got to Chicago and ran over and got on another plane and I’m sitting on the plane and they stuck me in first class because of all the changes that were going on. I’m sitting there and suddenly the pilot comes up and kneels down in front of this person sitting next to me and asks for their autograph. It’s kind of weird and all the stewardesses are kind of kowtowing to this person. It was Julia Child and she was on the wrong plane. She had a Delta ticket and didn’t know it and got on an American Airlines plane and they didn’t care, they checked her ticket and they were just happy to see her. So we’re sitting there and of course we were flying out and they were throwing food at us, I’m thinking, this has got to be absolutely the worst thing in the world is to try and feed Julia Child airplane food. I didn’t want to invade her life so I turned to her and I said, “This has to be quite different for you, eating this.” And she said, “Oh, you just make do,.” in her own little way in her voice. Then they started showing the movie. The movie was Driving Miss Daisy and I’d never seen the movie before and here’s this old lady who’s dying on this movie and immediately I’m going, how would you like to be 83 years old, watching this movie, sitting on a plane, thinking about your own life? I turned and looked at her and she said, “Quite maudlin, wasn’t it?” That was the sum and substance of our conversation but one of those experiences on a plane, on a trip that’s just weird.\n\nBack at your time being a director of the residency program, do you know why your program was originally selected to be a family practice program? \n\nThe first few were started, there were pilot programs back in the mid ‘60s and then there were a group of others that started in 1969 and this one finally went through all the stuff. Actually there were two in Akron at that time, in this little town of Akron that started at the same time and got approved and started in 1970. The group of family doctors, both institutions, basically said, we want to do that because we need to train more family docs. One guy left his practice in both places and brought his practice to the hospital to be the focus for the patients, for the residency program. It was support of the hospital to train more family doctors and support of the community family docs to get more people there.\n\nHow has that grown since it first got started? \n\nBoth programs, the one I was at when I went there, still in existence. It went up to 6-6-6 program. It was originally 4-4-4 and then it was 5-5-5, now it’s 6-6-6. Continues to do very well in training people. Has gone through all the changes of OB stuff and dealing with international medical graduates or trying to be involved in what’s happening in the area, involved in the development and starting of a medical school in the local area and involved in medical student education as well as just resident education. Those are the changes that they go through.\n\nYou’re focused so much on the patients. Which sorts of patients did you treat in your program? Who were, where did they come from? \n\nAgain, most of them came originally from the practice of Ed Shahady who started the program, who’s program director. A lot of them were from immediately local surrounding community areas, people who didn’t have a doc would often come in there. Some of them were from the Medicaid population or the indigent population but not all of them. A lot of them were happy with coming there and continued to stay there. Eighty percent of my patients came with me.\n\nHow was the program financed? \n\nPrimarily through the hospital. There was no medical school in the area at the time and there were no state funding programs at the time so primarily through the hospital. They didn’t have any federal grants, they didn’t have anything else so the hospital just made a commitment to continue to support the residency program. They didn’t have a big foundation supporting it or anything like a lot of programs. And the hospital always had medical education as a major component of the process within the hospital.\n\nWhat was it like coming back to the same program that you attended as a resident? \n\nI told you about the administration not making change easily. It was like that. Had all these wonderful experiences and new ideas and there were some people who didn’t want to hear about them or said, this is the way we’ve done it all the time, why would you want to change? So there’s some of that but it was also different in that I was now the teacher, not just a patient caregiver. The interesting thing is, there were still some people there that I had seen as their physician as a resident, so then came back to see me again. Some of them I still see and their family members. Some of these people I’ve been seeing for 30 years, off and on. The difference was, I think it would have been tougher if I’d just come right out of residency and done it but having been in the Navy and done it for awhile and been in the Academy and done it for awhile and having been away for awhile, you were like the expert, you came in from another place, or at least you had some alternative experience when you came back.\n\nDid you run into any surprises coming back, other than that people wouldn’t change, which you might have already guessed? \n\nNo real surprises. Nothing really surprising. The issues of dealing with other specialists in the hospital or dealing with other things or dealing with residents who were beginning to say, I don’t know that I want to work that hard. The other thing was, residents who would say, I don’t want to learn that because I’m not going to do that when I get out in practice. Excuse me, but that’s not your option, it’s the curriculum you’re supposed to learn. Well I’m never going to do that in practice, why should I learn that now? My analogy is, so, we should never teach English and Math because you’re never going to use them again in your life? I don’t understand that. Those were frustrations.\n\nWhat would you say was the toughest decision you had to make about the program? \n\nLeaving the program was tough but the tough part of it was not because I was going to do something I wasn’t sure about. The tough thing was, the time commitment was uncertain when I left to go to practice and also, the other tough thing was from a financial standpoint. I was well-paid and I had good benefits and I had a retirement program and I could stay there and be comfortable and grow with it and just relax and change my ways. I wasn’t sure I wanted to do that so it was not an easy choice to make.\n\nWhat would you say was your biggest satisfaction from working with the residency program? \n\nOther than the patients, the satisfaction was working with the students and residents and trying to help them understand the meaning of learning and also the importance of the Academy and the specialty. Those are things I love doing anyway.\n\nIf you could start all over again and do things differently, would you change anything? \n\nProbably not. Would I have not gone to teach? No, it was a great experience. Would I have picked someplace other than Akron to come back to? Maybe. My wife would probably say yes. She was concerned that I was coming back just to come back. She was concerned that we didn’t look at an alternative experience. The other place I would have gone would probably have been Virginia and that would have been a different experience and had an alternative opportunity. Again, it would have been unknown so do I regret not going there? No. Would I have done it differently? I have no clue. I know what I’ve experienced and I don’t regret it so could I have made a different choice? Sure. What would it have been like? No clue. [    ], no clue. Probably I would have made the best of it. Would I still be there? No clue. And that doesn’t bother me because again, who knows?\n\nYou said your biggest satisfaction besides the patients came from working with the students. Then you were awarded the Educator of the Year Award in 1991 and 1994. What goes into winning that sort of award? \n\nThat again, was from the residents and that came both from when I was in practice and after having left the residency program. That came because of the OB where I was not just delivering but also helping to supervise their deliveries and also the inpatient service and doing the rotations on the inpatient service and trying to bring them some clinical relevance. None of the other faculty at the residency program had any, other than practice within the center itself, had any practical experience so being exposed to other physicians within the community who would be part of their teaching program was pretty important. So tried to help them look at things from a practical standpoint and still from an educational and experiential standpoint was I think important to them.\n\nYou were also involved with the Northeast Ohio University College and you said the University of Kansas. How did you compare the different experiences? \n\nAt the University of Kansas, that was when I was with the Academy so it was one half-day every other week or so I’d go down and basically be a preceptor with the residents and that was about it. So you’d sit in the residency program and be a preceptor with the residents who were trying to deal with what they were doing. You come, both when I was on the faculty of the residency program and afterwards, my involvement with students and residents was such that…the involvement with students was that I’d go out and give a lecture now and again or help them with physical diagnosis skills. I’ll have them in the office for a half day at a time or for a month at a time and so they’ll kind of get a different feel for practical applications of what they’re learning. That’s kind of a fun thing to watch a little light bulb go off in their head when they see how the puzzle fits together.\n\nYou also go the NEOUCOM Outstanding Volunteer Faculty in 2003 and then you had a family practice scholarship named in your honor in 2004. How did you feel receiving those awards? \n\nThe first one was something where students and faculty would say, let’s recognize some of the community docs who are involved in some of the teaching. That was an honor that again, comes from just the experience of working with some really neat kids and having a great experience with them. I was pleased with that. The later is sort of like, when I was in the military I had a patient who sent a letter to the Admiral saying, they really appreciated what I’d done. So I got called to the Admiral’s office one day and I was like, what did I do wrong? I got there and I get a handshake and a certificate and as the warrant officer said to me, “That’s called an atta boy.” So I got an atta boy when I was in the Navy. You get an atta boy from your patients when they look at you and when they touch your hand and when they touch theirs and they cry on your shoulder or you give them a hug and they give you a hug back or when it’s childbirth or when it’s their death or their family or when you go through a wonderful time or a difficult time and you get that on a moment-to-moment. This is a family that I’ve been involved with for over 20 years and they made a donation to the medical school and asked that a scholarship for students who are interested in family medicine be started and that it be named in my honor. They made a contribution to the foundation of the medical school and the medical school gets to award whatever it is, $1500 every year to a student and I’m asked to be on the selection committee, along with a couple of other people. That was a huge honor. There’s nothing better than that, other than the day-to-day stuff that I get from the patients. That’s people saying, thanks for doing what you’re doing and we want to replicate you. It’s sort of like saying, we’d like to clone you. That’s just huge.\n\nThe American Academy of Family Physicians seems to have focused on the development of residents and student leadership through various steps, such as having voting residents and students in the Congress of Delegates and having residents and students on committees and commissions and on the Board. Why do you think the Academy did this and what do you think has been the outcome of that investment? \n\nWhen I was working for the Academy and when I was involved in doing stuff as a resident I kind of went back into some historical documents. Back in the ‘60s, a medical student group from the AMA had students that were sometimes placed on Academy committees or invited to come to Academy meetings. There were actually some motions made and brought to the Congress of Delegates back in the ‘60s by Kentucky and a few other states where they said, we need to have students on all of our committees because we need to expose them to our life as general practitioners. That was back in the ‘60s so there was this longstanding tradition of the Academy of doing things. Then in 1971, 1972, Tom Stern left as program director of the Santa Monica program out in California and came to the Academy and one of this pushes was to get residents and students involved in the Academy at this level. With him and then Jim Price, who was a good friend of his, who was the President of the Academy. In 1973 they had a meeting out in Denver at the Academy meeting where they tried to get people to bring residents to the annual meeting, which led to the first meeting I went to the following April and other stuff. This longstanding tradition and then there’s a push by the Academy to say look, you can’t start too early and it’s not about the Academy, it’s about the specialty. And it’s not just about the specialty, it’s about what the specialty means to our country and to our patients, to look at things from that perspective. It’s meant that the Academy has been able to pass on the tradition. It’s been able to pass forward or pay forward the things that have been given to all of us over our time and to share that news. It’s sort of like the old storyteller sitting around the campfire, how stories get passed on, you pass them on to the next storyteller. The Academy doing this, it’s been able to do the same thing. All the members of the Family have done that and having a resident on the Society of Teachers of Family Medicine and having involvement within residents in different levels of the RRC and other activities also, to try and get people to bring along the new generation and expose them to things rather than everybody saying, what’s that thing over there? It’s like, join us now and get involved. And it’s also been, we’ll help you grow into that position. We’ll help you to develop, we’ll help you to understand what your needs are and we’ll help you look at things from a different kind of standpoint. We don’t want to just bring you here and train you what the right answer is, we want to bring you in, listen to what you have to say.\n\nYou talked about some various roles you’ve had with the AAFP, what duties went along with that. Were there any other involvements that you haven’t discussed yet? \n\nWhen I worked there, the other thing I did was [    ] Society of Teachers because there are so many things between the Academy and the Society of Teachers that were done and the RAP program and other activities with all of that that went on. No, those were pretty much covered with all those duties and responsibilities there.\n\nWhat do you feel you were able to accomplish working for the AAFP and what are you most proud of accomplishing? \n\nSpeaking out on behalf of my patients. Bringing that feeling of history and longevity. I remember putting together some of the information about the alphabet soup of life so the residents and students that came to the NCFPR and NCSM and trying to help them understand the interrelationships of so many things that are being done. I think I’ve brought some of that old world knowledge with the new world concept. Also, I’ve been able to, because of that involvement, back in my own state and within my own community, help to keep people apprised of what’s happening on a national front because it’s not just going to the Academy and bringing them information about what’s going on here but almost more importantly, taking what’s going on other places around the country and bringing it back. Bringing it back to the community of people saying look, you need to be aware of these things, this is what’s happening. We’re looking about privileges or we’re looking about liability problems or we’re looking about legislative issues, we need to be making a big step about that here and not wait for somebody to hand it to us.\n\nWhat people did you work with within the organization most closely and what was your impression of those people? \n\nBack when I was a resident, Bob Higgins, Tom Stern, Bob Graham when he first was working with the Academy back in 1974. A lot of very involved people from many areas across the country, both educators and non-educators that brought a personal perspective but also a unique vigor and energy, most of whom were old general practitioners and who had been willing to make a change and look forward and be willing to look at things as they moved forward. Rosie [Sweeney] and some of the other staff people who are so actively involved in Washington DC and are so acutely aware of all the details that we have to do there. The international flavor that Dan Ostergaard brings and his awareness and lookout for people who may be underprivileged and looking at things from that standpoint. Tom Stern also brought in some Latin American issues and helped to keep us involved in the WONCA program and help us relate to all the things that are going on, just not within our country but across the world. Hugh Mayo, from Virginia, had an extremely great way of sending across ideas and stimulating people and getting them to think, getting them to understand. People from across the country who were execs in various levels of their state chapter who helped those state chapters make leaps and bounds and deal with them. Art Schilling, for example, out of Connecticut, the whole concept of organizing things and trying to help run things and keep everybody involved and work, not just within his particular situation in family medicine but across his entire state within the medical association in other areas, keep all that in balance. These people are just huge in experience that they have and also what they’ve brought to our specialty and were great teachers for me.\n\nHow have you seen the Academy change over the years? \n\nThey are attempting to be more forward looking, less stuck in tradition but still moving slowly.\n\nTape One, Side Two of the oral history with Dr. Ross Black, II, on Thursday, July 12, 2007, recorded by Lindsay Young over the telephone. \n\nYou were just talking about some of the ways that the Academy has changed over the years. \n\nWhat we had mentioned is that it has been willing to make more change and be able to do some of those things. It’s a challenge to spend money and not overspend money. It’s a challenge to appropriately spend the money of your members and meet their individual needs without mandating a direction for them all the time. Also, it’s a challenge to meet the process of life that changes, so helping to make some of that change. The Future of Family Medicine project probably did not go as well or as far as what it could have but with the step that’s come out of it now, with TransforMED and some other things, I think those are great opportunities for change. Not just looking at physicians in practice now but being prepared so the future physicians and also the stride now of actually talking about we need to change the system. So not just saying this is the way it is, this is the way we’ve been trained but to say, let’s make some changes in how that’s being done.  \n\nThe other movement of the Academy has been that it used to be, when it was first formed, we were into survival of ourselves and making sure we would survive. Now we’re not just surviving ourselves but we’re talking about the care of patients themselves and we’ve been talking about that since the ‘80s when we’ve been trying to deal with making a change in how the system works and as we continue to make changes in the system, we have to look at that at all levels so the process of working with internal medicine and pediatrics and some of the other specialties and medical school changes for curriculum, as well as residency changes is a huge change. That process of trying to constantly reassess, reevaluate and move forward, reassess, reevaluate and move forward and readjust what we’re doing. And also do that in an environment that is constantly challenging because so many members come from so many different backgrounds and had some very different personal beliefs, they’re trying to approach this from the standpoint of what’s right for our country and what’s right for our patients.\n\nIs there anything you think the Academy is not doing as well as it used to do? \n\nI’m not sure about that. The challenge is, things they used to do were done because that was what was needed at that time. Things they’re doing now are because those are the things that are needed now. The challenge will be what are we prepared to do in five years, the things that are going to be needed then. How are we going to assess that? And are we ready to continue to make those assessments and changes? I don’t think there’s stuff that they’re doing poorly now that they used to do.\n\nYou were involved in the formation of the National Conference of Family Practice Residents. How and when was that conference initiated? \n\nThat alluded back to the meeting in Denver in 1972 [sic] when they first had a gathering and then the first meeting was in April of 1973 [sic] and I was one of 40 some different people that were there and we sat around a TWA stewardess training facility, which was in Kansas City at the time, over in Overland Park someplace and we sat around for a day and a half or whatever, trying to figure out what it is and where we were and we were all coming form totally different backgrounds and experiences and had no concept of what was going or no idea where we would go with it. It was sort of like the modified group process program where everybody kind of brought their ideas together and the concepts of, what can the Academy do for residents and what do we need residents to understand about the Academy? But more importantly, how do we share concepts and bring input from residents into what the area of family medicine needs to be done across the country? Especially, it had only been in existence for five years, at the time. We’re already talking about, we need to be prepared for change and make that change happen. Out of the 40 some people that were there, we got in small little group sessions and talked about things and brought them back and talked about where we thought they were and had different people writing them down and giving reporting and one thing led to another and however it all came out, Bruce Bagley and I were selected to be the two delegates and Alan David was selected to the chair of the group and there were two other people selected to be alternates. We went on from there and went to a meeting of students and residents that was the Committee on Students and Residents that had already been formed and it already had other people appointed to it. We were kind of assigned to it as adjunct people afterwards. Came back in June for another meeting and then went to the Academy’s meeting that year in LA where we were seated as delegates. At the same time, they also that year for the first time, seated people from the Uniformed Health Services because they also were seated at that time for the first time as new delegates also. It got started like that and everybody kind of sat around and said, what are the issues? We don’t know, what do you mean what are the issues? It was more, what’s important back home and how do we communicate these things and how do we get other students and residents to understand what the concerns are and how do we share our fears and concerns with each other? How do we share the concept of excellence in education and excellence in experience? Those were the concepts that the Academy was trying to help us deal with and spread around.\n\nHow has that conference grown since it started? \n\nFrom 40 people it’s now 1,000. They have a two- or three-day process and they’ve put together a book on how to select residency programs and some information about what you can do in your own medical school environment. The expansion in the medical school area and having student interest groups and support of those student interest groups and trying to help them be aware of what their potential experiences are in the specialty and bringing all kinds of other support and activities. In addition, there’s another program they have which is just for the chief residents, to train the chief residents in how to meet what they need to do within their program, as well as what’s going on in each state chapter, to do the same kind of thing or to match that or to do it as best they can at the constituent level. To try and help them meet the needs of the residents because not everybody can go to that meeting. It’s been a huge growth and continuing ongoing development. But it also depends upon the chapter and also the residency programs and the medical schools to continue to support it philosophically.\n\nDid the organization turn out the way you thought it would at the beginning when you were all just kind of throwing ideas around? \n\nAt that time we had no concept of where it was going to go and there were things that we talked about over the next two or three years about what we hoped to get in terms of having representation of various groups, here, there and wherever and spoke with reality about which ones could or couldn’t happen but also, which ones were really appropriate and how they got done. As it turned out, I don’t know that I had any expectations. Has it turned out very well? It has turned out very well. Has it continued to serve the needs? Yes, it has. Is there any problem with it? Sure there is because not enough people can go and not enough people even know about it. But that again, depends upon the chapter and the medical school, as well as the faculty and all those locations that we supported with that. It doesn’t mean you always have to go to Kansas City or wherever, for the meeting because again, it can be replicated within the constituent chapter.\n\nYou’d mentioned earlier, also being involved in the Ohio Academy of Family Physicians, including, I think you were President from 1992 to 1993. Do you have any stories from working with the Ohio Academy you’d like to talk about? \n\nThose people did everything they could to help the students and residents, as far as I’m concerned. They would reach out and bring people to the meeting, have you bring people with you when you went to a meeting, try and coordinate phone call meetings. They used to do a program where the President and some of the other officers would travel around the state to visit the residency programs and the different community hospitals and departments of family medicine on a regular basis, just so that everybody got exposed to the Academy but also the Academy get exposed to everybody. The chance for interaction, the opportunity to interact, the opportunity to meet the needs of everybody, they have done an outstanding job of doing that. At the same time, being ready for growth. One of the processes, you mentioned earlier, the Academy and leadership development in the residency and the Academy has done that. One of the processes of leadership development is doing all this kind of stuff. How do we get other people to step forward and do these things? You’ve got to first drag somebody along, you’ve got to first say, what do you think about it? And begin the conversation, rather than just say, hey, want to go to a meeting with me? To expose somebody to something allows them to determine if they have an interest in it or not and so the mechanism of their doing it, both the national and the Ohio mechanism has really worked well. It was a great experience going through other committees and being on their Board and being their President. They’ve had some great staff people. The lady who’s presently the Executive Director was the Executive Officer for the President of the Ohio Senate for ten years. She is well-attuned to all the political issues and all the issues that go on in the Statehouse in Ohio. For having her as a representative of organizing our state organization and help us in all those ways is just…can’t have that another way.\n\nAre there any other organizations that you’ve been involved in that you’d like to talk about? Like ABFM Board of Directors or STFM committees or anything? \n\nSTFM Committees, the interesting thing about them is they didn’t have enough money. Everybody who’s on their committees usually pays their own way to the committee meeting and everybody who’s on the Board pretty much pays their way to the Board meeting. They don’t have a lot of money to be able to support people and when you do that, you’re really committed to being there and to being part of the process and working within the culture of other things. Being on the Academy Foundation, which 80 million years ago used to be the Family Health Foundation of America and it had a real broad scope and outreach. Some of the projects and activities of being on their Foundation Board and trying to help them raise their endowment and trying to help them grow and expose themselves and do some neat projects and work within the pharmaceutical and other allied industries, was a very, very good experience for the years I was there.  \n\nNow I’m on the ABFM and there are so many things changing with Maintenance of Certification and what’s going to happen with the Federation of State Medical Boards and probably requiring everybody to maintain their state license through Maintenance of Certification and if not, perhaps taking an exam every ten years, just to maintain the state license. All of that forward-looking ideas and also their interaction with the internists, pediatricians and others, there’s been a great experience and activity and now I’m on their foundation also and they’re starting to look at using their foundation in ways to help them do different projects and achieve certain experiences. It’s just a wonderful opportunity to be a part of that process and to again, bring my ideas there but also look at things and ask the questions that I alluded to earlier, such as why are we doing this and what are we trying to get out of it and where is this going to be in three to five years? Ask that kind of stuff. That’s been a neat opportunity to be part of.\n\nDo you recall when family practice became a specialty? \n\nIt was in 1969. The issue of the difficulties and challenges and all that went through it with the Millis Commission and all the other things back in 1964 and what they were looking at. It’s not too dissimilar to the same kind of concept which is being raised in perhaps a different way right now when they talk about the medical home. When the recent report by various entities are talking about, we need to re-look at the issue of the medical home, it’s the same kind of question that was being raised that time in 1964, which was, where are patients going to get their care and who is going to provide it and how can it be done in the best manner? It’s similar kind of questions that we thought were being answered by the development of family medicine but again, it’s who’s asking the question, where are you going to go with it and what commitment are you going to have to it? But what’s the bottom line? Are we going to maintain a specialty? Maintain a way of life for various forms of physicians and what’s the best thing for the patients? I think the Millis Commission and others were talking about what do we need to do to maintain family physicians and those people who do patient care? Now they’re asking the question differently right now, which is, what’s the best thing for the patients? What’s the best thing for our community? What’s the best thing in terms of how we spend our money and get the best care available to us? That’s the process of what’s going on now that’s an offshoot of what’s developed since the specialty developed.\n\nCan you talk anymore about how family medicine has changed over the years since you’ve become a family physician? \n\nFewer fights, fewer fights for privileges, fewer issues of concern relative to are you qualified to do things, to more of, what role we as individuals want to have. Fewer issues of survival in a local environment, more issues of survival in a global environment like what do we do to help us and to help our patients and allow us to survive physically, mentally and fiscally. It’s now become a fiscal issue. There are so many cost factors involved in the development of physicians and so many challenges to that, that some people are choosing to do other things. Also the periodic ebb and flow of energy for various people to go into an area of patient care that’s a commitment on their part. It’s a commitment of their time and their effort and their heart. There are clearly people out there that want to do that but can they survive in doing that kind of stuff? And what are the challenges to that survival?\n\nWhat’s your sense of where family medicine is headed in the future? \n\nDon’t know. That’s yet to be determined. It’s dependent upon how we can work on changing the medical school environment and how we can change the residency training programs and how we can change the issues of compensation and how we can change the concepts of activity. Things have changed so much since I started into my career of medicine in general, the kinds of technology and activities that are there. The thinking that you only need to see a subspecialist about something is somehow ingrained in people for whatever reason. Saw a guy the other day. I said, “You’ve got a piece of cotton in your ear, why?” He said, “I ruptured my ear drum.” I said, “How did you do that?” “I smacked my head in the water when I hit a wave when I was in my Ski-Doo” and I said, “What did you do?” He said, “I had a lot of pain and went to the emergency room and they told me I broke my ear drum and so I’m waiting to get seen about it.” I said, “You’re waiting to get seen about it?” He said, “Yeah, I can’t get into the ENT until Friday to see somebody.” I said, ,”Why are you going to the ENT?” He said, “That’s what the ER told me to do.” A, why didn’t he call his own personal physician? Why didn’t he have his own medical home? And why would the ER tell him he’s got to go see an ENT? The concept is, I broke an ear drum, what do I do about it? That’s a very simple answer. Anyone can answer that question who’s in medicine and have an understanding about it. You do nothing about it, you wait until it heals. You need to see somebody who can look at it and say, is it healed? And what are we going to do? And we’ll reassess it. In a month if it’s not healed, then we will go to the ENT. Again, it’s the whole concept of across the spectrum of life, how people approach questions, how people approach issues of, I have a problem, I need an immediate answer to it and where am I going to find that? Well, you may find that in a family physician’s office. The specialty as it changes, over time, is going to be an issue of how we’re able to meet that challenge but also, how we’re able to help the public and the community see what it is that needs to be done in the most appropriate manner. The insurance companies thought they could mandate that. Well, that won’t happen. The employers didn’t want to mandate it, although they tried to, so now as we return more and more cost factors over to the patients, the issue will be, they can go to whoever they want. Some people will say, where is the cheapest care? It’s not the cheapest but what’s the most effective? So the challenge in where we’re going to go is to apply that information we can do in research and apply that kind of data we have through study and reports and try and help the public in all manners. To say, where is your medical home for the things you need the most?\n\nDo you have any other views on important issues in the specialty or things related to your career that we haven’t addressed here that you’d like to share? \n\nOne thing is there are people who will lament change. Things aren’t like they used to be. Nothing is like it used to be so get over it. There will always be change. What you’re taught to do as a kid when you’re going through all forms of school, but especially in med school, be prepared for change, be prepared that things will change and how are you prepared to handle the change? Be prepared to be a part of that change. If you want everything to be the same then go bury yourself in a concrete wall someplace. Even that’s going to change after a thousand years. Just don’t worry about change happening, be a part of the change and help the change to happen in the right way.\n\nWhat’s your opinion of the state of healthcare in America today? What would you say needs to be done in order to fix it? \n\nPart of the issue is the medical home issue but more importantly, the process that everybody has to make a difference and everybody has to make a commitment. Talk to the legislators, they’re not willing to make a change in anything because they don’t think the taxpayers are willing to support it. Talk to the employers and they’re not willing to support it and they’re going to pass it on to the taxpayers. You talk to the taxpayers and they say, I can’t do that because it’s going to cost me money or it’s going to be something else. Everything is going to come down to a financial issue so you’re probably going to have to do a single payer system or some sort of mechanism that’s going to make the paying feel equal across the board. In addition to that, it’s going to be a part of every part of our life, that it’s going to cost or be covered in the cost factor of what we do, number one.  \n\nNumber two, everybody has to be committed to that kind of stuff and play more of a role with prevention and a better understanding of that. That includes the pharmaceutical industry. Talked to a patient the other day about her daughter getting HPV vaccine and she was worried about giving her daughter a foreign substance because her daughter is [    ], but she’s willing to take the meningitis vaccine before she goes to college because she doesn’t want her to get that. Okay, those are the same things. Speak about it philosophically, why are we only giving girls the HPV vaccine? If we really want to eliminate the disease, why not also give it to boys? Only being marketed for girls. That makes no sense at all. If we really want to eliminate it…we’re just going to prevent cervical cancer by giving it to girls. We should also give it to boys because then they won’t get it and they won’t spread it. That’s not even begun to be talked about. So as we talk about things like that and as we present things that are going to be…can we sell it? Can we use it? Yeah, but what’s the most appropriate way to do it? As we talk about what’s important in healthcare in the United States, we need to think about things from a more global standpoint and also from a preventive standpoint to try and prevent problems and what makes sense.\n\nCan you talk a little bit about the people who have most touched your life over the years? Who were they and why and how did they affect you? \n\nLinda, my wife. Supportive, helpful, a place to bounce ideas across, encouraging, there to do some of the things when I couldn’t. My parents in terms of some philosophies and approaches to caring about other people and living your life in a manner that’s appropriate. Ed Shahady as a program director and as an educator and thinking about how to approach things and how to answer some of those kind of questions of life, relative to patients and thinking about how you’re going to run your practice and how you’re going to do those kinds of things. Tom Stern from a forward-looking, global process of thinking about family physicians in the trenches and where they are. In Ohio, Dave Barr and Jud Reamy and some guys like that who were very supportive and actively involved with family medicine and residency students and involving them in the whole process of where things go. Then there are those after me too, those younger than myself, Mary Jo Welker and Ken Bertka and others who do all those things now and kind of carry us forward into other kind of role models and other activities. People like Florence Landis, who was the Executive Director of Ohio for over 35 years. Jackie Schilling, who was the Executive Director in Indiana for 35 years. Art Schumann, the same thing in Connecticut, those people who spent a lot of time with their job but they did it because they loved it. Doing your job because you love it, that’s symbolic.\n\nDo you have any last thoughts you’d like to add? This is your opportunity to share your thoughts to future generations listening to the tape or to set the record straight on anything you feel might be important to address? \n\nI didn’t do it and it’s not my fault. No. It’s a great opportunity to do this and it’s been an honor to be part of the process of the history of family medicine over the past 30 some years and it’s been a real blessing to me and my family for those kinds of experiences, but also the things that people have allowed us to do.\n\nThank you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150963/file/278395#t=0.0,3770.9982"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150963/file/278394","type":"Canvas","label":{"en":["Media File 2 of 2 - Black_Ross_17_b.wav"]},"duration":1607.15845,"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/150963/file/278394/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150963/file/278394/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/394/original/Black_Ross_17_b.wav?1750874725","type":"Audio","format":"audio/wav","duration":1607.15845,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/150963/file/278394","metadata":[]}]}],"annotations":[]}]}