{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/wm13n22g9g/manifest","type":"Manifest","label":{"en":["Dr. Robert Higgins"]},"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":["2008-06-18 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Sandy Panther (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","American Academy of Family Physicians","family physician"]}},{"label":{"en":["Subject"]},"value":{"en":["Robert W. Higgins, MD (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/153038/file/281678","type":"Canvas","label":{"en":["Media File 1 of 2 - Higgins_Robert_08_a.wav"]},"duration":2832.02609,"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/153038/file/281678/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/678/original/Higgins_Robert_08_a.wav?1752087113","type":"Audio","format":"audio/wav","duration":2832.02609,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678/transcript/81614","type":"AnnotationPage","label":{"en":["Dr. Robert Higgins interview transcript  [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678/transcript/81614/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Tape One, Side One of the oral history with Dr. Robert W. Higgins by Sandy Panther. Good afternoon, Dr. Higgins.  \n\nGood afternoon.\n\nI will just be taping you, I will be asking questions, please feel free to give whatever response you wish as inclusive and then as we pause I will move onto the next question. Would you please give your name in full.\n\nRobert Walter Higgins, MD.\n\nDo you carry a present title now or are you retired? \n\nI’m basically retired.\n\nCould you please give us some background information, where you were born, your parents’ names and so forth. \n\nI was born on November 15, 1934 in Uniontown, Washington, Whitman County, which was about two miles from the Idaho line. Born at home. The closest hospital was about 35 miles away over dirt roads. The doctor lived next door and delivered my brother and I both, at home. My mother had rheumatic heart disease as a child and was a high risk pregnancy but it worked out all right, obviously, we both survived. My father’s name was Nelson L. Higgins, he was a pharmacist at the drugstore in this little town of Uniontown. My mother, Abby Rowe Higgins, her maiden name was Rowe, had been a teacher and they met in Wenatchee, where he was a pharmacist and she was teaching high school and bought the drugstore in Uniontown.  \n\nThen in 1940, since there were really no schools in Uniontown, we moved to Pullman, just about twenty miles north of Uniontown and went to public school, starting in first grade. There wasn’t any kindergarten there either. Went through high school there. Enrolled at Washington State College at that time, it’s now Washington State University. Started out in Engineering but switched to Pharmacy, decided I’d rather do that. Graduated in 1957 from Washington State College in Pharmacy. I practiced Pharmacy for about two years in Wenatchee in north central Washington. It was while I was there, there were two general practitioners there that I got to know very well who tried to encourage me to consider going to medical school. Dr. Arthur Ludwick and Dr. Wayne Zook, both were active members of the Academy so I began to think about it.  \n\nI went back to Pullman, my father had died when I was a sophomore in college so I went back to Pullman to help my mother run the drugstore, she was not a pharmacist and was having trouble finding a pharmacist. When I went back I also enrolled in some pre-med courses and talked to a pre-med advisor, who encouraged me, as did some of my other professors also. So I applied to medical school. My mother died before I heard anything, from her rheumatic heart disease but I was accepted at the University of Washington so we sold the drugstore, my brother and I did and I went to medical school in 1961.\n\nPrior to that you were married? \n\nYes, I was married in 1956, year before I finished Pharmacy. My wife, Barbara Wright, at that time, had graduated from college. We were married and in 1958 our first son came along so I was married and had a child when I started medical school and a daughter after the first year. They obviously didn’t keep us busy enough the first year. Then our third child, incredibly poor timing, two weeks before I graduated from medical school.\n\nYou practiced medicine until you were drafted into the Navy. Can you tell us a little bit about the Navy? \n\nAfter medical school I did my internship at Los Angeles County Harbor General Hospital, a wonderful internship and tremendous experience. Then the Vietnam War was heating up and they were drafting…they drafted half the residents out of the hospital so we really got a lot more responsibility probably than most internship classes. I was actually drafted into the Army but I had done my homework and found a phone number of the person that allocated doctors to the different services through the Draft and when I got my Army draft notice I called him and told him I’d rather go in the Navy, my father had been in the Navy in World War II, was a Pharmacist’s Mate, actually. I decided I’d rather do that. He said, the Navy’s only taking one person this month but when I asked him if he’d filled it, he said, no, and I said, you have now. So I got the Navy. He said to tear up my Army orders so I went in the Navy. Two weeks after I went in the Navy I was in Vietnam. The Medical Officer I was supposed to relieve had been killed over there and I needed to get there very fast. I was supposed to go in December, this was August, and ended up going in August. I was aboard ship, the USS [    ] as the ship’s surgeon. We were anchored as a repair ship for small craft up to destroyers and we were anchored off the west coast of Cambodia, the Paladonis (?) Islands, the little Phu Quoc Island was the main island there. The southern one mile was held by friendly forces and the rest of the island was held by the Vietcong. We were there for three months and very busy.  \n\nThen we moved over to the mouth of the Mekong River in the Mekong Delta at a place called Cap Saint Jacques or Little Village of Vung Tau. I was there the rest of the time. Again, stayed very busy. I was the only Navy medical officer in the entire Mekong Delta for most of that time so if the ship went someplace I had to stay. I traveled in the delta a great deal to call on the Navy advisors, Marine Corps advisors throughout the Mekong Delta. Then every weekend we went out and provided healthcare and dental care and other types of support for villages around the delta. It was a very interesting…came to love the Vietnamese people very much, they were wonderful people. I was there for about thirteen months then was transferred back to the United States and spent about ten months at Moffett Field Naval Air Station, which is near Sunnyvale, California, just south of San Francisco. \n\nThen I got out of the Navy, left the Navy, active duty and went to Wenatchee to practice with the two doctors that talked me into going into medicine. But I stayed in the Naval Reserve while I was there so stayed in contact with the Navy. Then family medicine came along. This was 1968 when I left the Navy, went in, in 1966. Family medicine was just becoming a specialty and the Navy became interested in it. They had called me several times to see if I had any interest in coming back, helping them establish family medicine in the Navy. My answer was always thanks but no thanks for about three years. Then we got busier and busier, I had a huge practice, lots of BO (?), lots of surgery and many inpatients. I began to see less and less of my family and the Navy sounded better and better. Finally I decided, maybe I ought to try that. In actually just four years after I went into practice there at Wenatchee, went back in the Navy and was sent to Charleston, South Carolina to start a family practice training program in the Naval hospital in Charleston.\n\nYour history moved you around a lot but you had two very significant roles in the Navy and two honors. You were the first in two different areas. Could you talk about that?  \n\nActually, when I was in practice in Wenatchee, I was an Academy member and when I went back in the Navy I discovered I couldn’t belong to the Academy, I didn’t have a South Carolina license and I really didn’t have any plans to do it although I could since I had national board certification but that prompted some friends of mine in the Army and Navy and the Air Force to petition the Academy to start a military chapter. The Academy was very supportive of that and we were able to, in 1974, were seated as delegates in the Academy in the Uniformed Services Academy of Family Physicians. I was one of the founders of that. That was where I kept my ties to the Academy. I started the program in Charleston and was there six years. It was actually the second program in the Navy. They had started one in Pensacola that was just going when I came in. They were transitioning a GP program in Jacksonville to that. So I was there for six years and then I went to Bremerton, actually Camp Pendleton, they were having some problems in a pro-gram they’d started there. I took my best person with me and he had it all fixed by the time I got there, of course. I was there just two years and they wanted me to start the program in Bremerton. Went up there and did that but it was while I was in Bremerton that I was elected to the Board of Directors of the Academy. That was 1980. So the chronology was Charleston, 1972 to 1978, Camp Pendleton, 1978 to 1980 and then in Bremerton. That program was started also and has done very well.\n\nIn 1986 you were assigned as the Commanding Officer of the Naval Hospital [at Camp Pendleton]. Was that also a first for a family physician? \n\nActually the second and it was 1987. I became President of the Academy, we’ll go into that later, and returned to active duty in 1985, December of 1985. And in 1986 was sent down to… no, you’re right, it was 1986…to  Camp Pendleton as the Commanding Officer of the Naval Hospital, which is the largest command in Navy medicine. There were two hospitals, hospital at Camp Pendleton and hospital at Twentynine Palms, California and eighteen clinics in three states. So it was a huge command. The best job I ever had in the Navy. It was finalized in that command that I was selected for promotion to Rear Admiral. I was the second or third com-manding officer of a Naval hospital as a family doctor/GP. Actually, Ollie Emerine, Captain Emerine, whose son I trained in the Navy and was an Academy member too, was that and I believe down in Pensacola they had a GP that had been a CO. I was the first really board-certified family physician that was Commanding Officer of a hospital and then was first to be selected as Rear Admiral.\n\nDid you enter a career then as a Rear Admiral and what year was that? \n\nThat was one star, the lower half. Used to be Commodore. I was assigned as Medical Officer of the Marine Corps. I did that for two years, headquartered at the Marine Corps in Washington DC, excellent job also. Great way to go to Washington the first time. Then the Surgeon General of the Navy asked me to be his Deputy and I became the Deputy Surgeon General and after one year in that job I was promoted to two star or Rear Admiral and retired in 1993. We sign a gentlemen’s agreement, while we can stay by law five years as an Admiral from date of rank and if you’re promoted, then another five years but we sign a gentleman’s agreement in the Medical Corps to go after three years so that more people can be promoted through there. It’s very narrow, it’s one or two a year that are selected out of somewhere around, I suppose 800 captains.\n\nWere you able to live at the Naval Observatory in DC? \n\nNo, I didn’t. There was Navy housing available down at the Navy Yard and I chose not to do that. We bought a home. The Surgeon General wanted me to move up to Bethesda in the Navy housing up by the National Naval Medical Center when I became Deputy Surgeon General but for a lot of reasons I didn’t want to do that so we just kept our home and I lived there. It was actually closer to the Bureau of Medicine and Surgery than Bethesda was.\n\nLet’s now go into the Academy a little bit. I know you did both at the same time. As you stated, you founded the Uniformed Services Academy. Can you do your progression through the Academy ranks? \n\nActually in 1973 we started working on the Uniformed Services Academy and were seated then as delegates in 1974. I was an alternate delegate. I was the youngest. The other two services were both colonels and I was a lieutenant commander. Same as a major. The first president was Dave Doan from the Army. The second president was Rod Hoch, Colonel Rod Hoch from the Air Force, then I came along as the third president. I became a delegate in 1975, I guess. I was President of the Uniformed Services Academy for eighteen months because we changed our meeting date and I was hoping it would maybe be just six months but it ended up eighteen months. It was really a tough job because we had no office. I was the office, the President did everything. I was the one who said we need to have an Executive Vice President and we hired John Hinckley, who did a wonderful job for us for some years until he got ill. As a delegate to the Academy, It was appointed to a committee, the Scientific Program Committee of the Academy and also I served on some reference committees during the Congress of Delegates and I was chairman of the Reference Committee on Education and Sam Nixon, who has been a Speaker still, came to my chapter and said, you ought to run him for the Board of Directors. They went to my wife, Barbara, and said, what do you think? She said, if he wants to do it, that’s fine. They approached me and I decided to do that. In 1980, the meeting in New Orleans, it was a joint meeting with WONCA although I didn’t really get to the WONCA because running for office. Was elected. That was when we had three ballots. We elected one person then another person, then another. I was fortunate enough to be elected on the first ballot so I didn’t have to sit in suspense any longer. So I served on the Board of Directors and that was compatible with being in the Navy.\n\nThen the start of the third year is when the Chairman of the Board is selected and I was selected for that as Chairman of the Board also and served as Chairman. Again, that was a little tighter time with the Navy, I had to spend more time away but they tolerated it. Then was encouraged to run for President-Elect so I did and ran against my best friend, Doug Haddock on the Board. I think I spent half my time campaigning for him and he did the same for me. It was a close elec-tion but I ended up, by a few votes, the winner. We’re still good friends, which is really neat. I was President-Elect for a year and still on active duty in the Navy. As President, couldn’t do that. So I went to the Navy and they hadn’t dealt with this before, they hadn’t had a Naval officer in any part of the Navy that had been president of a professional society like this. An old-timer in the Bureau of Medicine and Surgery, Commander Clarence Mohler, did the research and discov-ered in 1926 the Navy had sent then-Commander Richard Byrd, or gave him a leave of absence for a year to go to the South Pole, funded by the Ford Foundation. So they used that precedent, they let me have a year leave of absence from the Navy without pay. The Academy pretty much made up the difference in pay, to be President of the Academy. So I did that, I had a year leave of absence, although I still technically was on active duty, I still had the other benefits, health-care and those things. And it counted towards retirement. At the end of my year as President I went back on active duty, still back at Bremerton and the next summer was when I was sent to Camp Pendleton as Commanding Officer.\n\nDuring your tenure you also saw the transition of the Executive Vice President, or then Executive Director of the Academy. Can you talk about that a little bit? \n\nWhen I became Chairman of the Board…let’s go back a little ways. I’ve never used alcohol for several reasons and so when I campaigned, I think I was the first person to run for office that had a hospitality suite with no alcohol in it and it was wildly popular. It was really interesting. I'd seen people get too much to drink during the hospitality suites and I wasn’t sure they were really functioning when they talked to the candidates, so we did that and really only had one person complain about it and he had an alcohol problem. That was very popular. And I was aware that Roger had a drinking problem. When I became Chairman of the Board I became painfully aware of it because my schedule out on the West Coast and his schedule here just didn’t jive very well and I had one hour a day in which I could talk to him. I had to make rounds of the residents in the morning, I was teaching and when we finished that, it was about","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678#t=0.0,630.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678/transcript/81614/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"here or","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678#t=630.0,660.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678/transcript/81614/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"and he went to lunch at","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678#t=660.0,720.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678/transcript/81614/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"After lunch it was no use talking to him, in fact, they wouldn’t let me talk to him usually because he’d had quite a bit to drink at lunchtime. I just decided that we needed to do something about it. Nobody had done anything or confronted him. I wasn’t sure if I was going to be around next year so I convinced the Board that we needed to do a manager surveillance of the Academy and hire an outside firm to come in, knowing that they would find… it was really so obvious to a lot of the staff people here too and to a lot of our members. They were kind of wondering when something was going to be done. He’d embarrassed the Academy also at meetings by having too much to drink. I was told that if I pursued this I would have no future going on up in the office but I felt it was important to the Academy. So we did and it became… we had to do something. The management firm that came in put it right on the table in front of the Board and they had denied it kind of before but it was fairly obvious. Three of us were select-ed to confront him. Jack Stelmach, a Past President, Harmon Holverson, the Immediate Past President, and then myself as President because we obviously were through with our political time in the Academy. We asked the family physician and I can’t remember his name, it was out in California, whose practice was in addiction medicine. He was with us also. The idea was we would confront Roger and Margaret, his wife was there too and pay for his treatment and then he would continue as EVP, that was our plan. It didn’t quite go that way. Roger absolutely denied that he had an alcohol problem and his wife sided with him, which is not too surprising, I’ve been through this before a number of times. He absolutely refused and so he resigned, really kind of on the spot. We told him that we would still be willing to pay for his treatment for up to two years if he chose to do that, which he never did. Then we were left without an Executive Direct-or, which we hadn’t really planned for. We really had thought Roger would go with the treat-ment. He was a very accomplished person but his illness was really getting in the way of running the Academy well. We selected Mike Miller, who did a marvelous job. He was the Executive Vice President during my presidential year and I couldn’t have asked for a better transition. And then we selected Bob Graham then to…the Board decided they really wanted a physician in that job and selected Bob Graham. That was the story. The Academy lost a lot when they lost Roger. It was a far more personal Academy, not only to the officers and so forth but to the members too, I think. But it was dysfunctional too. Overall I think the outcome was very positive.\n\nAnd for the Academy, do you feel…and you had tenure with Bob Graham also, that that was a good decision for the physicians? \n\nYes, I think so. Bob was a very accomplished guy and having a physician as an EVP got us into forums that we hadn’t been in before because Roger was not a physician. So that was a great benefit to the Academy. Bob is a person that fills vacuums and if the Board didn’t give him good direction he went ahead anyway and so the Board had a tough job keeping up with him but they did and overall it was a good thing. He did retire and Doug Henley was selected, another physician. I think all in all, the Academy profited from the changeover.\n\nLet’s now move onto the World Organization of Family Medicine and I shall let you tell us what the acronym is and what the official name is. Could you start from the beginning of when you became involved and sort of go through that timeline of your extensive work with WONCA? \n\nAs I mentioned before, in 1980 there was a joint meeting of WONCA and the Academy in New Orleans. I was running for office so I really didn’t get over to the WONCA meeting although I was aware it was there and I had learned a little bit about it. I met the president of WONCA, Arthur Hoffman from the Netherlands, who now died about three years ago. Wonderful man. In 1983 as Chairman of the Board, the President of the Academy, Gerry Gehringer and I repre-sented the Academy at the WONCA meeting in Singapore. WONCA stands for the World Organization of National Colleges, Academies and Academic Associations of Family and General Practice. I tell people you have to know that before you can be an officer there. But we shortened it to WONCA and also call ourselves the World Organization of Family Doctors but WOFD doesn’t work very well and WONCA has such penetrance around the world that we just can’t get rid of it.  \n\nI went in 1983 to the WONCA meeting in Singapore and very impressed with what they were doing. We had a Past President of the Academy who had just gone out of office, Ed Kowalewski from Maryland and had been President of the Academy, President of the Foundation or at that time the Family Health Foundation of America, FHFA and I believe had been President of the American Board of Family Practice, then became President of WONCA. He did it all. He was there, I met him and a lot of the WONCA people and I was really impressed with what they’re doing. In 1986 I went to the WONCA meeting in London. I was approached by the Canadian College to be the Vice President for the Americas of WONCA. They had had the Vice President for the Americas and they thought an American ought to do it or from the US so I accepted that and became the Vice President. The Vice President at that time didn’t have as big a role as they do now but still, I got involved and I made trips to South America, I got to know a lot of the people down there, some wonderful, wonderful people down there. Julio Ceitlin, kind of a grandfather of Family Medicine in South and Central America, got to know very well and a number of people.\n\nIn 1989, I thought I might try running for the WONCA Executive Committee. Dick Inskip also went to the 1989 meeting and he was Past President of the Academy at that time. It ended up I couldn’t go to the 1989 meeting, it was Jerusalem, I was a medical officer in the Marine Corps, the Syrians had just captured Colonel Higgins and executed them and the Commandant says, we’re not going to lose Admiral Higgins. We’re not going so I didn’t go to Jerusalem, obviously. Dick Inskip did, as a matter of fact, go and ran for the WONCA Executive Committee and was elected, so he served on the WONCA Executive Committee in 1989. The next meeting was 1992 in Vancouver and he was an incumbent, he was reelected. But I went to the meeting and was actually on the planning board of it. Went to the meeting as the Vice President for the Americas.  \n\nThen in 1995, both Dick and I were interested in running for President-Elect and obviously the candidate comes from the national Academy and the AAFP chose to support me in running for the President-Elect of WONCA. The meeting was in Hong Kong and I ran unopposed, which was the best way to run for office and was elected President-Elect of WONCA in 1995 in Hong Kong. It’s a three-year term. I did a lot of traveling in supporting the national chapters and districts and so forth. Then in 1998, became President at the WONCA meeting in Dublin, Ireland. That was a wonderful experience and the Academy set up with the Ambassador, Jean Kennedy Smith, a reception for Barbara and I at her home. That was fun. But it was a wonderful meeting in Dublin. That was a busy three years also.\n\nIn 2001, the meeting was in Durbin, where I went out of office and then I was Past President for a year. Seven years was a wonderful experience. I traveled to somewhere around 60 countries, I think, altogether. Not all of it for WONCA meetings but for WHO meetings and things like that because we really worked very closely with WHO. In fact, one of the interesting meetings was the look back at the Alma-Ata Declaration, a 20-year look back in 1998 in Almaty, Kazakhstan. They originally did the Alma-Ata in the Soviet Union and the Union had fallen apart by then and the name of the city reverted to Almaty, which was the Kazak way of pronouncing it. That was a very interesting meeting. The look back, they discovered they were further from their goal of health for all by the year 2000 than they had been in 1978 when they made the declaration because of more specialization and fewer doctors per capita. It was in 1993 where we really started working with WHO and they discovered family medicine. At a meeting in London, Ontario, and the proceedings of that meeting was distributed around the world and really, many countries picked up on that, including Vietnam, where I had some action and after I had WONCA experience so that was a watershed event, really, for working with WHO. They began to realize that what they really needed around the world was primary care and the family medicine model is by far the best model of primary care. \n\nIt was interesting, they got a new Director General of WHO in I believe it was 2000, Gro Harlem Brundtland, the former Premier of Norway who was a GP in Norway. Very interesting lady and she spent the first six months of her time trying to learn this huge bureaucracy that was WHO so her focus was all inside. At the end of the six months she started interviewing with the NGOs, the non-governmental organizations that work with WHO and the first one she selected was WONCA so I went there with Michael Boland from Ireland, who was the President-Elect and we had a wonderful meeting with her and I think really accomplished a great deal in getting Family Medicine better known around the world.\n\nYou mentioned Vietnam. I know you had a very special project there. Would you tell us a little bit about that? \n\nWhen I was in Vietnam during the war, I really came to like the Vietnamese people very much. Again, no health care in the Delta, they really didn’t. They were in a rural area. They had doctors in the cities and they had a medical school but nobody was out in the rural areas so just in the back of my mind I always thought it would be nice if there was something we could do for that. Because of the proceedings from the meeting in London, Ontario, went to Vietnam also and professor Zum there, read this and said, that’s what we need in Vietnam. We have a lot of specialists but we don’t have any primary care doctors. He wrote an article in the WHO Journal and Alain Montegut from Maine, a good member of the Academy and a good friend, read that article and he corresponded with him, he wrote back and the upshot was, Alain traveled to Vietnam and met with him and they decided it would be a good thing to try to do a project. It was difficult to get funding but Alain found some funding through the McKnight Foundation, the 3M people, Scotch Tape people. A small grant but he asked me to join him with that along with a residency classmate of his, Steve Cummings, who had been to the USAID in Vietnam during the war and then went to medical school, then did a family medicine residency with Alain. He spoke pretty fluent Vietnamese so he was of great help. So I joined the project and we helped them understand what family medicine was and then both the government and also the faculties in medical schools. They really began to understand that if they would support this that they could have a higher quality of healthcare system at less cost so they became committed to it and we helped them develop a curriculum. Diplomatically we really had to be careful. We were chal-lenged once, how can you come and tell us how to practice medicine in Vietnam, looking straight at me. So I told him, had a very distinguished professor of public health, that we couldn’t and that wasn’t why we were here. We were here to help them understand how they might do this. But they were the only ones that knew what they needed in Vietnam and we could bring ideas from around the world on how it had been accomplished elsewhere but they were the ones that really needed to work and get this curriculum developed and so forth and we’d be happy to help in any way we could. That seemed to satisfy him, he became one of our strongest supporters actually.  \n\nWe targeted three medical schools to start family medicine residencies and we brought… about this time also, we did bring three people, one from each school, one to the main medical center where Alain was and one to Boston University and then one to University of California, Irvine. They were from Saigon, Hanoi and Thai Nguyen, a rural medical school north of Hanoi. They trained here for about six months and they spoke English before they came, although they had a refresher course in it and learned the fundamentals of family medicine and how to teach family medicine, some research in family medicine, very bright people, very well-educated. They went back and started three residency programs in the three schools. Had really good support from the schools and also the government. We got those three going and then the medical school down in Can Tho, down in the Mekong Delta, which was a small fishing village when I was there in 1966, now a city of 1,000 people. Grow a lot of fruit in the area, a lot of fishing and so forth. Had a nice hospital there and the Union Oil Company was drilling for natural gas down there and they wanted to do something for the community and heard about our project so they were willing to fund getting started in Can Tho and in the meantime, the China Medical Board of New York, who has been around since the 1920s and has funded a number of projects in the Orient got a new president, Roy Schwartz. He had retired but he had been the Vice President of the AMA for Science and Education. Before that he had been Dean of the Medical School in Colorado but prior to that was at the University of Washington, one of my professors when I was in medical school there and the one that started the WAMI project in the northwest, Washington, Alaska, Montana, Idaho, now Wyoming of community training centers and so forth. He became president of the China Medical Board and shortly after that I ran into him at a meeting in Phuket, Thailand, WHO meeting and congratulated him on his new job and said, oh by the way, you need to come to Vietnam with us to see what we’re doing there, so he did. He came to Vietnam and he was very impressed with what was going on and went back to his board and said, we have to fund this fully. It’s going to be good for Vietnam and it’s going to be the best role model we could ever have for a developing nation, developing a rational healthcare system. It’s functional and high quality and cost effective. So they have us nearly $2 million over six years and that allowed us to bring more people in the US to train as trainers and to give them support equipment for the clinics and help them decide on where to train the doctors and just kind of support. It became more and more obvious that they were going out on their own and we were more consultants as it went along. So now, the grant has run out and we haven’t been back for a little over a year but it’s still going on.  \n\nTwo more started, Hue and Haiphong, both good medical schools so they have six active programs. Now also, there’s a family practice faculty development program with a master’s degree in Manila, University of Manila that was run by a good friend, Donna Leapondo (?) and we are now sending some of the people down there, we can send three or four down there, maybe five, for the price of one to the US so doing that pretty much. And more junior faculty now. It’s really making a difference. We’ve got a study going funded by New York Life Insurance and the Karolinska Institutet on outcomes of what happens when family physicians come into an area in a clinic and it’s showing really good things. Up at Thai Nguyen it’s made a major difference in that. I guess part of this too, Laos and Cambodia, who are close, wanted in on this type of thing and Alain has been to Cambodia, we’ve all been to Laos and we got some funding through the Atlantic Philanthropies to fund a project in Laos and we have sent five of their doctors to Bangkok to train. They speak the same language basically, as the Thai people and so they’ve gone, five doctors, to Bangkok, to study for two years to become family doctors. They’ll come back and then try to upgrade the other doctors in their district. Also in Nha Trang, which is really a beautiful resort area of Vietnam south of Hue, has no medical school but the faculty of Hue has started a program to come down on the weekends to train the doctors in that area, to upgrade their skills, the GPs that are there for a two-year time and then they’ll get a certificate of training for that. So this will upgrade their skills too. It’s really upgrading the quality of healthcare in Vietnam markedly, and Laos. Cambodia is more of a problem because of funding and they’re just not as organized, the government there has been through a hellish time in the past. They’re getting organized but it’s hard.\n\nHave you done any other international projects in other areas of the world? \n\nI worked in Argentina a little bit when they were getting started, the Construction Workers’ Union and that was Julio Ceitlin and Rubin Roja, Jorge Gelthran was another one that was in on that. Really good people down there. That was a real success story. They took over the health care system, it was really costly, in fact the union was virtually bankrupt because of the health care for the 5 million beneficiaries they had, members and beneficiaries. They got a new presi-dent who knew Julio and Julio suggested they really try to start a family practice model and we had to retrain some internists and pediatricians because there weren’t enough family doctors. It worked very well. They were very willing to do that and starting a family practice model and my goodness, the health care cost dropped precipitously, the quality went up precipitously and the satisfaction, it was off the records. It’s been a real success story. I went back down there also to help them with certification of family doctors. They want to get started for family medicine which would then spread to the other specialties. It’s been a real success story. They are also in the process of starting some family medicine residencies within their clinics in collaboration with the medical school. They’re the biggest user of family medicine right now, although the social service system there is beginning to see the daylight on that also. So I didn’t have as big a part in that as I did in Vietnam but it was a very interesting time.\n\nTape One, Side B of the interview of Robert W. Higgins, MD by Sandy Panther. \n\nDr. Higgins, there are a few things that I would like to cover in this next section. One is the AMA. I know you were very involved in committees of the AMA as a delegate from the AAFP. Could you explain those, please? \n\nI became an alternate delegate to Bob Shackelford from Mt. Olive, North Carolina. He was a Speaker of Congress of Delegates, AAFP and became the delegate to the AMA when they began to have delegates from the specialty societies. I was Past President when I became alternate to Bob Shackelford. That was when we had one delegate and one alternate to the AMA. I became quite active in the AMA at their meetings, mainly because being in the Navy I knew a lot of people from other states and so forth and the caucus we met with was not a state caucus but in fact, the Service and Specialty Society Section. A fellow there that was very, very influential in the Service and Specialty Society Section, David Carmichael, a Cardiologist, was also Rear Admiral Navy, Medical Corps Reserve and was retired. He tried to promote more military at the AMA and so he somehow arranged that I became the Chairman-Elect and then the Chairman of the Service and Specialty Society Section and that’s a real bully pulpit and it worked very well. I think as a family doctor you really know how to work with the other specialties. There have been a lot of problems before because there’s too much of their own agenda and not enough of the total agenda of all the specialties so I think it worked out very well. Going through that you really get to know the officers and the trustees of the AMA and the more people you know at the AMA, the more influence you have. After I believe three years being the alternate to Bob Shackelford, he retired from that and asked me to stay on. There was an election but there was only one person running so it was a quasi-election and I became the delegate. The first year, Glen Aukerman, a Past President, was alternate delegate and then the next year they selected Ed Langston as alternate delegate and he and I then served for, I suppose about eight years as the delegate and he was the alternate. We had an inordinate amount of influence because Ed had moved around a lot also and I think between the two of us, we knew the majority of every state caucus and every other specialty caucus. While we only had one vote on the floor, we had a number of people kind of in our pocket that if a contentious vote came up, we could call on them and they would stand up and speak to the issue on our behalf and vote so we got the first female president of AMA elected. Got her on the Board of Trustees, Nancy Dickey, and then got her elected. I was privileged and honored to give her nominating speech. So we had a lot of influence.\n\nIt came about that there was a reorganization of the AMA and they decided that they would give specialty societies the number of delegates according to the number of members they had and I believe there was one for every 5,000 members. Don’t quote me on that, maybe not that exact number. And that was an attempt to get the specialty societies, try to get more of their members to become members of the AMA and so I remember the first year we did that we had five dele-gates and that was kind of like herding cats to get them to agree on how we should do things and so forth. It was kind of like in the Navy, I was the ruler. The AMA is a very different political animal than the Academy and you’ve got to be there a few years to begin to understand it. I don’t particularly enjoy the politics bug I understood them. I didn’t agree with them either but I under-stood them. Herb Abramowitz was a family doctor from Ohio that was on the board and he was up for reelection and it did not look good for him. It was an issue for if we voted for someone we really didn’t like it would take votes away from another one so Herb would get in. We finally explained to the five people, the delegates and he won by about three votes so if we hadn’t done that, he would not have gotten back in. So you’ve got to do things like that. But it gets more difficult with more delegates and more expensive too. I’m not sure if we have any more influ-ence now there than we did before. Probably do but we had a lot of influence with just one delegate and one alternate so that was my AMA. I probably would have had an opportunity to go on up but I chose not to. I was getting too old for that kind of stuff and Ed Langston had a real interest in it and he’s now Chairman of the Board of Trustees of the AMA and I’m sure we’ll see him as President of the AMA. A good choice.\n\nYou were very lucky to receive many, many awards during your career, some of which were really important in family medicine but some of which were very personally important. Could you sort of highlight the awards that you’ve been honored to receive? \n\nI guess I’ve had a most fortunate life. I tell you, not really an award but I was married in 1956 to Barbara Wright and she was a wonderful wife for almost 46 years. I couldn’t have asked for a better wife and she was known by everybody in the Academy and in WONCA too. She was kind of first lady of the world of family medicine. She tragically and unfortunately, died very sudden-ly and unexpectedly in February of 2002. It was a real shock. I got support from a lot of people, Academy people, from WONCA people and friends and so forth. I was twice blessed because Judy, then Judy Glenn, I’d known for 50 years, met her in college when she married my best friend and actually was the best man at their wedding and their first child, Eileen, was Barbara’s and my godchild and we stayed in contact through the years. Actually when I wrote a chapter for Bob Rakel’s textbook, she typed the manuscript. We were living in Bremerton then and she was living in Seattle. Anyway, we got together and eventually in 2003, got married. Again, I can’t believe how blessed I am in that side of my life. I couldn’t ask for more. And Judy knew Barbara very well too and our kids knew each other and now that's a very important part of a remarriage. They get along so well, they get together whether we’re there or not.\n\nThe other awards, I guess fall into the category, I got quite a few military awards, Navy Commendation Medal for my work during Vietnam and also the Secretary of the Navy’s Commendation while I was in Vietnam. For starting the residency program…and by the way, the Navy is very austere on awards. They don’t give out as many as the other services do, except for maybe the Marine Corps, which is part of the Department of the Navy, of course. I was awarded the Navy Commendation Medal again in Charleston for starting the residency program there. Camp Pendleton, was there two years and got a change of command and everything, got no medals there, which is fine. I didn’t do all the work, Jerry Nowack, my faculty person really was the one who turned that around and he did get an award, which is great. I went up to Bremerton and started the residency there. I guess I got a Meritorious Service Medal for doing that, which is the next step up from the Navy Commendation Medal. As CO of the hospital down in Camp Pendleton I was also awarded the Meritorious Service Medal there, even though I was just there a year. I was surprised.\n\nWhen I became the Medical Officer in the Marine Corps I worked very hard and fortunately we did what we did because they were really ready when the first Gulf War came along. I was given the Legion of Merit, which is the next award up for that. Then went over as the Deputy Surgeon General and primarily, when the first Gulf War started, the Surgeon General of the Navy was out of the country and so I got a call from the White House saying, this is what’s happened, Saddam Hussein sent troops into Kuwait, the President has decided to take a stand. He wants both the hospital ships in the Gulf of Hormuz as quickly as we can get them there. That was a Sunday afternoon. We had one in Baltimore and one in Oakland and we had advertised they should be on their way within five days and we actually got out of Baltimore in three days and out of Oakland in four days, on the way. At the same time I called the Seventh Fleet surgeon, who happened to be floating in the Indian Ocean at the time and he flew ashore in a helicopter and secured hospital beds for us in Bahrain so that we’d have hospital beds for any casualties if something happened immediately. Then we got three fleet hospitals underway also at the same time. So we had all of that support in very short order. It was a lot of work but I had a lot of people to help me, we had a good team. When I retired from the Navy I was given a Distinguished Service Medal, mostly for that work with the First Gulf War. Also was Chief of the Medical Corps and so forth. That’s the highest peacetime award in military, Distinguished Service Medal. So I was very honored and very surprised when I got that and very honored that the Assistant Comman-dant in the Marine Corps, General Walt Boomer, did my retirement. He was a good friend and that was nice. We had 1,000 people there at the retirement.\n\nIn the Academy, being President was award enough but the Florida Academy gave me an Award of Merit and the New York Academy did the same. After I retired, I was awarded the John G. Walsh Award and that was a surprise, although I found about it at the WONCA meeting in Durbin so that would have been in 2001 when I received it. Rich Roberts was at the meeting and was I guess President-Elect of the Academy, or President. We had a reception there at the Consult’s house in Durbin and before this huge crowd of people at the reception, read the letter of award to me from the Academy that John G. Walsh awarded. That was really special to me for a number of reasons, one, I knew some of them pretty well and the person who got it the year before me Nikitas Zervanos, who was a good friend for years. I used to run with him at meetings. He got it the year before and I thought that was a wonderful thing, he’s such a wonderful person. Also, I’d had an experience. I did not know John G. Walsh but I had an experience on an airplane, flying from San Francisco to Seattle, a lady sat next to me and asked me what I did. I told her I was a family doctor. She said, I had the most wonderful family doctor and he unfortu-nately died just a couple years ago but he was just a wonderful person. I just really loved that guy as a doctor. I said, what was his name? She said John Walsh. I said, John G. Walsh? She said, yes. I said, well I never knew him but I know of him because he was very active in the American Academy and died prematurely but the highest award in the Academy for a member is the John G. Walsh Award and she didn’t know that. What a thrill to get that award, never realizing when I talked to her I’d ever be a recipient of it.\n\nIn 1998, was the Distinguished Alumnus Award from the University of Washington School of Medicine that year and in 2002 and I found out about this two weeks after Barbara died. The Board of Regents of Washington State University had made me the Board of Regents Distin-guished Alumnus of Washington State University of 2002. I was the 32nd recipient and that had been going for years and years. They don’t select one every year. People like Edward R. Murrow and Ablesons that converted nuclear energy into useful uses. Gary Larson, the cartoonist, Larry Peters from the Peter Principle and people like that. John Fabian, the astronaut was a good friend, I went to high school with him. But what an honor that was. That was kind of fun because we had dinner with the President of the University, Lane Rawlins and his wife, Anna Provost was there and some other people and they asked me if there was somebody that they could invite that were good friends of ours. And Judy went with me. This was in the fall, 2002. I said, I know that Phil and Doris Cleveland are going to be in town that weekend. He was very active in the Academy and was Vice President of the Academy at one point. He and I started out in the first grade together so knew each other very well. We invited him. They asked Phil then if there was a couple they could invite that would be a surprise to us that we knew very well and they invited Wayne and Evelyn Zook. So they showed up at this dinner and that was really a thrill to see them too. Hadn’t seen them for awhile. It was a wonderful award. I was very honored.\n\nAnother award I got, I was made a Fellow of the Philippine Academy of Family Physicians. Another really distinct honor was 2005, December of 2005 I was awarded Honorary Membership in the College of Family Physicians of Canada. That was a distinct honor for me. I’d known the President of the College for years and been to their meetings. Sometimes I feel I know more people there than I do at the American Academy, it’s grown so much. That was a distinct honor.\n\nBesides the drinking issue, which you had mentioned earlier and really were influential in changing the Academy’s policies regarding alcohol, you also were a very strong advocate of smoking cessation. Could you tell us a little bit about that? \n\nYes. When I campaigned, partly for the Board and as President, the family physicians really ought to be good role models for their patients. I did, I ran everyday. I had to, to stay in shape for the Navy and pass their physical fitness. Actually as Medical Officer for the Marine Corps, I had to pass the Marine Corps physical fitness at age 58 and 59. I think I was the first President of the Academy maybe that was a runner. We’ve had them since then obviously and people on the Board when I got there, Dick Brummett, for one, was an avid runner. Anyway, we worked with the airlines some and with the Flight Attendants Union, I know, when I was Chairman of the Board and President-Elect, to try to get smoking off of airlines. The Flight Attendants Union of course was very anxious to do that. They had to clean their clothes after every flight, the tobacco was so bad. That eventually happened and when it did happen it went like wildfire. First it was some domestic flights, then all domestic flights and then all international flights. It was just a short time it seemed like.  \n\nThen in 1986 when I went down to Camp Pendleton as Commanding Officer, the first week I was Commanding Officer there I made the announcement there that we were going to throw all tobacco out of the hospital. The first thing that happened, the union boss came to me and said, you can’t do that. The National Labor Relations Board had made a ruling that tobacco could not be an issue with the union so I had that, that people from DOC had sent me and so I showed them that. He knew immediately what it was. I said, I’m going to form a committee on how to do this and I want you on a committee so we can represent your union people on that committee, on how to get rid of the tobacco. I snuck in a smoker to be Chairman of the committee. I told him it’s not whether, it’s how. They came up with wonderful ideas and we accomplished that in a short order and actually got 70% of the smokers that were civilians, to quit and maybe as close as 80% of the military that smoked, quit through the programs they set up. It was a wonderful thing. And within a year, every military hospital was smoke-free. Within five years every Navy build-ing was smoke-free and now, most of the ships and submarines and so forth are smoke-free. It’s really been gratifying to see that happen.\n\nAlso, I was a real advocate for DOC, on the Board because I thought we ought to support them. \n\nAnd DOC stands for?   \n\nDoctors Ought to Care. It was a wonderful organization. We had a number of Academy members, including Tom Houston, he really was the one that kind of organized it. Finally convinced him…I think what really convinced him was, the Surgeon General, C. Everett Koop, came to our Academy meeting and gave those people his Award of Merit for their work with DOC and the Board said, wow, if he did that, it must be all right and supported him. They did some really wonderful things. That carried on, the billboard projects and all that is still going on many places. It’s made a major difference in the number of smokers in this country.\n\nNow I’d like to switch over to the philosophy you have toward family medicine. Can you tell me, from your perspective, how you feel family medicine has changed over the years that you’ve been a family physician? \n\nIt’s obviously gone from general practice to really a specialty and it truly is a specialty. When I was involved, there’s general practice and we had the opportunity through study and challenging the Board exam to become board-certified. That was the route I went. In fact, I think it was several years later before we had a President that had done a residency. There just weren’t any around then. It was a much broader specialty then. I did a lot of obstetrics, did a fair amount of surgery, pinned hips, a lot of fracture work, appendectomies, some gyn surgery and so forth and cardiac care unit work, the whole works. It was a really busy practice when you did all that. Through the years, they’ve been better trained to do those things. For a lot of reasons, one is malpractice insurance has limited the practice. I didn’t to tonsillectomies, I knew how to do them, I thought I did them very well but I quit doing them because it made such an impact on our liability insurance premiums, we didn’t do enough of them to pay the difference so we quit doing those and I think that’s what’s happened to a lot of family doctors. OB has gone out of sight, the premiums and a lot of family doctors don’t do enough deliveries to pay for the difference in the premium adjustment. So that’s made a major and unfortunate impact on family medicine. I always thought obstetrics was the ultimate family experience and actually, I have obstetricians tell me that they thought family physicians ought to be doing the majority of the deliveries and just count on them if they’re a problem because it is such a family experience. I actually had the experience when an OB/GYN specialty decided that they were going to have to have six months of family medicine training during their training. I spoke to a number of training programs in OB/GYN on what family medicine really was and what they needed to get out of it. That women get other diseases besides pregnancy and gyn problems. That was kind of fun, it was well- received. They weren’t sure they really wanted to do family medicine in their practice, that they’d find a good family doctor near them that would do that part of it. So that’s changed.\n\nThe funding has changed too and the whole way of practicing medicine. One of the reasons I loved the Navy was that we still could practice what we thought needed to be done. We didn’t have some third party in between us telling us we can’t do that, we can’t do that and so forth. It’s still that way, it’s still wonderful to be able to practice like that.  \n\nI think another major change that I’m not sure is best either for the patient or for family medicine, is a hospitalist. I think the family doctor knows that patient the best and I never had any compunction about asking a consultant in if I had a patient in the hospital. But to give up control of that patient, just give them over and not see that patient until they come back, then I don’t know what’s going on in the hospital either. I don’t think it’s a good way to practice medicine. It’s become very popular because it’s taken the family doctors out of that obligation of going to the hospital twice a day and all that but that’s where I learned medicine, from my consultants. I asked questions all the time of them, how are you doing this now? That’s a good way to keep up. So I think that’s one thing that’s happened in family medicine that… not really in family medicine, in medicine, that’s impacted on family medicine terrifically.  \n\nI think the payment thing though is probably a little critical. Young people just are not going into family medicine now. There was a little upswing this year, which was good and I don’t under-stand that because it still costs, coming out of medical school, a $140,000-150,000 debt. To try and pay that off as a family doctor is really, really tough. But you go into some narrow specialty that charges exorbitant fees and you can do it in a couple of years. So it doesn’t take a rocket scientist to figure out where they’re going to go. Again, in the military it was nice. We got a lot of people in family medicine, the military medical school, 35%, 40% of the class went into family medicine because they don’t have anything to pay off and they loved family medicine. They got a good experience in it in their third year and so forth. We also picked, pretty much the cream of the crop out of medical schools for the Hills Scholarships, professional scholarship, because you can get out of medical school without a debt with that. You can get your tuition and books paid and a stipend and you can actually, if you’re frugal, can get out without any debt out of medical school and you have a year for your obligation in the military. A lot of people are realizing it’s a nice place to practice so it’s worked out well. That’s made a major impact on the healthcare system in this country and on family medicine, specifically.\n\nI keep saying this, the politicians keep asking the wrong question. They keep asking, how do we pay for healthcare? They ought to be asking, what should the medical profession look like? What should the mix be of specialists and primary care versus other specialties? Once they start to do that and copy some of the countries around the world that have a far better healthcare system than we do for less money, then we’ll have a good healthcare system.\n\nWhat do you see for the future? \n\nHopefully, it’ll become so expensive that there’s going to be a real crisis, more so than there is now and people will have to look at other alternatives and embrace the concept of primary care. There are so many studies that show the relevance of that. I think the future is bright and medi-cine is not going to go away, obviously, people still need doctors. I think they need family doctors more than ever now, typically with the mobility of society, there needs to be some common denominator in their healthcare. I think the future of family medicine, it’s going to be discovered again. It was discovered in the late ‘60s when there was a crisis and really flourished. Now, a lot of other factors, particularly the pay feature, has impacted it. It’s going to be redis-covered and redone and I think it’s going to be…the Academy is doing some good things now towards that end. Future is very rosy.\n\nI’d like to ask you a personal question. What achievement in your career are you most proud of? \n\nThat’s the easiest question. My three children. Fred, who turned 50 this year, I can’t believe it. He’s got his own business, he’s in partnership with a fellow and they design integrated computer systems for business offices, government offices and so forth. He’s got two sons that are bright, young kids. Avid birdwatchers. My daughter is a graphic design artist, married and has two daughters, has a nice practice in graphic design art but does it at home. Then my youngest, Jay, who has three children, he’s a school counselor over in Wenatchee. Had a tough experience with his first wife who was schizophrenic and decided she didn’t want to be treated or take her medi-cine and ran away from the home. They eventually divorced. He just remarried three days before I went to South Africa this spring. A wonderful lady and we’re very excited about that and his kids really like her. That’s my proudest achievement, my three children.\n\nYou mentioned birding. I would like to pursue that. What are your hobbies? \n\nI’ve got too many hobbies. I built model airplanes for years. From age six. So you can figure out how many years that is and still do that some. It’s not foremost. Right now I’m trying to organize all my memorabilia and maybe write my memoirs someday. Tom Stern keeps after me for that, and Judy. I used to fish a lot, flyfishing particularly. I haven’t done that much. I’d like to get back to that. Birding, we do a lot of birding, that’s fun. We used to do a lot of backpacking. I was a scoutmaster for some years. Out in nature is good for us, we enjoy that. We just went to Africa, went birding and watching animals, seeing animals. I do collect stamps some. Like to read, part-icularly history. Music, I like music. I’m trying to get back to my cornet, although I’ve given that up a little bit right now since we’re gone so long. Judy’s after me, she’s quite a musician. I picked it up again and started in. That’s pretty much it. Friends. We stay in touch with our friends and that’s so much fun. One’s life is really measured in the number of friends you have and we’re rich, indeed. Just wonderful.\n\nWhat is the toughest decision you’ve had to make in your career? \n\nI guess two of them were tough. Marrying Barbara wasn’t tough, marrying Judy wasn’t tough. Those are big decisions. Giving up a profession I had, a pharmacy, to go back to medical school, four more years of studying plus postgraduate training and so forth and married and had a child. My parents were both gone so I really had to earn my way through. That was a tough decision. Barbara helped me with that and some of my professors did and I’m glad I did it, it was a good decision. The second was to go back in the Navy. I had a very active practice, I had a big prac-tice and I’ll tell you, practicing family medicine is very seductive. You get instant gratification many times a day and it’s hard to give up. We liked Wenatchee and it’s a great place to raise kids and so forth but I just didn’t see them, I didn’t see my family and the Navy wanted me back and I thought, well at least I’ll try it for a couple of years and see how it is. I think if I’d known how hard it was to start a residency program I wouldn’t have done it but ignorance is bliss sometimes. It went well and they kept giving me more challenges and I never got around to getting out. Never dreamed I’d be an Admiral, that wasn’t my goal. The Navy was good to me and I hope I was good to the Navy. Those were the two toughest decisions I made.\n\nYou held many, many leadership positions. What would you consider your leadership style? \n\nFirst and foremost in leadership is take care of your people. The Commandant of the Marine Corps that I worked for, Al Gray, he enlisted, rose up through the ranks and became Comman-dant of the Marine Corps. I can remember many times, he said leadership is simple, you only have to remember three things: one, take care of your people; two, take care of your people; three, make damn sure you take care of your people. That is really true. Even if you have one person that works for you, you’re a leader and you got to take care of that person and you’ve got to nurture them. If you don’t bring them along to where they’re nipping at your heels for your job, you’re not doing your work. It’s really important to do that. What you’re doing when you do that is you’re letting your people know the whole scope of the business that you’re doing and helping them understand every part of it. That’s how you nurture people to become leaders themselves. When they understand the business the business runs better. Or whatever you’re doing, the office runs better. And if they’re taken care of they’re more willing to work for you. You’ve got to get out and see people. This management by walking around was a big thing, but it’s important. You got to know your people and you’ve got to take an interest in them. If any-thing, that would be my style of leadership. Taking care of your people is first and foremost. When I retired from the Navy I was made an Honorary Chief Petty Officer, Honorary Master Chief Petty Officer and Honorary First Class Petty Officer, three different ranks. The Chief gave me a shadow box with all my ranks in it and my awards and a US flag that flew over all the assignments I had except for the ship I was on in Vietnam, which is no longer around and then my own personal flag, two-star flag as an Admiral and a little plaque that had all my duty stations. At the bottom of it, the most meaningful thing in the whole shadowbox, it says, “He took care of his people.” I tell you, I broke into tears when I saw that. That really is where it’s at. That would be my leadership style, I guess.\n\nYou mentioned Dr. Ludwick and Dr. Zook as two of the people that were very influential in your career. Do you have any other individuals who touched your life, particularly? \n\nYes, I most certainly did. A couple of professors of Pharmacy, Dr. Al White who I used to cut wheat with also, in the summers. He was the first person I went to after Barbara when I thought about going back to medical school. And Dr. Donald Farner, who was Chairman of the graduate school at Washington State University and professor of Physiology was another great mentor. And Herb Eastlick, my premed advisor when I went back. Major mentor in my life. Then medi-cal school, certainly Roy Schwartz was and [    ] repaid. In the Academy I certainly did. Sam Nixon was a real mentor. He’s the one that really suggested I ought to run for the Board of Directors and we became good friends. We almost lost our friendship over the Roger Tusken deal. He didn’t agree with what happened and I sat down and said, Sam, your friendship is too important to me. Let’s agree that we can disagree on one thing and be friends otherwise and so we became very good friends again. He was a real mentor to me. I hadn’t thought about this. Some of them really come to mind right away.  \n\nWilliam O. Robertson was a professor of Pediatrics in medical school, was the person that started the poison control centers in the US. He was responsible for that. Got the Benjamin Rush award for that from the AMA but he was active in AMA and was a mentor, both in medical school and at the AMA. I remember when he got that award, the meeting happened to be in Washington, DC and we took him down to the Bureau of Medicine and Surgery where the only statue of Benjamin Rush is. He [Rush] was the only physician signer of the Declaration of Independence and we took Dr. Robertson’s picture in front of Benjamin Rush’s statue with the Benjamin Rush Award. That was special. Then I had some mentors, Red Furken in Canada and Don Rice, certainly Julio Ceitlin in Argentina and some mentors elsewhere around the world, Doug Westfab and David Game in Australia and Rajan Rogkumar in Kuala Lumpur, Malaysia. We visited last year. Wonderful mentors.  \n\nThere have been a lot through the years that I’ve leaned on for support. Certainly in the Navy I’ve had some good mentors too. Don Hagen, who actually was [Executive Vice] Chancellor here in Kansas University Medical School for awhile after he retired. The person that got me back in the Navy was certainly a mentor to me also. Mickey McMann, my former CO in Charleston, what a mentor he was, from the first day I was back in the Navy, truly and became my Commanding Officer and we were still good friends. Judy’s met him now. Feisty little Irishman. I love the guy, he’s really neat.\n\nProbably in the Academy, maybe the most important mentor I had of all time was Tom Stern, still a good friend. He’s something else, special. I guess I got the story that when Judy and I started going together, Tom’s such an old curmudgeon that I decided I’d take her down to Salem to meet Tom Stern because if she could get along with Tom Stern, she’d get along with any of my friends. They’re close friends. They got along famously. I’ve had so many mentors through the years, I just hope I passed a little bit of that along.\n\nAs we wrap up this interview are there any last thoughts you’d like to add? This is your oppor-tunity to share thoughts with the people in the future who will be listening to these tapes. \n\nI’m not sure who’s going to listen to this in the future, anybody, but I think we all need to encourage young people to not be afraid to make major decisions in their life. No decision is a decision and opportunities come along and if you don’t grasp them, you never get anywhere. I think we need to be good mentors to young people, to show people that you can make major changes in your life and go even further than you thought you would. I think I was a mentor to Fred because he had a very good job, my oldest son, with Avanade. He was with Andersen Consulting and then with Avanade, a Microsoft and Andersen consulting venture. Through a difference of opinion of where they wanted him to live, he quit. He must have been 42 or 43 years old, had a family and he quit his job and was unemployed but he is now doing better than he ever did and I like to think that maybe he saw that you can make major decisions like that and do well. I think that’s really important to get that across to young people.  \n\nSailing was another thing I loved to do. In sailing, most people when they sail, to sail upwind, which is safer than sailing downwind and you get further, better opportunities usually. They got to tack back and forth and they pick out a spot on the shore and sail towards it and they get close and come about and tack to the other shore. But really good sailors know their boat and they know the wind and they’ll climb the wind. They’ll sail toward the shore and they may have an object there but they’ll take advantage of every little whiff of wind and sail and will often get further each time and exceed their goal. Get there quicker or even exceed, go further than they thought they could. That’s like life. You need to climb the wind, you need to take advantage of those opportunities that come along and not be afraid to do that and you’ll go further than you ever realized. \n\nI have one more story if I could. I think his name was Eddie Jones, he was a student member of the Board a few years back. An African-American fellow. I was at the Academy meeting, walking through a hallway and Rich Roberts, the President at that time, stopped me and said, Bob, I want you to meet the student member of our Board. So I stopped and went over and he said, Eddie, this is Dr. Higgins, a Past President of the Academy and Bob, this is Eddie Jones [sic], our student member of the Board. Eddie looked at me and said, “Hello, Skipper.” The air on the back of my neck went up and I said, “Eddie, I remember you, you were one of my corps-men at the 13 in Camp Pendleton.” He said, “You remember that?” I said, “Absolutely I do.” I said, “What are you doing here?” He said, “You told us many times, all the enlisted people, that we could be anything we wanted to be if we took advantage of the opportunities the Navy had. Just untold opportunities. Education. I decided I wanted to be a doctor, a family doctor like you” and he said, “Now I’m a third-year medical student at Ole Miss and I’m looking at family practice residencies. Here I am.” I tell you, what a thrill. He took advantage of those oppor-tunities and he’s going further than he ever thought he would, I’m sure, when he graduated from high school or grade school or wherever and here he is, a family doctor. We need to tell people that, take advantage of those opportunities.  \n\nWhat a great way to end an interview. It has been an honor and a pleasure, Dr. Higgins, to have conducted this interview with you and I look forward to the next time we can take your career steps one step further. \n\nThank you, Sandy, it’s been a pleasure for me. We go back a lot of years. You probably knew most of this anyway but it was an honor to do it with you.\n\nThank you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281678#t=720.0,2832.02609"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281679","type":"Canvas","label":{"en":["Media File 2 of 2 - Higgins_Robert_08_b.wav"]},"duration":2866.0738,"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/153038/file/281679/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281679/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/679/original/Higgins_Robert_08_b.wav?1752087115","type":"Audio","format":"audio/wav","duration":2866.0738,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153038/file/281679","metadata":[]}]}],"annotations":[]}]}