{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/ww76t0k28h/manifest","type":"Manifest","label":{"en":["Dr. Julie Wood"]},"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":["2014-11-17 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Urooge Boda (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","family physician","American Academy of Family Physicians"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154864/file/284023","type":"Canvas","label":{"en":["Media File 1 of 1 - Wood_Julie_Julie_14_a.wav"]},"duration":2194.99703,"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/154864/file/284023/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154864/file/284023/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/284/023/original/Wood_Julie_Julie_14_a.wav?1754491506","type":"Audio","format":"audio/wav","duration":2194.99703,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154864/file/284023","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154864/file/284023/transcript/82282","type":"AnnotationPage","label":{"en":["Dr. Julie Wood interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154864/file/284023/transcript/82282/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"This is side one, tape one of my interview with Dr. Woods, a family physician from Leawood, Kansas. My name is Urooge Boda and I’m conducting this interview on November 17, 2014 at Dr. Wood’s office in the American Academy of Family Physicians National Headquarters located in Leawood. \n\nJust to start this off, I’m going to ask you some basic questions and, obviously, if you could just give me the answers to them. Would you please give me your full name?\n\nJulie Kristen Wood.\n\nAnd what is your present title?\n\nI serve here at the American Academy of Family Physicians as Vice President for Health of the Public and Inter-Professional Activities.\n\nWhen and where were you born? \n\nI was born on June 2, 1968 in Mexico, Missouri in the U.S. My parents are actually from Paris, Missouri and the hospital was in Mexico. But it’s all in Missouri, yeah.\n\nWhat are your parent’s names?\n\nMy dad’s name is Larry Gray. Gray is my maiden name. And my mom is Ruth Gray.\n\nWhat did your family do for a living?\n\nMy dad, most of the time, when I was a kid, served as an agricultural chemist. So I grew up in a rural area, in several different small towns. From the time I was about second grade on, the same town, Mason, Missouri. But he worked in an agricultural store assisting farmers with their crops. And my mom was a teacher. Although, by the time I was born she was semi-retired and was a stay-at-home mom. But she trained as a teacher and sometimes would substitute. But most of the time … I saw her as a stay-at-home mom.\n\nWhat did she teach?\n\nElementary. Mostly first and second grades.\n\nAre you married?\n\nI am, yes.\n\nWhat is your spouse’s name?\n\nHis name is John Wood, and I met him while I was in medical school. He’s an ICU nurse.\n\nSo, you definitely met at medical school?\n\nYes, I met him when I was a fourth year at Strich (?) and then we started dating when I was in year five. Then we got married a week after I graduated.\n\nThat must have been hectic.\n\nIt was a hectic time. Got married right after I graduated and then we had a very brief honeymoon for a few days. Then we packed up and we moved to Wichita where I did my residency and then started my residency. So it was all very quick. People said, oh, June is a very nice time to get married. But there were really not any options, it was just the available time. It was a really nice time, but …\n\nThat’s nice. At least you bought some time then. Do you have any kids?\n\nYes, we have two. Amy who is eighteen, soon to be nineteen. She’s a freshman in college. And I have a son. His name is Will and he’s a sophomore in high school. \n\nWere they all born in Missouri, I’m assuming?\n\nNo, my first, Amy, was born in Wichita while I still was a resident. She was born when I was a third-year resident, toward the end. She was four months old when I started my practice. So, I moved back to my hometown of Macon. Then Will was born when I was in practice.\n\nThat was in Macon, Missouri. So, you said you grew up in Macon, Missouri.\n\nWe lived in several small towns and then from second grade on, I lived in Macon. So the earliest – graduated from high school in Macon, came to UMKC, went to med school there. Then graduated and went to residency in Wichita. Then moved back to Macon.\n\nFrom Kansas City, Missouri?\n\nThat’s pretty much been the circuit.\n\nA lot of us get caught up there between the borders. So, did you have any role models when you were growing up? I know you said your father was an agriculturalist, so …\n\nYes, he was very much into the math and science, so I think that was helpful. I had one grandmother, although I knew her, she was not well and passed away when I was pretty young. She was an RN and she went off to school and left and came back at a time when that was not a common custom. So, I’ve always looked up to her, although didn’t know her in that role. So, I think there’s some medicine in the genes there. But no one in my family was directly medical. There were some really good family physician role models in my town that I looked up to as well. Although, when I started school I wasn’t quite sure what I wanted to do. I was interested in a lot of different things. But that was the idea of what a doctor was, in my mind, in retrospect, as I started doing things in school. But that’s what I had in my family and I think I had good teacher genes and I had good math and science genes. Good academic role models as far as my parents and then good physician role models in town. Good country docs.\n\nI think that’s the best, like when you’re in a closer community, that’s when you just really get… So, did you have any dreams or goals when you were growing up, like young? Was there any sort of specific dream that you wanted to achieve?\n\nFor quite a while, like through the middle school years and early high school years, I wanted to be an astrophysicist. I was really interested in astronomy. And about my sophomore year in high school I realized that I was more interested in the biological sciences and then got the medical interest. I always liked working with people and I really liked the biology side, the anatomy. And that’s when it all started kind of clicking that I wanted to do that. I found out about UMKC and was interested in that program and wanted to apply there. And I still like astronomy and astrophysics and when Cosmos was on I was excited about that. But now I’m glad it’s more of a hobby and interest. I like math but I’m not sure I’m strong enough to do that as a career. And I’m glad my daughter is following that path. She’s got those skills that are a lot stronger than mine. So she’s living out my dream by … I’m living it out vicariously through her. So that was my first interest. Then I kind of started finding where my stronger interests and skill sets were. So, it was about my sophomore year on that I really kind of knew my path in medicine in general.\n\nThat’s nice. I was about to mention the same thing. I was like, yeah, you had mentioned about your daughter, so that’s wonderful. Do you have any stories from your childhood that you would like to share with us maybe?\n\nNot specifically. If I come back to it, I’ll think about it.\n\nYou said you had gone to high school in Macon, Missouri. So what were your early days of school like? I know some people say it’s the most memorable time. So was there …\n\nIn high school or …\n\nEven before, if you would like.\n\nWell, that school is really small. I’m sure there are smaller. My graduating class was ninety-eight people. And certainly when I came to college, there were people that came from smaller schools, but not a lot. And I found out that there was a thing called AP credit and there were all these things that I didn’t have. And people were, like, why are you taking chemistry 101 and English 101 and what’s wrong with you? So it was kind of a disadvantage, so I really had to dig myself out a little bit, although I learned a lot really fast. I think my school was good. But it was a small school and just didn’t have some of the advantage of a larger school. But I wouldn’t give anything for it, growing up in that small community. There’s a lot of nice things about growing up in a close-knit community. I went back, obviously. I took my family back there for quite a while. We moved again, which I guess we’ll probably get into. So, I think growing up there was great. Probably one of the biggest influences for me was they had a really great music department and I started playing clarinet. And I had both, we had woodwinds and our band instructor. A very well-established music department for a small school that did quite well and was very competitive. And so I think I learned a lot about myself and discipline and that you didn’t have to be from a large school to do well. And it was all about your own discipline and also the group work. So I learned a lot about what I needed to do to get things done both with other people and myself. And I still have a lot of musical love from that. So I appreciate that fro my school.\n\nThat’s wonderful. I totally understand. So, you had said that about smaller schools being … I used to go to a small high school as well. So, what is sort of the advice you would give? You did your research and found out about UMKC. What kind of advice would you give to students who are from smaller schools?\n\nIt would be interesting now. I have not looked back to see if they have done more advising for the kids coming out of that size school or that school itself on … Because we moved away from there. I went back and my daughter was in first grade and my son had not yet started school. But I think there are some things to do for kids who are college bound to have a little bit more academic study and advantage that are college bound. I think the classes I had were good, but they were gone really fast. So, I think anyone can do well if you have the interest and motivation to do so. And you don’t necessarily have to have those, but I think they would have been helpful to be on the same starting point as some of my peers. So that was a little overwhelming when I first got started. And I think I didn’t have some of the same study habits. Because for the most part, it wasn’t too hard in high school. There were some classes … Calculus was hard, no matter how you cut it. I think except for a few people that really like that kind of stuff, that have a natural talent. But it just took me a while to hit my learning curve and a lot of hard work. But my main thing would be like when I was in band, it takes perseverance and self-discipline and you do it.\n\nDefinitely. So, you said you went to UMKC. What did you do your undergraduate work in? \n\nAs you know, at UMKC, at least for many of the people that go there, it’s a combined program. So my program was integrated throughout the medical school years. But my undergraduate degree is in biology. And most of that was done in the earlier times, then I finished it out as I went through. But technically it was in biology because I didn’t have any other … It’s very focused. So it’s a little bit of a misnomer because I didn’t have anything about plants or animals. It was all people. It really should be called human biology because it’s like new (?) biology 1, new (?) biology 2, which is microbiology and human anatomy and all these kinds of things. \n\nThat’s wonderful, yeah. That definitely related more closely to …\n\nYeah, and that’s all you get through the next six years. So it was good. I really liked the program a lot. I liked the urban clinical exposure.\n\nSo like you said, when you entered the medical phase of the six year program …\n\nWhich is right at the beginning in some ways. As you may know, the UMKC integrated program, the first two years are more undergrad with some sprinkling of patient care and some medical terminologies and things like that. Then the last four are more medical with some sprinkle of undergrad in there. But once we got into the more patient -- and things …\n\nSo, how did you adjust? I know you said you hadn’t taken AP courses and all of a sudden you find yourself immersed in college classes. Also, on top of that, it’s the medical terminology type classes. So how did you balance that?\n\nI also had some culture shock, I think, going from a small town, one stoplight, to the city. I drove but I had never driven in the city before. So all those kinds of things of going from many different cultures … I was pretty isolated to two cultures in my community to many. So that was exciting but it was new. So that was good. But I think that all happened kind of at once. And it was overwhelming but good. Once I got the whole academic thing down … But it didn’t happen all at once. At first I had some adjustment to do. I didn’t make the most ideal grades in my first semester. Then it got better. I got some help. I got some tutoring. And then eventually I became a tutor because I clicked. You know, it all came into effect (?). And I also understood the importance of it and I wanted to help other people; you know, kind of pay it back. But that’s hard. And I’m lucky that happened to my daughter right now, trying to talk to her. I mean I totally get it, where she is exactly. It’s like I don’t need help. But it’s a different kind of environment and it’s okay to have some help. But that’s hard when you’re the person in that shoe, in those shoes, so …\n\nThat’s wonderful that you got to tutor.\n\nYeah. And the nice thing about that was that it helped me keep my skills up for studying for boards and things like that. But I really enjoy that a lot. I like to teach. And that was sort of my first entrée into that. But I would have never believed that in the first couple of semesters when I was struggling through some of the early chemistry like even general chemistry and organic and then biochemistry. And I really thought I loved biochemistry. And I think my biology professor would never believe I ended up as one of the biochemistry tutors – and I love tutoring that. But part of that was because I got a tutor that was wonderful. She was a good role model. An older medal student, older than me. She wasn’t old, she was young too, but she was a couple of years older than me. And she taught me some good study skills, she was really smart, I wanted to be like her, you know. And so I wanted to help kind of emulate that as I moved  through the health field.\n\nThat’s wonderful. I think that makes a huge impact on someone else. You’re like  a role model.\n\nExactly. And I think that’s important to continue. Because no matter where you are in life, you need to learn something. Then you can pay it forward. It continues your whole life.\n\nExactly. And now you probably can recall and recollect so much more, too, now that you’ve authored twice.\n\nOh, yeah. Now I’m working on getting an MPH. So now there’s still things I need help with. And I will pay that forward again when I learn it. I have most of it I’m getting, but the biostat’s a little hard, so I’ll try to get some help on that. So there’s always something. But there’s probably something that I can help the next guy coming up. It’s just a continual cycle. And the older you get, the more you see that, I think. And definitely as you go through medicine with patient care and with learning medicine.\n\nSo it’s a cycle.\n\nYeah.\n\nDo you have any stories from the six years of medical school that you would like to share with us?\n\nThat’s a long time. That’s a broad question. Let me think about it. It will probably come out as we keep going.\n\nThat’s fine; we’ll come back to it later.\n\nOkay. There were a lot. It as a good time. I look back on it fondly. It was a lot of hard work. An the same with residency.\n\nYeah, I’ve heard a lot of stories about how tough residency is for a lot of people. Speaking of residency, what directed you towards a career in family medicine?\n\nThat’s a good question. When I was first in med school I went to a lot of different interest groups and clubs and things to kind of see. I had a lot of interest, when I first started, in the brain. I still think the brain is fascinating. Neurology. In my year 1 docing group at UMKC, this is where we go around with our docent. It sounds like a museum, but it’s actually where we would go and learn and follow around a medical professor, basically to help teach us some basic skills. And I had an excellent experience in my year 1. I still think back to that frequently. Of course, you’re eighteen coming out of high school and one of the things I always remember him saying, if you listen to the patient, 80% of the he will tell you what’s wrong. You know, it’s a little humbling when you are getting ready to learn all this stuff over many years, but very true. \n\nI lost what I was going to say …\n\nWhat directed you towards family medicine?\n\nOh, yeah. One of the things, I always liked neurology and the brain and all that. And he did a great job of showing us a lot of different examples of different careers, introducing us to different specialties and doctors and things. So one day we went over to the rehab unit and he introduced us to physical medicine and rehab specialists, which I thought that was fascinating. You know, the doctor was helping people who had had strokes, who had severe spinal cord injuries. And I thought that was it, I was going to do that. Then after a while I decided, I thought it was fascinating but I don’t think I wanted to do it every day. And in my second year, I went to a family medicine interest group meeting. And, of course, I had some background for family medicine, having those role models in my town. And they had a panel and they had … First of all, there were a lot of people there, so I thought that was kind of interesting. And they had food, which was not a great reason – but it was interesting too. Most of the meetings did – and that’s a great way to attract medical students. And then the panel was fabulous though. It was really good. And I remember two of three docs --. One of them was a rural doctor, one of them was an academic doctor and then one of them was a doctor who had sort of an office practice type. And they all talked very passionately and fondly about what they did. And they were candid, so they talked about the good things and the bad things. They were very different in their practices and how they tailored it to their communities, what their community needed, what they liked to do and what they were good at. And I was, like, this is awesome. And they took care of the whole life cycle. I was sold from then on. I had some deliberation back and forth as I went to school because I really liked OB a lot. I wanted to deliver. But I found that I didn’t like the surgery as much, so I got away from OB/Gyn. Plus, I noticed, my own observation was that I didn’t seem to notice that the OB/Gyns were quite as happy in their careers. I was stereotyping but … And, also, I didn’t want to do the surgery. And I kept wanting to take care of the babies and they were like no, we don’t do that. And I didn’t like the idea. I liked the idea of the continuum in the family. Then after my OB rotation, which was really one of my most satisfying rotations, even though I liked OB … I did a couple of family medicine rotations and did great OB on that and thought that’s it. I also liked critical care a lot. So there were a lot of things in there. But then I found that I could do all that in family medicine. So, those are some of the things I was thinking about in that last year or so. But it was really my second year, that panel, to show you how pivotal it can be. And some really good mentors in school too. Not only the ones I saw growing up, but there were some excellent rotations I had. I got involved with that family medicine interest group. I kind of was in the right place at the right time with the Missouri Academy of Family Physicians and got on the board because I was involved in leadership in the Family Medicine Interest Group at the school. And at the time we rotated around and we sat on the board. Then that got me involved with a whole group of different kinds of people from around the state. And if you have a youngster that’s showing an interest, they tend to show interest in you as well. And so I did a rotation with a couple of them and they’re still mentors today. I just saw a couple of them at the recent meeting. And it’s heartwarming, you know, to see them and see how they’re doing. And they’re still interested in you and helpful to you. \n\nSo the physicians, they were -- or was it …\n\nI don’t think any of them were at UMKC at the time. I was a second year, so I don’t know how they got there. I assume the older students that were leaders in the Family Medicine Interest Group knew of them or helped recruit them to come be on this panel. And they were all really good and very different. A mix of rural, urban, academic, male, female. Very different personalities. Extremely different personalities, which was good to see. And I really liked the idea that they were customizing -- with their community and they were working with what their skills were and what they wanted to do. And their practices shifted a little bit over time too and I liked all that. And I really liked the breadth and the holistic approach. \n\nSo at these meetings, did you …Did they happen like monthly?\n\nYeah, every month. \n\nAnd they were just discussions about … \n\nYeah.\n\nSo you could come with your questions, if you had any?\n\nYeah, they usually had a speaker. Sometimes they were self-led by the students. Of they would have a guest speaker. Sometimes they would be about the residency match or another family physician coming in, talking about what they did. They were very helpful.\n\nThat’s a wonderful resource.\n\nThat’s one of those things, the Academy usually helps get a whole network nationally, down to the states, down to the schools. It’s been going on a while, obviously. And from personal experience, I think it clearly is --. So anytime I hear about groups like that, I’m, like, thumbs up, they work.\n\nIt sounds wonderful, definitely.\n\nAnd often it’s in schools, including UMKC, which are not family medicine friendly. It’s very specialty friendly. So it’s helpful to have this kind of information and positive peer influence and the community docs coming in, because often you don’t see that in the schools. It’s very --, so you don’t that kind of real world view.\n\nWhere did you do your residency?\n\nI went to Wichita, Kansas. At the time it was St. Francis Regional Medical Center and their residency program. Since then it’s merged with the St. Joseph program, it’s the one called Via Christi. The hospitals merged while I was there but the programs didn’t merge. And as I left, the programs merged. But when I got there and through the time I was there, it was St. Francis Program.\n\nDo you have any stories you would like to share from then? I’ve heard a lot of stories about --…\n\nWell, I don’t have a specific story. But if you tell me a topic, I can come up with a story probably. My program was very…I knew I wanted to go back to a small town. I didn’t specifically seek to go back to my hometown, although they called me up and said, hey, why don’t you think about coming back? And I said, I need help with loan repayments. And in Missouri there’s not as many options and Kansas has much a more formal loan repayment  system. So, I said well, that’s really nice. I would like to think about that. But I’m probably going to have to stay here to look at options for my loan repayment. And they said well, what if we pay your loans back? And I said, well, let’s talk – because I thought it would be kind of nice to go back home. So, I went and talked to them and they just had a more direct community-based way to do so over time. It was paid back over time. And I looked around at some of the --, but that’s what I ended up doing. Which isn’t really a direct residency story, but … So, that’s how I ended up. About early in my second year, I knew what I was going to do. But I selected my residency program because I at least knew I wanted to practice in a small town. And my program had a lot of focus on…some programs, there’s always in residency a core curriculum that one must attain. But some have a little more niche. So, mine did a lot of obstetrical training, surgical OB. So I got training to do C-sections, which I did in practice. And then a lot of pretty good hospital care and training you to be out in small towns. A lot of them also went to small towns in Kansas, small towns in Missouri. So a lot of our stories I can think of were based on doing really busy call nights. This was before all the rules. You heard  a lot of these stories, I’m sure. We were up a lot of hours, lots of babies. But I was looking for that, so that was good. Our situation was, the first year we were stationed on the OB unit. So we would do deliveries as our main thing and then we would do everything, which I loved. Because it wasn’t like you were on (inaudible). If you did admissions, you did medical admissions, you did everything.\n\nAt once?\n\nYes. It was like family medicine call. That’s what it was. But your headquarters was OB. So you were running the OB ward for whoever was in labor. And then you had a second or third year in-house with you. So, what you would do is manage OB. And then if you got called to go do an admission, either adult or child, because it was a hospital that had a children’s floor. It was the children’s hospital in town too. So you could get a pediatric hospital call or an adult hospital admission call while there was someone in labor or many someone’s in labor. So, if you had to leave the OB floor, you called a second or third year and said, hey, I’ve got to go do an admission or two or three and I have these many people, will you check on them. And occasionally had to call the backup guy on call. So I really liked that because it was all this management of multiple things going on and it prepared me well for practice. And when I got out into the small town, that happened. I was doing that. Like if somebody was coming into the ER, somebody was dying. I literally had one time a man dying, and we were working on making that a comfort situation; we were resuscitating. But I was doing that and at the other end of the hospital was waiting on a birth. It was very bittersweet as a physician. It was all going well, you know. It was a neat moment. I’m, like, this is a family doc, you know. You’re caring for, making sure that the end of life is going well and the beginning of life is going well. And not everybody gets that opportunity. \n\nI know that you had started, you said you worked in Macon, Missouri. When you started off, were you the only family physician there? And what kind of practice did you join?\n\nWhen I went back to Macon I did an office share arrangement with one of the doctors that was already there. We had a separate business arrangement but we were in the same building. And he was a doc that had been there for quite a while. And then I did that for a little under a year, but that didn’t work out very well from a business perspective and I decided I wanted to be on my own. That was also at a time where a lot of hospitals were buying up docs and I decided I want to go that route and be an employed doc, so I moved out of that situation and I got myself employed, which was good and bad. That first situation wasn’t a good business arrangement. So I was in a different location. I was technically solo, although I was in a group. Not with a group businesswise, but it looked like it. (Inaudible.) Then I was actually in a building  by myself. But the first two years I really didn’t have anybody to share call with per se and that was tough. And then after that, there were two new doctors. And there were other doctors in town, but they were all kind of on their own. There was not any bad relationship necessarily, it was just kind of every man for himself thinking. And everybody did OB. This other gentleman that was in the practice, one of the reasons I did that was because he did and it seemed to make some sense. Although basically the reasons it didn’t work out is once I got there, he kind of decided he wanted to not be there all the time, so that didn’t really help things very much. Soon after that I got there, then another doc came to town, then another doc came to town. They both did OB. So, we sort of formed a group without walls and we all practiced similarly. Then we were on call every third night, every third weekend – it was wonderful. In that situation, I was there for seven years total. And there ended up being a big malpractice crises in Missouri, this was the end of 2002, the beginning of 2003, where the rates went up extremely high without any cases or anything. And all the docs decided to stop doing OB and the hospital decided to stop doing OB. And many of the OBs in the area, neurosurgeons, all these people were dropping all these --. And I didn’t really want to stop, but it was kind of a deal breaker. I really had not planned on leaving, but I did. And around the same time, I had gotten a job offer to come to Kansas City to become a residency faculty and OB, which they would cover my malpractice. That way I might get to teach. And I always thought I wanted to be a teacher, but I thought I would probably do it a little later in life when I had a little more experience. But I had seven years. So it wasn’t like I was coming fresh out of residency. So it accelerated that practice. I was seven years out of residency and had a young family which I wasn’t seeing very much. Because even with the other two doctors there, I had really, really, really busy hours. I wasn’t home a lot. We did our own deliveries unless you were out-of-town. Which I loved – but at the same time I had, you know … When I moved, my daughter was in the first grade and my son was four years old. So, then when I went to being residency faculty, there were still busy hours but they were a little more predictable. And that was here in Kansas City, so …\n\nThat’s wonderful. And I totally understand, it must be hard.\n\nBut that was hard, losing my practice. That was kind of heartbreaking.\n\nWhen you were working with a partner, was that a private practice or …\n\nYes.\n\nWith a lot of healthcare reforms that have occurred, where do you see private practice itself going?\n\nEven when I was in the employed practice in the small town, it was really hard to do. I think we were fairly savvy in how we were doing it. I had a pretty decent employer, although it shifted from a smaller employer – they sold out to a larger employer in the city. And that got difficult because the city didn’t understand. They wanted to raise all these rates that were not appropriate for the small town and they didn’t really care when we said, hey, you can’t raise our fee from $40 to $80. That’s not okay for this small town. But they were, like, all of our whole system in Missouri charges this rate. Well, I get that from the bean counter standpoint. But when you’re a farmer in our town and the rate has always been $30 and now it’s $80, how do you explain that. It’s not okay. So those kinds of things are really hard as you get into those systems. But I think there are possibilities with what we are seeing with some of the new systems. Probably more like ACOs (?) or small practices in rural towns creating that work where they’re still independent but having some buying power and some leverage in working together in economy to scale and things like that, but staying independent. But I think you still can’t negotiate together necessarily with anti-trusts and all that. So it’s still tricky. But I have a lot of difficulties because they would just think you’re signing this contract. And a one man guy in a little town, you have no negotiating power to get a better rate with a third-party payer and things like that. So we would get the worst contract ever and no ability to fix it. So that’s why I’m saying with some of these newer, emerging models, I feel hopeful that … But it would be some new ways of doing things still for the healthcare system. Hopefully there are some ways that they -- or more employed physicians. But as far as what I saw as what I saw happen …","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/154864/file/284023#t=0.0,2194.99703"}]}]}]}