{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/xd0qr4qw3f/manifest","type":"Manifest","label":{"en":["Dr. James Jones"]},"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":["2009-09-14 (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 physician","American Academy of Family Physicians","family medicine"]}},{"label":{"en":["Subject"]},"value":{"en":["James G. Jones, 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/153043/file/281686","type":"Canvas","label":{"en":["Media File 1 of 2 - Jones_James_09_a.wav"]},"duration":3412.81149,"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/153043/file/281686/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153043/file/281686/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/686/original/Jones_James_09_a.wav?1752088691","type":"Audio","format":"audio/wav","duration":3412.81149,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153043/file/281686","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153043/file/281686/transcript/81616","type":"AnnotationPage","label":{"en":["Dr. James Jones interview transcript  [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153043/file/281686/transcript/81616/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Please start this interview with your biographical and family data: where you were born, parents’ names, siblings’ names and so forth.\n\nI was born on December 19, 1933 in a little village of Pembroke, North Carolina, in the southeastern part of North Carolina. It is a predominantly Native American village, home of the Lumbee Indians. My father was Houlton Bruce Jones, my mother Nora Revel Jones. I have four siblings: an older brother Bruce Jones, then Dr. Gloria Sims was an educator. Then just younger than me Janice Schroeder currently of Salt Lake City. And then the younger brother unfortunately died last summer from complications of a stroke, Ray Jones. And my older sister Gloria is also deceased. I grew up in Pembroke. I attended public school there. My father and mother were divorced when I was five years old. Both left North Carolina and my father went to Buffalo, New York where he went into a private business, an automobile repair business. My mother migrated to Washington, DC. And they both remarried and had another family after that. I was reared by my father’s parents Arthur and Dudley Jones. And particularly my grandmother was a great influence on me. She was a retired schoolteacher and had a great deal of influence on my development. My grandfather was a farmer. Really a jack of all trades. He was also a brick mason, was renowned in our community for his design and building of church steps some of which are still in Robinson County. After I graduated from high school I attended Mars Hill College which was a junior college. I had originally enrolled at White Park (?) but just as I was ready to sign on that, the person who had been a newspaper person, and I was a newspaper boy for the town, the man died who ran the orphanage and I went by to see his widow to give my condolences and she expressed disappointment in the fact that I was not going to go to Mars Hill which was a small Baptist college in western North Carolina because that’s where Mr. [    ] wanted me to go. That’s kind of a heavy burden for a seventeen year old. So the last minute, with her help, I changed my plans and went to Mars Hill, a very tiny college of only about 2,000 students. It worked out really well. It was a junior college and gave me two years of preparation for a more senior university, which I transferred to Wake Forest in my junior year. Graduated from Wake Forest with a B.S. degree in Biology and a minor in Chemistry. Following that I was admitted to Wake Forest University School of Medicine. A notation there is that I was both the first minority student ever admitted to that medical school and also the first Native American. I finished medical school there, had a fairly good academic record in both college and medical school. I originally had planned to go into surgery because my reason for going to medical school had initially been because I felt I was being led to become a medical missionary. With some good pastoral counseling when I got to medical school, Wake Forest had developed the first full educational program for pastoral counseling. So a wonderful man named Dr. Robert Young who I went to see because I was starting to have some doubts about whether or not this was the appropriate channel led me to understand that you didn’t have to go to Africa to devote your life’s work to God. And that was very useful to me. I had been influenced significantly both in college and actually before college by Dr. Albert Schweitzer, the great missionary doctor who had gone to Africa. One of Dr. Schweitzer’s teachings is that everyone has to find his or her own Lamberéné which was the small village in Gabon where he had established his hospital and the hospital still exists. His writings had also been emphasized to me by my all-time favorite professor at Wake Forest, Dr. Reed, who has written several books. So Dr. Young got me to understand that what Albert Schweitzer was teaching was that one could give a life of service without necessarily becoming a missionary or without going to some foreign country. And that was sort of how I fashioned my life. Even so, I had elected to go into surgery because as Dr. Schweitzer found out if one was going to go to a very remote area, one needs to train in surgery. It was not really until almost the very end of the match time, I had visited no other hospitals having made my desire known to the chairman of our surgery department who was a Harvard man and who had arranged for me to go to Boston for one year of internal medicine and then come back and train with him in surgery at Wake Forest. It became obvious to me during my clinical rotations that I really was not adapted well to being a surgeon. I didn’t like their lifestyle. I didn’t like their disposition. And I thought I either would become that way myself or I’d have to work with people like that. And so it became pretty obvious to me that I wasn’t going to be a surgeon. And after three sleepless nights I made that known to our chairman of the department of surgery who, to his credit, understood that and advised that I go to a general rotating internship at a large city/county hospital. That led me to Grady Hospital in Atlanta nicknamed the Bellevue of the South which indeed was exactly what Dr. [    ] had told me to do. And it was a very, very wonderful experience. I entered that general rotating internship with three interests. I was interested in pediatrics, orthopedics and internal medicine. I went there with an interest in three different things but it was a wonderful year. It stood me in good stead along with my education at Wake Forest. Wake Forest at that time was a very theoretical, heavily academically-oriented school with very little clinical practice. For instance, I had never seen an African-American patient. Of course, in Atlanta that was the majority of patients we saw. So it was a wonderful experience. I delivered about 250 babies while I was an intern. Just got a really good bearing. I was invited actually to do residencies there in three different specialties but I was somewhat leaning towards coming back to North Carolina and doing what was called general practice in those days. I really was confused also about which specialty to choose. I was invited to do orthopedics, OB/Gyn and [internal] medicine. There was a world-famous cardiologist at Emery at that time, actually was the president of cardiologists, Dr. Willis Hurst. I really liked Dr. Hurst and he had wanted me to train in internal medicine and then go into cardiology. Orthopedics was a great specialty. At any rate, I was just confused so I decided to get my naval obligation.  \n\nThose were the days when every able-bodied American male was obligated to do two years of military service. I chose to do mine in the Navy. Had really no basis for that except they had a good-looking uniform and I looked good in it. So I chose the Navy and was surprised when I got my orders that ordered me to report to the Commanding General at Camp Lejeune Marine Corps Base about ninety miles from where I grew up. I joined the Navy to see the world and they were sending me in my own backyard which was sort of a disappointment to me. I also was surprised to find out that I was attached to the Marine Corps. So I called the Pentagon thinking there had been some mistake in my orders and they informed me that the Marines were part of the Navy and that I should get my butt to Camp Lejeune which I did forthwith. There’s a really funny story there.  When I got to the gate, my orders said to report to the Commanding General. Well, some corporal tried to stop me at the front gate and take my orders from me and said he would take it from there and I said are you a general and he said no, I’m a corporal. And I said but my orders said to give it to the general and I’m not giving it to you. So he had to call his captain and relieve me of my papers and was probably ready to put me in jail by the time I explained that I wasn’t going to get in trouble my first day by not giving my orders to the general. But I got in, had no uniform and my Commanding General at that time was a real spit-and-polished Marine and later became Commandant of the Marine Corps. So they had to hide me for a couple of weeks because I didn’t have a Navy uniform and he was so charged with protocol that they were afraid he would really put me in jail for not having a uniform. Finally, they could hide me no more because he kept asking for this Dr. Jones. And they took me to see the General and there I showed up with at least a suit on. And he said “Dr., where is your uniform?” and I said “I don’t have one, sir.” And he happily said the damn Navy, they’re always doing things backwards. So he finally arranged to get me a uniform and I had my two years with the Marines in the bogs and swamps of eastern North Carolina about fifteen miles from where I’m sitting today actually. So that was a wonderful experience. While I was in the Navy I had been doing some moonlighting at the emergency room in a little town of Jacksonville, North Carolina, at that time a population of about 30,000 maybe. It’s the town outside the base of Camp Lejeune Marine Corps Base. I had been going there because they were so short of doctors, they had to appeal to some of the Navy doctors to fill in their emergency room. That was way before the days of emergency medicine doctors. And I had been doing that primarily on the weekends and got to know the doctors in town. About the time I went in the Navy I had been approached by a surgeon in the little town of Laurinburg which was near the town I grew up in. He was putting together a multispecialty group and he wanted me to be the generalist and I had agreed to do that. But just about six months before it was time for me to be discharged from the Navy I got word from the doctor that the group was not going to materialize and that he was very sorry but he had no place for me unless I still wanted to come on and go into solo practice which I really did not want to do. And I still had not made up my mind about which specialty that I might ultimately end up in. \n\nI was heavily recruited then to start practicing in Jacksonville, which I did in 1962 when I was discharged from the Navy. I had a wonderful, wonderful experience in practice. I saw 25 patients my first day and don’t recall seeing anything less than that the whole time. General practice was significantly different from what we now call family medicine. I had been trained at Grady Hospital and had the opportunity while I was in the Navy to do essentially residency training with those two years also because it was the beginning of Vietnam and most of the specialists from the Naval Hospital at Camp Lejeune had been deployed someplace else, either to the war or someplace to relieve someone else who was going to war. So they really didn’t have a lot of help in the hospital at that time. So Frank White, another general practitioner, a general medical officer who is now deceased unfortunately, he and I approached the people at the hospital and they were happy to have us come and essentially do a rotating residency. We went from service to service depending on where the needs were. And they had to train us because they really were shorthanded, so it wasn’t accredited but we essentially had a two-year residency program which further caused me to be committed to doing general practice. I couldn’t really find a specialty that satisfied all of my interests except to go into general practice. And in North Carolina you could enter general practice at that time. Actually, there were not a lot of residencies around. There was certainly no residency in general practice and no such thing as a residency in family medicine (that was 1962). So I entered practice, was really wonderful. As I said, it was the beginning of Vietnam and the Marines had been shipped out and left a lot of pregnant women with no doctors at the base to deliver them. So my first full year in practice I delivered over 200 babies. And I did house calls in those days, I did surgery, I did orthopedics. Because there was only one general surgeon in the town, so I assisted him in surgery on my own patients which is what all the general practitioners did in those days. I delivered babies. Eventually we got an OB/Gyn. We didn’t have one when I started. And then he and I had a collaboration so that if I got in any kind of an emergency he would come to the hospital immediately to help me out. In exchange for that I exclusively referred my gyn surgery cases to him. He’s still in practice and we’ve been dear friends over the years. I was so busy because I was making house calls, doing surgery and seeing an office full of about 40 patients a day and got very little sleep, as you might imagine, with 200 babies. So I ultimately had to get a partner or decide that I was going to go back into a specialty. I kept some sort of unofficial records to see how many patients that I was able to manage with the medical knowledge that I had and how many I had to refer to someone primarily in Bloomington which was about 50 miles away and it turned out that I was able to care for at least 80% to 85% of the patients I was seeing. And it just didn’t make much sense to me to then go into a specialty which would narrow my interest. So I took the option of being committed to general practice and to finding a partner. I was happy to find one of my classmates, a brilliant, brilliant mind. He finished second in our class in medical school. Just fooled around; he was the kind of guy that would make you sick because you would be up all night studying for an exam and he would go to bed at 9:00 and he would make an A and you would make a B or something like that. But Tom Kitchen was his name. He was a wonderful person. We had taken different internships. But he was a wonderful partner. He also did obstetrics. He did not like surgery, so I gradually as a surgeon got [    ] and we were able to give that up and were gradually able to give up emergency medicine for the same reason. We actually had extended hours back in the ‘60s which turned into being a golden hen. We were open two nights a week to make it easier for people who worked to come in to see us. We also worked half day on Saturdays. It worked out very, very well. We were extremely busy. We made a good income considering that we had obstetrics and orthopedic procedures and so forth. Our income was significantly higher than some of the other things like general internal medicine or psychiatry or anything except the surgical specialties – which I’ve always thought as really the appropriate pay rate for family physicians. I find it distressing that we are at the very end of the pay scale that only provides [    ] services. But that’s another discussion we can have sometime. At any rate, I stayed there and was extremely happy. I became Chief of Staff of the hospital, President of the county medical society.  \n\nI was very interested in education from the beginning. I had students in my practice almost all the time from schools as far away as Virginia but certainly from the University of North Carolina and Wake Forest and Duke. We had students virtually all the time in our practice. We also had nurse practitioner students and that concept was just beginning to emerge with some size in North Carolina. I had become very, very involved with the Academy of General Practice in those days. And then when they started discussions about family medicine as a specialty I became sort of the leader in North Carolina because at that time I was chairman of our education committee and sort of had established a reputation for education because I had arranged for CME courses for family doctors and had developed a little program based on the writings of Dr. Rafael Sanchez, a noted family physician who later became Assistant Director of the American Board of Family Practice. Rafael Sanchez had done a study that showed that general practitioners would go to educational courses, it didn’t even matter if they were on holidays or weekends so long as they didn’t have to travel more than 100 miles from their practice. And using that data, North Carolina is a fairly large state from east to west, and it became a real problem for doctors to go from one end of the state to the other. So we came up with a scheme to have three consecutive days of meetings. We would start in the eastern part of the state on Friday then on Saturday we would be in the Piedmont section and then on Sunday we would be in the far west. And noted national speakers thought that was a clever idea because on one trip away from home they could contact several doctors. And by the time you added all the doctors in the three sites, there was a significantly large percentage of the general practitioners. And that’s sort of the way I got my start in the Academy and continued my interest in education. I suppose that also led to my being later on appointed to the Commission on Education of the Academy. It then became my job in that role to sell the concept of the board certification to practitioners in North Carolina. I ran around all over the state trying to persuade doctors that it didn’t make any difference how old they were, that they really needed to become part of this new movement that I saw as the only viability of general practice. I thought if we didn’t specialize in family medicine and have some equal footing with other specialties that general practice and the Marcus Welby kind of general doctor that everybody loved would vanish from the American scene. So I was really adamant about that. Then it occurred to me I had to take the boards myself and that if I flunked I’d be in one big stew. But at any rate, they didn’t have very many sites. That very first board [exam] was given in 1970, as I recall. And the nearest testing center from where I was in Jacksonville, North Carolina was Atlanta, Georgia. And I remember going down there in the hot summer time to Emery University in a non air-conditioned room and we sweated through that first board exam; but most of us passed our boards. Then the next quest in my political life then at a relatively young age, and I think was 37 or 38, I was elected President of the North Carolina Academy of Family Physicians or at that time I think it was General Practice Physicians. In that role as I traveled around I became concerned about the large number of general practitioners who were getting on in years, so I persuaded the Academy Board to fund the research project that looked at the demographics of those general practitioners in North Carolina. Probably the real surprise, that study showed that about 55% of the general practitioners were 55 years old or older which meant that in a decade North Carolina would have a profound shortage of general physicians and would have virtually no one in rural North Carolina. North Carolina even today is primarily a rural state although we have some metropolitan areas now which were just really getting started in the ‘60s and ‘70s. I then went on a mission as President of the [North Carolina] Academy to then the three medical schools in the state pleading with them to embrace this new specialty of family medicine and to create academic departments. I got a cold shoulder and a not at all friendly reception for me at the schools and was particularly disheartened that the University of North Carolina at Chapel Hill whose Dean was Ike Taylor, and Ike Taylor is the father of James Taylor the great singer. So it was interesting getting to meet Dr. Taylor. But there was absolutely no interest in starting a department of family medicine in North Carolina. And this is kind of an interesting story because it doles back on this...I think decided that the only hope for getting the Department of Family Medicine started at North Carolina would have to be through the legislative process. And the only thing that would affect would be the University of North Carolina. But if we could do that, we could maybe demonstrate the need for family doctors in North Carolina. It just so happened that the most powerful politician in Raleigh in those days was one Senator John Henley. And if that name is familiar sounding to you, he was the father of the current CEO of AAFP, Dr. Douglas Henley. John Henley’s father had been a general practitioner. Senator John himself was a pharmacist. He had a great affection for his father and for general practice. His oldest son had attended medical school at the University of North Carolina and had decided to go into ear, nose and throat surgery. And all of this emerged at the same time that Senator Henley was president pro tem of the Senate. He then was very easily persuaded to help us write legislation that would require the University of North Carolina legislatively to have a Department of Family Medicine. And indeed with his help that’s exactly what happened. Following that the leadership at East Carolina University which is the third largest of the sixteen branch campuses of the greater University of North Carolina in Greenville, North Carolina, they had a very aggressive chancellor at that time, Chancellor Leo Jenkins. Leo, long before the University of Washington started talking about the University Without Walls, Dr. Jenkins had conceived of an idea that really we ought to make education available for people not necessarily just on the college campus. So he created ways for Marines and the Air Force and Army people, all that had bases at North Carolina, to get education while they were on duty. And this led him eventually to decide that he needs to have a medical school because the eastern part of the state had no opportunity for tertiary care and really had no potential for educating doctors for the future. And he was advised by a person who later became one of my mentors, Dr. Edwin Monroe, who was a general internal medicine person who practiced very briefly. And so they had applied to the legislature for funding for a medical school that would emphasize the training of family physicians. And this was in the early ‘70s just after family medicine had become a specialty, so the dates worked out very fine. And at that time I was President of the [North Carolina] Academy and I then became a very outspoken proponent for this new school much to the consternation of the deans of the other three schools. And as it happened, even the president of the university system opposed this, and I got to know him fairly well because we were on opposite sides of the debate. But I persuaded the Academy of Family Physicians to come out as the only medical group in North Carolina that championed the school at East Carolina. And they went on after a couple of legislative sessions to get funding for the school with a mandate written into the legislation that it would emphasize the training of family doctors. So I went back after my tenure was over as President of the Academy to just being a practitioner. And then because I had been so visible in the debate, I was then recruited heavily by the chancellor of the University in Greenville and also by the president of the system, since he and I had gotten to know each other in debating, to go to Greenville. I really did not want to do that. I had always been in love and I think probably still my first love in family medicine is that of a clinician practitioner. I just love people and I particularly love family medicine and general practice. I really resented that I tried to find someone else to help them do their job. But to make a long story short, I ended up agreeing to go for two years to help start the department. I went to East Carolina, which is in Greenville. We founded the Department of Family Medicine first with the help of one doctor, Thomas Stern, was sitting on his patio. Tom and I drafted the application for the residency program and we had big dreams. But with Tom’s encouragement we wrote an application and got approval for 12 positions per year, which was a sizeable residency program in those days, which would mean we would have 36 residents on board in the small town of Greenville. But we got accredited for it and the department became formed. I graduated my first residents in 1980. Several of those resident have gone to do [    ] things. The most memorable one is still on the national and state scene, Dr. Allen Dobson, who is one of my early chief residents...Allen has just finished a tenure as Deputy Secretary for Health \u0026 Human Resources for North Carolina, head of all the health activities in the state. He is now doing both state and national work because he’s put together a program called Community Care of North Carolina which is being touted as one of the models for health reform nationally. And I’ll get back to that a little bit later. Then I went to East Carolina and was going to be there for two years. I stayed there for 20 years. We built a fairly large department. Was recognized by U.S. News and World Report as one of the top five departments of family medicine in the country. That department several years running has won awards from the American Academy of Family Physicians for the largest number of graduates going into family medicine. It ranks in North Carolina the largest number of graduates in primary care, and especially family medicine, and going away the largest school producing practitioners for rural areas. That was sort of the way we developed our residency program there and it’s gone on to be very successful.  \n\nIn the meantime, I continued to be interested in the organizations of medicine. Just before I left private practice I had been vice president of the state medical society. In Greenville I became the head of the section of family medicine in the hospital and chairman of the Department of Family Medicine both in the hospital and in the university. I served as a member of the old Commission on Education in the AAFP. Got to know Tom Stern and Nick Pisacano very well, two of whom I consider the fathers of modern day family medicine. Served with some remarkable people, [    ], Tom Nicholas, Ross Egger, Dr. [G. Gayle] Stephens from Alabama. Just some remarkable people who went on actually to be the pioneers for establishing the educational credibility for the specialty of family medicine. All of those guys were on the Commission of Education that developed under the tutelage of Dr. Tom Stern who later went over and did work with the Foundation and recruited a lovely young lady named Sandy Panther to work with him. So I sort of felt like I was educated in family medicine, in the principles of family medicine, by the giants of our field. I learned from those names that I just mentioned and many, many others who were the first wave of chairs. Hiram Curry in South Carolina who was one of the early successes of family medicine. Marian Bishop. The names just go on and on of people who came through the Commission on Education of the American Academy of General Practice and then Family Physicians. The most remarkable experience. I feel extremely fortunate to have come along in an era when I had opportunity to meet and learn from those people. I also had an opportunity to serve on the Residency Review Committee for Family Medicine actually two different terms. Served on the board of the RAP program which, again, was with Dr. Stern. Learned a great deal about that. I was involved with the Society of Teachers of Family Medicine in its formation and later the formation of the [Association of] Departments of Family Medicine which primarily were the organizations for the chairs of the academic department. I’ve really had an opportunity to be involved in all of those organizations. I’ve had a leadership role significantly in the American Board of Family Practice where I ended up being Vice President of the Board. I had an opportunity to be elected and the privilege of serving on the Board of Directors of the American Academy of Family Physicians and later as Chairman of the Board of the Academy. That was followed by my election as President of the Academy of Family Physicians in 1989-90. And during that time I became a Board member of the Foundation for the American Academy of Family Physicians. Worked closely with Sandy Panther. We got to be dear friends during that time. Actually, I think it’s notable that the Foundation really was struggling at the time that Sandy and I worked together. There were leaders in the Academy of Family Physicians that really had sort of written off the Foundation and wanted it to take a plaque and go home. Sandy and I were determined that was not going to happen. I became elected President of the Foundation and Sandy and I rolled up our sleeves and went to work so that there was a significant place for the Foundation, that it contributed a lot to all the organizations of family medicine and that it had a rightful place. One of my great rewards looking back on my career is that the Foundation became strong and viable.  \n\nDr. Jones, I just would like to go back and pick up a few items bringing you up through your chairmanship at ECU. Just go back to your early life. What made you begin to decide that you wanted to become a physician? \n\nAs I mentioned earlier, I’m a Lumbee Indian. I got that heritage from both my parents that were part Lumbee Indian. I was raised by my grandmother who really stressed academic achievement. I was really relatively small while I was growing up. I actually didn’t grow much until I got to college. I was only 5'6\" and weighed 120 pounds when I graduated from high school. So I really didn’t have the opportunity to do sports although I would liked to have. I just wasn’t big enough. So I decided to try to excel in academics. I had wonderful science teachers. But one in particular, Mr. Sampson, who himself had wanted to be a physician but really his family couldn’t afford it financially. So I had made known to him and I had really decided by the time I was in the eighth grade that that’s really what I was going to do. So when I got to high school and got to know Mr. Sampson and he really sort of took me under his wing and encouraged me to pursue science, and I was academically very good in science. So it started there. And it was sort of coupled with my religious experience of wanting to find a place to serve mankind to make the world a better place. It’s sad though, the awful experience. And were it not for my grandmother’s teaching me to persevere, I probably would have been turned off. And I hope that no child has the experience that I had. But those were the days of prejudice and I actually went to the one and only doctor in our little village, a white doctor, and asked him what it was like to be a doctor and told him on the telephone that I wanted some day to go to medical school and would he give me some advice about what to do. The only response I got was a real belly laugh as he hung up the telephone, laughing about this little Indian boy who wanted to become a doctor. And I tell that story not so much to raise empathy as much as to say that in some ways it probably shaped my determination even more. But it was a combination of my interest in science, a good teacher, a negative experience with the doctor trying to find out what it was like, and this connection with my spiritual calling to a life of service.  \n\nThe next question I have, somewhere along the line in your training you obviously became married and had children. And I would like to go back and pick up your children, their names and grandchildren. \n\nThank you for asking. They’re the object of my affection, along with my wonderful wife. I was married to a nurse that I met while I was in medical school. A wonderful lady, Jeri Roper. I married her just after I graduated from medical school. We went to Atlanta together and she actually after a nursing degree was enrolled at Agnes College, a well-known girls’ school in the South. And we had a good life together. We were in the Navy together. We had two boys, Jim or James Grady, Jr. Jim is a man who actually probably should have been a physician. I made the mistake that a lot of doctors of my generation did by really trying to have hands-off on career choices for your children. Regrettably, both my boys decided they didn’t want to do medicine because they had seen how much of my life it had taken up and they didn’t want to make that commitment. And, in fact, probably was my overzealous devotion to medicine that ended up making that marriage not work. At any rate, we were married for several years and had a wonderful time together for most all of that time actually. So Jim finished up at the University of North Carolina, did graduate work in marine biology down at a branch of the University of North Carolina at Wilmington, known for its oceanography program, and really had wanted to work in marine biology. Regrettably, after he finished his studies the only jobs he could get were research jobs and he didn’t do too well being away from people. He’s a very outgoing person. So he finally found after a while he just couldn’t do that. Then he went into private business, an equipment rental business which he was very successful with. And about three years ago he decided that he felt called to be a minister in the Methodist church. So he is currently in his third year of seminary at Duke University and at the same time he’s pastor at a small, little Methodist church just north of the Raleigh-Durham area. I’m very, very proud of him. He’s married to Susan. They have no children. Susan is a researcher at the medical school at the University of North Carolina, Chapel Hill. Number two son who came along three years later is Robert. Robert went to a private university in North Carolina, Campbell University. Also graduated from their law school. Worked in the Public Defender’s office for two or three years then was in private practice of law until about the early ‘90s, about ‘94, ‘95 when he successfully got a position with the FBI. He is a lawyer with the FBI and has been stationed in Georgia. Recently was reassigned to the FBI headquarters in Washington where he’s head of their leadership college. He has my only two grandchildren. The oldest boy is Chase. Chase is a sophomore in high school. He just moved in with his dad in northern Virginia. And Robert is remarried and his second son and my second grandchild is Gunnar. Gunnar is four years old, full of life. They are both wonderful people. Chase and I have gotten to spend the last three years together because his mother is the in-house counsel for the teaching hospital here in Wilmington. So he spends much of his weekends up here with me and Michelle. I was remarried 13 years ago to a wonderful, wonderful young family doctor, Dr. Michelle Wass-Lehman (?), now Dr. Michelle Jones. We first met when she was a medical student at East Carolina and then we actually got to know each other and started dating after I had moved to Raleigh working for the Governor. And she did her residency at Duke Medical Center and is in private practice of family medicine here in Wilmington with what is now the largest multispecialty group in the state. I’m very proud of Michelle. She’s gone on to become a leader on her own right. She has recently finished a tour as both the President of the North Carolina Academy of Family Physicians and also Chairman of the Board of the North Carolina Academy of Family Physicians. She is currently in the leadership college of the state medical society. She has been head of the Section of Family Medicine in our large hospital here. She just continues to do good things. We are very, very happy and we have established a home here on the Intracoastal Waterway in eastern Carolina.  \n\nDr. Jones, I would like to go back now and pick up on your leadership roles starting in North Carolina, then the Academy Board, the Foundation Board, and then go back to your career from the time you left the Department at ECU. On the Academy, I note that you served there from 1984 to ’90 on their Board.\n\nThat was the American [Academy of Family Physicians] Board.  \n\nYou’re right. Let’s go back to the Board in North Carolina. You were President in 1973 on that Board. Can you tell me your proudest accomplishment serving on that Board? \n\nMy absolutely proudest, that’s easy. Although I had many proud moments, the easiest one was that I persuaded the Academy to come out publicly in support of a new medical school for the state that would emphasize the importance of training family doctors, and they did that. It wasn’t easy. Many of my friends were opposed to it. But they did support me and they did support the Academy. That act after the school was approved has made the Academy of Family Physicians of North Carolina very visible and also very politically significant in the state. And I think that’s probably the best work I did.  \n\nWere there any disappointments during that time? \n\nNot major disappointments. I found out that academics respond much slower. I regretted the fact that we had to go to the political process to get the University of North Carolina and then subsequently Wake Forest and Duke to follow suit to become interested in producing practitioners, family physicians for the state. I was disappointed that I wasn’t able to persuade them. But then, again, that didn’t happen in many places. But I would like for North Carolina to have been a leader in family medicine education without having to be forced to do that. But it works either way, I guess.\n\nNow back to the Board on the Academy. That was the one from ‘84 to ‘90. I will ask the same questions, your greatest accomplishment and any disappointments? \n\nIt was a wonderful time. I’ve always had the philosophy that all one can ask for in life is that whatever work that you have chosen to do undergoes change and you have opportunity to influence that change. And I think I was given that opportunity with the Board. I think the Board, some of the best work that we did was while I was on the Board. And actually in those days I was Chairman of the Board. It was an elected process in those days and it was before you ran for President. So as Chairman of the Board I did, I think, two important things. Actually several. But one is I settled about a decade-long dispute with the IRS that substantially financially profited the Academy. We had been in a dispute with the IRS about revenues from our magazine and that was settled early on when I was Chairman of the Board. Also, had the foresight of purchasing a large building for us in Kansas City and moved into the headquarters building. And also we procured during that time a property to house our Washington staff. So those were some of the major, they were big ticket items that happened while I was on the Board and Chairman.\n\nAnd then the Foundation, I think you sort of hit that with the financial, being responsible for the financial viability of the Foundation. Were there any other accomplishments and/or dis-appointments when you served with the Foundation? \n\nOne of the great things, I actually was helping to expand the work you and Tom had started. And that was the wonderful relationships that you were able to develop on top of the work that Tom had done in connecting with corporate America. Those were the days historically when I think we were probably closer to the leadership of some of the major corporations in America. The pharmaceutical industry for sure. But, also, I recall you reaching out to several other industries. I always remember the Dairy Council and several other of those things. Somehow along the way, I don’t know if it’s just economic times, but it seems to me that we go off that connectivity to corporate America that you had such a large role in and that I certainly supported. I think if we are ever going to get where we need to be as a specialty organization, I think that it’s going to be through things like that. We really need to get the public to get into the debate about the necessity of having well-trained generalist physicians as a foundation of our health care network. So I think that the work we did in connecting with corporate America through our Foundation was extremely critical to that. There were so many good things that I think we did with the Foundation. I don’t recall if it actually started then but I know that we had an emphasis on starting a research grant program so that we could foster academic [    ]. We served as a forum for virtually all of the other organizations within family medicine in that we had no particular ax to grind or no particular territory to stake out. So the Foundation became a very non-partisan in a lot of the places to house various programs and indeed facilitate communication between the different organizations of family medicine. I feel that some of our greatest accomplishments were, and I hope you do, too, Sandy, that we just determined we were not going to let the Foundation go away as some of the leaders wanted it to do.   \n\nAnd I would agree that you made that possible. It took somebody of your ilk to be able to convince them.\n\nBut you did the work.\n\nNow I would like to go back to what you have been doing since you left the Department Chair position at ECU. \n\nAfter I was President of the Academy, and I would like to go back and touch on a couple of things there, too, when we get finished with this...I think I finished my tenure on the Board in 1991 or so. And in 1994 after the Clintons had failed an attempt at national health care reform much like the debate we’re in as we’re making this tape with President Obama (he’s finding out some of the same forces that the Clintons had to deal with)...But as the Clintons failed at the national level to institute health reform the North Carolina, through its legislature, decided that it may well be the states needed to do health reform and the feds was not necessarily the best place to do it. So the legislature decided to do health reform and they formed an entity called the Health Care Planning Commission. And I was appointed by the governor at that that time, Governor Jim Hunt, who actually I had known for awhile and had been an ardent supporter of. He actually asked me to be in his cabinet in a previous administration and I gratefully declined. He then appointed me as head of his Health Planning Commission. And it was a remarkable enterprise. I decided to try to not make the mistakes that Mrs. Clinton had made. And I made it a very public process. We had several commissions under the Commission that went around the state holding public hearings and really was able to generate a significant amount of interest. Regrettably, the political fortunes changed at sort of the peak of what we did after two years. The conservatives gained control of both houses of our legislature and they brought the Health Planning Commission to its demise. It’s interesting, the current debates, you could actually go back and pull out chapters of our discussions and access some of our recommendations and they’re unfortunately the same thing we’re dealing with now. While I was doing that I was actually also, with the understanding of the Governor, keeping up my clinical skills by being a member of the faculty at the University of North Carolina-Chapel Hill, which is very near Raleigh, so I was able to do both of those things. And then when I finished in Raleigh I actually then the last couple of years was on the full-time faculty at Chapel Hill where I had a wonderful opportunity to in addition to seeing patients and teaching students and residents, to help them develop endowed chairs. They were the only major department in the medical school that did not have endowed chairs at that time. And taught by this fundraiser, Sandy Panther, how to do that. And so we raised enough money to endow two chairs during the time I was there and I’m also very proud of that.  \n\nAnd then once you left Raleigh you…\n\nI then moved to the eastern part of the state. We’re just north of Wilmington. Michelle had been offered a position with Wilmington Health Associates which is now the largest medical specialty group in the state. And I had really planned to retire and did for about six months, I guess. Then I was recruited to help sort of fill in in one of the state-operated rural health clinics about an hour’s drive away from where we were living. And I just absolutely fell in love with the place. I was able to help them restructure. They have three clinics in very isolated rural areas. I’ve actually seen patients in all three of those. I became their Medical Director and helped them recruit younger doctors. And I just totally enjoyed that experience. I finally retired from that a year ago in 2008. But I’ve had the wonderful of going back to do what I started out doing, practicing there in the rural part of the state. At the same time I became involved with the formation of the Community Care of North Carolina. I made reference earlier on to Dr. Allen Dobson. North Carolina looked at almost having to privatize Medicaid. I realized when I was head of health planning for the state that health care expenditures were just eating up way too much of the state’s budget. One in every five dollars was going into health care, either Medicaid or the state health plan or various other ways the state subsidized health care. And obviously that was just too much. The state couldn’t build roads or schools or support law enforcement in the way that we all expect it to and continue to have health care eat up so much of the budget. So rather than to farm out the Medicaid to some third parties, Dr. Dobson and some of his other colleagues asked the state to let the physicians manage Medicaid, which is unheard of, I suppose, in the country. And so they developed a not-for-profit organization, Community Care of North Carolina. I was part of the formation of that and currently serve as the vice president of the statewide organization. Under that statewide umbrella there has developed now 14 local networks. One in southeastern North Carolina is called the Community Care of the Lower Cape Fear. I’m the Medical Director for the six-county area and what we do is through case managers we manage the Medicaid program for the state in this particular region. And now every county in the state belongs. We have six counties here. Statewide we have about 1 million Medicaid patients that we manage. The process is to help improve the standard of care by best practice model. We have used national guidelines and provide educational programs for the providers. I say providers because they are primary care physicians and in a lot of places their satellite offices are operated by P.A.s or family nurse practitioners. We audit their practices which they have allowed us to do to point out areas of improvement. It’s just been a remarkable success. It has saved the state of North Carolina over $500 million in the last five years. They have improved the quality of care by all of the auditable standards that we have. And it’s just really remarkable. The decrease in emergency room visits for Medicaid patients has gone down dramatically in the specific diseases that we have managed. And it’s also, in my judgment, allowed the Medicaid program to keep from having to decrease physicians’ reimbursements because we turn the money back into the state to keep in the program. It has now been nationally recognized as one of the hospital strategies for moving forward in the health reform. So I’ve still been active in putting this together. I’m very excited about it. I think it has great promise both in North Carolina and nationally. We have just gotten approval from the federal government. The first time any state has been awarded a Medicare project. So we’re currently doing a demonstration project for the feds in Medicare as well as Medicaid. If this goes well, we’ll be able to manage Medicare as alongside of Medicaid. So it’s very exciting and it’s allowed me to continue to participate.  \n\nJust one other question career wise. You have also been involved in peripheral activities other than medicine? \n\nI have been involved in some business ventures with partners in the commercial business of producing and raising and marketing catfish. We also are considering some other business ventures. But have also been involved with the medical missions a great deal. I have a great passion for that sort of thing.  \n\nAnd with the Foundation you were involved in the Physicians With Heart project? \n\nIt was thanks to your enticing me to do that. We have become very good friends with you and Dick, of course. But also Gary in the Heart to Heart program. You and I have been on at least one trip but then you’ve been on several doing humanitarian work as well as sort of spreading the gospel of family practice. I think that it’s a wonderful partnership with family medicine in America to go to these places, provide financial aid. Again, some of the payoffs for your reaching out to corporate America. You certainly know the numbers better than I do but I know that millions upon millions of dollars’ worth of medical supplies, both pharmaceuticals and other hospital-related equipment, has been given to struggling post-Communist countries. And again, it’s one of those things I look back on and am pleased to have participated in that. I also currently serve on two other boards. I’ve been involved with the Albert Schweitzer Fellowship. It’s a Boston-based fellowship that tends to continue to emphasize the philosophy of Dr. Albert Schweitzer, the Novel Peace prize winner of dedicating young people to lives of service and championing them and urging them. We have chapters now not only in Boston but in North Carolina, Vermont, California, Texas and several other places. And it’s just been a wonderful thing to watch young people in the health science field be willing to commit to a life of service when everyone else think the young people in this country are going downhill. I’m also currently on the boards of a foundation in North Carolina that supports the work of various rural health initiatives started by a wonderful man who died way too soon, Jim Bernstein, that promotes rural practice and tries to enhance and encourage opportunities for young people to go live and work in rural North Carolina. I continue to be busy. I’m blessed with a wonderful wife to help me during this time of our life. And my health remains fairly good and I’m just really having a wonderful time.\n\nJust to sort of recap, what was the position that you held that you enjoyed the most in your career? \n\nThat’s really hard because I’ve been blessed way beyond anything that I might have imagined as a little boy in that Indian village way back. I think the two things that helped probably define me most have been being President of the American Academy of Family Physicians. Its association with the Foundation and with the other organizations. That really was one of the pinnacles of my career. And the other thing though that I’m extremely proud of is having the opportunity to help found a medical school, to chisel in its very foundation the principles of family medicine and its commitment to train doctors for the people of this state. I’ve had honors upon honors beyond what were due me. But I look back on it and think that those were probably the high points. They also were some areas of disappointment. As an Academy president I really feel that I had opportunity to make differences that didn’t get made. One of the regrets of my life is that we were not able during the ‘70s and ‘80s when we all thought that the new specialty would bring credibility and value to family doctors, I regret that didn’t happen. I personally feel some responsibility. I was the family practice sole designee in restructuring reimbursement for doctors in America. You may recall that that was based on a study at Harvard headed by medical columnist Dr. William Hsiao. And I represented family medicine there. While I was able to persuade the people around the bargaining table, the other specialists including the American College of Surgeons, that we ought to be reimbursed at a better rate, when they did that test in the field they found family physicians didn’t feel that their services were valued at the same value that I was trying to sell them at. I would wish somehow that I had been better able to persuade our own colleagues to make a more forceful statement about their rightful value in our system, and that didn’t happen. And I was the person who was the go-between the practitioners and the people -- in this new system of payment. And we didn’t come out any better and I feel some personal responsibility for that.\n\nWas there any position that you enjoyed least or did not enjoy in your career? \n\nI’ve been blessed. I didn’t enjoy much serving with the Marines, to be totally honest. There are some big mosquitoes in the swamps of eastern North Carolina. I still look back on that as probably the only time. I have just been blessed, Sandy. I have had such a wonderful, wonderful life. And you know me personally. You know how far that I’ve come from my humble beginnings. So I really can’t say any major disappointments. I’ve just been so honored to have served. I got at odds with Dr. Pisacano that I regret. I really believe strongly that the American Academy of Family Physicians, that family medicine as a discipline should merge with internal medicine. And I debated him publicly on that and sort of fell out of favor with him. I regret that because I love Nick and have a lot of respect for him. We did honestly disagree on that. Regrettably, neither one of those specialties have been able to continue to gain in either popularity with the medical students or with the profession of medicine in general. Both of us have been relegated sort of as a stepchild as far as reimbursement is concerned and several other things. So he may have been right if we had merged. I still have problems giving up some of the breadth of family medicine that we would have had to do in that process. I regret over time that when I look at my wife’s practice some of the things that I think were the most rewarding that I did as an early general practitioner, family doctors no longer do. Very few family doctors deliver babies. Almost none of them do surgery. By and large they’re giving up hospital privileges to hospitalists. We used to also man the emergency room. Little by little I have watched us give away big chunks of the clinical aspects of the general practice that I regret. And it’s sort of hard to get it back once you’ve given it away. And I think we’ve sort of placed ourselves into a little corner that I’m not always happy about.\n\nYou may have answered this already, but in what position do you feel you accomplished the most? \n\nProbably as Chairman of the medical school department. I was able to have influence on what our school became. I think had I not been there they would have made it just another little traditional medical school. And I really put myself on the line for that because the worst thing that I could do is they could make me go back into practice, which was my first love anyway. So during those first years there was a bitter competition between me and the dean of the medical school. So when I look back and realize that this school now has emerged as one of the few medical schools of that generation that has remained true to its primary care mission, I think that probably means a lot. I am really pleased that I had been involved at the time when family medicine became a specialty. That’s very rewarding. I’m just blessed to have been in the right place at the right time for a lot of things.\n\nThe last thing before I give you a chance to be philosophical, you had mentioned that you were very blessed with your honors. I noticed that in 1988 you were named the Indian Physician of the Year. Were there other honors that you were blessed with? \n\nI was and thank you for asking. I have so many. I was given an Honorary Doctorate degree after being involved with the Health Planning Commission for the state.  One of the most prestigious things in North Carolina is to be chosen by the leading newspaper in the state as what they call the Tar Heel of the Week. You can only be that one time in a lifetime. I actually got selected twice. And I received the highest award that both the state of North and South Carolina give. The North Carolina highest award for citizens is the Order of The Long Leaf Pine which I received from one of our former governors. I also received the Order of the Palmetto which is the highest honor from South Carolina. I’ve just been blessed. But at the very end, and I guess this is a segue into the philosophy, though I’ve been blessed so overwhelmingly both personally and professionally, I think the thing that means absolutely the most to me and that I would give up all those other accolades for is that I really value friendships, the friendship that I enjoy with you and people that I’ve met in these various activities. At the age I am in life now, looking back on it, they are the most meaningful and rewarding parts of my life, the personal relationships that I’ve developed.  \n\nAny other words of wisdom that you would like to do as we wrap up this tape? \n\nI hate to end my career looking on a cynical note. And I try hard not to be because as you and others know me know that I’ve always been optimistic. I do worry about all of medicine in America at this point. We’ve somehow gotten away from being a servant profession, which I think medicine is at its best when it’s viewed as a servant occupation or profession. We’ve somehow managed to make a business of medicine and the business of medicine seems to take most of our energy and most of our attention so that you end up having doctors more concerned about their income than they are about their patients. And that’s a sad state of affairs. I watched it happen during my professional career. It’s a really sad state that we’ve arrived at in American medicine. I don’t know if there is the political wheel within the profession of medicine for us to go make some of those wrongs right again. I have very cautious optimism that we can. But I’m not so anxious to see what all of the debate is going to come out. If doctors remember that we really are privileged to be healers. It’s a high, high honor. It’s not about how much money you make or even about the status you have in the community. It really ought to be about the honor of service. And I’m afraid we’ve gotten away from that. I’m not sure that the doctors who have come to think of it as a business, a high-paying profession, that they’re going to be willing to give that up so that we can do what I think everybody knows is the right thing to do and that is to have the foundation of our health care delivery be affordable and accessible to everyone and that the primary provider, the medical home or the system like that ought to be with well-trained generalists which I think ought to be led by family doctors. That’s my hope for the future. I must say that I’m only cautiously optimistic that it will happen.\n\nThank you very much. This has been my pleasure to be part of this process with you. It is always more informational for me and much greater. I have been blessed to be able to do this with all the past presidents of the Academy and the Foundation. So thank you, Dr. Jones, for your time. \n\nThank you, my dear. And thank you on behalf of all of us in the discipline of family medicine for all of the contributions that you have made. Many people don’t know of the great work that you have done. I have been blessed to have been associated with you and I consider being friends with you one of the great privileges of my life.  \n\nThank you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153043/file/281686#t=0.0,3412.81149"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153043/file/281685","type":"Canvas","label":{"en":["Media File 2 of 2 - Jones_James_09_b.wav"]},"duration":2386.26142,"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/153043/file/281685/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153043/file/281685/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/685/original/Jones_James_09_b.wav?1752088674","type":"Audio","format":"audio/wav","duration":2386.26142,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153043/file/281685","metadata":[]}]}],"annotations":[]}]}