{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/zs2k64d03s/manifest","type":"Manifest","label":{"en":["Dr. Roy Gerard"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Description"]},"value":{"en":["\u003cp\u003e This is a fascinating interview of an 83-year-old physician who was still practicing in a university department of family medicine at the time of the interview. Dr Gerard served in World War II, was wounded in France, came home, and started college after the war. Like many family physicians, he tried other college majors before medicine, but wound up in medical school. He returned to the area where he grew up, started a practice in the early 1950s, and hung up a shingle describing himself as a family physician. In the late 1960s he established a residency program in his community. He later asked the dean at Michigan State University College of Medicine why the University had no department of family medicine. He was asked to help start a department, and he became its first chair. He has a strong belief that the key to being a good family physician is knowing the patient, a concept he calls the \"Wise Physician.\" His beliefs helped define the way family medicine was taught in his department. He continues (at the time of the interview) in the department where he was the chair as  a past chair, a role he described as being more challenging than being chair--leadership without authority is how he described it. His background is colorful (he has 14 children) and illustrates the trials and tribulations of the early family physicians and family medicine educators. \u003cbr\u003eLocation: Michigan \u003c/p\u003e (summary)"]}},{"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":["2017-11-15 (created)"]}},{"label":{"en":["Agent"]},"value":{"en":["Dr. Joseph Scherger (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["family physician","family medicine","American Academy of Family Physicians"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"summary":{"en":["\u003cp\u003e\u0026nbsp;This is a fascinating interview of an 83-year-old physician who was still practicing in a university department of family medicine at the time of the interview. Dr Gerard served in World War II, was wounded in France, came home, and started college after the war. Like many family physicians, he tried other college majors before medicine, but wound up in medical school. He returned to the area where he grew up, started a practice in the early 1950s, and hung up a shingle describing himself as a family physician. In the late 1960s he established a residency program in his community. He later asked the dean at Michigan State University College of Medicine why the University had no department of family medicine. He was asked to help start a department, and he became its first chair. He has a strong belief that the key to being a good family physician is knowing the patient, a concept he calls the \"Wise Physician.\" His beliefs helped define the way family medicine was taught in his department. He continues (at the time of the interview) in the department where he was the chair as \u0026nbsp;a past chair, a role he described as being more challenging than being chair--leadership without authority is how he described it. His background is colorful (he has 14 children) and illustrates the trials and tribulations of the early family physicians and family medicine educators.\u0026nbsp;\u003cbr /\u003eLocation: Michigan\u0026nbsp;\u003c/p\u003e"]},"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281589","type":"Canvas","label":{"en":["Media File 1 of 3 - Gerard_Roy_Pt1_08_a.wav"]},"duration":2884.05841,"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/152994/file/281589/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281589/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/589/original/Gerard_Roy_Pt1_08_a.wav?1752070795","type":"Audio","format":"audio/wav","duration":2884.05841,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281589","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281589/transcript/81599","type":"AnnotationPage","label":{"en":["Dr. Roy Gerard interview transcript  [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281589/transcript/81599/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I am Joseph E. Scherger on November 15, 2007, I’m here in the Board of Curators of the American Academy of Family Physician and today we are doing the oral history of Roy Gerard from Michigan. Roy, would you please just state your full name?\n\nRoy Joseph Gerard, MD.\n\nWhat is your present title? \n\nI’m Professor and Founding Chair of the Department of now Family Medicine, used to be Family Practice ----.\n\nWhere and when were you born? \n\nI was born in Bay City, December 18, 1924. \n\nBay City, Michigan?   \n\nYes.\n\nWhat are your parents’ names? \n\nMy father’s name was Roy, my mother’s name was Grace, her maiden name was Fisher and she was from England. My father, the name Gerard is French, his family came from Quebec. The area that I lived in Bay City was called Banks and it was called Banks because the people who lived there were French Canadian fishermen who lived on the banks of the Saginaw River originally. It was a French ghetto.  \n\nSo your father is French Canadian and your mother is English?\n\nYes.\n\nWhat did the family do for a living? \n\nMy father worked for Consumer Power, he was a lineman and unfortunately when I was about twelve years old, was electrocuted and so my mother raised me and I have an older sister who is deceased, named Pearl and a younger sister named Jacqueline who’s also deceased. But my grandfather lived on that street and ran a meat market, it was Fisher Meat Market in the French part of town.\n\nSo Bay City is not too far from Saginaw where your original practice was?\n\nThat’s correct. I practiced in Saginaw so I could be close to my family, which was in Bay City.\n\nHow many miles away? \n\nTwelve, thirteen miles.  \n\nThat’s something. The next question deals with marriage and marital history and I know in your life with fourteen children, you’ve got a complex history. Share what you would like here for this tape.\n\nMy first wife and I, I met her shortly after I came out of the Army in World War II, her name was Patsy and she was from Bay City. She and I had ten children together, seven daughters and three sons.  We had a wonderful life together as a family. Unfortunately, she had a cardiac arrest back in 1979 and was left quadriplegic and lived like that for two years. Died in 1981.  \n\nAnd then you remarried?\n\nI remarried in 1986 and that marriage didn’t work out for me, although I have a little girl by that marriage. Oddly enough, I came home one day and my wife had left me with a four year old child but I raised her.  \n\nAt this time your other ten children were in the house?\n\nAt one time all the kids were together. By the time my wife died, everyone was gone. My youngest son was away at college.  \n\nSo they were on their own. You have fourteen children.\n\nSo ten years ago I got remarried and my present wife, Debbie and we had a little girl that’s ours, her name is Sara and she is seven years old. We have adopted two little girls from Guatemala, Kimberly, who is three and a half and Vanessa, who is sixteen months of age so it gives me a round number of fourteen kids. The kids are all over the country now.\n\nAre we going to need to do another oral history in a couple of years to update your children? \n\nThat’ll be interesting to see how that works.  \n\nI’m the Men’s Health Editor for Revolution Health and I get a lot of questions about how to be able to maintain your ability to have children and I think you should be doing that and not me. That’s really something.\n\nYou grew up in Bay City, your whole childhood there? \n\nYes.\n\nTell me about your role models when you were young. \n\nGood question. Obviously my mom, who was a hard working woman to support us after my father died, was a model for me. My oldest sister, Pearl…actually my two sisters, they both graduated from high school as valedictorian of the class. I was the family idiot. I only got more than C’s in high school when I wanted to play football. I went to a Catholic school and I had a Sister Mary Cresensia (?), don’t ask me to spell that and she taught math and all the sciences. The war was going on, I graduated from high school in 1943 and the Army came to our community and wanted us to take a test for a specialized training program, people who were going to be drafted. I decided I wasn’t even going to compete with that exam because of being the family idiot, I wasn’t going to embarrass my family so I didn’t enroll to take that test and this nun came to me and said, Roy, I want you to take that examination. I said, why would I do that? You look at my report card. She said, I want you to take that exam. She was the principal.  So I took an exam at Bay City Central High School, I was at St. Mary’s, which is a Catholic school and it was the most relaxing exam I’ve ever taken because I figured I wasn’t going to do very well anyway, I’ll just  do it. Lo and behold, I got the highest score on that exam in Bay County and the result of that was that when I went into the Army, I did infantry basic…they sent me to ASTP, which is Army Specialized Training Program and at the end of my infantry training, sent me to the College of Puget Sound in Tacoma, Washington in a pre-engineering program. I had never even thought about going to college. It was strange because my report card…and I have a copy of my report card somewhere that my older family has seen. It was…but the point is, that principal knew something I didn’t know and it changed my life.  \n\nThat’s really great. Your dreams for yourself before this discovery that you were smart, what was your identity of what you were going to do? \n\nI thought I would end up working at the automobile factory. In fact, my grandparents, who were English, had thought it was a good idea because back then if you had a job on line, you were making pretty good money. My grandmother on my mom’s side, thought I was lazy when I came out of the Army and decided to go to college. She thought I should go to work on the line so it was interesting.\n\nTell me about your Army experience in World War II. \n\nWhat happened was, I went to the College of Puget Sound after my infantry basic training in 1943 and spent a couple of terms there. Then in 1944 the war was accelerating so all the ASTP units were disbanded and we were assigned to various combat units around the country and I was sent to Camp Cook,, California, which is now where Vandenberg Air Force Base is and I was made part of the Eleventh Armor Division, the 55th Armored Battalion and we went to England, in September of ’44, went to England and stayed there and completed our training until December of 1944 when we were sent to France. We thought that we were going to be stationed in the southern part of France just to keep the Germans who had been isolated when the breakthrough happened at Saint-Lô, that we were going to be there. Unfortunately, the Germans had a counterattack in December, actually it started December 18, which is my birthday and we found ourselves driving across France and my outfit was committed to combat December 31, 1944, which is the day I got wounded.\n\nTell me about that. \n\nWe were taking a little village called Acul and none of us knew what we were doing. I was the shortest man in our outfit and our captain asked me to get on a portable radio and see where the Germans were. I was peeking around the corner of a building to see and I couldn’t see so he sent a guy who was taller than me, to stand behind me so he could give me the information so I could get information as to where we were being fired on and so I’m standing there with this man, oddly enough his name was Jack Beverly, he’s from Kansas, which is strange, and I’m just about ready to say something when a mortar shell landed in front of us, another one landed behind us and another one right on us and killed everybody except me and this guy on top of me, Beverly, he saved my life.  \n\nHow many was everybody?\n\nAbout seventeen.  \n\nAnd Beverly was killed too, he fell on top of you? \n\nYes, he fell on top of me so he actually saved my life. My arm was hanging out, my butt was out so I got shot in the arm and shot in the butt.  \n\nWhat a horrific story. That’s probably been a nightmarish scene your whole life.\n\nYeah. In fact, just last week our public channel station has had a thing on the war and they had the Battle of the Bulge and they showed the Eleventh Armor Division and I remember the snow and how cold it was. The casualties were just…I don’t think you’re ever prepared for war but we didn’t even have a warm up, it’s like being a substitute player.\n\nYour rescue, what was that like? Here you are laying there with everybody, you didn’t know if everybody was dead around you but…\n\nI didn’t know. I was laying there in the snow and the building I was standing next to was on fire and I thought I was dying. I started to pray and so I heard a call, “Hey, Junior,” they called out, that was my name. “Hey, Junior, can you walk?” And I said, “No.”  \n\nHow long after the explosion? \n\nI would say thirty minutes or so, about thirty minutes. I’m laying there and I figure well, I’m going to die and I hear, “Hey, Junior, can you walk?” I yelled back, I said, “No.” He said, “I’ll come and get you.” So this guy, I don’t know his name, picked me up, carried me in his arms, was shot in the neck while he was carrying me and then set me down on a snow bank down a little hill out of the fire where I laid for it must have been a couple of hours and somebody then came and dressed my wounds and then a man walked by me and looked down at me and started to cry, took off his overcoat and covered me. Then before I knew it, I was put on a Jeep, on the front of the Jeep on a stretcher, I think that’s how they used to give the wounded people…and then sent to a battalion aid station, it was a Belgian farmhouse where my wounds were treated. Then from there, I was put on an ambulance and they sent me to Liege, Belgium, I think it was a former seminary or something like that where New Years Eve I was operated on.\n\nWhat surgery did they have to do? Just removing shrapnel and such? \n\nPrimarily shrapnel. My arm, I got seven or eight sites from here, my elbow, I lost a bone here and up in here. My arm was pretty well blown apart.\n\nThe man who carried you, was he killed? \n\nNo, he wasn’t killed. They treated his wounds and he walked away. I don’t even know who he was.  \n\nBoy Roy, talk about feeling fortunate and God looking after you.\n\nIt‘s strange because I forgot about the farmhouse and then when we were in this seminary, they ---- the seminary that night, we thought we were going to get shot again and then a couple days later I was taken to a railroad spur to be put on a train to go to Paris and unfortunately, the Germans started to drop B2 rockets on the railroad spur and I was in a tent hospital and suddenly they threw the back of the tent off and there was an airplane there and they put me on this plane and flew me to England. The war was over for me. Strange story is that a hundred years later I’m in medical school and I go there on the GI bill and ---- had to do with being disabled and so the Veterans Administration wanted me to have a physical exam because I have a disability so I was at the University of Michigan Medical School. I didn’t want people there to know anything about my wounds so I called my mom, who was in Bay City and said, could you arrange for me to see a doctor, I need an exam. When I was growing up we didn’t go to the doctor. So she said, sure, I’ll set you up at the Allen Medical Clinic in Bay City. So I hitchhiked from Ann Arbor to Bay City, went to the Allen Medical Clinic, walked in, I said, I’m Roy Gerard, I have these papers and a Dr. McPhail was to take care of my wounds, so he looked and said, “Where were you during the war?”  I said, “I was ----.” “When were you wounded?” “December 31, 1944.” He said, “Could you describe Battalion A station where your wounds were treated?”  I said, “Yes,” so I did it and he said, “I was the doctor who treated you.” \n\nUnbelievable. \n\nThat was just crazy. The room I remember, those women were praying and so on and so forth, it was crazy. That was a crazy experience. Then, now I’m Chair of the Department of Family Practice, College of Family Medicine and I read this essay written by Bill Close from Big Piney, Wyoming.  \n\nI know Bill Close.   \n\nOkay. I called Dr. Close and said, Dr. Close, if you could talk about rural practice, I read your essay, if you speak as well as you write you’d be an inspiration to medical students and I’d like you to come to Michigan State and give a lecture and I’ll give you an honorarium and pay your way. So he did. He came and he gave a wonderful lecture. After the lecture I took him out for dinner, we were having some wine with dinner and I said, “Dr. Close, what did you do during the war?” He said, “I flew air ambulances for the Army Air Force.”  I said, “Was your nurse named Penny?” He said, “Yes.” He was the pilot of the plane that flew me out of Belgium.  \n\nWow.   \n\nAnd he and I have become good friends. I’ve been out to Big Piney to see him. That’s weird.  \n\nIs he doing well? \n\nHe was the last time.  \n\nBecause he contacted me ten years ago when I was Chair at UC Irvine about some of the writings I was doing and then I got his Africa book and his book on…he was doing all that other work of course. \n\nHe wrote that book on Ebola ----.  \n\nSometimes reality is stranger than fiction. If someone wrote this you’d say ---- the coincidences are unbelievable.\n\nAnd there’s one more story of this. Two or three years ago I’m doing a physical exam on this young guy who has a farm outside of East Lansing. He was describing his farm and that his feeble parents, he used that term, lived at one end of the farm, he lived at the other end of the farm. They took care of the farm and he would cross country ski in the wintertime, go back and forth to his parents but the sense of family was overwhelming. That was just me. We’re using electronic medical record and so I wanted to complete his records so I went in the back of our clinic, sat there with, oddly enough, Dr. WinklerPrins, who is my physician and I said, Vince, let me tell you about this experience, this family and so I told him about it. He said, that’s nice, that’s strange because I had just had a family experience, let me share it with you. I have this woman in her eighties who I admitted with pneumonia and unfortunately she had a stroke and her two daughters and her son haven’t left her bedside and she’s at Sparrow Hospital and there’s a picture of her when she was a nurse in World War II and my skin began to…the hair began to stand up. I said, what’s her name? He said, “Katherine Kerr.” My skin really went up again. I said, can I call the room? I think I know the woman. So I called the room, her daughter answered and I said, “This is Dr. Gerard, Dr. WinklerPrins talked to me about your mother. Was your mother’s maiden name Tremble?” And it was. And this was the nurse who wrote my first letter home.  \n\nI know why you’re called the Greatest Generation.\n\nThat’s a crazy story.  \n\nThat’s wonderful, Roy.\n\nI went to her funeral and her daughter came to me when I walked into the church and said, “I have something for you.” And she was looking at her mom’s desk and found a picture of me when I was in this Army hospital.  \n\nAnd you were twenty years old when all this happened?\n\nYes.\n\nTake me into the post-war period. I know you eventually graduated from college at the University of Michigan but why don’t you take me through that post-war journey that led to medical school?   \n\nI wasn’t sure back then what I wanted to do when I enrolled at Michigan. I really wanted to be a rocket scientist, that was…I had seen rockets.  \n\nFamily idiot to rocket scientist. \n\nAnd I was in pre-engineering, it wasn’t so farfetched to do that. So I took a lot of science courses and was in that direction except that a friend of my mom’s, one day we were talking about goals and he said, “Roy, I think you’ve got better people skills than you do some of your science skills, have you ever thought of medicine?” I said, “No.” He said, “I think you ought to think about it.” I thought about it and took a couple of courses, Zoology and so on and I was fascinated by it and just switched my major, just like that.  \n\nSo you got treated, you were discharged from the Army, you had this examination to define your disability, did you go right to the University of Michigan in Science, switching over to Zoology? That was a direct move? \n\nYes.\n\nHad Ann Arbor been a place that was the logical choice for you? Why not Michigan State? \n\nOddly enough, my first wife, Patsy, when we were dating, took me to my first U of M football game. Her father was a Michigan fanatic. It just was logical. Her family was in love with Michigan, I didn’t care but the roots were kind of set.\n\nWhere did you meet Patsy along the way of this story? \n\nActually when I came home from the Army I went to a dance and she was a high school senior.  \n\nYou were the wounded soldier.\n\nOh yes.  It was crazy.  \n\nSo she’s from Bay City also.\n\nYes.\n\nSo you were in Ann Arbor together, post-war, the college student. \n\nYes.\n\nWhen were you married? \n\nWe were married in ’46.\n\nSo you finished Michigan in ’49. You stayed there at Ann Arbor to go to medical school…\n\nActually I lived at Willow Run Village, which was in Ypsilanti, which is outside of Ann Arbor. They used to build, they were called bombers at Willow Run back then. \n\nHow many medical schools did you apply to? \n\nI applied to two medical schools, Johns Hopkins and U of M. I got accepted at U of M.  \n\nThe grades were good? \n\nYes, they were.  \n\nGood for you, that’s terrific. When you started medical school, you had switched from rocket science to medicine. What was your vision of yourself as a doctor?\n\nI wasn’t sure. Part of me, I thought about general practice. One of the things that happened to me, what kept happening to us is we kept having babies and so I ended up with three kids on graduation. One of my sons was born the year I graduated, ’53.  \n\nMedical school or college?\n\nMedical school. So I had three kids by the time I graduated from medical school. I got a job about the end of my sophomore, beginning of my junior year at Beyer Hospital in Ypsilanti and I was an extern so when I got through with classes I would go over there and I would do everything. They paid me, it was close to where I was living and I could eat there too, which was an advantage. One of my first days there I had a white coat, it felt really good. I got in an elevator with a lady on a stretcher and she turned to me and she said, “Doctor.” And here I’m a medical student. “Have you ever delivered a baby?” I said, “No.” She said, “You’re going to now.” [Laughs.] There was a nurse with her and by the time we got to the third floor, I had delivered my first baby, my white coat was no longer clean but the romance was there so when I was at Beyer I hung around Labor and Delivery and I delivered at least a hundred babies by the time I graduated. Most of the docs who I was associated with were GPs and they were my role models.  \n\nThat was the 50s, I was three years old when you graduated from medical school.\n\nHow old?  \n\nThree. I could be one of your children. So delivered a baby? I was an extern and met my wife on an elevator, St. Elizabeth Hospital in Dayton, Ohio. That was a wonderful thing to do early in your career.\n\nSo general practice? You then went back to near home to Saginaw for internship. \n\nYes. My advisor at Michigan was a pediatrician and I told him I wanted to go into general practice, Taubman was his name, in fact there’s a Towsley Continuing Education Center at the medical school. He told me I would waste my medical career if I went into medical practice.  \n\nEven back then?\n\nBack then. So I went to Saginaw, did an internship at St. Luke’s Hospital. Wasn’t sure then what I wanted to do. The best role model for me in the community happened to be a Dr. Bullington who as a general internist who was program director for the internal medicine residency program. I thought he was the best doctor in town so he was my role model. At the end of my first year I had a Dr. Casino, who was a general practitioner as a patient, came in with acute MI. With our wisdom we kept him in bed for a month and put him on Coumadin. I was attending resident and one day making rounds he said, “Roy, you’ve got a vacation coming up, would you be interested in covering my practice?” I said, “Dr. Casino, I don’t know anything about general practice.” He said, “Agnes, my nurse will tell you what to do.” And I said, “Oh, well I don’t have a car, I don’t have a bag.” He said, “You can have my car and my bag.” I said, “Well, I’ll talk to my program director,” so I talked to Dr. Bullington and he said, “You know Roy, you ought to do it, it might be fun for you.” And so, I did it and Agnes told me what to do. But what I didn’t know was, every day I would round at the hospital to see my patient, Dr. Casino. He gave me a laundry list of home visits that he wanted me to make and I was, first of all I said, “What do you want me to do?” He said, “Just to talk.” He told me about the patients so I started making home visits every morning and it was wonderful. The romance was started because that really set the whole scene. I’d never had so much fun in my life.  \n\nAnd that was right there in Saginaw?\n\nYeah. His office was in Birch Run, just outside of Saginaw in Birch Run Township, so rural. So I would go to farmhouses with my bag, his bag, introduce myself and find out what was going on, what I was supposed to do. They always would give me some breakfast, coffee, we’d sit down and talk, I got to know families and that did it.  \n\nWonderful story. So you then, after that internship, started practice in Saginaw. Tell me about that.\n\nI wasn’t sure at first what to do and so I worked for an orthopedic surgeon named Dr. Sulbrath (?), he was a good surgeon. Absentminded. He let me see patients in his office. I didn’t have any overhead but what he didn’t tell me was he was absentminded and he would schedule patients in his office and then have surgery so I would come to my office to see a couple of patients who were mine and have ten patients of his who needed to have casts taken off or the back pain taken care of so I didn’t realize at the time but it was a wonderful training course in orthopedics. I forget exactly how long I used his office, six to eight months and then I opened my practice. But I didn’t want to be called general practitioner so I called myself and I had a gold sign, Roy J. Gerard, Family Physician and the first thing that happened is the Saginaw County Medical Society called me in front of the ethics committee for advertising and wanted to tell me, I had to explain to them the difference between a family physician and a general practitioner and I’ve been doing it ever since.  \n\nI read that in your “Wise Physician” essay, it’s a wonderful story. Just by putting a shingle out and having that was advertising. An amazing story. \n\nSo the years of practice and you’re a witness to the entire development of family medicine as a specialty and you immediately became part of it in your community. Tell me about the transition from your practice to the residency program in Saginaw.\n\nThe community was struggling. The hospital where I did my internship was the best place in town other than St. Mary’s for general practitioners but they were shrinking in number and some of them were not great and so we tried…Bullington, who was my role model, helped me to develop a curriculum. So we tried to develop a residency there and it wasn’t going anywhere.  \n\nWhen would this have been?\n\nIn the 60s, ’67, ’68. I finally talked with people from the Academy. I had Tom Stern and all of… \n\nDid Tom Johnson ever…?\n\nTom Johnson came to Saginaw.  \n\nIn his Cadillac?\n\nYes. Tom Johnson came, Gayle Stephens came. I had all kinds of people telling me what to do and how to do it and so we got approved in 1968 and my office became the model family practice room and I had a couple of residents, one of them is Jim O’Brien, who is now Chair of the Department of Family Practice, University of Louisville. Anyway, Jim was one of my first residents. It was a piece of cake with a guy like him, from Ireland. He had wonderful communication skills. I knew my patients. We developed curriculum day to day. We came here, STFM was, used to a motel in that wrinkle there (?) and we put together the curriculum.  \n\nGreat story and certainly Saginaw…I’ve been aware of its reputation all through as being a really great residency and what it’s done and procedures, great things. But you went on after doing that for five or six years, you went on to be the founding chairperson. \n\nYes. What happened was, see, the medical school, the College of Human Medicine started in the 60s and they were looking for communities where they could send medical students and Dr. Hunt, Andy Hunt was the first dean there and he was a pediatrician. A very innovative kind of guy and I said to him, “In this new medical school how come you don’t have a Department of Family Practice?” He said, “Why should I?” So I had to define for him, again, what I thought family medicine was. He said, “Would you work on a committee with me?” So I got on a committee at Michigan State and put together, with some help from both internal medicine and pediatrics, in particular, pediatrics, a guy named Ray Helper, who is dead now but he helped me the most. He said, “You know Roy, if you put together a new department, understanding the family ought to be the basic science of family medicine like anatomy is the basic science for surgery, then understanding the family should be the basic science for family medicine.” So we put together this document and much to my surprise, the college approved setting up a new department. Then we got a committee to look for a chair and I got on that committee. I never thought I would do it because my roots were in Saginaw, Bay City and we interviewed people but nobody quite got what I thought was the family piece and it was the family piece, the basic science being the family that I wanted to tease out that I finally ---- and much to my surprise, but heck. \n\nSo you moved to East Lansing and how many children by then?\n\nActually I had ten because my youngest son was born so I had ten kids with the exception of one daughter who was off to college, we were all home.  \n\nDid you relocate in ’74 as founding chair? \n\nWhat happened was, I started in ’74, I put a house up for sale and couldn’t sell it, I commuted and in ’76 moved the family there.\n\nNow your story, your story and the evolution of the department comes together so as you share this part of it, feel free to enrich it. Again, this is your oral history so I want the focus on you, not the department per se but I think out of this will ---- the development of one of our great departments is contained. Tell us that story. \n\nIt was a struggle. Moving my family was the biggest part of that. The medical school itself, I was an instant professor, like making instant coffee and it was a learning process for me to know what to do. It wasn’t too long after I started as chair that I went to a chair’s meeting and the dean announced, we got a budget cut. So I got my first taste of budget cuts as chair. One of the things that did happen was, there was a project that was being run by Montefiore called the Institute for Healthy Development and I got involved with that and it was an interdisciplinary effort by a lot of different medical schools around the country. The model for that was collaborative healthcare and a team and obviously it was pretty apparent for me at that time that in order to be successful in family practice it had to be collaborative.  \n\nAs you were doing this I was a medical student and then became a resident. I joined the health team movement of the 70s that you’re talking about, probably read some of the early things. I thought it was very exciting.\n\nYou were the only one in the beginning, I would suspect. Who did you build the department around? And how did you build the department? And I’m also especially interested in the regional campus model. \n\nI wasn’t sure how to do that. That’s a good question. First of all, I had to get some faculty. What I did was, Jim O’Brien was finishing his residency in Saginaw and I knew who he was and then with Doug McKeag, Doug had just finished his residency in Grand Rapids so I hired those two guys and Bob Landick, who was working on a residency in Lansing and Rod Jacoby, who I interned with who was a rural family doctor. I wanted to be sure to get all the elements there. They were my first faculty. It was interesting because Doug McKeag, in his background…and then David Howell. I got to remember David.  \n\nFrom California.\n\nYeah. I hired David as a resident from California. He was a wonderful guy. So I hired all residents that I knew and Doug McKeag was in exercise physiology. One of the things that happened in Saginaw that was an eye opener for me was, at one of the local high schools at football practice when I was still a residency director, a kid got hit in the neck, had a football accident and he asphyxiated. People just watched him die and so that bothered me so I developed a curriculum as part of the residency in sports medicine. Fortunately, there was an orthopedic surgeon named Ben Name who ended up as an Olympic doctor. He helped me set up the sports medicine curriculum as part of our residency so when I started the department I got Doug McKeag who was interested in exercise physiology, David Howell was interested in sports medicine so beginning to spin off sports medicine as part of family practice. O’Brien was interested in geriatrics so I wanted to combine sports medicine and geriatrics, figuring that people who exercise as elders would be healthy. Those people were very responsible for the department. I sent Jim for a fellowship at Duke and he came back with a real focus on gerontology.  \n\nLet’s take a break because I know our tapes are going to be ending here and let’s also do a bathroom break. I’ve had too much coffee. When you sit do you still have discomfort in your buttocks from the shrapnel wounds? \n\nNo. \n\n(Changing tape.)\n\nWell Roy, we’ve taken your story right up until you’re going to East Lansing in the early 70s to be the founding chairperson of the department and you’ve shared a little bit about some of your early faculty recruits, how you became strong real early in sports medicine, geriatrics but tell more about the role that you got to play in some of the early days of the specialty, the early days of STFM, the founding group that you were part of. Share some of that history for us. \n\nObviously, working in a medical school you’re on strange turf. You’re not sure where you’re going. I had a lot of good supporters looking back at the chairs in the departments. Some of the strongest people, much to my surprise was Dr. Kirshbaum, the head of OB/GYN, Gill Rile was head of pediatrics and a guy named Scot Swisher, who was head of internal medicine. We would meet every Thursday at somebody’s house and talk about how we can make the medical school stronger. They had been in academia longer than I and so they were the ones who helped me develop a relationship with the community residencies. We were fortunate enough that Dr. Hunt was sending medical students to Flint, Kalamazoo, Saginaw, Grand Rapids and to the Upper Peninsula ---- that we had a site for medical students in Escanaba and in Marquette and so one of the things that required a lot of traveling was flying to those sites. Back then, I don’t know how we afforded it but we had an airplane that the medical school managed. I could fly to any one of those sites to talk about how the medical school was doing and how’s the residency. We hadn’t developed a clerkship then and so developing the residencies as role models for the students because the students in all of the communities needed a place to see patients and the Family Practice Center was the logical place and so I made that happen. I have medical students whose teachers were family physicians.  \n\nSo the school was really founded with this regional campus distributed model right from the beginning?\n\nYes.  \n\nEven before you had clerkships in family medicine and any residency programs?\n\nCorrect.  \n\nSo you really had to recruit faculty in all of these regional campuses? \n\nYes. I had a lot of family physician faculty members who were clinical faculty members who were…the students, you figure they’re doing their hospital years in a community hospital and who are their faculty? Family docs. Not that the pediatricians and other people weren’t doing it but obviously having a strong Family Practice Center presence was important and particularly, like in Escanaba and Marquette. I’m a trout fisherman so I would sacrifice a month and go teach in Escanaba and I could go trout fishing every day and it was wonderful. I brought the family with me.\n\nYou were recruited to Lansing with this notion that the family was the basic science of family medicine. How did that evolve for you in that department? \n\nI was fortunate enough to…the luckiest thing for me was my relationship with the Kellogg Foundation. The Kellogg Foundation gave dollars for the department when we first started so I didn’t have to use state funds and so I had some flexibility who I would hire. Then this relationship with the Robert Wood Johnson Foundation for Health Teen Development so I had somebody paying for the curriculum piece of it and somebody paying the dollars to support it at the same time so my faculty became very interdisciplinary. I figured, what do I know about the family? I got involved with, there was a guy named Cy Warby who was a family therapist in the psychiatry department and Linda Garcia-Shelton who’s a PhD psychologist and they taught me what I ought to know about family and so I could incorporate it into our curriculum. Just having those dollars to be that flexible because I didn’t have to go to the dean and say, I need dollars for this. I had dollars I could play with to develop that very special piece. Oddly enough, I was looking at one of the Rakel’s textbook, third edition and forgot that I wrote three chapters on the family with either a nurse or a psychologist back then.  \n\nI saw those publications and wondered who that co-author was. Those are great. Blake Smith, you also wrote with him.\n\nOddly enough, I needed some help in starting this department. Being an instant chair and Blake applied for the job and I found out he had a mathematics background and I figured there’s no way in God’s green earth is this going to happen but I hired him and he was an inspiration. I could give him an idea and he could turn it into a grant proposal overnight and I think much of the success of the department had to do with my vision but his ability to turn the vision into practice.  \n\nSo Linda Garcia-Shelton joined you in the early days because she became very prominent at STFM as you did and is a good friend of mine.\n\nIn fact, oddly enough, Linda Garcia-Shelton and I used to do live family interviews and have them taped, not knowing…I can’t believe I did that but we would do family intervention interviews, live for medical students. I forgot about that.\n\nTell me about your success in getting medical students to become family doctors, your predoctoral program because Michigan State has been a leader, especially while you were there in generating family doctors.\n\nI think the medical students are easy from the standpoint, we’re happy. We’re a new department and I think the fact that we liked what we were doing was an inspiration to medical students, plus the fact that we were flexible and be willing to do things. For instance, the first PBL [Problem-Based Learning] curriculum at Michigan State I got involved with. We used to call it Track 2 and I just decided I wanted to play with it and see what happens. I’m still teaching the PBLs now, in fact, oddly enough, my chair, I don’t necessarily want this in the tape, he told me in my annual review last year he said, do you realize that you get the best ratings of anybody doing PBLs? And all I’m doing is having fun but keeping a page ahead of the students.  \n\nI’m glad that is in the tape, Roy. You’re a prototype of the wise physician and you wrote that essay, probably the publication that you’re most known for is that Wise Physician and obviously that comes out in the PBL.\n\nTell me about this general practitioner from Saginaw that founded this department and began to think about what made the Wise Physician.\n\nThat’s a good question. I think for me, the Wise Physician is kind of a no brainer because in the Wise Physician you get to know the patient and the patient gets to know you so the doctor/patient relationship just spins off of that. I’ll be doing hospital rounds in a week. First week in December I’m going to do hospital rounds and we’ll have maybe anywhere from twelve to sixteen patients, most of those patients are strangers that I’m giving with a first-, second- and third-year family practice residents and I might have some medical students. I tell them right up front, when we meet together, I say, “You know, you may not learn a lot of science of medicine but one of the things you’re going to find out from me is I want to know who the patient is.” So I make the residents sit down and find out who the patient is. To me, that’s the Wise Physician. When I’m a patient that’s what I want. I fired a couple of doctors who are my doctors because they didn’t get it.\n\nAs you were maturing as a Wise Physician, what role models did you have and did you use? I always think of the Osler quote, “It’s just as important to know the patient with the disease as the disease the patient has.” But who became, as you became an academic, if you will, became the people you used or read?  \n\nThat’s a good question. This general internist who I knew, who’s my program director probably had a bigger influence on me because of his relationship with patients than his knowledge of medicine and I think he’s always inspired me. I think I saw that in him and wanted to be like that. I don’t know if that answers the question.  \n\nIt does. \n\nYou mentioned Bob Rakel and writing for his textbooks. You stood among the giants in finding family medicine. Who were your colleagues that you most, not only respected, but sort of aligned yourself with as this specialty was being born?\n\nObviously Rakel…I had a very wonderful relationship with Tom Johnson, with Bob Rakel, with Marian Bishop, Tom Stern, Lew Barnett, just sit around and talk with those people and pick their brains, what you ought to do was a unique opportunity. --- O’Connell. I spent a lot of time with him talking about the American Board of Family Practice. We’d share ideas and learn what’s practical and what will work. A guy from California.  \n\nLee Blanchard? \n\nI know Lee Blanchard but the psychologist from… \n\nDon Ransom?\n\nYes. Those people were inspiring.\n\nI remember really early publications coming out of your department about behavioral science and family medicine and some of the very early things you did. You also recruited Howard Brody. How did that happen?\n\nThat was interesting because Howard was a medical student at Michigan State. Andy Hunt said to me towards the end…when he was still a medical student, “I’d like to cultivate Howard as a potential faculty member, can you give him a job?” Because he was working on his PhD and his family practice thing so he graduated from medical school, I gave him a job in his interim but then he did his residency with Barnett in Virginia but I kept communications open to him so I was able to, with Andy’s help, hire him back after he’d completed his residency and his office is right next to mine. So Howard and I became, obviously good friends. He was a free thinker and continues to be.  \n\nPretty smart guy.\n\nYeah.\n\nIs there anything else you would like to add up to 1991? I want to move into your sort of career after you left as chair and what all you’ve done since then. So is there anything you’d like to add that we haven’t covered?\n\nNo, I don’t think so.\n\nLet’s go up to the transition then of ’91. Obviously that’s now been sixteen years ago and your career is vibrant and active as almost a full-time person now. Let’s talk about your whole story and kind of moving onto the next phase of your career.\n\nI think it’s hard, if I look at myself, it’s harder to be an ex-chair in a department. Some people want to stop working and I don’t want to do that. Obviously a Wise Physician continues to work because he’ll stay healthy and can function longer. I’m a little frustrated because when you’re no longer a chair you don’t have the same influence that you have when you are a chair so to some extent I’m an unhappy camper. It has nothing to do with our present chair, has more to do with the direction that I see family medicine going. I get angry at times when we talk about the advanced medical home, patient-centered advanced medical home and so in my recent time I have posted a couple of signs in our medical school, “Homes for sale” and circulated this to the chair of pediatrics and the chair of internal medicine and the chair of family practice that because of the fact that there’s confusion over the new home and whether or not we can finance, mortgage our new home, maybe what we need for this century is a collaborative home in which the three primary care specialties would work together in developing a new primary care model. That’s where I’m at and I’m in the process of trying to pull that off.\n\nTell me more about your vision of this collaborative home, this new primary care model.\n\nFirst of all, I want it to be family-centered. When I look at the documents that the American College of Physicians and American College of Pediatrics have looks at, only pediatrics looks at the family as a unit of care and because of that I have major concerns about where we’re going. With all of the stuff with minute clinics and all of this stuff going on in the world, I think we have to look at, is our model really the model for this century and should we develop a new model together? That’s what I’d like to do but I’m not sure whether the Academy has that vision and wants to do it. We’re so built around rhetoric now.\n\nTell me more about this new model looks like.\n\nOkay. The new model goes back, to me, to collaborative. A collaborative model of healthcare should have the physician…first of all, primary care should be a symphony of care and the family physician, the general internist and the pediatrician could be the conductors of this symphony and who plays the instruments would depend upon the nature of the tune. With American healthcare in disarray, I think we need to develop a score that will work because we have too many unhappy players. We have unhappy physicians who complain about not being paid enough, we have unhappy patients who complain about cost and people not knowing who they are and so rather than rest on our laurels, I think we ought to look at what would really work.  \n\nThat is wonderful. May I quote you on the symphony of care? \n\nYes.  \n\nI’ve heard that before but not articulated that well in the current context.\n\nI’m a member of the Collaborative Healthcare Association.  \n\nMe too.\n\nIn our community, Amy Otem, who is a residency faculty member and myself. That’s kind of sad.  \n\nIt is and it’s needed now more than ever. Do you think that the internet health information technology, people being able to have personal health records, do you think that’s going to play any role as tools in this new model?\n\nI don’t know about that, that’s a good question. One of my frustrations with the new technology is that we have all this information but nobody at times knows who the patient is and so to find a way to capture the narrative in the electronic and I don’t know how to do that yet so that the story that the patient tells has an influence on doctor/patient relationship and decision making.\n\nWe’re not getting close, I could get off on a tangent and you and I could strategize about this because I spend a lot of time thinking about the web-based personal medical home with the patient being able to provide their story. We now have tools to guide the patient so they don’t get too much off on tangents.\n\nYou’ve got Dr. Google.\n\nDo you think medical history products, some of those allow us to form a framework just like this interview is bringing out your story and then building healthcare around that but everyone working together rather than disparately is so critical. So you self-described yourself as an unhappy camper. There’s a great book on leadership by Heifetz who talked about leadership with authority; i.e., being a department chair and then leadership without authority, that is, being a leader without a job and you could look at sort of Al Gore right now as leadership without authority. You’ve spent the last sixteen years without the authority of being the chair. Tell us some stories along the way that have been important for you, both personally and professionally because your personal life has obviously gone into a whole new phase and you shared some of that and the Guatemalan children. Let’s focus on the personal. You mentioned before we started the tape that you’ve got this love affair if you will or focus on Guatemala. Share some of what you’ve been able to do personally and professionally outside the department since you stepped down as chair.\n\nObviously I’ve tried very hard to be an effective, loving parent and spouse. I think my wife and I, our world is around our children and there’s a big difference between an older parent than a younger parent. Having raised families in different times, I think I’m a better father in this period of time than I was when I was so busy doing this or that and so I take time to be a father, time to teach children. I read. One of the things that I love to do is to read to children now so I do that with my little girls and I find that just a fantastic experience. And getting involved in their schoolwork. I don’t carry my career home as much as I did when I was a younger parent so there are two phases.\n\nAnd you must be simultaneously a parent and a grandparent.\n\nYes.\n\nHow many grandchildren? \n\nTwenty-eight.\n\nAnd some of them living near you? \n\nSome of them. In fact, I have a grandson who just started Michigan State University. I squeeze in a lunch with him to find out how he’s going. That’s a whole different experience.\n\nProfessionally you’ve been going to Guatemala. Tell me about the time and what you do there.\n\nSo far, most of the time when I’ve gone to Guatemala until the last two visits, I’d just gone there to jump through the hoops that you have to, to take children home. The last two times I’ve gone to Guatemala, I was there three times this year, I did go into a place in Antigua, which is just outside of Guatemala City. There’s a mission, I call it a mission, called Common Hope, they’re sponsored out of a non-profit organization from Minneapolis. They educate kids so I have a couple of families now that we are sponsoring down there, sending these kids to school and go down there and visit them. Common Hope has a primary care clinic now that I just found. This primary care clinic is run by a Guatemalan physician who graduated from medical school in Guatemala and went to Mayo Clinic, was in Mayo Clinic for thirty some years, I’m blocking on his name, as a pathologist and is now running…he has some physicians there and now looking at that clinic as hmmm, that may be my next step in my relationship with Guatemala. I’d like to go down there and work with that Common Hope thing because I already know some of the families because I already know some of the families because I’m actually educating some of the little girls and little boys there. If you send $60 to a family in Guatemala they get it, through this organization. \n\nHow much time in the year do you see yourself doing this? \n\nI don’t know. It depends on what I can negotiate with the university. I have been talking to one of my colleagues about trying to get the Institute for International Health at Michigan State interested in Guatemala and I’ve been working on the two deans. We’ve got a college of osteopathic medicine and a college of human medicine. Just take a look.\n\nYou’ve been witness to the disruption of the College of Human Medicine, the letting go of the dean, the movement to Grand Rapids. What’s your take on all of that? \n\nI think it’s ultimately going to change Michigan’s College of Human Medicine in a negative way. I think the relationship with communities over time will vanish. I have major concerns because I think Grand Rapids bought a medical school and they don’t have the same goals. They just don’t, they bought a medical school and it’s going to function. We’ve increased our class. What I worry about is the presence and philosophy of the medical school in 2012.  \n\nLet me ask you, going back to one other comment that’s going to stick in my mind for a long, long time because I often reflect on the difference between general practice and family medicine. When you were an intern, a general practitioner asked you to cover his office and you said, “I don’t know what to do” and he said, “Ask Agnes, she’ll know what to do.” How would you describe the difference between a general practice, which was a Wise Woman, an observer like Agnes would pretty much know what to do with patients compared to what the professional expectations and needs are of a family physician today.\n\nThat’s a good question. In our clinic, I don’t think there’s an Agnes because Agnes knew the patients and knowing the patients was really what Agnes was telling me. In our clinic we get the work done without knowing who the patient is. And that’s sad.  \n\nThat takes you right back to your definition of the Wise Physician. It all starts with knowing the patient, the narrative of the patient and knowing the patient. So even though the burdens of diabetes care and disease management program and all the preventive guidelines and all those things that didn’t exist back in the days of the 50s when the Type 2 diabetic came in, it was a pretty simple visit. Diet sheet and a refill of Diabinese or Orinase, whichever one you were using then and that’s all you did. \n\nThat’s it.  \n\nNow, to just meet the guidelines, you’ve got to worry about so many different things, the complexity of the job has advanced greatly but the point you’re making is that the quality of the job is less if you don’t know the patient.\n\nI don’t know if we have any time but when I ran the Kellogg International Fellowship on Health, I had an eye opening experience. I had a physician named Rodrigo Guerrero from Colombia, Cali, Colombia, who had a health clinic in Agua Blanca, a barrio outside of Cali and I hadn’t been there before. It was this awful place and Rodrigo was giving these people who came to this place, tools for survival. He taught them how to build homes and he developed a healthcare system. Okay. And he divided the barrio in patches. Every patch had a person from the patch identified as the link to the primary care center and once a week they had a barrio meeting where everyone from all the patches were represented and the physicians then knew what the problems were and it was a piece of cake to know who needed this, who needed that. The health educator, I forget the term they use, was a person who knew the patient and so the effectiveness of care using that same model, I went to the family thing ---- a couple of years ago and treating Type 2 diabetics in Dallas, Hispanics. They divided the community in patches and developed a health educator, Hispanic, from the community and they were able to get the glycated hemoglobin far lower than the primary care offices were. Significantly lower, just by knowing the patient. Had nothing to do with drugs.\n\nI was fortunate to become a Kellogg National Fellow in the late 1990s and that made me, I’m sorry, it was 1988 to ’91 and I saw you because they had joint receptions of the Kellogg National and the Kellogg International. That made me a collaborative person. It wasn’t the beginning because I did a little bit of that interest in medical school but that turned me into a collaborative professional. It’s not the way most doctors and academic leaders think.\n\nI know.  \n\nIt’s not the way any specialty, including family medicine that almost has self-serving reflexes that we’re the best and we’re the chief and the captain and all of this and so when you’re a true collaborative thinker you look at that psychologist and consider them an equal. While you’re conducting a symphony, that’s different than being the autocratic captain of the ship so you’ve got that sense of true interprofessional collaboration and your story has given you that is uncommon in medicine, including our specialty.\n\nAny final reflections? I’d like you to, Roy, wrap up this thing by giving advice to family medicine.\n\nI think keeping an open mind and a broad vision of what the problem is. I think ---- we’re wonderful ---- the thing and that’s not true. I don’t know how to summarize that thing.  \n\nYou’ve been getting angry lately.\n\nYes.  \n\nWhich is good. Anger is a source of creativity and thoughtfulness. I think you’ve expressed a lot of it.\n\nWhat we ought to try to do, with the help of the other disciplines, primary care, pediatrics and general internal medicine is just open up enough to develop a collaborate model, just look at it. It would not be any different than making a special kind of soup.\n\nWho all would be on your healthcare team? \n\nIt would have to be everything that relates to the social nature of medicine so obviously social workers, psychologists, nurses, teachers, school teachers and eventually physicians because it’s more of a social issue than it is a medical issue and to make the medical issue work you have to have the social conduits. We just don’t have that and I think when I look back at my life, I discovered that the home visit was a social conduit back then and we have to find out what that social conduit is in this next century and the willingness to be flexible enough and give up turf to make it happen.  \n\nWell said. I think we ought to wrap up on that note unless there’s something else you can think of because that was too good to not go on with. This concludes the oral history of Roy Gerard, founding chairperson, the Department of Family Medicine now, was Family Practice at the College of Human Medicine at Michigan State University to Joe Scherger on November 15, 2007.\n\n(Taped conversation ends.)","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281589#t=0.0,2884.05841"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281587","type":"Canvas","label":{"en":["Media File 2 of 3 - Gerard_Roy_Pt1_08_b.wav"]},"duration":2473.99302,"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/152994/file/281587/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281587/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/587/original/Gerard_Roy_Pt1_08_b.wav?1752070788","type":"Audio","format":"audio/wav","duration":2473.99302,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281587","metadata":[]}]}],"annotations":[]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281588","type":"Canvas","label":{"en":["Media File 3 of 3 - Gerard_Roy_Pt2_08_a.wav"]},"duration":2478.2931,"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/152994/file/281588/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281588/content/3/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/281/588/original/Gerard_Roy_Pt2_08_a.wav?1752070789","type":"Audio","format":"audio/wav","duration":2478.2931,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/152994/file/281588","metadata":[]}]}],"annotations":[]}]}