Dr. Jean Sullivan, 2009 Recipient of the Drexel University College of Medicine Boots Cooper Community Service Award - established to recognize a graduate of Drexel University College of Medicine or any of the predecessor schools, who has, over the years, achieved significant accomplishments in his/her professional field, touched the community through leadership involvement, and provided a significant impact on community health aspects.
Drexel University College of Medicine Dean Richard Homan, Alumni Association President Dr. Suzanne Steele, Dr. Jean Sullivan, and Alumni Association Award Committee Chair Dr. Joseph Capo (l‐r) May 1, 2009, Philadelphia, Pennsylvania
Nomination Essay Dr. Jean Sullivan’s entire life has been marked by an instinct to serve others. It was a trait that she had before becoming part of the Woman’s Medical College of Pennsylvania 100th anniversary entering class of 1950 and after graduation in 1954. WMC, however, gave her the training and inspiration from those who came before her and from her classmates to act on her instinct. For her, obtaining a medical degree was not simply a license to make a good living among the people from where she once came, but as the Methodist ministry had been for her grandfather, a means to provide care for those in need in
Dr. Jean Sullivan, 1954 graduate of Woman’s Medical College of Pennsylvania
Dr. Jean Sullivan’s Boots Cooper Community Service Award communities that are in need – far from where most medical schools and health institutions usually are located. Ironically, her unanticipated retirement in 2006 with her “boots on” after fifty-two years in the field brought in full relief a particularly singular accomplishment in a lifetime of service to others. In 1986, Dr. Sullivan established a community health clinic in Leslie County in rural southeastern Kentucky. Over the subsequent twenty years, many of the over 3,000 families living in the county came to her homespun-looking Redbud Family Health Clinic looking for the personal care that Dr. Sullivan, her two nurse practitioners, and her entire staff could offer. In addition to maintaining her clinic hours, she made countless visits to homes and travelled a regular circuit of rural hospitals throughout southeastern Kentucky to be on duty as the sole doctor on weekday nights and over entire weekends. Most significantly, by the time she reluctantly retired, forced by failing health and only after considerable persuasion by her staff and family, the quality of care and personal service offered by Redbud Family Health Clinic influenced the renowned Frontier Dr. Jean Sullivan’s neighbor, Edna Pace, painted the signboard for the Redbud Family Health Center Nursing Service to make her clinic one of theirs. We would like to nominate her for the Boots Cooper Community Service Award to recognize her accomplishment. But more important than her recognition, we believe her award would be an inspiration for current and future medical students to follow her path in making the courageous career decision to be a primary care doctor in rural America – a career path that does not attract or accrue the usual professional honors or acclaim. According to a report by the Association of American Medical Colleges, fewer than three percent of recent medical school graduates plan to practice in rural areas or small towns. The Kentucky county of Leslie, deep in the mountains of Appalachia, to which Dr. Sullivan devoted almost half of her career, has long been recognized as woefully underserved by the medical profession. Only a few handful of rural counties in the United States have a lower ratio of doctors to residents as Leslie County [thus earning a high priority score of 14 for a designated Health Professional Shortage Area (HPSA) by the United States Department of Health and Human Services] AND also have so many families who are below the official poverty rate. The helping hands of many who came to know Dr. Sullivan as a neighbor and consider her as one of their own was borne out of respect for her decision to stay and serve their needs.
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Dr. Jean Sullivan’s Boots Cooper Community Service Award
Doctors to Residents Ratio 2679:0 9627:0 13755:0 2907:0 5870:1 5006:1 4262:0 10285:1 7546:1 12370:0 3414:0 3479:0 7208:1 9988:1 8197:1 4674:1 3601:1 3065:1 7401:1 3559:1 3377:1 3510:1 4868:1
HPSA Metropolitan Indicator Description Frontier Frontier Frontier Frontier Frontier Non‐Metropolitan Frontier Non‐Metropolitan Frontier Non‐Metropolitan Frontier Non‐Metropolitan Frontier Non‐Metropolitan Non‐Metropolitan Non‐Metropolitan Non‐Metropolitan Non‐Metropolitan Non‐Metropolitan Non‐Metropolitan Non‐Metropolitan Non‐Metropolitan Non‐Metropolitan
State South Dakota South Dakota South Dakota South Dakota South Dakota Alabama North Dakota Mississippi South Dakota Mississippi Texas South Dakota Texas Mississippi New Mexico Mississippi Mississippi Louisiana Mississippi Texas Louisiana Texas Kentucky
County ZIEBACH TODD SHANNON JACKSON MELLETTE GREENE SIOUX HUMPHREYS DEWEY NOXUBEE HUDSPETH BENNETT PRESIDIO QUITMAN MCKINLEY TUNICA JEFFERSON MADISON TALLAHATCHIE STARR EAST CARROLL ZAPATA LESLIE
Source:
http://datawarehouse.hrsa.gov/HPSADownload.aspx
Percent of Population Below Poverty Level 53.0 51.8 58.0 36.4 35.0 34.3 39.0 35.4 34.2 32.8 35.0 38.8 36.4 33.1 36.0 35.6 35.0 36.0 32.2 55.1 40.2 35.0 32.3
HPSA Score 25 24 23 23 21 21 20 20 20 20 19 18 17 17 16 16 16 15 15 14 14 14 14
U.S. Department of Health & Human Services, Health Resources & Services Administration, Nov. 14, 2008
Deeply self-effacing as a converted Quaker in a family lineage full of devout Methodist ministers, Sunday School instructors, and church trustees, and a tad rebellious as indicated by her decision to convert after having sampled numerous other houses of Christian worship over the course of a decade, Dr. Sullivan never sought medical jobs in places or institutions that were likely to attract attention to herself. In 2005 when she unexpectedly was recognized by her community during the Hyden-Leslie County Chamber of Commerce Civic Night, she cut short the speeches being given in her praise by standing up and strolling up to the stage to confiscate her recognition plaque. Ironically, the local news coverage of the mishap that ended her fifty-two year medical career gave rise to the only recognition that she probably would have ever countenanced – that of being “one of the most beloved doctors” in rural southeastern Kentucky. While making a routine mid-day home visit to a patient living on a rural dirt road in late August 2006, Dr. Sullivan made a wrong turn. She drove up a long abandoned strip mine access road that followed a mountain ridge for several miles where she eventually became stuck in the mud. Despite her backwoods efforts – at the age of eighty one - to use branches under the spinning car tires, her car stayed stuck and it soon became dark. With no human habitation nearby, she was forced to sleep the night in the backseat of her car. Meanwhile, her disappearance became of urgent concern to her staff and community, and a televised search and rescue was mounted. The following morning she was found, relatively unhurt. Her car with over 300,000 miles was towed off the mountain. All of eastern Kentucky heard the televised good news that “one of the most beloved Page 3
Dr. Jean Sullivan’s Boots Cooper Community Service Award doctors” had been found. The local sheriff told the reporter that “everybody that lives here we all know her she’s kinda like the family doctor.” A Frontier Nursing Service spokesperson added that “she’s provided a lot of health care to the people of Cutchin and Leslie County.”
Local news coverage of Dr. Sullivan’s mishap and her car covered in mud after it was retrieved off the mountain ridge where it had gotten stuck in a mudhole.
In addition, the public words of praise from Frontier Nursing Service probably were deeply satisfying even for a self-effacing personality such as Dr. Sullivan. She had been inspired by the Frontier Nursing Service history that she had absorbed while in WMC. In 1984 she had been energetically recruited by FNS to be its medical director of the Mary Breckenridge Hospital. She was enthusiastic about a once-in-a-life-time opportunity to work for an organization that had achieved renown since 1925 for reducing mortality rates and providing health care in the medically underserved region of rural southeastern Kentucky. Less than two years later, however, Frontier Nursing Service fired Dr. Jean Sullivan when FNS was influenced by a locum tenens physician in a dispute over the proper treatment of ob-gyn patients. At that moment, at the age of 61 when most are beginning to think about retirement, Dr. Jean Sullivan “decided I had worked for others for thirty-two years, and now I’m going to work for myself” as she later told a newspaper reporter. Anybody who has known or worked with Dr. Sullivan probably would recognize that it took thirty two years for her to finally make her first selfish career decision and would also recognize that she never did it again. Second, those familiar with the issues of rural medically underserved communities and southeastern Kentucky would recognize how extraordinarily unique her “selfish decision” was for a community long accustomed to both being chronically short of primary care physicians and to the transience of physicians who often only came and left as a result of locum tenens
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Dr. Jean Sullivan’s Boots Cooper Community Service Award temporary placement, national health service assignment, or visa requirements. Few young general practitioners are willing to try to make ends meet with the variable and uncertain income of starting a practice in geographically isolated places like Leslie County despite the region’s rich folk life traditions. Dr. Sullivan’s decision and her subsequent service to her rural community left a lasting and deep impact. The moment the town pharmacist heard about her decision, he invited her to open her office in several unused rooms on the second floor of his drug store. In the winters, her neighbors in the nearby hollow known as Thousandsticks where she found a home in an abandoned Appalachian square box house that had four rooms Dr. Jean Sullivan’s neighbor, Edna Pace, painted this drawing of the Appalachian box clustered around a two-sided house as it looked when Dr. Sullivan first made it her home. stone fireplace perched on a steep rocky hillside would ensure that her dirt road was cleared of snow and that she had coal for her Franklin stove. Most of her clinic staff came from local families who had lived generations in the region and embraced her as part of their families. Reflecting the attachment that she earned by staying with them, one of her clinic staff members wrote to her upon her retirement, “You are a friend so dear, you have helped me find my place in life. I consider you a member of my family. I’m gonna miss you so much. Before I came to work for you I had changed jobs many times, but I knew I had found a place I wanted to stay when I came to join your office. You are the most unselfish person I know, and so generous with everyone else. You have devoted your life to the care of others, including us. We do not feel abandoned. We know we have been blessed to have been able to keep you as long as we did. People come and go in our lives, but only a few are so special you want to keep them forever. To me and others, you are one of those keepers. Forever your friend and devoted employee.” Dr. Sullivan’s devotion to Leslie County where she lived and worked and other nearby counties of Kentucky went beyond medicine. Mary Ethel Wooton, a native of Leslie County and an FNSdelivered baby, board member of Frontier Nursing Healthcare, Inc, and member of the Hyden City Council, wrote a remembrance of Dr. Sullivan’s service that was published as the top story in the local newspaper upon her retirement. Page 5
Dr. Jean Sullivan’s Boots Cooper Community Service Award Those who worked with her in the clinic said, “patient income was never a factor in the level of care.” When patients asked, “how much do I owe you”, many times Dr. Sullivan’s answer would be, “how much do you have?” “How about five dollars?” they added. “She always put others before herself; she devoted her life to serving others.” In addition to her own practice, Dr. Sullivan worked with the health departments of Leslie, Knott, Letcher, and Perry Counties. She helped with the Hospice program, the Cutshin Clinic, [FNS’s] Mary Breckinridge Hospital, the Hazard Appalachian Rural Hospital, and the Hyden Nursing Home. She was even the rare doctor who still made visits to patients’ homes. Each year, she made a mission trip to the Philippines to extend medical care to those in need. She loved the beauty of flowers and often brought examples from her yard to share with those at the clinic. Many art students from Leslie County High School made annual trips to the museum in Cincinnati compliments of Dr. Sullivan. Donna Fields, also of the Redbud staff, talked of Dr. Sullivan’s passion for animals. “Once she saw a dog lying in the highway. She thought it had been hit by a car, so she stopped to move its body off the road. When she picked it up, she discovered that it was still alive. She drove it to the vet to have its injuries treated and when it was well, took it home to be her pet.” “On another occasion, she found a barn owl on the side of the road. Although it was dead, it was not damaged. She obtained permission to have it mounted by a taxidermist, then donated it to the science department at the high school. She wanted the beauty of animals to be preserved for others to see and appreciate. She is such a wonderful person – always thinking of others.” She healed us, inspired us, taught us, and enriched our lives. What Dr. Jean Sullivan demonstrated with her Redbud Family Health Clinic was not cutting edge medical research, not a new model of care delivery; just a heartfelt commitment to provide care to a region long accustomed to a severe shortage of doctors. She chose to stay and, just as important, live among her patients in the highlands of southeast Kentucky. Few outside of the Frontier Nursing Service could have anticipated that Dr. Sullivan’s successful communitybased health clinic would twenty years later inspire FNS to approach her with an offer to take over her clinic. For a long period after Dr. Sullivan was fired in late 1985, FNS suffered considerable management turmoil which peaked in 1992 with the
Dr. Jean Sullivan (seated right) with her Redbud Clinic staff September 2006
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Dr. Jean Sullivan’s Boots Cooper Community Service Award resignation of its local board, medical director, and the departure of two experienced nurse practitioners who joined Dr. Sullivan’s clinic and stayed with her through out her years there. Almost eighty years after FNS was founded by nurse midwives travelling on horseback, its new leadership realized that fewer and fewer patients were coming to its flagship hospital and its increasingly moribund network of rural clinics. On average, forty to forty-five patients a day were going to Dr. Sullivan’s free-standing clinic where the physician-nurse practitioner team offered comprehensive and well-regarded primary care including preventative health services and the management of acute and chronic diseases for individuals of every age. To help restore FNS reputation for high quality personal care, they decided to make Dr. Sullivan, her staff, and the Redbud Family Health Center part of their network of clinics. Making a difference in the lives of her patients, serving her community, and inadvertently nudging Frontier Nursing Service to stay true to a mission that had helped inspire a young medical student at Woman’s Medical College of Pennsylvania are Dr. Sullivan’s proudest accomplishments. 2008 December, Myles Nienstadt, myles@mylesoffice.com
Brief Biography of Dr. Jean Sullivan’s Career Dr. Sullivan is a retired family practice physician who has held numerous medical positions across the country. Prior to her retirement in September 2006, she practiced at the Redbud Family Health Center that she established in 1985 in the medically underserved rural highlands of southeast Kentucky. She also served as Medical Director of the Frontier Nursing Service, Clinical Instructor for Frontier’s School of Midwifery, Physician at several southeastern Kentucky rural hospitals, and Medical Consultant for local health departments and county boards of health. From 1974 to 1984, Dr. Sullivan practiced in Arizona as a Medical Director and Clinical Assistant Professor of a University of Utah-operated family health center in Page, Arizona on the western border of the Navajo Reservation, and later at a University of Arizona-managed community clinic in Tucson. Prior to her family practice, she worked as a physician in Connecticut at the Southbury Training School for the intellectually disabled and at the Yale-New Haven Hospital Pediatric Clinic from 1963 to 1974. In 1954, she began her medical career in the San Francisco Bay area with the Kaiser Foundation Hospitals and later with the Oakland Public Schools. In addition to her long and distinguished career as a physician, Dr. Sullivan served in 1956-1957 with the American Friends Service Committee’s Medical Unit to re-establish basic medical services at a war-damaged provincial South Korean hospital in Kunsan; with the AMA’s Project USA to provide locum tenens service for rural clinics in northern New Mexico in 1973 and on the Standing Rock Sioux Reservation in South Dakota in 1979; and as a volunteer physician participating in several medical missions for the Love for Life Foundation in the Philippines.
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