Primary Care: What Affects One Affects All By Samuel K. Williams, III, M.D.
In Georgia, as elsewhere in the World, there is a primary care provider shortage, and by some estimates it may not be filled in the near and distant future, consider this: “In a real sense all life is inter-related. All men are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly. I can never be what I ought to be until you are what you ought to be, and you can never be what you ought to be until I am what I ought to be... This is the inter-related structure of reality.” With this quotation by Dr. Martin Luther King Jr. in mind, I would like you to consider this story of a primary care physicians’ struggle to provide healthcare in the State of Georgia. In the summer of 2012, I arrived in Albany, Georgia with my wife, and daughter from Baltimore, Maryland. In Baltimore, I had recently completed a 2 year Geriatric Med-
icine and Gerontology Fellowship, at Johns Hopkins Bayview Medical Center. And, during my final year of the fellowship, worked concurrently, full time, at probably one of the busiest Federally Qualified Healthcenters in Baltimore, Total Healthcare, Incorporated. “Total,” as it was loving called, is located in West Baltimore, in the same community where “The Wire,” was filmed. I worked with a dedicated, and “hard working family,” of physicians, including Dr. Christine Fleurimond, and others. Soon after obtaining my job there, where I was fulfilling the National Health Service Corps (NHSC) Obligation, we started working on a Patient Centered Medical Home (PCMH) project, which was under the leadership of the new CEO, a charismatic, Faye Royale-Larkins, and led directly by Mrs. Bessie Bailey-Weaver, of the University of Maryland Medical Center. I was directly responsible, for introducing the utilization of the
Wisconsin Star Method in the care of nonelderly, indigent patients, and taught the PCMH team the appropriate utilization. Which, Mrs. Bessie, eventually demonstrated that she had learned it better than me! The PCMH team included a Nurse Care Coordinator, Clinical Pharmacist, Community Health Workers, and a Social Worker, whom, I can’t help but recall, Mrs. Ingrid Paymar, who was quite impressive. During my short time there, I was excited about the PCMH, and it’s potential to impact healthcare, in the community, and in society at large. Shortly before transitioning from “Total,” I accepted a full time fellowship at Georgetown University, in Washington, D.C., to complete a nephrology fellowship. Where, I hoped to carve out a ‘microniche’ in the area of geriatric medicine and gerontology, so-called, “geriatric nephrology.” And, I thought that it would be Continued on page 6
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