A Crisis Becomes an Opportunity in 1997

The Family Practice Clinic/Family Medicine Residency Program transformed medical service/accessibility in Waco starting in 1969. It got stronger and stronger, served thousands of patients, and brought many primary care docs to Waco, but the 1990s brought financial crisis and the real possibility of closure. Director Bob Brown loved to teach, but found himself (and longterm CFO Allen Patterson) increasingly submerged in seeking funds for the Center’s continuation. The hospitals and local governments supported it faithfully, but financial reality was becoming oppressively dismal. When Bob stepped aside to focus once more on training doctors, FPC reached out and hired the man that could guide them through what seemed impossible to what became a stronger institution than anyone ever imagined.

I first met family medicine physician, Roland Goertz, when I was the family medicine student leader at UTMB med school and invited the Texas Academy of Family Physicians president to speak to UTMB students in 1994. He was also the family medicine dept. chair and CMO of managed care operations at UT Houston med school, and had done his faculty fellowship training at Waco in 1986. Roland came to Waco in April 1997 (I was in my intern year here) to head up the program and hit the ground running. He had observed and studied an entity called a Federally Qualified Health Center while in Houston, and Allen had been learning about them as well. Roland Goertz, Allen Patterson and development director Susan Sellers tackled the complicated application process, but there had not been a new FQHC program approved in Texas for four years.

The three wrote applications, processes, policies and grants for two years,and were helped by many across the state that believed in what was happening in Waco. It was approved August 1999, and the benefits of federal support began coming in March 2000, and none too soon as the Center was down to 5 days of operating reserves. The transformation was remarkable. At that point, the FPC (now called Family Health Center) had one primary site and the faculty and residents served 14,000 patients. As of Dec 31, 2015, FHC served 58,196 unduplicated patients at 14 sites. 79% of those patients make less than 100% of the federal poverty level. The FHC had captured the goal that the Waco physician leaders first collaborated on from 1965 to 1969 in framing this organization, to serve the needy of Waco with excellent medical care and bring a strong supply of primary care physicians to our town.

For his work in Houston and Waco, Roland was named the national family medicine physician executive of the year in 2006 and then served as the President of the American Academy of Family Physicians in 2010-11 and brought his leadership skills to a national level.

Bradford Holland, MD

Brad came to Waco in 2002 fresh out of ENT residency at Wake Forest University and Bowman Gray School of Medicine after having done med school at UT Southwestern in Dallas. He is one of our most active physicians socially and politically, having served as the McLennan County Republican Club for 4 years, honorary chairman of the Cattle Baron’s Ball in 2010 (himself a cancer survivor), as assistant Scoutmaster with his boys, and this year served as the president of the Waco Symphony Association. He is of course also a strong physician leader in Waco and Texas, serving as the TEXPAC State Board Chair, and leading the Texas Medical Association Lone Star Caucus, and a past MCMS president. I have served alongside him for several years on the county medical society board, where we all look to him constantly for understanding and guidance in an increasingly complicated medical world.

What is the work you are doing now?

I am working with the Texas Medical Association to rejuvenate our Political Action Committee, TEXPAC. Because medicine and healthcare have become so politicized, it is extremely important that physicians play a major role in the legislative process that governs healthcare; otherwise all the decision will be made by the lawyers serving in the Texas Legislature. TEXPAC is the way we physicians make our opinions matter in politics and healthcare reform. If you’re reading this, make sure you’ve joined TEXPAC!

How do you feel things are in Waco medicine today?

I think Waco has a strong, highly respected medical community that takes excellent care of patients. But times are changing: the impact of the hospitals actively recruiting physicians to our community has also resulted in a much higher turnover than we have previously experienced. That is, physicians lured here with high incentives are not so willing to stay after 3 or 5 years, so we have more new faces that don’t stick around. It’s not possible to know everyone like we used to. This phenomenon is not unique to Waco. As both hospitals become part of much larger entities, and fewer decisions are made in Waco regarding healthcare, we need a strong organization of local doctors to keep healthcare decisions centered on our local community needs, and not just the larger region’s needs. In Waco, that role is being filled by the county medical society and I’m glad for that, because physicians make better decisions about healthcare than hospital systems.

What do you hope to see happen in the future?

I want us to reclaim our profession, such that we are not just one of the cogs in the healthcare wheel. It’s a relationship–that austere and highly-valued doctor-patient relationship–that symbolizes the ultimate trust the patient places in us when they seek a cure for ailments. Healthcare is NOT about populations, computerized records and data-pushing infomatics with SCIP protocols and government definitions of quality. So these are crucial days, and we need to make sure that we don’t allow our profession to be changed for the worse in ways it has never been changed in the last 5000 years. Doctors make people well, heal the sick, treat disease. We practice the healing arts. When we try to do other things, we get distracted from the essence of our profession, and we can’t let that happen. Physicians need to reclaim their position as Captains of the healthcare team, and reassert that everything we do is for that one patient sitting with us in the exam room.

If there is one message you’d give to today’s physician, what would it be?

Our profession is what we make it, and how we leave it for the next generation is being determined today. It’s not enough to talk about the “good old days” of medicine unless we are all working to make tomorrow better for the patients and physicians to come.

This entry was posted in Profiles Of Waco Medicine and tagged . Bookmark the permalink.