For The Love of Medicine: One Physician’s Journey Through Healthcare & Technology from the 1980’s-Present

(For privacy purposes, the names of people, hospitals, entities, and cities have been made vague.)

1980s: An Early Pioneer in Urgent Care??

My mother grew up poor in East Texas. She was married at 18, and if it were not for that man cheating on her and leaving her, she would never have gone to a local community college and had a professor recognize just how intelligent she was. This led to her going to the University of Texas Southwestern Medical School, which is regarded as the top medical school in the state. She was the first person from her college ever to be accepted.

My mom was an early pioneer of urgent care in the 1980’s. A city hospital in a suburb of Dallas-Fort Worth needed a way to alleviate the ER, so leadership proposed a solution they heard was being done to varying degrees of success in other cities. Shortly after my mother completed residency, she joined the new urgent care clinic as one of two partners. Because the local primary care physicians had come together and become very up in arms about the formation of this 9am-9pm acute care offering, the local hospital and the urgent care came together with the Primary Care Physicians to communicate the goals of the urgent care: to alleviate the ER from non-emergency needs, to refer new patients to the local PCP’s, and to fill up the schedules of any newly hired area PCP’s. There would be some friction from time to time when a patient would say they preferred to see my mother rather than their PCP. For the most part, it was a harmonious ecosystem for about 12 years until the hospital was sold and my mother decided to go into private practice as a family physician herself.?

As a child, some of my earliest memories are in that urgent care clinic. On Friday nights, my dad would take us up to the clinic with Chinese food and pizza, and we would sit in the break room watching Family Matters and Step by Step. When the 8:00 pm hour came, I would hold my breath and pray that a rush of patients wouldn't happen so my mom could come home with us on time. I could tell that she was doing the same thing. Sometimes she didn't get home until midnight. I would sleep on the couch close to her room or in her bed just so I knew she was there. In my 30’s and having experienced what it is to run scaled urgent care operations, I know that there are still families who hold their breath every night wondering when they will get to see each other.

A New Millennium: Women-Led Private Practice and Real Estate Venture

As she set up her private practice with her new partner, their first big adventure was opening a new building together on a major highway in Dallas-Fort Worth. When I think back on that as a woman in business now it makes me very proud: they were two female physicians who invested in real estate to rent to other healthcare specialty and service tenants their patients could utilize to access care conveniently. On the day of the building opening, my mom was thrilled, but none of her family showed up to celebrate. We were all busy with other things. My mom cried. As an adult, I have now opened more clinics than I can count, some of them I have personally painted with my own hands because it was what could be afforded at the time. My family has also not shown up to grand openings of clinics I poured my heart into. If I opened a clinic in DFW, my mom showed up every time she could because she knew exactly what it felt like. This brings me to tears when I think about it.?

2000-2007: Electronic Health Records Transform Patient Data Accuracy

After moving into the new building and making sure that Y2K didn’t actually make the entire power grid go down, my mother took the next big leap of faith in technology: the paper chart to electronic medical record transition. It took about 7 years, so much patience, and the stress it caused was palpable amongst her whole staff. During some of these years I was a middle school girl. If you have ever been someone who identified as a middle school girl in your life, you know you were a special type of irrational and rude. I probably didn’t just show apathy to what she was going through, I likely put salt in her wounds. Now, I want to go back and give my mother a thousand hugs for enduring a 7 year EMR transition.

One of the joys of finishing that EMR transition brought was being able to come home after her last patient at 5 pm, even if it meant that she brought the computer home with her and compliantly finished charting at home. It was around the time that I was in the midst of high school. Gone were the days of deciphering illegible handwriting in charts, trying to stay on top of recurring patient events, risks of missing medication allergies, and filing charts. The technology came with new challenges, but the benefits far outweighed the challenges.?

Shortly after I married and found my own career in a startup urgent care company. My mother joyfully retired from her primary care career, and I remember attending her retirement party as I was preparing to open a new clinic near there. Even though she was so excited to retire and focus on being a grandmother to my niece, she still loved medicine and giving that love to others. She continued to supervise and teach advanced practitioners for 10 hours a month at local convenient care clinics, and worked with a few other collaborators to open a free clinic for the homeless and uninsured.?

2017–2020: Telemedicine Improves Access to Care?

When the urgent care business that I was serving as the COO for advanced past a start up, we started to seriously consider an up-and-coming technology called telemedicine starting in 2015. In 2017, we decided to launch our telemedicine platform with Solv. Health. All along, I had been talking to my mother about what we were doing, and how we would accomplish our goals with our provider team. Not all of our physician leaders were on board at the time, but my mother saw the vision because she knew even at that time telemedicine was the future of access to care.?

After talking with my former CEO and President, we made the decision to make my mother the Medical Director of Telemedicine and she wrote our first Telemedicine Scope of Practice. Her calm demeanor and vast experience easily assured the trepidation of the providers who once were insistent that they would not ever participate in seeing patients virtually. One of the key elements that helped win the providers over was my mother saying to them, “Speak to and see the patients the same way you would in an exam room. Get as many vitals as you can virtually. Listen to their respirations. Hit as many points of your physical exam as you can. Review as much of the History of Present Illness (HPI) as possible. This is a real patient visit, you just cannot touch the patient. Do not focus on what you can’t do, but what you can do to assess the patient.”

2020: The COVID-19 Pandemic?

At this point, I had given birth to my first child who my mother was caring for while I worked full-time along with completing her duties as the Medical Director and Supervising Physician of Telemedicine. She gracefully retired for a second time. A few months later, COVID-19 hit the United States of America. My mother came out of retirement one last time to join me and my provider team because she knew in March of 2020 that we were in for the fight of our lives.?

More than just a supervising physician, she gave us critical updates every day. She counseled her advanced practitioners in more than just medicine. Living in an area of the United States where there were doubts about the seriousness and communicability of the virus, she was bold in sharing her well researched knowledge but kind and compassionate in how she communicated. My mother continued to invest in her own knowledge so that she could multiply that investment in others. Upon her third retirement in 2021, she felt confident in the investment.?

With one last foot in the door though, she will have a final retirement when she is ready. My mother continues to supervise advanced practitioners who work at the clinic for uninsured and homeless patients she helped to found in the North Dallas-Fort Worth area. She plans to do this until she no longer can, for the love of medicine. I imagine there are many providers like her with stories to be celebrated.?

If I take only a few things from my mother I hope it is this: to make loving people through healthcare the pursuit of my professional life, to invest knowledge in myself I can then multiply in others, and to never be afraid of the unknown because there is beauty in what we make of it.