Member of the Month: Douglas Curran, MD
Athens FP wins race to become TMA president-elect
By Perdita Henry
Former TAFP President, Douglas Curran, MD, has been around awhile. He’s witnessed and participated in bringing about groundbreaking and essential health care legislation to ensure Texas looks after every Texan — regardless of their ability to pay or insurance status — and that physicians are fairly compensated for that care. As you may have heard, the fight to make sure Texas invests in the health of citizens continues, but Curran has once again taken on a new role — that of president-elect for the Texas Medical Association and continues to stay in the fight on behalf of his colleagues and all of their patients.
Typically, this is the part where I give you a few highlights of our conversation — but as many of you already know — Dr. Curran is one of the most quotable people you’ll ever be fortunate enough to speak with. He has a happy and determined way about him that is ever apparent when he speaks about his life, his profession, and his calling. So rather than summing it up, I’ll just let him talk.
Tell me a little about yourself and your career.
I’ve been around since Moby Dick was a minnow. I left John Peters Smith and then came to Athens where I have been since 1979. I’ve practiced family medicine from cradle to grave for that entire time. I’m still doing obstetrics, including operative obstetrics, bread-and-butter surgery, taking calls and taking care of patients in ICU as well as on the floor.
I’ve had the privilege of being part of a wonderful community. I’ve got to love on them and they have got to love on me and that’s as good as it gets. I have always wanted to be a doc that was endeared to patients and enjoyed medicine. It’s a trite comment, but it’s absolutely accurate, I have gotten to live the dream.
What sent you down the road toward family medicine?
I grew up in a small community that had two brothers who practiced there. We became friends and they were the ones who encouraged and empowered me. I remember talking to Dr. Weaver about going to medical school. I told him I thought I might want to become a doctor and asked him to tell me about it. He said, “well you have to get through four years of college, four years of medical school, and three or four years of residency.” And I said, “Oh my goodness, I can’t do another 12 years.” He replied, “Oh, you don’t do another 12 years, you do one day at a time.”
I had no idea I’d be looking at this kind of career. I haven’t done years, I’ve done one day at a time, just like he said.
You have a unique perspective as a rural physician. What has practicing full-scope family medicine meant to you?
I can honestly say almost all my patients have become my friends. The hardest part about not doing this every day is I would miss seeing all my friends. They come in, we work together, and figure out how to best take care of them, and doing the things they want to do. That’s the scariest part of slowing it down, missing those friendships and relationships. I think that’s one of the unique opportunities rural medicine offers you.
“I won’t see a million kids in my career. I won’t see a million people, but if I helped a million kids get care, that’s huge and it’s such a good feeling.”
Advocacy has been a large part of your career. Where did this passion come from?
It started 20 years ago with testifying at the Capitol on issues I’m passionate about, Medicaid — taking care of everybody not just people who have insurance. Our group decided somebody needed to go tell the story of small-town family medicine where we do everything and we take care of everybody whether they have money or not. We needed to be sure that part of the story was told. That’s how I began my experience in organized medicine.
I’ve met some real encouragers along the way. One of them was Tom Banning. Tom and I visited many times and he said, “You know you’ve got to do this, we need you,” and that was all the encouragement I needed. I visited with Lou Goodman at the Texas Medical Association and he asked me some strategic questions, “How does your family feel about you being involved in this?” and “How does your group feel about covering for you when you’re asked to do extra things?” Those were important questions I needed to answer. My group said, “go get ‘em” and my wife said, “I’d rather you do this than run for political office.” So that’s how I went down that road.
When Texas added about a million kids to CHIP, it was exciting because I had testified so many times. As it passed, they interviewed one of the conservative legislators who apparently stated that he wasn’t going to vote for it. When the reporter asked him why he decided to vote for expansion he told a story. He told one of the stories I’d told about one of my patients that needed care, but couldn’t get it because of their circumstance. He said, “We just need to fix that.” For me that was a real humbling moment because maybe I helped a million kids get on CHIP. I won’t see a million kids in my career. I won’t see a million people, but if I helped a million kids get care, that’s huge and it’s such a good feeling.
“Docs realize what they have to say is important, but they often feel like nobody listens.”
Do you believe family physicians recognize the importance of their voice as advocates?
Docs realize what they have to say is important, but they often feel like nobody listens. You can get really frustrated after a while when you think “no one is listening to me” and “I really can’t do what I want to do.” I think that’s the biggest reason docs are frustrated now and why we see increased burnout and all these other things going on. I think a lot of it also has to do with the constant threat of change and everything that keeps happening.
We’re all in this state of flux but there is great opportunity for us. Now more than ever we need to speak up as family doctors. Speaking for our patients in such a way so we can develop good policy. I think we will be listened to when we bring common solutions to the table. That’s what family docs do. We figure out how to take care of patients in a common-sense way. When we bring that to solving problems for insurance companies, Medicare, Medicaid, and all those other things, we can make an enormous difference if we can just be heard. We can’t get discouraged even though people may not listen or not pay attention we just have to get up, dust ourselves off, and try to keep changing it. Don’t give up!
Has your outlook on advocacy shifted as your career progressed and how?
I’m a little more realistic. To quote a well-used phrase, “advocacy and change is the art of the possible.” You can do certain things in a certain environment and other things just aren’t possible. I think I’m more realistic about what I can get done and I try to look at things like, “ok, here’s an opportunity and I’ve got to take advantage of that now, but my opportunity may be different in two years depending on who is in the House or the Senate.”
I’m not afraid to fail. I’m not afraid to step up and say, “Look, this is what you ought to do, whether you do it or not is your problem, but I have to tell you the truth.” I’ve been telling people they have an illness or disease for years and it’s not fun. If I have to tell my patients hard things, I can certainly tell a politician they ought to do the right thing. I’m realistic about my expectations when it comes to advocacy but still just as passionate about my responsibility to step up, to say the right thing, to do the right thing, and try to move things in the right direction.
“If I have to tell my patients hard things I can certainly tell a politician they ought to do the right thing.”
You are a past TAFP President. What do you envision for your term as president of TMA?
As far as where I think TMA is headed, it’s in a direction to improve the quality of care patients get. Improve the access to care, for all patients. Right now, we have access issues for Medicaid patients and enormous access issues for the working poor, we must address those. I will work on the areas of how we get better access to health care for all Texans.
I also want to work on better and fairer payment for all physicians. I think as alternate payment models come out, it’s going to give us an opportunity to change how we pay doctors. I’m looking forward to making all of that work. I think that’s where doctors are, they want to be paid fairly and properly. My time will be spent being sure patients get the best they can get, in terms of quality and having adequate access to care, and for physicians I want less hassle and a more appropriate payment model.
Why is it important for family medicine physicians to participate in advocacy?
It not just important it’s essential. If you look at how physicians are paid in today’s world probably half of our payment is in some way is coming from entities influenced by the Legislature. Even insurance companies are influenced and regulated by the Legislature. If you’re not there defending your profession and advocating for your patients then we’re not going to get the things we need to take care of our people. You need to be in the game, if you’re not, you miss out on opportunities to improve the care of your patients.
TAFP’s Member of the Month program highlights Texas family physicians in TAFP News Now and on the TAFP website. We feature a biography and a Q&A with a different TAFP member each month and his or her unique approach to family medicine. If you know an outstanding family physician colleague who you think should be featured as a Member of the Month or if you’d like to tell your own story, nominate yourself or your colleague by contacting TAFP by email at firstname.lastname@example.org or by phone at (512) 329-8666. View past Members of the Month here.