Member of the Month:
Michael R. McLeod, MD
Family doctor practices in all settings in his journey of medicine
By Kate Alfano
Member of the Month Michael R. McLeod, MD, practiced in the rural town of Cuero, 100 miles east and slightly south of San Antonio, for the first 18 years of his career, practicing full-spectrum family medicine. He was a practice owner for 11 of those years, during which he converted his solo practice into a federally designated rural health clinic with five providers and 22 employees. After selling the practice to the local hospital, he spent two years in an employed setting before deciding the arrangement didn’t work for him.
McLeod spent a year working seven rural emergency rooms from Luling to Madisonville fulfilling a non-compete requirement to practice outside a two-county area. “Working 24-hour shifts in different rural communities outside the one community I’d called home for 18 years reminded me how inadequate our primary care system is at meeting the needs of our citizens,” he said.
In October 2018, he accepted a position with Texas A&M Health Science Center in Victoria teaching family medicine residents and medical students in the DeTar Residency Program. Then one year later he opened a solo private practice modeled after Direct Primary Care (DPC) clinics — an affordable monthly membership plan for all patients in addition to accepting Medicare.
Why did you choose family medicine?
I never really had any doubt that I wanted to be a family doc. I was drawn to taking care of several generations of the same family, and being a part of significant life events such as childbirth. I felt family docs could help when patients are sick and are empowered through long-term relationships to help their patients stay well.
What was the most enjoyable part of your rural practice?
My patients. I learned so much from them over the past two decades. Not all of the lessons have been easy, but I truly couldn’t have become the doc I am today without the amazing people for whom I’ve been honored to care. Patients have taught me about medicine, aging, resilience, faith, trust and life in general. Close relationships with my patients gave me the chance to appreciate and learn from their life experience and challenges. In a rural setting practicing full-spectrum family medicine, I was around my patients in all the medical settings as well as in church, schools, sporting events, community events and kids’ activities. Being a part of a rural community helped me appreciate the role a physician can play in the lives of patients both in and out of the office.
What aspect of the health care system is in greatest need of change and how do you feel we (TAFP, collectively, and individual family physicians) can help implement that change?
Our health care system has grossly undervalued preventative medicine. As family physicians, we are able to change the entire paradigm of medicine from “crisis care” to “healthy care.” The loudest voices in health care are those who profit the most financially, most often not the ones actually providing care. We spend billions or trillions annually as a society on expensive care that would be unnecessary if we just embraced the importance of preventative medicine. Investing in prevention now can reverse the unsustainable growth in health care expenses that will eventually cripple our national economy. We as a specialty need to be the loud voice in our practices, our communities and our government, educating all in making positive steps to promote healthy habits and prevent the need for expensive care.
What do you enjoy about academic medicine?
I had always wanted to return to the academic setting and help young family docs see the fullest potential of our specialty, and how much they can positively impact the lives of their patients. I intentionally put formal academic medicine on hold until I had enough time in my career to survive the school of hard knocks. I’m just getting started, but am excited to see the passion most residents have for taking great care of patients. That passion has been the strength of our specialty in the past, and hopefully will carry our specialty forward as leaders in meeting the challenges facing medicine now and in the future.
What is the best part of your DPC practice?
Providing excellent comprehensive care and service to a limited number of patients with a low-overhead business model has restored my joy in practice and my belief that we really can fix the problems of organized medicine with effective primary care. By reducing the relationship to simply between a patient and their doctor, I’ve found the ability to truly meet the individual needs of each of my patients, minimizing many of the negative influences imposed by third parties such as health insurance companies.
Why are you involved in organized medicine?
Mark Twain said the most important days of your life are the day you were born and the day you figured out WHY you were born. Similarly, the most important day in my career was becoming a family doc in the first place. And though my joy has always been caring for my patients, I feel called to step out of the comfort of an exam room and try to make a bigger difference in the lives of many other patients, most of whom I’ll never meet. I know I’m a family doc because of my love for my patients, and I want all patients to have access to a physician who cares as much about them as I do about my patients. I feel I can make a difference by participating in TAFP and TMA. I’m very interested in the myriad of problems we as physicians face in caring for our population and am committed to trying to make our primary care system more effective (and appreciated) both in rural and non-rural settings.
What advice would you give to the future generation of physicians?
At its roots, the practice of medicine involves the care of one person for another. We all struggle with the myriad of outside influences that affect our practices, our pocketbooks and our patience. These factors often discourage us, even to the point of losing our passion for our career. We must always stay connected to what is most important in what we are called to do — the care our patients. If we take care of our patients well, they will take care of us. If we can just close the door of the exam room, turn away from the computer screens, ignore our smartphones for a few minutes, and simply attend to our patient...then we are closest to the pure practice of medicine. In that moment, our ability to heal, to comfort and to help in a truly meaningful way is greatest. And in that moment, we will find our sense of purpose and passion for our career.
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.