Member of the Month:
Seth Cowan, MD
Longtime TAFP leader reflects on a magnificent career
By Perdita Henry
My conversation with Seth Cowan, MD, started out like many Member of the Month interviews. I asked him to tell me a little about himself. He began with the basics. He grew up in a small town just outside of Detroit, Texas, was valedictorian of a graduating class of 15 students. His father, a rural mail carrier, hand delivered his medical school acceptance letter. “I worked every summer on the farm. I was chopping cotton when I got my acceptance to medical school,” he said. “I went to the University of Texas and then to University of Texas Medical Branch Galveston. I finished in 1953.”
I asked my follow up questions, “Why family medicine? Did anyone inspire you?”
“My family was very close to our family doctor, doctor Mears,” he said. “He had an office in the back of the drug store. I thought it had a delicious smell and I was fascinated by the instrument cabinets.”
The last statement. About the smell of Dr. Mears office, that was a new one. Thus far, no one had ever noted the smell of a doctor’s office as one of the numerous reasons why they choose to become a doctor. My curiosity was piqued, so I asked, “What did Dr. Mears office smell like?”
“Just like doctor’s offices smell. [Laughs.] I don’t know if I can describe it, but I liked it. Some people are turned off by it.”
In the conversation that followed, Cowan gave me snapshots of his life. The small-town doctor’s office located in the back of the drug store. A boy filled with curiosity and fascination as he peered into the family doctor’s instrument cabinet. A young man working in the heat of summer, unaware his next chapter is about to begin. Dust kicking up behind a father’s car as he heads to deliver the letter his son’s been waiting for. The 25-year-old doctor settling in to Colorado City and his life as a physician. A decision to move on from what was into what could be.
All moments of a well-lived life and a fulfilling career. Now, well into his retirement, this long-time member of TAFP, and former Foundation president, shares some of what led him down the path of family medicine and what he learned along the way.
Why did you choose family medicine? Were you inspired by anyone?
My family was very close to our family doctor, Dr. Mears. He had an office in the back of the drug store and he made house calls. I thought his office had a delicious smell and I was fascinated by the instrument cabinets.
The summary statement about him was that he always came. My mother always said she felt better when his car went past our place. We always took him vegetables from the garden and meat when we killed hogs.
My dad was a rural mail carrier and back then none of the roads were paved. Dr. Mears would sometimes call him in the middle of the night to take him down on Red River — my dad was a good driver in the mud — to deliver a baby. He never charged us.
I interned at University of Oklahoma hospital and in 1954 I went to Colorado City to practice. I was 25 years old. Back then, Colorado City was a town of 6,000 and had three older family physicians. All three were good doctors and in some ways that was my residency. One of whom was my cousin, Kenneth Cowan, MD. He was 15 years older than me and my mentor. When I started, we worked at the office, made rounds at the hospital twice a day, and made house calls after work.
I learned a lot — both in medical and community activities. I became chairman of the chamber of commerce. The community supported and tried to develop young men, so it was a really good experience. I was there a year and a half before Uncle Sam invited me to Turkey for two years. The Korean war was going on and they ended the draft — except for doctors.
The Air Force had just taken over the base from the Navy, so it was really a start-up. We had two doctors to start and eventually grew to five. I was the only one who had practice experience, so we did it like I did it in Colorado City. The patients liked it. We let them choose their doctor, we admitted them to the hospital, and followed up. I spent my last six months there as hospital commander. I enjoyed Turkey. Afterward, I went back to Colorado City.
The 60s census showed that there were 17 metropolitan areas in Texas that were growing, and small towns were shrinking. Colorado City was experiencing that, and I wasn’t busy. I was the youngest of the group, so I decided to leave and go to Garland.
I talked to a senior doctor, Bill Rhodes, MD, who delivered all three of our daughters, about going and he said, “well, you’d be a damn fool if you didn’t.” [Laughs.] I was solo in Garland three years, and looking back, I think I was trying to recreate what I’d left. It had been a good experience. By the time I retired in 2000, we had joined with two other groups, one in Arlington and one in Northwest Fort Worth. And we had over 50 family medicine doctors in 11 locations in the metroplex. We were Family Health Care Associates.
How did you make a difference in family medicine and the Garland community in those early years?
There was only one group there when I arrived. Most of the doctors were solo. I had in mind to create a group, so in ‘65 I added my first partner. I became chief of staff at the hospital. We were able to get some preceptors from Southwestern to come out and work with Garland Family Doctors. Garland had more family doctors than any city in Dallas county. The city was growing and thriving and so did my practice.
You had preceptors rotating with you in Garland. Was precepting a passion of yours?
Let me tell you about my preceptorship. My senior class at Galveston was the first large class and we all had to have a rural rotation. I did mine with Chester Callen, MD, who was the fifth president of TAFP – I found that out after I got there. I also found out that he had been written up in the Saturday Evening Post a few weeks earlier.
He took me to a TAFP meeting at the big hotel in Houston and he also took me to Dennison where they were starting a new chapter. On the way, we spent the night in Fort Worth. The doctor we stayed with, Holland Jackson, MD, was the first Texan to become AAFP president.
Dr. Callen was one of the best physicians I’ve ever known. When I arrived, he gave me the American Medical Association’s book, Code of Medical Ethics.
“Doctors don’t talk about other doctors,” he said. “Being a general practitioner means you are the General. You’re in charge. Sometimes you refer patients and the specialist will try to take over, but you still have the primary responsibility to the patient.” While I was there I worked after hours and lived in the hospital. At night I took call, saw patients, did labs, and sometimes filled prescriptions in the pharmacy. He took me on house calls, too. It was eleven weeks and probably the best learning experience I had in medicine.
I really had good mentors.
Now in Garland, we were trying to get preceptors into medical schools. We didn’t have them at Southwestern. I heard Dr. Sprague, president of the health science center at the time, speak about family medicine. He said something positive and I decided I was going to create a relationship with him. So, I wrote him a letter, thanked him, and gave him some positive reinforcement. Our communication went on from there.
After that, we had two preceptors who just appeared in Garland. I asked them, “How did you know about us?” They said, “Well, your letter was posted on the bulletin board.” That is how we got preceptors in Southwestern. In a later letter, he wrote to me and he said, “I wouldn’t say you badgered me, but you were the most persistent.”
What makes someone a success?
The best definition of leadership I know of, is from a book called “Leadership is an Art”, by Max DePree. He said, the first responsibility of leadership is to interpret reality to the organization, and the last is to say thank you. In between, become a servant and a debtor.
You have to serve, and you have to allow others to help you. It takes more than one person to accomplish almost anything worthwhile. Creativity is widely dispersed in the population and people want to succeed, create, and grow.
You've been a member of TAFP and AAFP since 1958, you served as TAFP Foundation president, oversaw the development of the scholarship program, and served on numerous committees and commissions. What drove you to dedicate so much of your time to these organizations?
Part of it’s just my personality. Looking back, I had a motivationally rich environment most of my life. My dad used to tell me, “To whom much is given, much is required.” I had a strong sense of duty and responsibility.
Originally, the Foundation meetings were just a group of past presidents and no one wanted to go to them. I saw my responsibility as trying to revive it. There was an educational aspect, so we had a strategic planning meeting in which we decided three things: to support students and residents and engage in research. We formed a scholarship for the past president. It was the first scholarship it really caught on and we perpetuated that idea.
I think I’m given more credit than I deserve.
What has your experience as a TAFP member been like?
I had been on the membership committee and I learned if you do one job they usually gave you another one. [Laughs.] It’s been tremendously rewarding. I see family medicine as the basis of medicine in general. The associations and the learning, the whole aspect has been enjoyable and worthwhile.
What piece of advice would you give to someone facing challenges in their career?
The first thing is talk to someone you respect. Medicine allows individuals to utilize their abilities in so many different ways.
Knowing oneself is tremendously important. A long time ago, I read an article called “Myself as an Instrument.” First utilize it for what is good and worthwhile, but also avoid doing damage with it. Sometimes you need to try harder and sometimes you need to change.
What would you say to those who maybe thinking about becoming more involved with TAFP?
You know, the Academy is so rich in talent. Everybody wants to make a difference. When I think back to the younger group, I think most Academy members wanted to contribute and they just rose up.
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.