Member of the Month:
T. David Greer, MD
Rural family physician gives lifetime of service to patients and community
By Kate Alfano
T. David Greer, MD, is a longtime rural family physician in Henrietta, Texas, which is a town of around 3,000 people on the plains of North Central Texas. After graduating medical school from UT-Galveston in 1964, he served as a U.S. Army flight surgeon in Germany for three years and one year as a combat aviation group flight surgeon in Vietnam.
Upon discharge from active duty, he established a private practice in Henrietta, where he served the surrounding communities until his retirement from traditional office practice in 2014. He continues to spend a few days a week staffing the local county hospital emergency room. Though Greer planned in his early career to strike out on his own in a new town – away from the shadow of his grandfather, a well-respected general practitioner in Henrietta – he was asked 50 years ago by the community to “help out on a temporary basis” and agreed.
Greer was the 2004 TAFP Texas Family Physician of the Year, he received the 2006 Ashbel Smith Distinguished Alumnus Award from The University of Texas Medical Branch – Galveston, and he has received numerous other honors, including 2016 Citizen of the Year for Clay County. He regularly serves as Physician of the Day for the Texas Legislature and has been an important voice within organized medicine.
Why did you choose family medicine as a specialty?
First I thought I didn’t want to be a physician at all because your time is not your own and you’re obligated to do things when you have something else planned. But with time I thought I’d certainly like to pursue medicine. Then in medical school, every rotation I went through I liked. After psychiatry I was going to be a psychiatrist, after surgery I was going to be a surgeon, etc. Family medicine combined all those into one and fit the bill of being able to treat a patient comprehensively.
What do you feel are the best and most challenging parts of practicing in a rural area?
Family medicine in a rural area means you don’t have all the specialties readily available. You learn to be more responsible in taking care of patients and increase your self-reliance, but balance that with knowing what you don’t know. The best part of rural medicine is personal for the most part. Most of the people I took care of knew me by my first name. You fit into the community; you become a part of it. You can see where everyone fits in and the needs that are there.
One of the elements I miss by working in the ER now is the continuity of patient care I had in my private practice. I believe continuity of care is a foundational tenant of the practice of family medicine. If I took care of patients and had to send them to a specialist in the hospital, I would go see them there. Many times I assisted with their surgeries. I followed them all the way through until they were back in my office. You get a better idea of what’s going on with your patient. You’re there and you’re a part of it.
Maybe a downside to rural medicine is that when you’re raising a family you’re not always there. I’ve missed my fair share of recitals and ball games. You can’t be both places but that’s what happens when you sign on to be a family doctor in a rural area. I have grandchildren now and my son and daughter think I’m overcompensating for missing their programs. It’s not unusual for me to go to Abilene [three hours away] to see one of my granddaughter’s tennis matches.
How do you feel the practice of medicine has changed over the course of your career?
Obviously government intrusion into the relationship a physician has with their patients has increased exponentially. However, one dramatic change for the good has been the technological advances in medicine. There were conditions when I first began that were lethal that are now able to be treated. Patients haven’t changed a whole lot in terms of their lifestyle; knowing that they shouldn’t smoke and should diet and exercise. For several years I made house calls. It’s not a cost-effective way to practice medicine but patients appreciate it. I do think the solo practice model like I had is diminishing. Now doctors coming out of medical school and residency don’t want to take the risks and don’t have to. Some of the doctors don’t see patients in the hospital now, they don’t do procedures like we used to and they’re not doing surgeries. I think young doctors today are well qualified and capable, it just may be that medical schools don’t train on these procedures.
Why is it important for family physicians to be involved in advocacy and public policy?
They go hand in hand. As an advocate you’re advocating for your patients and for medicine. Patients will come to you with questions that are not only medical in their content, but things that involve medical policy such as Medicare and the Affordable Care Act. You have to stay as well informed as you can.
Why is your membership in TAFP/AAFP important?
From the standpoint of organized medicine, TAFP and AAFP deal in public policy and advocacy every day. They stay on top of the issues that come up that will affect the practice of medicine. Also when we gather at the annual meeting, we have the opportunity to discuss what’s going on in our area and see how other people have solved these problems. A lot of those issues are the same. It’s something that gives people an opportunity to see how it’s happening outside of your area and how you stack up. Our representation in Austin is outstanding. Our TAFP staff look out for things that may be affecting all of medicine and family medicine. They keep members well informed of the issues and how we, as members, can effect change and what may be coming down the pike.
What advice would you give to a young family physician just starting out?
I can speak for rural medicine. You need to be aware of all aspects and issues of your patients. That’s why it’s important to mix in with the community, to know what’s going on with the patient in the community, what’s troubling them and how it affects their health. I’ve always told my patients to call me anytime day or night. It goes with the territory. But I’ve found that if they have the freedom to do that, they’re actually more respectful of your time. They don’t call you for hangnails.
I used to tell residents when they would ask me where to practice: Go where you’re needed. But, if you go there, make sure your spouse and children will be happy there. Then work your tail off, become a part of that community and things will come around. But, it might take you 50 years!
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.