Profile -- April 2003
By Larry BeSaw
That old debate over heredity versus environment doesn't mean much to Charles W. Bailey Jr., MD, the Houston plastic surgeon who becomes Texas Medical Association president on April 3. He's a product of both. His father is a doctor. His grandfather was a doctor. Two uncles were physicians. To top it off, his grandmother took the first nursing examination ever given by the state.
"I grew up in a very medically oriented family," he said in a monumental understatement.
For young Charles Bailey, growing up in Austin meant watching his father care for a wide variety of patients, ranging from the poor who often could not pay him to the president of the United States. The elder Bailey took care of President Lyndon B. Johnson and his mother and delivered Luci Johnson Turpin's first two babies. The Johnsons and the Baileys were close. LBJ threw a surprise party at his ranch for the younger Bailey's 19th birthday and had a pair of boots custom-made for him. And on the day before he died, Mr. Johnson wrote the elder Dr. Bailey a letter thanking him for all he had done for his family.
So it is no wonder that after receiving his undergraduate degree from The University of Texas at Austin, he entered The University of Texas Medical Branch in Galveston, earning his medical degree in 1967. He served his internship at Memorial Baptist Hospital in Houston and his residency at Hermann Memorial Hospital under the auspices of The University of Texas Health Science Center at Houston Medical School. He achieved honors from the National Board of Medical Examiners in surgery, obstetrics, gynecology, and pediatrics.
In his more than 30 years as a TMA member, Dr. Bailey has had many roles. He has been a member of the TMA Board of Trustees for four years, including service on the group's executive committee, and has worked with numerous TMA committees. He also is a delegate to the American Medical Association House of Delegates.
Dr. Bailey also was graduated from South Texas College of Law where he was assistant editor of the Law Review . He has been a member of the State Bar of Texas since 1980.
A licensed pilot at 17 (he says flying and the need to anticipate and be prepared for unexpected problems have helped him in his surgical practice), a water skier, an underwater photographer, and an avid reader, Dr. Bailey, 62, has practiced plastic surgery in Houston since 1973. Town & Country magazine named him one of the top cosmetic surgeons in the United States and one of the top five cosmetic surgeons in Houston. He was listed in Best Doctors in America, Central Region , from 1996 through 2001.
Texas Medicine interviewed Dr. Bailey shortly before he took office.
Texas Medicine : You grew up back when doctors still made house calls. Did your father ever take you with him?
Dr. Bailey : Sometimes on weekends, or when it was appropriate, he would take me with him to see patients who had no transportation. I remember when he removed the cast from a little boy's arm. He borrowed the saw from the hospital, went over there, and took the cast off just because they couldn't get to his office to get it done. My mother and I and my oldest sister would sit outside the emergency room in the car when he would go there to see people and watch ambulances come in. Sometimes he would take me on rounds through the hospital. The thing that was the most memorable about the hospital rounds was that he knew every hospital employee by name and would stop and introduce me to the janitor sweeping the halls, the nurses, the blind man who managed the candy counter. The other thing that made an impression on me was at Christmas when patients who couldn't afford to pay him would come by and bring firewood or things they had grown on their farms.
Texas Medicine: What you described is quite a change from the way medicine is practiced now.
Dr. Bailey : If you look at what we do today, there isn't a lot of that going on. Because of Medicare and Medicaid, a lot of those "charity" patients are covered by some sort of reimbursement program. Ironically, if you really think about it, those programs in a way have taken something away from us as physicians because the opportunities to give our services with just the gratification of having done something for another person don't come along as often. That gratification you get from taking care of patients is one thing that no entity can take away from you. They can take away your autonomy as far as how you run your office. They can take away money. They can take away many things economically, but they can't take these things that I mentioned, and these are the very things that are in short supply.
Texas Medicine : Does it worry you that many young physicians may be missing something because they are opting for employed positions with regular work hours?
Dr. Bailey : I think it's inevitable that using that type of setting for your practice means you will miss some of the things I've mentioned. The thing I worry about more with that type of setting is the fact that your motivation as to what to do, the hours you work, and so forth, become somewhat stifled by the fact that you're working a regular eight-hour day. I think what has made physicians special over the past 150 years is that we have chosen a profession that requires a lot of drive, energy, an unusual work ethic, and a striving for excellence, initially in schooling and then in caring for patients. It has attracted a certain type of person that a 9-to-5 job in the business world may not appeal to. I fear that in the setting you describe, a lot of that may be lost, even if it's brought to the table initially. Sometimes, under those circumstances, those qualities gradually erode or disappear. It's more of a job than a profession and that concerns me.
Texas Medicine : Turning to your upcoming presidency, what do you hope to accomplish?
Dr. Bailey : As I look at all of the challenges that present themselves, certain things do stand out. If you look at the data we have collected about the state of medicine in the Rio Grande Valley along our border with Mexico, you see problems that are magnified because of the geography. We're going to have to do a number of things legislatively and otherwise to try to improve things in the border counties; otherwise, medical care in that area will be woefully thin.
Texas Medicine : Do you have some specific suggestions in mind?
Dr. Bailey : First of all, what I personally plan to do and what I hope we can do as a group of physicians is to reacquaint ourselves with our colleagues in the Valley who are more or less isolated down there. We have to realize that it's not just a border or a Valley problem. It's a problem for organized medicine, for our institutions of medical learning, and we're going to have to work together to address some of the issues, such as availability of liability insurance. That's a tough problem all over the state but it's literally driving people out of those counties where they're needed most. There are other things we're going to have to address with respect to the poverty level in the area. We're faced with potential Medicaid cuts so there are going to be some economic problems down there.
One thing I have noticed with the duress that physicians have been put under economically, both through government programs and through problems with reimbursement from different carriers, is that we have become mentally preoccupied with the many problems that relate specifically to us as individuals and this has not given us time to think about the problems in general that affect people other than ourselves.
Our fraternity of medicine, which has traditionally been very strong with very strong bonds, has been weakened to some extent by the fact that we're so distracted by a lot of these external pressures. It's paperwork, it's EMTALA, it's CLIA, it's HIPAA. Twenty years ago, operating a medical practice was just like running a small business. Now it's become a very complex business, so you don't have a great deal of time for organized medicine, for charity work, for a lot of things.
I would like to show the people along the border that physicians in the rest of the state recognize the problems and understand that they're not just border problems, they're problems for the whole profession. We need to join together with our brothers and sisters in medicine and try to come up with some solutions. These challenges give us an opportunity to tighten our bonds as physicians. Tradition, although an intangible concept, is a very important thing for the well-being of any profession. You can't translate its value into economics, but from the standpoint of pride and of feeling like you're providing a useful service, in many ways, tradition is like religion. We have to preserve that.
Texas Medicine : The young physicians are the future of TMA. What can the association do to attract young doctors who have not joined TMA?
Dr. Bailey : One thing we can do is to let young physicians know what we do for them, what benefits we can provide through our medical economics, legislative, and legal departments, and how our physician advocacy efforts are dealing with payer problems and credentialing problems. What a lot of young physicians don't realize is that these TMA departments become an extension of a physician's office. A solo practitioner can have in his office a legal department, a department of socioeconomics, and a department that deals with legislative issues at his finger tips on an "800" number that can save him hundreds if not thousands of dollars a year. People are amazed when they ask me about a problem, I give them the "800" number, and the problem's resolved in 10 minutes or is on the road to being resolved.
The other thing we're going to have to do is look at physician groups and the young physicians who join these groups. We're going to have to study their lifestyle, what they deal with, and the structure of these practices to determine what we need to do to be of value to them.
Texas Medicine : You've got both a medical degree and a law degree. Do you practice any law at all?
Dr. Bailey : About the only thing I do related to law is some consulting in the area of risk management and medical liability, working with some of the malpractice liability companies. I don't spend a great deal of time on that. I've been licensed to practice law for 22 years, but I want my constituency to know that I am the son of a doctor and the grandson of a doctor, and I am committed to the medical community.
Larry BeSaw can be reached at (800) 880-1300, ext. 1383, or (512) 370-1383; or by email at Larry BeSaw.
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