Member of the Month: Richard David, MD
Small-town doc builds new residency program focusing on rural family medicine
By Samantha White
Almost two years ago, a new family medicine residency program launched in the small town of Athens, with Richard David, MD, at the helm. Sponsored by The University of Texas Health Science Center at Tyler, the program David is building along with TAFP member Doug Curran, MD, is a bright light for the shortage of rural family physicians in Texas.
Who or what inspired you to become a family physician?
You know, I never thought much about anything else. I had a Christian upbringing and certainly a passion for helping people. I thought about my options and of course when you’re a freshman in college everybody’s premed, right? So that’s what I picked. I really liked science in high school and excelled in it. It was a challenge for me, and I like challenges.
When I got to Baylor (College of Medicine), I always figured I was going to do family medicine. I never really thought about anything other than that. Every time I went through a family med rotation I really liked it, so it was hard for me to say I didn’t want to do that. I wanted to do a little bit of everything.
I was also inspired by my family doctor growing up. I’m going to do a grand rounds next week on house calls. Although I don’t do that many house calls, I revere them. When I was in 7th grade I played a football game (for Euless Trinity High School), it was an all star game that was really important to me, but I played with 104 fever. My mother called the doctor and he came to the house, and I never forgot that. A few years later I broke my arm playing football, and he dealt with that in his office, and I thought that was pretty cool too.
Then of course, in the 70s, Marcus Welby, MD was on TV. That was an inspirational TV show for me. That was what I aspired to, that kind of family medicine.
What drew you to the small East Texas town of Athens?
I was at JPS for residency and I’d never heard of Athens. But Doug Curran came and was recruiting people. He came to JPS and made rounds with us one day and approached me about coming to Athens. I wanted to be away from the Metroplex, but I didn’t know where Athens was. The reason I was so attracted to it was because I could do what I was trained to do. I wanted to deliver babies, I wanted to take care of sick people, I wanted to work in the ER, I wanted to not have any restrictions on my abilities that I trained for.
The partners were great mentors. It was just a good fit and it’s been a great fit ever since. Our kids grew up here together, we worked together, we went to church together, it was kind of like family the whole way. After I was here for six months I knew this is where I wanted to stay. I got here in 1985 so it’s going on 37 years.
What was the vision behind starting a residency?
Over the last 10-15 years I’ve toyed with the idea of trying to become a part of faculty somewhere. It was just something I wanted to do. I do a lot of teaching – of youth in our church, I coached, at Sunday school – I love teaching. This is something I knew I’d like to do toward the end of my career when the economics are not quite as important. This was kind of a godsend really. I was sitting in my office one day and I heard Doug talking about a residency starting. What started that was UT bought our hospital and the system in Tyler and they wanted it to become academic. They essentially since then started a lot of different residencies. They thought Athens was the perfect place to start a residency because of our heritage and our legacy and the abilities of our faculty.
What I envisioned at the time was maybe teaching a couple afternoons a week. The next day I visited with Dr. Curran, Dr. Elueze (who is the DIO in Tyler), and Dr. Tompkins (who is the director of the residency program at Tyler). And by the end of the meeting I was the director. It was kind of a shock!
I believe Athens is a great place to train family physicians. I believe our faculty has great talent and abilities. I have seen the decline of full-scope family medicine over the last several years, and Doug and I are champions of that. This is a way we can kind of spin back that decline a little bit and try to go the other direction and get more primary care physicians who don’t just do ER, hospice, nursing home, or outpatient clinic. You know, our original charge was rural family physicians.
Our mission statement is to train competent family physicians who can practice independently in a rural setting and be able to take care of 90% of what comes through their door. We currently have four first-year physicians. We will have a class of four every year, so we’ll have a total of 12.
How many applicants did you have for those four positions?
Last year we had 700 or 800 applicants. About half were U.S. graduates, and about two-thirds of those were from Texas. We interviewed about 100 and I would say at least 40-50 of those were seriously interested in what we have to offer.
You are affiliated with a hospital, but you’re doing community-based training.
Yes. We have a clinic, which is an FQHC and not owned by the hospital. Currently its partially funded by the hospital, but it will eventually be totally independent from the hospital. We want to have an independent practice. We’re trying to get residents who want to work independently, own their own show in some form or fashion, and not necessarily be employed physicians. That’s a trend we see that we kind of bemoan – the decision to become employed and become beholden to an employer. That puts somebody else in the patient/physician relationship who doesn’t need to be there. We feel like independent practice creates the best advocate for the patient.
What do you enjoy about teaching?
As I got older my social group and the people I spend time with are all my age and I miss hanging out with younger people. Sharing in their growth and success, watching their abilities improve. I also enjoy just conveying knowledge to someone else. I also do a lot of administrative and organizational stuff. That’s something I have done over the years, starting in scouts, soccer, and starting some things here in town. I just enjoy organizing and starting new things. My wife usually helps me with that so it makes it a lot easier, but this time I’m kind of doing it on my own.
Everybody when they finish their career, they want to have something they can look back on and be proud of. Of course I’m proud of my career, but this residency program – if we can get it up and going and independent with the FQHC, I think we’ll really be proud of what we’ve accomplished.
What do you enjoy doing outside of medicine?
I enjoy lots of things outside of medicine! I have nine grandchildren and have been married for 43 years. I’ve been a member of my church for a long time. I like music, I sing in a barbershop chorus and the church choir, being outdoors, backpacking, and cycling. I have three kids – the oldest is seminary-trained and works at a Christian camp in Tyler, one who is a family doctor who is planning on coming to Athens this year, and our youngest is a web designer for a financial institution.
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 email@example.com or by phone at (512) 329-8666. View past Members of the Month here.