Published on October 13th, 20120
HHR Exclusive Interview : “Dr. Ada Fisher”
HHR, sat down with Dr. Ada Fisher and had a lively conversation about the American healthcare system, its challenges and its opportunities. We also spoke about her life growing up as young black physician in Durham, NC.
HHR: How long have you been a practicing physician?
Dr. Ada Fisher: When I entered med school at the University of Wisconsin at Madison the initiation of their Family Medicine Program had begun. This experience allowed medical students to work with patients during their first year and I was assigned my first family to follow through a pregnancy. This timeline would give me at least 40 years on the battlefield though I am only 21 going on whatever.
HHR: What year did you attend medical school?
Dr. Ada Fisher: I graduated from medical school in 1975, an occasion which I will never forget for my mother flew out for the ceremony as did 4 of my 5 siblings. I hadn’t intended to go to the graduation, rather just assume my residency position in Rochester, NY; but their visit was a pleasant surprised and demanded that I must go. What also made it memorable is that our ceremonies were May 13, 1975 and it snowed Mary 7th of that same year.
HHR: Given the time period what was your experience in medical school being both black and female?
Dr. Ada Fisher: I was the first black female to graduate from the University of Wisconsin at Madison Medical School. You don’t have enough paper for me to tell you about all of these experiences. One of the other things important to me was that I joined Synagogue Beth El where Rabbi Manfred Swarsensky led that congregation. Such was a stabilizing force for me during often difficult times. I also had people and professors who invested in my success which was also most appreciated.
HHR: Before the Civil Rights movement bore fruit, were you ever prevented from seeking the appropriate medical care for yourself or, for your patient, or for another member of your family?
Dr. Ada Fisher: I was very fortunate to grow up in Durham, NC in a prosperous black environment where people had good paying jobs, career options, etc. We had about 6 black doctors then serving a population of less than 30,000 blacks, Lincoln Hospital was our refuge and ability to pay did not limit care or access to it. The hospital had an affiliated Nursing School and the issues of care facing much of the population today were not as obvious then. It is like we have back-slid. Many of the members of this and other professional classes belonged to my father’s church and we supported them with our resources as well as our bodies to apply their Art and Science of Medicine.
Before I was born, my father as had his father used his church as a social ministry forum to address the needs of his congregation. From this he at one time had built a membership of over 2000 with programs in athletics which became so good that they were usurped and became the Durham Recreation Leagues; allowed the unions to organize there and provided job training assistance; started health clinics which the public health departments took over; influenced politics through the formation of the Durham Committee on the Affairs of Black People (which was then bipartisan); witnessed the emergence of the Durham Business and Professional Chain and had prior to his ministry the black library formed on site from the personal book collection of Dr. James Shepherd, (founder and first president of the State Normal College for Negroes now North Carolina Central University) which subsequently became the Stanford L. Warren Library In medical school, Madison, Wisconsin did not have a large black population as the largest such group for that state was to be found in Milwaukee, Wi where the black medical group was called the Chocolate City Medical Society.
My family had access to the care that we needed. I remember that when my father had his cataract surgery, Dr. W. Banks Anderson, Sr. for whom several things at Duke are named, performed the procedure and all of us went to Dr. Anderson for our eye care without having to sit in the segregated waiting room. Dr. O. Max Schiebel was a white physician who provided surgical care for blacks at Lincoln Hospital. There is a history there which is worth another book. It was the persistence in health care inequities after the Brown vs. Topeka Kansas Board of Education 1954 decision which was most interesting. But in limiting the essence of this discussion to health care, you like so many others are missing the forest for the trees.
HHR: Do you believe that access to health care is a right?
Dr. Ada Fisher: I believe that Health Care is a choice but not a constitutional mandate found in our US Constitution though states may have such. As such under the 10th Amendment to the Constitution the Romney/Ryan position of giving states this responsibility is correct. No one should have a right to demand a service based on someone else’s talents. Try getting your car fixed for free, even though my Ford Service Center now charges more per hour than doctors. I went into medicine for a lot of reasons but wanted to try to save the world. I quickly appreciated that the world didn’t want to be saved, at least not on the terms that I was prepared to do it. I have often given my best professional advice to patients only to have them ignore it, but being willing to consider suits when things don’t work out as they desire. I have run a detox center for a 16 county catchments area and know that such does not work and there is no cure for substance abuse though folks would like to keep throwing money at this problem or mandating treatments which may not do the trick.
As an experience occupational physician I have seen how good work place programs can decrease worker injuries, resultant disability claims and do some prevention in quite creative ways. There are ways to incentivize changes in behavior which may produce better outcomes which is part of what my book Common Sense Conservative Prescriptions Solutions for What Ails Us, Book I is about.
HHR: What is an example of a conservative solution to healthcare and how would it differ from a more liberal solution?
Dr. Ada Fisher: Obamacare is about a government takeover of health care imposed through limiting access to certain procedures through its boards and panels, controlling cost via decreasing reimbursements to providers including facilities and taking a G-d like attitude that they know what is best for us. Patients will not get to keep their doctors per its 2,700 bellicose pages, retain Medicare Plus, depend on workplace health benefits but may fall to Medicaid level coverage and other take-aways will possibly result.
I believe we must change the paradigms in health care to make the Public Health Department the entry level for care. There are 3,145 counties in the USA, all with health departments which should be an entry point which would thereby make available some access to health care. Such issues are defined in my book. The book also tells how you create jobs which can change the dynamics of people’s lives. My book is designed to help you think differently about issues as well as come up with your own solutions.
HHR: Why do you think that healthcare is so expensive?
Dr. Ada Fisher: Healthcare is expensive for a lot of reasons. This is an educationally intensive profession and the cost of such is not cheap. Obamacare would have doctors work for much of nothing while many spent over $100,000 for their training and delayed much in their lives. This is a labor intensive profession in that from nursing homes to surgery the number of people required to do certain things is tremendous and people labor or human capital is not cheap. This is a research cutting edge field where everyone wants the latest, producers want the biggest bang for their bucks and no one wants to bear the “real” cost for such.
HHR. Given the rise in mental health issues around the country; do you have any suggestion on combating issues so associated
Dr. Ada Fisher: There is an entire section in my book detailing Mental Health, Our National Shame where 1 in 10 families are so affected and cures do not exist. We can treat people and make them more sociable but much of mental illness is genetically based and there is no cure for this. Interestingly in New York state, prisons house and hold a large percentage of the mentally ill. In this nation nursing home beds are increasingly housing those with mental challenges due to the de-institutionalization moves of the 1970s.
Jobs for people in this category aren’t even on the national jobs meter. When I was Medical Director of the Amoco Oil Company I use to irritate folks when I said self service stations wiped out a lot of jobs for in such a focus the trend was away from allowing those with issues and challenges a chance to be self supporting contributing citizeens. Somehow in a push to save a dollar we have put more folks on the dependency roles. One of the things we need to do is invest in research into drugs which are long acting and not totally dependent on patient compliance for administration to deal with people suffering from psychosis. This would allow folks to function independently and be less of a perceived threat to others. In the concept of least restrictive environment and requirement of a danger to self or others before interventions can be done, policy wonks quickly forget it is hard to convince people who are mentally ill to take medicines, considering that many of them think there is nothing wrong with them.
HHR: You recently wrote a book, what is the title? Why did you choose to write this book?
Dr. Ada Fisher: My book, Common Sense Conservative Prescriptions Solutions for What Ails Us, Book I is available on-line through Amazon.com for $22.75 is quite timely especially given the presidential race and this election cycle which I talk about. This book is not solely about health care but looks at the broader pictures in America. I was intrigued that Karl Rove called it powerful especially since it engages in a discussion about the mindset of both political parties, consultants and pundits which can undermine democracy and efforts to do the right thing, stuck in the mud thinking sinking under its own weight and some of our problems as well as much of our promise. My local paper called the book my opus magnus given its length which is why it is written so that people can reference areas of interest or chose to use the SOAP to get to the heart of an issue without necessarily having to read current concerns and a historical perspective that is too often lacking in our political discourse.
Common Sense Conservative Prescriptions has one of its chapters go through a brief synopsis examining the values of our 44 presidents. Conservative trends are identified dating to Andrew Jackson (reportedly one of my great great ancestors approximately 4 generations ago) and Dwight D. Eisenhower who was right on the mark in his farewell address to the nation. It also takes on what is in the US Constitution that folks are missing, why the tea party movement got legs and fairer ways to deal with the entitlements such as Social Security, Health Care, Education, Immigration, Tax Reform and other issues including embracing foreign policy and military changes which would save money and still allow superior national security. In taking a very different look at how we solve this nations problems while digging deeper to examine citizen impacts, best practices are explored.
The book is broken up into sections which may be easier to digest as ones interest is peaked. Quite different in my work is also the historic demonstration of the pivotal impact of black Americans on this nation’s founding, laws and development as well as that for the Republican Party and many of its policies. Additionally a family practitioners methodology is used in coming to its conclusions and shows how such a vantage from politicians and other citizens can be used to objectively do the same. Hopefully reading this will give you a different perspective. I’ve lived and served in the black community when possible thereby having some credibility which others may not on issues of blacks and the Republican Party which is long standing and detailed. This work also demonstrates why the non-traditional media has so much difficulty in dealing with the Obama Phenomena.
The solutions in the book will give all something to think about. The revealed realities of politics ought to make people want to get informed as well as more involved. I’ve lived and served in the black community when possible thereby having some credibility which others may not on issues of blacks and the Republican Party which is long standing and detailed. This work also demonstrates why the non-traditional media has so much difficulty in dealing with the Obama Phenomena.
HHR: What are some future challenges you see with regards healthcare in the United States?
Dr. Ada Fisher: The cost of health care consumes almost 20% of the GDP for the nation. Fixing the economy requires that Health Care be part of this fix. 9 issues of care including provider distribution, malpractice, drug costs, etc. are dealt with in this book which get to the quick of the problem and aren’t truly covered in the Affordable Care Act.
HHR:What is likely to happen to the healthcare industry under The Affordable Care Act?
Dr. Ada Fisher: If this act stands, the best minds will not go into health care for they can’t afford it. Black physicians will continue in being an increasingly disappearing breed for we cannot afford the cost of the education and the changing admissions standards will limit who gets in, who stays in and who can get out. Minorities will increasingly find that they aren’t going to be as likely to get in and the burdens of our practices which are too heavy with patients on Medicaid, No Pay and Little Pay will drive us out of business. When they cut my lights off because I was being nice, didn’t take in enough to pay the bills and couldn’t afford to pay the staff for compliance with the paperwork required by federal regulations, I got a rude awakening on Healthcare Economics. Health care will more rapidly be rationed and many will suffer.
HHR: Do you believe that The Affordable Care Act will actually be affordable for most middle class Americans?
Dr. Ada Fisher: The Supreme Court has already said the act as it stands is a tax. What part of tax don’t people understand? Taxes seldom go down and when folks aren’t required to pay something for services rendered, not even $1, they will use more of it with abandon.
HHR: What has been the most uplifting experience for you throughout your career as a Physician?
Dr. Ada Fisher: I loved delivering babies. Usually it is a happy experience and all the babies were different. I also learned much in sitting with the dying and listening to them. As has often been said, no one then has ever said they wished they had worked more or had more, but rather they appreciated the often missed family bonding opportunities.
HHR: How have you juggled your career with your homemaking responsibilities throughout the years?
Dr. Ada Fisher: I have been fortunate enough to make a decent living in doing things for which I have a passion and was at one time adequately paid. When I adopted my two sons, being able to afford child care, to expose them to the world of sports or arts and seeing the world through their eyes was unique and gratifying. I don’t do housework and will tell anyone, I don’t have a domestic bone in my body. Don’t come visit for the house is a mess and though I cook well per my sons, I have seldom used the oven since they left home.
HHR: What has been the most heart-breaking experience for you throughout your career as a physician?
Dr. Ada Fisher: The death of my mother for whom I was named and the death of my second brother within the last week, whom I called my “Main Stem” hurt tremendously for with all my training and knowledge I quickly learned that one can’t solve all problems and the people you love often don’t benefit as you would like from your training. I also found tragic the cases of abuse I saw in the Emergency Room particularly the rape of young girls. I despair over diagnosis which couldn’t be made because the resource to determine them was unavailable. But the biggest hurt is more global in terms of the introduction of politics into the medical decision making process which is wrong; the squashing of professional independent judgment by this increasingly litigious society; and the over specialization of many into areas such as plastic surgery where the cosmetic end overshadows much work needed for those born with defects or disfigurements.
HHR: Where do you see the American health care industry overtime?
Dr. Ada Fisher: If we are not careful, health care will become technological to the extent that human contact with doctors is removed and mid-level practitioners will replace us in the name of our own professional arrogance as well as the need to save a dime. We will increasingly be systems driven and decision making solely determined by cost/benefit analysis. On the plus side we may get lucky and have people more involved in diagnosing their own problems such as is done with home drug testing, pregnancy testing, etc.
HHR: If there was one medical innovation you could implement throughout the United States to improve the overall health of citizens, what would that be?
Dr. Ada Fisher: As a constitutionalist, my one concern in a free and democratic society is the increasing loss of privacy. The move to make all records electronic gives the government access to people’s most personal information with no guarantee that it will be secure and cannot be violated as spammers and hackers already do with national security information. The medical innovation which would put patient’s in the driver’s seat of the own healthcare is already at hand –thumb drives. Rather that allow the rapid invasion of people’s privacy, it would be simpler to download individual medical information on a thumb drive or cell phone (discussed in the book) thereby allowing the individual to give their information to who they wish to have it. If we continue to lose more of our privacy as the Patriot Act and the Affordable Care Act are doing, fundamental constitutional freedoms of this nation will be lost.
HHR:Where can our readers find your book?
Dr. Ada Fisher: Currently my book is available on-line through Amazon.com for $22.75 as well as the CreateSpace Store. After October 15th it should be available to order through bookstores such as Barnes and Nobles or Books-A-Million. And I am trying to complete contracts allowing Kindle and Digital Mediums to offer it.
HHR: Dr. Fisher, it was a pleasure speaking with you.
Dr. Ada Fisher: Mr. Ivory, Thank you for taking the time to interview me and get the word out on this comprehensive book which looks at solutions not just for health care but for our economic and other societal woes in a framework on how politics works, some historical perspectives that are different and solutions to serve which would seem the best interest of the majority of people, no matter the party in the majority.
BUY THE BOOK: Order Common Sense Conservative Prescriptions Solutions for What Ails Us, Book I now. It’s available for order through Amazon.com for $22.75 http://www.amazon.com/Common-Sense-Conservative-Prescriptions-Solutions/dp/146818864X