1998 Family Physician of the Year targets inner-city health care
Since he agreed to help start a new HMO in North Carolina last year, Melvin Pinn, MD, MPH, of Charlotte has learned far more than he ever dreamed he would about managed care. He can rattle off statistics about managed care's penetration in the state. He talks about joint ventures and starting a managed care rotation for family practice residents. But he's never wavered from his greatest interest: caring for inner-city residents.
As medical director of an inner city health center in Charlotte for 17 years, Dr. Pinn secured the trust and friendship of residents in the community. He frequents area restaurants and stores, often encountering former and current patients.
"I'm not a hero or a movie star, but it's hard for me to go anywhere and get out of there quickly," he says with a laugh. "I start asking about their mom and dad, and I always want to know about children I delivered. That always makes you feel good, and you don't want to rush those moments."
His work to tackle the health issues plaguing urban America earned Dr. Pinn recognition from the Academy as well. The Congress of Delegates honored him as the AAFP's 1998 Family Physician of the Year during the Assembly in Chicago.
From marbles to medicine
Dr. Pinn grew up in Lynchburg, VA, in a house with his mother, grandparents, brother, uncle, and one of his uncle's children. His grandfather worked in a foundry and was the family's caretaker.
A versatile athlete, Dr. Pinn played football, basketball, tennis, table tennis, and baseball, and he swam. "But I think I was the best marble shooter that ever lived," he says. "People always giggle when I say that, but I honestly believe of all the things I participated in, I was best at marbles." He was the state marble champion in 1956 and was invited to the national championship, but he didn't have the money to make the trip to Columbus, OH.
Playing sports, he met many African-American professionals, particularly physicians, who volunteered to work with the teams. One of those doctors, the late Walter "Whirlwind" Johnson, MD, was a general practitioner who coached Dr. Pinn and other young people, including tennis stars Althea Gibson and the late Arthur Ashe. Dr. Pinn later went to college on a tennis scholarship. "So, the general practitioners played a role as I was growing up," he says.
Those early role models might have triggered a subconscious interest in family practice, but Dr. Pinn says he picked the specialty because if offered him the opportunity to do a little bit of everything. "It emphasized continuity of care, and I really believe in that," he says.
He was the first FP in 10 years to deliver babies at a large 900-bed hospital in Charlotte. He did that until 1987, when the hospital's political climate, the glut of obstetricians in the area, and malpractice insurance costs forced him to give it up.
"We continue to do prenatal care," he says. "If you can provide excellent prenatal care, you will impact delivery and the baby tremendously."
Improving urban health
Dr. Pinn's goal for his patients has always been to provide them with excellent health care. "You're serving the Medicaid population, people who can't pay, the truly indigent," he says. "They deserve the same level of health care that you or I might get in the commercial sector. I spent almost 20 years working for that. As a family doc, you get to know folks, and you can make those things happen."
He has served on countless boards and committees to address urban health issues, such as adolescent pregnancy and HIV and AIDS, citing the old "if you want it done right ..." theory. "Any time I had a chance to serve, I tried to make a positive change," he says.
One such effort was the Governor's Commission on Reduction of Infant Mortality. When the commission was formed in 1995, North Carolina ranked only behind South Carolina as having the highest incidence of low birth weights and neonatal deaths in the country. The commission formed local committees, which took on challenges such as improving teen health, getting prenatal care to pregnant women quickly, encouraging the use of birth control, informing pregnant women about community services, and involving agencies and hospitals in addressing these issues.
In 18 months, the state's infant mortality rate dropped by about 3 percent. "It showed that a group of citizens, including doctors, could get together and create programs across the state to impact infant mortality," says Dr. Pinn. "I was real pleased with that."
Urban practice brings rewards
The first step in improving urban health is getting more doctors to practice in inner-city areas, says Dr. Pinn. He's encouraged by residency programs offering inner-city tracks, and he hopes residents will find urban FP mentors. One of his own mentors is family physician Lucy Candib, MD, a professor at the University of Massachusetts in Worcester, where Dr. Pinn was a resident. "She kept the focus on the real people," he recalls.
He is particularly excited about a new urban track -- part of the Carolinas Health Care System Family Practice Residency -- in Biddlepointe, NC, with three residents. In addition to his job as the medical director of the Wellness Plan of North Carolina, Dr. Pinn will precept and teach some rotations, and may see patients at the new clinic starting this month.
Urban practice offers special rewards, Dr. Pinn tells FPs in training. "When you look back, you feel real good that you've impacted somebody's life, that you've set an example," he says.
Melvin Pinn, MD, was named 1998 Family Physician of the Year.
- FP Report is published by the AAFP News Department.
