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Profile of a Rural FP: J. Carter Mayberry, MD
J. Carter Mayberry, MD (standing) with brother and partner Andrew Mayberry, MD (seated)
Name: J. Carter Mayberry, MD (Benson, AZ)
Clinic: San Pedro Family Care, PLC
Years an FP: 14
Years a Rural FP: 14 (including 4 years on the Apache Indian Reservation before returning to Benson, AZ)
HPSA-designated Community? Yes
Critical Access Designated Hospital? Yes
What prompted you to become a rural family physician?
I grew up in a rural community; my family has been here for five generations. The attraction to return was very strong and I was able to return to my hometown ten years ago. My practice is in a slightly larger community about seven miles away.
I grew up in a rural community; my family has been here for five generations. The attraction to return was very strong and I was able to return to my hometown ten years ago. My practice is in a slightly larger community about seven miles away.
Community
It was settled by Mormon pioneers in 1877 on the banks of the San Pedro River, where the original settlers could get enough water for their crops. The original irrigation canal still exists, keeping the community greener than most of the surrounding desert. Benson has a population of about 2,500, with a mixture of families like mine returning to raise their children here, “snowbirds” who come mostly in the winter, and families whose breadwinner commutes to Tucson (about a 45-minute drive). There is some farming and there is a plant that provides nitrogen for fertilizer and explosives for the mining industry.
It was settled by Mormon pioneers in 1877 on the banks of the San Pedro River, where the original settlers could get enough water for their crops. The original irrigation canal still exists, keeping the community greener than most of the surrounding desert. Benson has a population of about 2,500, with a mixture of families like mine returning to raise their children here, “snowbirds” who come mostly in the winter, and families whose breadwinner commutes to Tucson (about a 45-minute drive). There is some farming and there is a plant that provides nitrogen for fertilizer and explosives for the mining industry.
Andrew Mayberry, MD, and J. Carter Mayberry, MD, standing outside of San Pedro Family Care.
Clinic
Started by L. Michael LeSueur, MD, an internist and my brother-in-law, in 1981. I joined him in a new building in 1998. My brother, Andrew W. Mayberry, MD, joined us in 2000. Dr. LeSueur retired in June 2007. We have had three nurse practitioners and one physicians’ assistant work for us. About 30 percent of our revenue is from Medicare. We stopped taking new Medicare patients, however, to avoid getting even further out-of-balance with insurers and because of the perpetual uncertainty on Medicare reimbursement. Andy and I had been working as part-time hospitalists in the Benson Hospital, rotating with a third family physician every three weeks, but stopped so that we could devote our full attention to our office practice. We have six exam rooms and a procedure room. Each of us sees between 15 to 20 patients per day; we work 4.5 days per week. We perform cryotherapy, minor skin & nail procedures, apply casts, etc. We do not perform prenatal care due to the associated exorbitant medical liability costs.
Started by L. Michael LeSueur, MD, an internist and my brother-in-law, in 1981. I joined him in a new building in 1998. My brother, Andrew W. Mayberry, MD, joined us in 2000. Dr. LeSueur retired in June 2007. We have had three nurse practitioners and one physicians’ assistant work for us. About 30 percent of our revenue is from Medicare. We stopped taking new Medicare patients, however, to avoid getting even further out-of-balance with insurers and because of the perpetual uncertainty on Medicare reimbursement. Andy and I had been working as part-time hospitalists in the Benson Hospital, rotating with a third family physician every three weeks, but stopped so that we could devote our full attention to our office practice. We have six exam rooms and a procedure room. Each of us sees between 15 to 20 patients per day; we work 4.5 days per week. We perform cryotherapy, minor skin & nail procedures, apply casts, etc. We do not perform prenatal care due to the associated exorbitant medical liability costs.
Typical Day
I get up at 4:30 a.m., go for 3-mile walk with my wife along a tree-lined, two-lane paved road. We often see deer and other wildlife en route. We have a family morning devotional with our sons. I arrive at the office around 7:45 a.m. We have a “morning huddle” with our staff to coordinate any last-minute issues there might be. We installed an electronic health record system in our office in August 2007. That was extremely difficult at first, but worth it now. After seeing morning patients, I usually have 30 minutes for lunch. Andy and I go for a short walk, then return for afternoon patients, finishing around 4:00 p.m. I finish up the computer work, prescriptions, reviewing labs and consultant notes, etc., around 5:30 p.m. When I’m working in the hospital, I go there first, often taking most of the morning, then work in the office in the afternoon, sometimes returning to the hospital after clinic hours. My hospitalist week starts on Saturday, so rounds then take about 5 hours as I learn about new patients. Sunday rounds take about 2 hours. We are on call for hospitalized patients 24/7 during that week. Inpatient load ranges from 2 to 10 in our 22-bed hospital.
I get up at 4:30 a.m., go for 3-mile walk with my wife along a tree-lined, two-lane paved road. We often see deer and other wildlife en route. We have a family morning devotional with our sons. I arrive at the office around 7:45 a.m. We have a “morning huddle” with our staff to coordinate any last-minute issues there might be. We installed an electronic health record system in our office in August 2007. That was extremely difficult at first, but worth it now. After seeing morning patients, I usually have 30 minutes for lunch. Andy and I go for a short walk, then return for afternoon patients, finishing around 4:00 p.m. I finish up the computer work, prescriptions, reviewing labs and consultant notes, etc., around 5:30 p.m. When I’m working in the hospital, I go there first, often taking most of the morning, then work in the office in the afternoon, sometimes returning to the hospital after clinic hours. My hospitalist week starts on Saturday, so rounds then take about 5 hours as I learn about new patients. Sunday rounds take about 2 hours. We are on call for hospitalized patients 24/7 during that week. Inpatient load ranges from 2 to 10 in our 22-bed hospital.
Challenges
Medicare reimbursement, which leads the way in other insurance reimbursement. We are considering “opting out” of Medicare. The business aspects of the practice have been exciting, but challenging. We consult financial experts liberally. That is expensive, but I think they help us avoid making costly mistakes and our time is best spent seeing patients.
Medicare reimbursement, which leads the way in other insurance reimbursement. We are considering “opting out” of Medicare. The business aspects of the practice have been exciting, but challenging. We consult financial experts liberally. That is expensive, but I think they help us avoid making costly mistakes and our time is best spent seeing patients.
Rewards
Being able to care for people I grew up with and who helped raise me. For example, I cared for the father of one of my best school buddies. This man was also my middle school teacher and now had terminal cancer. It was sad, but very rewarding to be a part of the transition from this life to the next.
Being able to care for people I grew up with and who helped raise me. For example, I cared for the father of one of my best school buddies. This man was also my middle school teacher and now had terminal cancer. It was sad, but very rewarding to be a part of the transition from this life to the next.
Advice
You can make more money elsewhere, but I think the benefits of raising my family in a rural setting are worth the financial sacrifice to do so.
You can make more money elsewhere, but I think the benefits of raising my family in a rural setting are worth the financial sacrifice to do so.
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