At just 11 years old, Karen Smith, M.D., went on the trip of a lifetime.
2017 Family Physician of the Year Karen Smith, M.D., examines Gabriele Jones in her Raeford, N.C., practice. Both Gabriele and her husband, Donald Jones, are among Smith's many loyal patients.
Smith's mother wanted to visit Walt Disney World with her children. In 1972, the family made the trip to Orlando, Fla., and it's where a young Smith learned the power of imagination, belief and creativity. Walt Disney's famous saying, "If you can dream it, you can do it," resonated with her.
Smith's mother died from sarcoidosis not long after the trip, but the memories they created inspired her daughter to pursue a career of medical service.
"It's amazing what a mother can instill in her children," Smith told AAFP News. "Those memories are in us, and those memories are what have allowed me to do what I've done … with the grace of God."
For her efforts, Smith has been named the Academy's 2017 Family Physician of the Year. The award recognizes a family physician who stands out among his or her colleagues for providing compassionate and comprehensive care, enhancing the quality of the community, and acting as a credible role model. Today, 43 years after her first trip to Orlando, Smith has returned to the city to accept this award during the AAFP Family Medicine Experience.
- Karen Smith, M.D., of Raeford, N.C., has been named the 2017 Family Physician of the Year.
- The award recognizes a family physician who stands out among his or her colleagues for providing compassionate and comprehensive care, enhancing the quality of the community, and acting as a credible role model.
- After more than two decades in rural practice, Smith says she still is driven by the power of touch -- physical, emotional and spiritual.
'We Will Take Care of This Family'
Smith's adventure in rural family medicine began in 1992. She had just completed her residency at the Duke/Southern Regional Area Health Education Center Family Medicine Residency program in Fayetteville and was tapped by Harvey Estes, M.D., to set up a practice in the underserved town of Raeford, N.C., located about 20 miles west of Fayetteville. Estes worked for the North Carolina Medical Society Foundation's Community Practitioner Program, which placed doctors in underserved areas.
Despite the town's need for a doctor and the financial support provided by the medical society and what is now the North Carolina Department of Health and Human Services' Office of Rural Health, Smith encountered resistance. During one of her first visits to Raeford, Smith attended a town meeting to discuss her placement. Most Raeford residents said they wanted her to start as soon as possible, she recalled, but Estes' leadership and support were critical in helping her establish her practice.
"Dr. Estes stood up and said, 'You need a doctor. We have a doctor, and she's ready to be here,'" Smith said. "Dr. Estes made it clear everyone would have equal access. I was of the mindset that it did not matter who you were. We are going to make sure you receive the best possible care you can find."
Smith has stayed true to this philosophy ever since, and the community has grown to embrace her, not just as their doctor but also as their friend and confidant.
"The love the patients have for her is amazing," said Maurice Brownlee, R.N., F-N.P. Brownlee trained under Smith in the spring of 2016 through the Duke Adult-Geriatrics Primary Care Nurse Practitioner Program. Smith is the type of doctor, he said, who works from sun up to sun down, seeing 40 or more patients each day, and who doesn't even take a break to eat. "She's the only doctor, and the wait time is just a tad bit long. But every last one of her patients says they don't care."
Smith also is committed to providing as much care as she can in her office -- or in her patients' homes -- because she knows it's a burden for many of those patients to travel for care, Brownlee said. During his training, he recalled three patients who visited Smith with major lacerations. "They needed to be in the ER, but she stopped and she sewed them up."
As the quintessential rural family doctor, 2017 FPOY Karen Smith, M.D., cares for patients of all ages. Here, Corey Locklear is the center of her attention.
Patients know that Smith will respect them and that they'll receive care even if they're not able to pay for it, he said.
So do other professionals in the community, according to Smith. She recalled an evening when an attorney knocked on her clinic door after hours to ask for help. The state health department's Division of Social Services wanted to remove an infant from his clients' care because they thought the mother was unfit to care for her child. Smith suspected that a language barrier was contributing to the family's challenges. She accompanied the attorney to court the next day and recommended a home health nurse visit the family to see firsthand how the mother and newborn were bonding.
"That mother and father and baby were never separated," Smith said. "They continued to receive care in our office. And word spread in the Latino community that we are not people who turn our backs. We would take care of them as people and as a family.
"It was something so simple for me to say, 'We will take care of this family.'"
The members of Stephanie Carter's family have been patients of Smith's since fleeing New Orleans just before Hurricane Katrina. On arriving in Raeford, one of Carter's top priorities was finding a physician. Her son David has tuberous sclerosis complex, and Carter was relieved to find that Smith was knowledgeable about the genetic disorder.
"There are times when David is going through a crisis, and it's almost like this is her child, and she's taking it very personally to make sure he's doing well in terms of school, home and health. I really appreciate it," Carter said.
It's a level of compassion that Smith's father, Joseph "Melvin" Smith, says she was born with. As a young child, she was conscious of those around her, he told AAFP News. "She was concerned with other people more than herself."
Smith said she holds this saying close: The power of touch -- physical, emotional, spiritual. It was a mantra that came to her while she was attending Mount Pisgah Missionary Baptist Church. "I hear so many people say, 'The doctor didn't even touch me, didn't listen to me with the stethoscope or hear my words," Smith explained. She's made it her mission to connect with each of her patients in one of these ways and provide culturally appropriate care. "Maybe we don't have to touch physically," she said. "But can you not connect with them emotionally? If someone is hurt and crying, can't you shed a tear with them?"
Karen Smith, M.D., poses with her husband, Michael Hendricks, and four second-year Harvard Medical School students. They are, from left to right, Patricia Corona, Sophia Meyerson, Andrew Foley and Mark Herzog. At the request of two Harvard students who wanted to learn more about rural medicine, Smith visited the school in July and spoke at length to 30 students about the joys of practicing as a family physician. "I've never been on campus at Harvard," she said. "This was the most exhilarating day of my teaching career."
'It's a Small World, After All'
Smith's impact extends well beyond the walls of her Raeford clinic. The busy doctor has teaching appointments at three medical schools, she serves as the Hoke County Health Department medical director, and is a member of the AAFP's Commission on Governmental Advocacy and the Family Medicine for America's Health Payment Core Team. She's also long been involved in the North Carolina AFP, serving as chapter president in 2004-2005 in addition to having served on numerous boards.
As a Meaningful Use Vanguard for the Office of the National Coordinator for Health information Technology, Smith has shared her knowledge of electronic health records (EHRs) with doctors throughout the country. During her lectures on EHRs, she draws on almost 25 years of experience with digital records.
It's almost unheard of for a rural physician to have so many years of experience with EHRs, but when Smith first started in Raeford, she inherited 18,000 paper charts -- each thicker than a phonebook, she said. The practice was literally buried in paper records, so with the backing of Estes, she began researching EHRs being used in North Carolina. From the early days when she couldn't get a digital subscriber line -- better known today as DSL -- in her office, her practice has evolved with the changing technology. "If this little rural practice can get computerization, everyone in the U.S. should," she said.
She's also traveled to places such as Denmark, Egypt, Italy and Mexico as part of her advisory and consulting work. Each time she travels, she learns something that can be applied to health care in the United States or to her practice, she said.
"My mother's favorite ride in Disney World was 'It's a Small World,'" Smith reflected. "It really is a small world, and the impact just one believing family physician can have is far greater than what the imagination can behold."
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