House Calls

By Judith Zwolak
Photography by Paula Burch

It wasn't the financial accounting or organizational behavior classes that most challenged Regina Benjamin (B '91) while she studied for her master's of business administration degree at Tulane a decade ago. What really baffled her was the concept of creating wealth.

"The accounting classes weren't that bad because I had had math and knew some of those principles," says Benjamin, who was a young family physician six years out of medical school when she started the Tulane Executive MBA program in 1990. "But the idea of creating wealth--I didn't understand that. What do you mean creating wealth? Either there's wealth or there's not."

A natural disaster seven years after her graduation finally brought home the lesson. As Hurricane Georges ripped through the Gulf Coast in September 1998, the building that housed Benjamin's medical practice in the tiny coastal town of Bayou La Batre, Ala., became one of its victims. Five feet of water invaded her Bayou La Batre Rural Health Clinic, while waves from the storm knocked over the refrigerator and heavy diagnostic devices. After the storm, she could not salvage one piece of medical equipment. For legal reasons, the clinic kept the 4,400 patient charts, mostly unreadable clumps of wet paper.

Benjamin, the only doctor in the small fishing village of 2,500 made famous by a mention in Forrest Gump, thought she had lost it all.

"I sent out letters to my patients telling them that we didn't have a building anymore, and they would have to get a new doctor," she says. "But my practice didn't fall apart. It still existed regardless. People showed up in the emergency room where I was working and I visited patients in their homes. Even though I didn't have a building, the entire practice stayed intact."

Only now reopening the building that will serve as the physical embodiment of her practice, Benjamin says she finally comprehends what her professors tried to drill home in business school.

"I understand that 10 years ago I created something that wasn't there before, that was an entity that didn't need a building," she says. "That was a hard concept for me when I was in school and I really didn't understand it until Hurricane Georges. Then I thought, 'Now I know what they meant at Tulane.'"

A conventional measure of wealth comes in the form of dollars and cents, but Benjamin's yardstick seems to gauge a different type of affluence. Doctoring the working families of her native South Alabama was a choice she made not on the basis of possible income, but on the desire to provide her medical services where they were most needed. In the process, she's made a name for herself on a national level, becoming the first African-American woman to be elected to the American Medical Association Board of Trustees, serving as a medical school dean and reaping accolades and awards from organizations throughout the world.

Over the years, the national media also has noticed her work. Benjamin was featured in a New York Times article, "Angel in a White Coat," was named "Person of the Week" on ABC's "World News Tonight," and Time magazine called her one of the "Nation's 50 Future Leaders Age 40 and Under."

Not bad for someone who didn't consider a medical career until she was in college.

Benjamin was born in 1956 and grew up in then-rural Daphne, Ala., now a suburb of nearby Mobile. She was a good student from a working class African-American family. As a child, she had little contact with the medical profession.

"I didn't see many physicians at all," she says. "I didn't see a black physician until I got to college. I didn't grow up thinking I was going to be a physician. It just wasn't in my thoughts."

She headed off to college at Xavier University in New Orleans, initially planning to become a pharmacist. Joining a pre-med club altered her plans, and Benjamin went on to enroll in the second medical class of the new Morehouse School of Medicine in Atlanta, which was then a two-year program. She finished her second two years at the University of Alabama School of Medicine in Birmingham and graduated with a medical degree in 1984.

Benjamin's introduction to rural health came after graduation, when she fulfilled her obligation to the National Health Service Corps, the federal program that provides medical education scholarships in exchange for a graduate's service in an area where other physicians have chosen not to go. After her residency at a family practice in Macon, Ga., Benjamin traveled back to the Gulf Coast of Alabama to fulfill her three-year commitment and worked in a practice in Irvington, about 10 miles from Bayou La Batre.

Although her scholarship dictated that she would start her medical career in an underserved area, Benjamin says she likely would have worked in a rural area regardless.

"I just like this type of medicine," she says. "I've always had this strong social conscience and sense of social responsibility."

In 1990, Benjamin started her own practice in Bayou La Batre, a town without any doctors in an area where about 60 percent of the working population, mostly self-employed in the seafood industry, has no health insurance. Making ends meet required moonlighting in emergency rooms and nursing homes at night and on the weekends. Her own practice remained her chief devotion, however, due especially to the connections she developed with her patients and their families.

"I like getting to know my patients and making a difference in their lives," she says. "The little things: the hugs, the smiles. They are very precious. It's very rewarding to tell a mother that her child is going to be OK or to sit with someone and help them through a major illness or difficulty."

These personal relationships with patients can also lead to some of the most frustrating times in her career, she says. After counseling a patient for years to quit smoking, Benjamin will find herself in the emergency room tending to his stroke. Or she'll prescribe a medication to a patient who can't afford to fill the prescription.

"These are the issues that got me involved in organized medicine," she says. "These are the problems that take more than a prescription pad to solve." Benjamin calls her participation on local and national organizations her "fun stuff." Serving as a board member of the AMA, state and county medical societies and organizations such as the Kaiser Commission on Medicaid and the Uninsured is a way to take her concerns and add her voice to the national debate on health care and public health.

She speaks for her patients, the working class, poor and elderly whose problems with health-care access and affordability rarely receive attention. In the 1990s, long before it became part of last year's presidential election campaign, Benjamin was promoting such issues as prescription drug coverage for the elderly through Medicare.

"This was a major issue for me and I'm happy that it's now being talked about," she says. "Five or six years ago, it wasn't on people's minds. I saw patients choose medicine over food--people who have worked all of their lives and had a Medicare card but still couldn't pay for medicine."

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