House Calls
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Benjamin is also a strong believer in the power of education to prevent future health problems. Through the AMA, she has worked on programs to promote the use of bicycle helmets and seatbelt use, but she remains most passionate about tobacco. She never misses a chance to counsel her patients on the dangers of smoking.

"My mother smoked all her life and she died from lung cancer," Benjamin says. "Whenever I get a chance, I tell people not to smoke. But, unfortunately, my young patients are taking it up now. These are public health issues that we have to deal with."

Another critical health-care issue Benjamin has focused on is 44 million people without health insurance in this country. As one of 15 commissioners on the influential Kaiser Commission on Medicaid and the Uninsured, she has helped bring the issue to the attention of politicians and the media.

"Our group has put out a lot of information on the uninsured," she says. "A lot of research went into coming up with that 44 million number, and I think it's making a difference. We've given legislators the facts and the numbers to support the case that we have a lot of uninsured people in this country."

Her practice, where more than half of her patients are uninsured, gives Benjamin firsthand knowledge of the problems faced by those without health insurance.

"The very, very poor have Medicaid, but it's the people who work who are in trouble," she says. "The premiums are fairly high in our area, about $1,200 a month for a family. That's their whole paycheck or more. And they're working in the fishing industry, so insurance companies won't sell to them because they're high risk."

Benjamin will travel in her pickup truck to patients' homes to examine them and perhaps prescribe medicine--not expecting anything more than a hug or a plate of food for payment. But when this patient is hospitalized or needs diagnostic tests Benjamin can't provide, the lack of insurance becomes a major hindrance to getting the care he or she needs.

"A lot of the uninsured are just hoping that nothing bad happens," she says.

Through her personal practice and advocacy work, Benjamin sees no easy solution to the problem, but hopes for a nationwide movement to provide universal health access for everyone in the country.

"I think there certainly can be a minimum benefit that everyone could have and then you could buy more on top of that if you wanted it," she says. "It can't just be a government program. It has to be something that everybody is a part of--government, private industry, individuals."

She cites the Children's Health Insurance Program, a federal- and state-sponsored program that aims to provide insurance to all uninsured children in the country, as a step in the right direction.

"Now, we need to cover the parents of those children," she says. "If we do that, we've come a long way toward providing universal coverage."

Benjamin says physicians have a duty to lead on this issue and advocate for a resolution to the challenge of providing health insurance for all.

"It's part of the obligation of being a good citizen, being a good physician, to get involved," she says. "It's a way to make a difference."

As associate dean for rural health at the University of South Alabama College of Medicine, a position she recently left to focus her attentions on her practice, Benjamin has also noticed disturbing trends in access to health care in rural areas.

"Universal health care is not the total answer. You can have an insurance card and nowhere to go," she says. "I haven't seen rural hospitals close in the last year or two, but they're threatening to because they're facing such difficulties. And a lot of rural physicians are either retiring or closing their practices because of the time and money pressures associated with managed care. That's certainly decreasing access."

These are the reasons she continues to take on more "fun stuff," joining national and local boards and committees and letting her voice speak for her patients' concerns. It's a task she might not have felt as comfortable taking on without her business degree.

"My MBA has really helped me on all those boards I serve on," Benjamin says. "I'm able to read a balance sheet much more easily and understand investments and planning. I don't know if I could have been as good of a board member or contributed as much if I didn't have the MBA."

When Benjamin opened her own practice in Bayou La Batre, the young doctor was a confident clinician with six years of doctoring under her belt and a devotion to her new patients who desperately needed a local physician. She moved into a small building and set to work designing the space. Her first meeting with an office supplies salesperson taught her how little she knew about the business side of medicine.

"He asked me where I was going to put the Xerox machine and my charts," Benjamin says. "I hadn't even thought about it. I had only thought about the clinical side. I decided I really needed to know something about business, particularly due to the fact that I had patients that I couldn't make pay what they didn't have. I had to find ways to be more efficient and to deliver health care in the most cost-effective way."

A brochure from the Executive MBA program of the A. B. Freeman School of Business arrived in the mail, and Benjamin applied and was accepted into the 18-month, intensive program. In January 1990, she began making the two-hour drive from Mobile to New Orleans every other weekend to take classes and meet with her study group.

"It was a great experience," she says, "but it was pretty intense."

Started in 1983, the Freeman EMBA program is designed for mid- and upper-level managers who want to earn an MBA without interrupting their careers. Students move through the 24-course program as a group, meeting in class on alternate weekends and gathering in assigned study groups at other times.

"As opposed to the full-time MBA program, this program is designed more for executives and focused more on strategy and decision-making," says John Trapani, senior associate dean of the business school and professor of finance.

Trapani, who has taught in the program since its inception, says students such as Benjamin, who come to the program with a wealth of personal experience and a desire to learn more about business, rarely have problems with motivation.

"You never have to explain to the executive students why something is important," Trapani says. "They really understand and appreciate management education because they see the applications of it immediately, whereas regular MBA students typically have less experience and sometimes a faculty member will have to motivate the topic."

The program also is designed for students to learn from each other through their participation in study groups, case studies and group projects. Trapani's description of a typical situation in the executive program almost sounds like the setup to a corny joke.

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