Richard A. Smith (physician)
Richard A. Smith
|Born||October 13, 1932|
|Died||March 10, 2017|
|Citizenship||United States of America|
Richard A. Smith, MD, MPH, (13 October 1932 - 10 March 2017) was an African American physician and a global health leader. He is one of the founders of the physician assistant (PA) profession. Smith also played an integral role in desegregating US hospitals during the 1960s while serving in the Surgeon General's Office of Equal Health Opportunity (OEHO), overseeing the desegregation of more than 7,000 US hospitals and associated training and blood supply programs.
Early life and education
Smith was born in Norwalk, Connecticut. He obtained a BS and an MD from Howard University in 1953 and 1957, respectively. He completed his residency in public health and preventive medicine at the University of Washington. Smith obtained an MPH from Columbia University in 1960.
Smith was an officer in the US Public Health Service (USPHS) for 25 years (1956-1981). Smith's USPHS assignments included serving as a Medical Officer for the Peace Corps stationed in Nigeria (1961-1963) and as the Deputy Medical Director of the Peace Corps worldwide (1964-1965). In 1966, Smith was appointed to the Office of Equal Health Opportunity (OEHO) where he led efforts to desegregate US hospitals. The OEHO has been described as "a tiny office, with just five employees buried beneath layers of bureaucracy in the Department of Health, Education, and Welfare." The OEHO was charged with certifying whether US hospitals were in compliance with the Medicare bill and Title VI of the 1964 Civil Rights Act, under which, hospitals wishing to become Medicare providers were required to desegregate their facilities in order to receive Medicare funds. The OEHO was created in February of 1966 and they were tasked with enforcing Title VI compliance in more than 6,000 US hospitals before July 1, 1966 when the Medicare program would begin. Serving as the Director of Operations for the OEHO, Smith oversaw the desegregation of more than 7,000 hospitals and associated training and blood supply programs. Smith's early efforts included a visit to a hospital in Marshall, TX, where he was sent as the personal representative of President Lyndon B. Johnson. Marshall was Lady Bird Johnson's home county and it therefore held great symbolic significance to President Johnson and to his policy goal of desegregating all US hospitals. When Smith, an African American, arrived in Marshal he was met by a group of white locals in pickup trucks with shotguns. Smith later reported, “When I went to Marshall, I thought I was going to be killed." Smith held extensive meetings with Marshall Hospital leadership but they stood firm, contending that they would never desegregate their facility. Smith's final reply, "Fine, but you just tossed away $100 million in Medicare funding." One week later, the Marshall hospital board chairman called Smith to say, "The trustees have just fired the administrator and want to know what they have to do to desegregate and get the Medicare money." After the passage of the Medicare and Medicaid amendments in 1965, the US experienced a physician shortage due to an influx of new, previously underserved patients seeking health care through these programs. Recognizing the needs of underserved communities, particularly those in rural America, Smith created the MEDEX program, one of the first PA programs in the US, noting that PAs could serve as an "extension of the physician — another pair of skilled hands." The term MEDEX was derived from the phrase, médecin extension (French), meaning physician's extension. Smith founded MEDEX at the University of Washington in 1968. The program was a joint effort between the Washington State Medical Association and the School of Medicine at the University of Washington. The first class of students, former military medical veterans aged 22 to 55 years, matriculated in June 1969. After successfully establishing the program, Smith moved to the University of Hawaii in 1972 where he expanded upon the MEDEX concept with the creation of MEDEX International. Smith brought the MEDEX model to over 30 countries, working in collaboration with the governments of several nations, including Costa Rica, Guyana, Kenya, Botswana, Liberia, and Pakistan. Although Smith retired from the USPHS in 1981, he continued to serve as a national and international consultant on healthcare delivery. He also continued to advocate for increasing opportunities to minority clinicians and for expanding care to underserved communities and patient populations worldwide.
Awards and honors
Smith received a Retired Commissioned Officers Recognition Award from the US Public Health Service in 1999.
- Hooker, Roderick S.; Cawley, James F.; Everett, Christine M. (2017). Physician assistants: policy and practice. F.A. Davis Company.
- Cawley, James F.; Cawthon, Elisabeth; Hooker, Roderick S. (2012). "Origins of the physician assistant movement in the United States". Journal of the American Academy of PAs. 25 (12): 36–40, 42. doi:10.1097/01720610-201212000-00008. PMID 23600002.
- "MEDEX Founder Dr. Richard Smith: Multiply My Hands". University of Washington. Retrieved 29 December 2020.
- United States Public Health Service, Commissioned Corps. "Commissioned Corps Bulletin, Volume 14, Number 3". Retrieved 29 December 2020.
- "Richard A. Smith, MD, MPH: 1932 – 2017". University of Washington. Retrieved 29 December 2020.
- Ballweg, Ruth; Chambers, Margaret; Doran, Todd J. "Remembering MEDEX founder Richard A. Smith, MD, MPH". The Journal of the American Academy of PAs (JAAPA). Retrieved 29 December 2020.
- Ballweg, Ruth; Wick, Keren H. (2007). "MEDEX Northwest: Workforce Innovations" (PDF). The Journal of Physician Assistant Education. 18 (3): 30–39. Retrieved 29 December 2020.
- Sternberg, Steve (29 July 2015). "Desegregation: The Hidden Legacy of Medicare". U.S. News & World Report. Retrieved 29 December 2020.
- Smith, David Barton (2016). The Power to Heal: Civil Rights, Medicare, and the Struggle to Transform America's Health Care System. Vanderbilt University Press. ISBN 978-0-8265-2107-1.
- Tidwell, Mike (2000). "The Quiet Revolution". American Legacy. 6 (2): 25–32.
- Cohen, Alan B.; Colby, David C.; Zelizer, Julien E.; Wailoo, Keith A. (2015). Medicare and Medicaid at 50 America's Entitlement Programs in the Age of Affordable Care. Oxford University Press. ISBN 9780190231545.
- Smith, David Barton (2015). "The "Golden Rules" for Eliminating Disparities: Title VI, Medicare, and the Implementation of the Affordable Care Act". Health Matrix: The Journal of Law-Medicine. 25 (1): 33–60. Retrieved 29 December 2020.
- "The Birth of the Physician Assistant". nih.gov. Retrieved 29 December 2020.
- Smith, Richard A. (1970). "MEDEX". JAMA. 211 (11): 1843–1845. doi:10.1001/jama.1970.03170110049010.
- Smith, Richard A.; Banta, James E (1969). "Global community health--a "new" health direction". American Journal of Public Health. 59 (9): 1713–1719. doi:10.2105/AJPH.59.9.1713. PMID 5817612.
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