Full Text of the Excerpt

KAREN KRUSE THOMAS:

About what percentage of your office patients were black?

JAMES SLADE:

Probably 80 to 90 percent. We always have seen whites, and most of our white patients have been children. But we do see a few adults who insist on coming. Word of mouth gets around, if you treat a child and he gets better, they spread the word.

KAREN KRUSE THOMAS:

Have you seen economic conditions change in this area, and has that affected your practice?

JAMES SLADE:

I think economic conditions have improved for a large group of people. But what has primarily made the difference in medical care is Medicaid and Medicare. Other doctors might see more paying patients, but I see a tremendous number of Medicaid and Medicare patients. These people are getting better care, particularly with Medicaid, since you can take it anywhereߞdrugstore, hospital, doctor's office, not so much with Medicare. Particularly when you've got a large number of single parents. Without Medicaid, they don't have a good source of income, so that makes a difference. That has been a real boon. There has been industry coming into the area, but I'm not so sure that has impacted particularly the black community that much. Some, yes. But I think from a health standpoint, it's been those two programs that have really made a difference. A lot of times you'll see a child in your office who needs to go to the hospital. A lot of times the mother doesn't have the means to go, and will try to treat them outside, and keep them away until almost the last minute, until they're so much sicker. Now they don't mind bringing them in earlier, because they know there's a means of reimbursing.

KAREN KRUSE THOMAS:

Earlier in your practice, do you remember some of the ways people would try to treat themselves to avoid going to the doctor?

JAMES SLADE:

We had grandmother's remedies! [Laughter] They have Tylenol, and sometimes by the time they get to you with an ear infection, the ear is draining. But that began to fade out with Medicaid, around 1970. You still see some trying to treat themselves, but most of them don't hesitate to come in.