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JAMES SLADE:

As far as the amount of socialized medicine, that's never been a big thing among African-American physicians, as it has among non-African-American physicians.

KAREN KRUSE THOMAS:

Why do you think that's true?

JAMES SLADE:

When you look at blacks as a whole, group things seem to mean a little more to them, like in terms of the church. That's one of the institutions that's really meaningful to blacks, it's not just a club, it's more of a family gathering, although they don't always act that way. White physicians can go to the country club and play in the golf tournament on Sunday morning, or whenever it is, whereas the black physician, I know some now who go on the golf course, but back when I was coming along, you probably couldn't find half a dozen black physicians in the country that played golf, particularly in the South. The church was the uniting force, and its a social gathering place. Helping somebody in groups has never been a threat, so I think that's one reason why black physicians have never been threatened by so-called socialized medicine. You don't turn anybody down anyway, or it's a lot more difficult for the black physician to turn away the poor people, particularly the blacks.

CATHERINE SLADE:

Another thing, you find very few rich people in the black race. Most of them might have been in the same situation at one time, until a better opportunity came along. So they know what it's like.

JAMES SLADE:

Also, if the black physician starts turning away his own people, he gets into all sorts of trouble. He's not going to attract a lot of non-blacks just because he turns away blacks, and he puts himself in a bad position with his own race, because people say, "Now he's a big shot, he won't even see us." Basically, he's taught not to reject his own.

CATHERINE SLADE:

It's a loyalty thing. As I think about it, I can remember hearing people get very upset with him. If he didn't have time to make a housecall or do something they wanted him to do, they would go over to a white doctor who they know wasn't going to go on a house call. But because [Dr. Slade] wouldn't do everything they wanted him to do, they were going to go to someone else. They expect more of you.

KAREN KRUSE THOMAS:

The patient would go to the other doctor to punish you, even though they wouldn't get any better service with that doctor?

CATHERINE SLADE:

They're not getting any better service, they just didn't like it if you turned them down and wouldn't make a house call.

JAMES SLADE:

But they're going to get out of the house to see the other doctor, because he's not going to make no house call, either! By the same token, they're also more loyal. I have patients who will wait in that office for three or four hours before I get to see them.

CATHERINE SLADE:

Maybe they give more, but they expect more.

JAMES SLADE:

It amazes me, by and large. Maybe a few white patients would wait, but most of them, if I'm not there close to on time, they take off. Which is their right to do so. I call and have my nurse tell them I'm going to be late, and they won't move.