“What can we, as health systems, do together?”
A conversation with Legacy Health Board Chair and alum Dr. Jeffrey Fullman
Oct. 5, 2018
You might say Jeffrey Fullman, M.D. '80, was destined for a career at Portland's Legacy Health System. The internist was, after all, born at Legacy Emanuel Medical Center. And, even before medical school, he worked at the hospital in several jobs.
After earning his medical degree from OHSU School of Medicine in 1980 and completing an internal medicine residency at University of Missouri-Columbia in 1983, Dr. Fullman returned to Oregon to start a solo private practice. In 1992, he helped found Cascade Physicians medical group. He has been on the medical staff at Tualatin's Legacy Meridian Park Medical Center since 1983 and has been affiliated with Legacy all those years, serving in a number of leadership positions such as president of the Meridian Park medical staff and as a member of the hospital's board of directors.
As the Legacy system grew and consolidated, Dr. Fullman was tapped for greater responsibility. Today, he is chairman of the Legacy Health System Board of Directors. He served on the system's board from 1999-2008. After a one-year break, he was re-elected to the board in 2009 and became chairman in 2014. He sees patients four days a week in his Tualatin office and serves on the OHSU School of Medicine Alumni Council.
Recently, we sat down with Dr. Fullman to discuss his long career. Below are highlights.
On changes he's seen
One of the biggest changes I've seen in my career is the employment of physicians. It's difficult to go into private practice today. Increasing numbers of physicians are employed by a hospital or health system. I used to round on patients in the hospital, but now hospitalists deliver that care. I stopped hospital care three or four years ago. This has simplified my life, and the hospitalists are very good. But we've developed these silos of care where we lose some continuity, and that's not always best for patients.
On workforce needs
We need more people going into primary care. We don't need more subspecialists. Residents train in hospital settings with subspecialists. We need more primary care mentors for residents, and we also need an economic incentive for primary care –such as debt relief –that will ease the financial burden of medical education. Debt forgiveness may be an incentive for residents to choose primary care. When I was in medical school, tuition was $900 a term. Today, a medical education is tremendously expensive. Health systems should take the lead on addressing this.
On advice to future physicians
Go into primary care!
When we talk about how to best deliver care, we now pay attention to social determinants of health. For example, we should look at where people live, what they eat, and at their levels of education. We're asking: how do we keep people healthier? Physicians are very much into quality and doing the right thing. But what is quality? Is it getting a mammogram? Is that a quality outcome? Instead, we should look at how often a person is homeless or if they finished high school, for example.
Unity Center for Behavioral Health is a great example of Portland health systems coming together around a common goal to meet the needs of those requiring mental health assistance. I'm proud of Legacy's leadership in fostering this collaboration. Mental health care has been an area of great need for years. Unity is making a big difference in this area. We can also look at other areas for collaboration. I'd like to see a Portland collaboration around gun safety. This is a public health issue that impacts us all.
On Legacy's achievements
I'm proud of many things Legacy has done, but I'm particularly proud that we built the Legacy Salmon Creek Medical Center in Vancouver, Wash. We have also supported Central City Concern and have improved care for the homeless in collaboration with others.
On life outside work
I enjoy traveling with my wife, Anne, and spending time with family, including our twin sons, Michael and Chris. I run on a regular basis and have completed a number of marathons and half marathons. I'm also section hiking the Pacific Crest Trail. Each year I do another piece of the trail. A friend and I have completed Oregon, Washington, and about half of California. In April, we did another section in the hot, dry desert of Southern California. It wasn't my favorite section, but we will be done with the desert soon. We have only about 800 miles of the trail left.
On finding joy in medicine
For me, taking care of patients for decades has been a delight. The best part of my day is when I sit down with patients and interact with them. I also have great partners at work. It is a pleasure to collaborate with them on a daily basis.
Medicine is still a great avocation. To me, it is an avocation, not a job. It's a remarkable privilege and honor when people let you into their lives at their most personal moments. The rewards are not awards or accolades. The rewards are in the relationships. Nothing is better than hearing, "You listened to me. Thank you."