Waitus O. Tanner, M.D., oral history interview, December 11, 1992

              DR. BROWN: This is an interview with Dr. Waitus 0. Tanner. He
served as President of the South Carolina Medical Association in
1977 and 1978. We are here in Dr. Tanner's office in Columbia,
South Carolina. The interview is being conducted by Dr. Laurie
Brown and Ms. Manya Greene. This is December 11, 1992. Dr.
Tanner, the first thing I want to ask you is a little bit about
your family, where you grew up, your family of origin. Would you
like to tell me a little bit about them.


DR. TANNER: It is so nice to talk to you today. I was born in a
rural area in Georgia. Near the town of Temple, Georgia. My
mother was named Pearl Belcher, my father was William Rollings
Tanner. I lived most of my life in the City of Columbia for the
last probably 50 years. I am the first physician in my family and
so far the only one in my family. So I did not grow up in a
physician's family. When I was eight years old I went to grammar
school in Columbia and High School and went to the University of
South Carolina and graduated from there. I went on to medical
school which was then the Medical College of the State of South
Carolina. Probably my mother was the most important influence on
my life. She was a very nice lady, very intelligent and very much
of a driver. I had one brother and my brother died when he was
fifteen and I was twelve. That probably was what influenced me a
great deal to go into medicine although nothing was ever said about
that. As I say my mother was a very strong person and I am sure
that she indicated to me that was what I was going to do. I had
some very good experiences at the University of South Carolina and
I was always pleased with my education at the Medical College in
Charleston. I believe one of the questions that you asked was who
influenced me at the Medical University and I still remember a few.
Of course Pratt Thomas who we used to call PT. He was not very
much older than the students who were there. As a matter of fact,
he doesn't look much older than that now when I see him. Still he
was very important to me. There was a fellow by the name of James Fred
Kinard a physiology professor who we were all very fond of also

and he seemed to be a favorite.


DR. BROWN: I saw Dr. Kinard last night. He is still Dr. Kinard.


DR. TANNER: Of course we liked all of the professors. Some of them
at the time we didn't like too much however. I remember a medicine
professor sometime we didn't like too much, Dr. Kelly who used to
get on us pretty bad. I also had to say that during my years in
the service. I served in the Yale Unit over seas and I also served
in the hospital unit and also served in the Harbor unit and I would
like to say I never found my education from South Carolina lacking.
The practical education was,
was much superior to those from the Ivy
League medical schools. I interned at the Columbia Hospital in
Columbia with my friend and close ally over these years, he has
been like a brother to me and that is Tucker Weston. We have been
on the hospital board; Marion Davis. We were quite a group of
them.


DR. BROWN: That is interesting.

How did you decide how you were

going to practice and where you were going to practice? Do you
remember?


DR. TANNER: Well I came back after serving two years overseas as a
medical officer and the last year as a military governor out there
in Korea. I came back and was so glad to get home and decided to
stay home. This is my wife's home and my family was here. I
really never considered practicing anywhere else. I started from
scratch. Like I said, I didn't have any family in medicine so some
of these physicians in town were very nice to me; Scotty Burnside-
and so I started in Family Practice. It was then general practice.

Delivering babies and surgery.


DR. BROWN: Now, why did you get married, were you married in
medical school?


DR. TANNER: I married the last six months I was in medical school
I was in the second class in 1943. They had the June class and the
December class. I graduated in the December class. I married
Jenny Floyd in June before I graduated in December. She was a
school teacher. She and I had been in love since high school and
dated the three or four years I was in medical school. We didn't
have enough money. Teachers didn't make much back then either and
you know medical students didn't make much. When we got the ASTP
program in the Army we got one hundred and fifty dollars a month
which was mostly was substance and that was a salary. So we
decided we were rich and we would get married. We have two nice
children. My son Neil and my daughter Lee. We have three
grandchildren. My daughter has two children a boy and a girl and my
son has one. We have a very nice family, it is small but very
nice. I have been practicing in Columbia now come January 7th for
46 years. In Family Practice rather than General Practice.


DR. BROWN: You have seen a lot of change in your time of practice
here.


DR. TANNER: I certainly have. Originally medicine was pretty tough
because we always had a high volume practice. It was very
satisfying and particularly since we dealt with the patients. That
was basically the thing to do. There was no third party, no
government insurance or HMO'S.


DR. BROWN: During this time, your whole practice has been a
memorable event. Is there anything that particularly stands out?
If you would like to mention a most memorable event? How I can ask
that I am not sure but will ask it anyway.


DR. TANNER: Well, I think one of my most satisfying experiences in
medicine has been my involvement in organized medicine. It has
been an addiction almost since I got into it. When I got into it
I was a solo practitioner and for several years I was an alternate
delegate. Any leadership role without a partner or anything was
very difficult. But I, somehow I got the feeling that if I didn't
get involved that someone else was going to do it and not do it the

way I wanted it to be done or that the way I thought was the
correct way to be done. I think some of my, because I have had a
million bad experiences in medicine as we all have. I think the
most satisfying parts of medicine is delivering babies and seeing
the mother and babies and delivering the babies later on when they
got grown up and it was a very satisfying practice. I think I read
once that doctors sometime complain about all the hard work and my
wife who is smarter than I am. She was smart enough to marry me.
She always told me you aren't cut out to be supporting your family
in the manner you are accustomed to, you practice medicine because
you love it and I read once that this fellow said if you complain
about your working hard, quit your griping because people admire
you and feed on that and I think that is true. I think really good
doctors, and I hope I am one, do have that feeling that you are
needed and you are doing something very pleasant. I am not sure
that others feel this. I hope they do. It is very satisfying. I
was involved in organized medicine, started out on the local level
and with the certainly gentle prodding of Tom Pitts- and Dave
Adcock, they were one of my heroes and Strother Pope, they got me
involved. As a matter of fact Strother Pope gave me some good
advice once. He said, during a medical meeting when they were
voting for alternate delegates for the medical association. I
asked him who to vote for. He said vote for yourself. If you
don't vote for yourself who else do you think will vote for you.
He gave me some good political advice. So we got involved with the
South Carolina Medical Association when Tucker and Piere LaBord and
some of the other fellows. For several years we sat in the back
seat we really didn't have that much influence in things. I believe
in working in the trenches first. We got some very good
experience. Everything we voted for got passed. I guess I started
about 30 years ago. 20 years I was in a leadership role. The most
important thing, I can say that back when we were sitting back
there we weren't too satisfied with the way it was being run. Back
then the Medical Association headquarters was located in Florence.
My old good friend Jack Meadors was an attorney and Executive of
the Medical Association. He also practiced law however, too. So
it was sort of an out of your back pocket organization, Tucker and
I were young turks and we didn't think this was too good and we
were going to move the headquarters. I will never forget old Dr.
O.B. Mayer of Columbia, a nice old gentleman. He was sort of
straight laced. So Tucker and I were young, bright people you know
and we were out discussing how were going to move the Medical
Association headquarters to Columbia and he came out of an elevator
from upstairs and he said, you young whippersnappers, you think
that people like me and. all my friends can't get that thing moved
so you all have no chance whatsoever of getting this moved. So we
were young and probably stupid enough to think we could do it and
by George we did it.


DR. BROWN: You did it!


DR. TANNER: We did it. The big changes in the Medical Association
at that time were, there were two changes. A lot of these things
come back to haunt you too, by the way. You have to think about
that

in politics. One of the things that we did was that we noticed
that the Past Presidents had such a influence on the organization
and that is probably good. We decided we would seek to alter that.
The other thing was that we also noticed that the Council, the
Governing body of the association was self perpetuating because the
council who represented the districts were elected by the House of
Delegates and were also nominated by the House of Delegates. So it
was just whoever was in power. By some lucky perk we got them to
elect the council by the district itself. It made a world of
difference. First of all the council didn't get re-elected. That
was basically how we got, I think how we got the association moved
and then we got some support from the Executive Director and we
feel the organization sort of turned around. I think we now have
one of the best organizations in the Country. At one time we
didn't have that. So we feel like things worked for the better and
I will say that we had some awfully good fellows in the
association. We had this uprising, when we moved to Columbia, as
you can well imagine, that met with opposition. I think we have a
stronger membership in Florence now that we ever had. It didn't
take us long to get them back. Of course other controversy was the
building. We used to catch a lot of flack. If you have a vision
you have a tendency to do what you think is the right thing to do.


DR. BROWN: Now this was done before you were President? The
building.


DR. TANNER: Most of this was done when I was on Council. I was on Council for nine 
years. When I was on Council Bill Perry was President, I called him on his birthday 
and he was very excited, and then Harold Hope was the President I believe I 
followed Harold. Most of this stuff happened when I was Chairman of the Council. It 
was a good Council. We used to have some long beat-them-up meetings. We had 
some good old controversial and busy things that came up. It was just things that 
had to be done. For example, during that time I think, even before Jack left the 
organization and started the Foundation because we had some people on the 
Council who had the vision enough to see that medicine would need to be a more 
pro-acive and active organization rather than are-active type. Up until that time we 
were a reactive type organization. Maybe a year or so later the Foundation was 
some more or less a favor. We were making visits to various places to
see how to run a Foundation. Then when they came up with the PSRO we needed 
physicians to make the applications for it. Charlie Johnson made the applications for 
that. At that time I was the
first President of the Foundation. Charlie Johnson was the
Executive Director of the Foundation. John Hawk interviewed
Charlie Johnson. We got Charlie from Los Angeles County Medical
Society which was larger than the South Carolina Medical
Association at that time. That is how we got into PSRO. Of course
with PSRO you have a tendency to get into other things and that is
when we hired Bill Mahon. As a matter of fact I interviewed with
Charlie Johnson, Dessie Gilland and myself were the ones that
interviewed and hired Bill. We got him from the Illinois Medical

Association. So then we built the building. Everybody said it was
"Tuckers Folly.” It turned out pretty good and we sold it for a
profit and we got a nice building out on 1-26 which is I think debt
free. At this time the Foundation and the Organization didn't get
along too good. Of course in addition to all these political
problems I presumed you might have - if I get too verbose let me
know. We had the same problems, and in about November of 1977 we
had the same problems facing medicine, access and quality, they
haven't changed and in addition to that now days we have others
too. We were really in sad shape as far as the malpractice
insurance is concerned. Our adversaries, we had a full
relationship with them. They didn't understand us, we didn't
understand them. When I was Chairman of the Board my job was to
improve the relationship of all the people we had to deal with.
DHEC, DSS, the Hospital Association. As a matter of fact we
initiated, I don't want you to think I did all of this. It was
part of the association policy coming from the Council. Our
Delegates body only meets once a year, the real ruling body is the
Council. We established a liaison with agencies, we established a
much better rapport with the Hospital Association. We invited the
DHEC and DSS Executives to meet with us. We also established
contacts with the pharmaceutical, the pharmacists and had
discussions with them and also established a rapport with the trial
lawyers who I am getting around to adversaries. And during my last
year on the Council or as President we got through the first
significant Tort Reform. We did this through a series of meetings
and with the help of Bob McNair and his firm, we had some very good
people on our side. Sol Blatt and others at the Legislature, at the
time his senior partner was a trial lawyer. We went down and
talked to Mr. Sol and he arranged that we got the first significant
change in the Tort Reform Bill. What was really essential was no
limitation and the three years under the present circumstances was
very significant. It was really the breakthrough we were looking
for. It got us in the halls down there to negotiate some of the
other things that we were working on. One of the other things
while I was in office we went through the controversy of a second
medical school. The South Carolina Medical Association went on
record as being opposed to it and this was not something that was
just merely a short discussion. It was very much discussed. Of
course we got a lot of criticism for that because they said is was
self serving. At the time we thought it was the right thing and of
course now we have a very good medical school here in Columbia,
which I am very proud of because I am a graduate of the University
of South Carolina. I am still not sure we can afford two schools in
South Carolina.


DR. BROWN: That is about the only problem, financial.


DR. TANNER: That is the only problem I have with it. I think
otherwise it has excellent rapport with local people. So I am not
criticizing it I am just telling you how it is. Also then we had
the JUA and the discussion of whether we needed the government run
insurance company and whether we needed to form our own. I have to
tell you that I was on both sides.

DR. BROWN: Hopefully not at the same time.


DR. TANNER: At one time or another I was on both sides. I will
have to say the best thing prevailed, we did get the JUA and under
the leadership of a lot of other physicians, Tucker, Don Kilgore,
Bart Barone and many others we have done real well. And as you
know we have one of the best malpractice insurance companies in the
country. Another thing I think we wrestled with and made great
strides in improving reimbursement and eliminated geographical
differences for rural physicians. We certainly didn't alleviate
the whole thing but it did help them. Let me tell you that was
very controversial. We had a lot problems with it. At one time we
were the only state in the country that eliminated geographical
differences in reimbursement. We were a pilot project and we were
very proud of that. Anytime you have medicine dabbling in politics
and anything that has to do with that you have controversy. You
can't make everyone happy all the time. As a matter of fact my
good friend, John Hawk, who I love like a brother, John never did
join the Foundation. He was always a hold out on that. The
Foundation has served us well.


DR. BROWN: Now let me ask you, in one of your President's Pages I
recall when you were discussing the problems, which are still with
us today, to access cost and quality and talked about the medical
school you mentioned the shortage and mal-distribution of
physicians. Has the medical school helped in that area?


DR. TANNER: I think for a long time it didn't do a very good job in
my opinion. I think after we had a residency program, particularly
in Charleston, was not geared to put people out in the boondocks
where we needed them. I think in the past few years we have made
tremendous accomplishments in that. They put in a core curriculum
in the Medical School which we have fought for very much. You
know, in a leadership role you have to forget that you are a Family
Practitioner, Anesthesiologist or Internist you must be just a
physician who represents everybody in the state. This has disturbed
us for many years and I think just recently after the Academy of
Family Physicians meeting in Hilton Head we got a report from down
there from Dr. Curry and O'Neal Humphries about the progress they
are making putting our primary physicians throughout the state.
That has improved tremendously in the last five years. It has
taken a lot of pressure. You have the old academic world which is
very hard to change. That is not the only part they have changed,
they have changed other parts too. That has changed for the
better. I think the third parties are going to have a big say in
that we are going to have to have more primary physician and put
them out in the deprived areas and rural areas. I think the
managed care needs to have more people in the area that needs care.
I think this will be a side effect of managed care. In managed
care you have to lean on your primary physician.


DR. BROWN: I don't know if it was you, maybe you told me, that my
friend Perry Davis in Sumter County is having someone come in and
work with him. Perry has been working all these years in Family

Practice all alone. So something must be alleviating the Family
Practice shortage a little bit.


DR. TANNER: I hope so and this is a nephew and so that helps too.
Of course my partner is my wife's first cousin and I helped raise
him. His mother and father died when he was fifteen. I think the
trend is a little bit better and I think the fact that Family
Practice and General Practice has raised its image. It was a fight
to get here. What I did after I retired from the Medical
Association active leadership, of course I served on the AMA for
eight years, we let somebody younger take over. I also went back
and all those years I have spent with the South Carolina Medical
Association I have somewhat neglected my own specialty group so I
went back and worked with the South Carolina Academy of Family
Physicians and served on the Board of the South Carolina Academy 
of
Family Physicians and was Chairman of the Board there which I was
very proud of. Everybody likes to be recognized by his peers. So
I know that and hopefully I put some bugs in some ears to make it
a little more aggressive than it has been in years. You know the
squeaky wheel gets the grease. And of course I served on the South
Carolina Blue Cross and Blue Shield Board for a number of years.
I just went off that, I told them I am too old. Which I am very
much in favor of , when you're old get off the Board. I very much
enjoyed it. I feel I did more good than harm with that and I think
we improved somewhat the rapport between them and I think we need
more of that between third parties and organized medicine. We
tried to promote that when I was on a board, you have to 
understand
peoples problems in order to be able to deal with them. When you
start to understand their problems then you do a better job. I met
with some of our friends and made some enemies but I enjoyed it.
I have always delighted in challenge and that is why I volunteer 
on
many committees. When people ask me what I am doing I tell them I
am working. My partner thinks I am not but I work Monday, Tuesday
and Wednesday mornings and Friday afternoons and night. My wife
thinks I am retired, that is about as much as she can stand me
being around anyway. My practice was good, I enjoyed it and I
think that I have hobbies. It is not a matter of working because
I don't know what to do with myself. I fish, and some people call
it golf, I am not sure what it is. I have a granddaughter that I
take care of and I have two others . Of course I love my
grandchildren too, but they are harder to love until they get to 
be
about 18. My other granddaughter is 18 and I can love her a little
bit better. When they are little you can love them a lot more. I
have plenty to do. I still love my practice, I still enjoy it. At
one time I was considering going the administrative route but I
said, look, I am not going to be happy doing that. I am happy
seeing patients. I enjoy it, I think it is relaxing. I think the
future of medicine, one of your questions.


DR. BROWN: I was going to ask you about that. What is the future
of medicine and where are we going?


DR. TANNER: Well I think the first major issue facing medicine now
is high tech costs. We have come to a point that we are able to
prolong death- to-well and I am sure others call it prolonging
life,
I am not sure what quality of life you are talking about. At one
point you think of people in the nursing home setting. The
insurance risk goes up. I had a very satisfying practice. I am
elderly now. It is very depressing when somebody else asks you how
you feel about wanting to maintain life and put off death in these
people. I am not so quick to answer. Mainly the problem we have
in dealing with people who have people in the nursing homes is
guilt. It is a major problem. Two things you hear most in a
nursing home are "I want to go home" and "put me back to bed". That
is

a sad thing you know. I think the American people are going to
have to decide when do you cut off care. I think that the British
have done that to some degree if they make the socialized medicine
thing work. I think what the planners have done in this country is
they have not, the planners and politicians, have not told people
that if this thing doesn't cost more than we are willing to pay it
is going to be rationed. Malpractice, it has done pretty well in
this state so far but we are getting more and more lawyers. The
more high tech we get the more suits are going to be possible
because I think some of these suits are in part our loss of image.
I think that is one of our real problems. Of course the
government many years ago says we are going out of our profession
into business. Some physicians are, I am a free enterprise person
from the word go, some of my colleagues are getting embarrassed by
their income. Organized medicine doesn't have the ability to do
that. We don't have the ability to keep some of our colleagues from
advertising. We can't do that because the FTC tells us we can't.
So I do It know what we can do about the doctor part of it before
the word provider. I don't know but I think that the other thing
is the government and third party interference. I think that is the
old golden rule. He who has the gold makes the rules. What they
are not paying the third parties are paying and they want to make
the rules. I think we are getting more and more cookbook medicine.
Of course the more we have the more it costs. And of course they
don't understand that. Of course we have another element that came
into the equation recently is the Empire Building by the Hospitals.
Hospitals want to get into it. They want to have the doctors
working for them. Hospitals now, the large ones are doing
extremely well. The small ones are going out of business. The
large ones are making so much money they have to hide it. They
have capital improvements or they have projects in which they put
up buildings for physicians and want to hire them. Another problem
is our new physicians coming out of medical school are broke. They
are not only broke but they are deeply in debt. They are going to
be good targets, both for hospitals to hire and HMO's to hire.
They are real vulnerable too. That is another problem I will not
get into, the cost of medical education. It is a problem. it
involves other things and the fellow gets out and has the ability
to practice and he wants to get his money back. I don't see
anything wrong with that it is just not maybe in the best interest
of access, the cost and sometimes quality. You asked me about some
of the fellows, persons, I met otherwise. I don't remember many.
Of course Hymen Ruben, Heyward McDonald was a fine senator. Old
Sol Blatt, of Barnwell. He is a very good friend of the medical

University you know. When push came to shove he really helped us
on the Tort Reform. Some of the trial lawyers have not been that
bad. Everybody hates Ellis Kahn, but I have had some good
conversations with Ellis. He has some good ideas about how to keep
out of trouble.


DR. BROWN: I have him speaking to a group of our residents sometime
shortly.


DR. TANNER: He will be very good. He will tell them now if you do
this you are going to get sued and I think that we need people like
that. Some people don't like him. Are there any questions you
didn't ask. my son is not a doctor by the way, he didn't go into
medicine. One question people always ask, do you want your son or
daughter to go into the profession. It is less and less a
profession and more and more a business. I think someone with the
same intelligence can go into another field and do as well. I
would not consider it to be a good business for most people. As a
profession you have to be dedicated. I can't think of anything
more miserable than being a physician if you are not dedicated.


DR. BROWN: I have said that a hundred times.


DR. TANNER: You can make a lot of money but if you are not
dedicated you will be miserable. Would I do it again, yes. I have
the feeling that somewhere along the line I have helped some
people. I think one of the best ways to be happy is to give
yourself away.


DR. BROWN: It is hard to beat.


DR. TANNER: I would probably do it again. I have really enjoyed
it. One of the best things I enjoyed is being a part of organized
medicine.


DR. BROWN: Is there anything else you want to add?


DR. TANNER: I have been talking, probably too much.


DR. BROWN: That is what this interview is all about.


DR. TANNER: I'll say this, I have been associated with some awful
fine people in the medical profession both as professional
colleagues and leadership. I think South Carolina has been lucky
to have the leadership that it has in the past several years.


DR. BROWN: I want to thank you for this interview and on behalf of
this interview, the South Carolina Medical Association and me and
Manya Greene it has been a real nice time talking to you.