Kenneth N. Owens, M.D., oral history interview, April 23, 1993

              DR. BROWN: Today we have an interview with Dr. Kenneth N. Owens from 
Aiken who served as president of the State Medical Association in 1984-85. We are in Charleston [South Carolina] at the Omni Hotel during the 145th Annual Meeting of the State Medical Association. Today is April 23, 1993. Dr. Owens, thank you for this interview. 
DR. OWENS: Well, thank you. 
DR. BROWN: We look forward to this interview and we are going to ask you a few questions that you can answer, or don't answer, you just let me know. DR. OWENS: That's fine. I'll do my best. DR. BROWN: The first thing I am going to ask you is a little bit about your 
roots, your family, family history, where you were born, a little bit about your family of origin. 
DR. OWENS: I was born in Denver, Colorado on September 15, 1923. My mother and father were married in Denver in 1921. My mother was born in Missouri into a family of physicians. My grandfather was a physician in Booneville, Missouri. I had the pleasure of going back to Booneville two years ago to research some of my mother's family, which I did not know much about. I learned that I am now the sixth generation physician between the McLanahan family and the Owens family, and my oldest son is number seven. 
DR. BROWN: Well, isn't that nice? 
DR. OWE S: It was quite an experience because my grandfather died in 1918 
of the flu and mother has not been very communicative about her family. In fact, she 
was bitter about her family. My dad was a printer. As you can tell, I grew up in very modest means as a youngster. I always talked about going to medical school, and mother [would say], "We can't afford to send you and the best thing is just to forget about it." Dad's continuing response was, "Son, if that is what you want, we'll find a way." Well, then came the Great Depression of 1929 and it looked like everything was gone. There was no possibility of my ever realizing what I had hoped to do. And then came World War II. I had gone to the University of Colorado. I had joined the Reserves with the hope that, because of joining the Reserves, I would be able to continue in school. The Army, in its infinite wisdom, called me to active duty in 1943 and I thought, "Good-bye, good-bye, no chance now." But then, after the invasion of France, the military and the Defense Department decided they didn't need us anymore. I was discharged in August 1944 after having been granted entrance to the University of Colorado School of Medicine, where I graduated in 1948. I took my internship at Fitzsimmons Army Hospital in Denver. I went into the military because I did not think that I could incur any more medical school debts. In 1948 $10,000 was a lot of money. Today, it's a great deal different. The majority of students finish $40,000 to $100,000 in debt, but to me in 1944, $10,000 was a million bucks! I didn't have any potential to try to pay it back. 
DR. BROWN: Did the GI Bill help you? DR. OWENS: The GI Bill helped me for one and a half years and then I was on my own. Those were a couple of tough years. Fortunately, I had someone who would 
help me with borrowing money. [They] loaned me money interest free with the understanding that, as soon as I was capable of repaying those loans, I would do so. decided that I had better stay in the military service and during my internship made the decision that I wanted to be an obstetrician. I then went to Brooke Army Hospital in San Antonio for the first two years of residency, and that was during the Korean War. We had too many senior residents, so they sent me to Letterman [Hospital] in San Francisco, and I arrived to find that I was the third senior resident in a department that could only handle one senior resident. So they sent me on to Mattigan [Hospital] in Tacoma, Washington, and I finished up my residency there. I stayed in the military and went to Korea. I spent four months in Korea and had a very interesting experience at commanding hospital trains. Maybe you know about hospital trains, but I doubt that our young friends know about hospital trains. I didn't know anything about railroads, and I found out that the Anny had moved over $70 million worth of rai1road equipment into Korea with no one responsible for any of that equipment except me. I was a regular Army officer at the time and they saddled me with that. We had an IG investigation. I learned an awful lot about army administration with that IG investigation. We had a terrible fire in Pousson in 1953 and my trains were scattered all over Korea. It took me a month to finally get them all back together. Then we went back to Japan where I spent three years; [that] was a very pleasant experience. We enjoyed our service in Japan very much. Our oldest boy was born there. We then came back to the United States in 1956 and went to Washington, D.C., where I was the Assistant Chief of Service at Walter Reed 
Army Hospital. Then we moved to Fort Bragg [North Carolina] where I got very upset 
with the Anny and resigned, got out, and went into private practice in Aiken. I have 
lived in Aiken ever since. 
DR. BROWN: How did you decide where to go into private practice? 
DR. OWENS: You know, I saw an ad in the JAMA and it said, "Practice for sale, 
OB-GYN, very reasonable circumstances." I didn't know where Aiken, South Carolina, was. So I got a couple of days off and drove to Aiken, and went down and met the gentleman who had the practice. He convinced me that I ought to move to Aiken. I went back to Fort Bragg and asked my wife, Joan, to go down with me. We went down and stayed with some friends in the area, and she said, "I want to bring our children up in a small town." And we ended up there. 
DR. BROWN: I want to ask you about who you married and about your children and family. DR. OWENS: I married Joan Baxter on April 5, 1952. My first child was born 
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in 1955, the second in 1959, and the last child in 1961. My oldest son ft9' an otolaryngologist in practice in Mt. Pleasant. We have two grandchildren in that family .
Kenneth, who is named for me, and Cameron who is named for his father and his grandfather. We have a grandchild in Alaska and then we have three step-grandchildren in both of the other families. We are going to have another grandchild in December, we are told, perhaps the first girl, perhaps. 
DR. BROWN: Is that right? You are handling the grandfather bit perfectly well. 
DR. OWENS: It's a lot more fun than it was being a father, I can guarantee that. 
DR. BROWN: Ken, tell me, do you remember how you first became involved in organized medicine? 
DR. OWENS: I was talking to John Hawk about this last evening, when I first went to an SCMA meeting; I went to the first SCMA meeting in I96 I. rd only been in private practice a couple of years. I went to Myrtle Beach and got to Myrtle Beach, and I thought, "My goodness, this organization is run by a bunch of old fogies; and I'm not sure I want to really participate in this organization." Well, then I met Tucker and Waitus about a year later. 
DR. BROWN: Tucker Weston and Waitus Tanner? 
DR. OWENS: I met Tucker Weston and Waitus Tanner and I evidently presented a resolution on the floor of the house on behalf of Aiken County. And Tucker came up to me afterwards and said, "Ken, we'd like to get you interested in the Medical Association more." I began to feel a little bit more comfortable about participating in organized medicine. Then Joel Wyman appointed me to the SOCPAC, which wasn't called SOCPAC at that time, [it was called] SCALPEL; and Joel asked me if I would serve on the SCALPEL Board, and I said I would be delighted to. I don't know anything about politics but I'd be delighted to serve on the Board. We had the Board meetings in Tucker Weston's living room. We had very, very casual meetings at the time. Then I was elected vice-president in 1972, and from then on it was continuous membership in the Medical Association in various capacities --secretary, counselor, back to being 
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secretary, and then finally president-elect and president over a period of twenty-some odd years. 
DR. BROWN: Do you remember what SCALPEL stood for at that time? 
DR. OWENS: South Carolina Alliance for Liberty ... -I've forgotten. 
DR. BROWN: ... Liberty, Education, and Life. 
DR. OWENS: You remember better than I do. 
DR. BROWN: I don't know how we came up with that name. 
DR. OWENS: And all we did was provide monetary assistance m the congressional elections. We were not involved at all in the state elections. We weren't involved in the governor's race. We weren't involved in anything else. SOCPAC has come a long way in its evolution, and I think it is to the betterment of the political situation. We are supporting PAC is supporting politician's and, even though some politicians say, "I don't want any PAC money," some of those politicians have the wrong idea of why such groups give them money. And they think we are trying to buy their vote, and that couldn't be farther from the truth. We want their ear, we want their ear. We aren't trying to buy anything. There are many reasonable politicians who understand the philosophy behind the PAC, but unfortunately there are a few who still are very resistant to the possibility of accepting PAC contributions. 
DR. BROWN: Do you remember during your early involvement with the state what some of the real issues were? DR. OWENS: Oh, I think there were continuing issues all of the time crescendoed 
up until 1973 when all of the private insurers pulled out of the state and left all 
physicians without liability coverage. And I believe it is certainly a compliment to a number of my peers, where I was not deeply involved at the time, they were able to go to the legislature and they were able to put the JUA very brief period of time, which rescued the liability situation in South Carolina. It's gentlemen of their caliber that we need more and more and more of, and I see among the younger generation physicians today. I think we've done a pretty fair job of educating young physicians about the wisdom of being active in organized medicine. 
DR. BROWN: That's so. I'm glad to hear you say that. Now, things like cost control and such as that were always subjects, weren't they? 
DR. OWENS: Always a subject, but I don't think cost containment was really a subject until about the last ten years. I think most physicians were very prudent in their approach to what they expected to be reimbursed for the services that they provided. We're always criticized that our approach was archaic, and that we didn't get properly compensated for what we were doing. I never felt at anytime that I needed to be better compensated because, if I had a reasonable standard of living, that's all I wanted. 
DR. BROWN: That's right. 
DR. OWENS: It wasn't a matter of accumulating a lot of resources. It was having a comfortable living, to be able to educate my children in the way that I hoped that they would want to be educated. My son decided to go to medical school and graduated from medical school with no indebtedness. And he said, "No amount could reimburse me for this." He said there were lots of students that would love to be in that position and their families did not have the capability to be able to pay their way through school. I always felt it was my responsibility to do this. It wasn't a matter of capability or anything else; it was my responsibility. 
DR. BROWN: Right. What other issues can you recall during your term of presidency? The government was getting more and more into medicine at that time. 
DR. OWENS: It [government] started getting into medical practice with the institution of Medicare and Medicaid in the 1960's, and the involvement of government in medical practice has become more and more complex as the years go by. The profession is being deluged with paperwork. And this is governmental involvement --the volume of paperwork. It does not facilitate one's ability to practice medicine. It only adds another more expensive approach, and the profession doesn't need that. Unfortunately, that is not the way the politicians visualized it. And I think our proximity to the politicians and our ability to educate the politicians are critical. Some of them listen to us. The vast majority of them don't listen to us. They think we have something specifically to gain from trying to educate them about why medicine is an expensive business. Well, it is more expensive now than when I practiced. Why? Because of technology. Technology makes it much more expensive, but more Americans want to avail themselves of that technology. They expect you to use everything in their [health] management. The old idea that we use our eyes, our ears, and our nose is maybe not passe, but it's certainly far less important than it was twenty years ago. I think that the 
intrusion of government is tragic. The American public in pushing for managed care 
doesn't really understand that managed care means denial of services, and they are not cognizant of this fact. Why does the Canadian system work? Young people in Canada think it's great. They don't use the services. Of course, you think it's great if you are not ill --it's wonderful. They don't look at the few dollars that they take out of their paycheck. But if you look at older individuals who require surgery of some kind, how do they get it in the Canadian system? They come to the United States. They don't get it in Canada because they have waiting lists for hernia repair and waiting lists for gallbladder removal and waiting lists for hysterectomies and waiting lists for everything. So they cross the border and come to the United States. 
DR. BROWN: Is there anything specifically that you can recall about your year as president that you would like to mention? 
DR. OWENS: I spoke to 26 or 27 different county societies during my year and I always talked about membership because I felt that there was a large nucleus of nonmembers who constantly criticized the Association for what we were not doing, and yet they were not aware of what we were doing for their benefit. Many physicians don't understand that when the Medical Association speaks, they are not just speaking for the membership. They are speaking for all physicians. And why not join? Well, I would continually be told that the membership fees are too expensive, it costs too much to join the Medical Association. It's a union. Well, it couldn't be farther from a union. There is nothing dictatorial about the Medical Association. Whether it is your local medical society or your specialty society or your State Medical Association. All of them are very democratic organizations, and you pay a pittance of your income if you belong to all of the organizations. It is a very small amount overall. 
DR. BROWN: Membership has been a problem with your term and many other terms. 
DR. OWENS: I think membership is a problem in every presidency, for every president. I think for every member of the Board, or the Council as it was called when I was president, membership is a critical problem, and it is trying to convince physicians . . . . Young physicians particularly say, "Well, I don't have time." That's all right. We understand that young physicians don't have time to spend on official Medical Association business. They should not deny themselves the privilege of being a part of the association. 
DR. BROWN: Now, in looking back at your presidency, Ken, can you think of anything that you might have done differently? 
DR. OWENS: Well, perhaps I wasn't the best spokesman in the world. I'm not a great public speaker. I'm not an aggressive person in that area, politically or personally. Unfortunately, I grew up in a family where my father met people very well and my mother was reserved. She didn't meet people well, and I guess that's what I learned. I was not very outgoing in my relationships with other people, and I should have been. I met a lot of people out of the various societies, but I didn't meet as many people as I should have. I have a lot of long-standing friendships in all of those smaller societies that 
there is no amount of time or money or effort that I would give for those associations. 
DR. BROWN: I think that was one of the big things that you did to help the medical societies, and that making these friendships and letting them know about the state association and issues in medicine, etc. 
DR. OWENS: Well, I hope so. I see a number of young physicians that I think I was partially responsible for stimulating the interest in the Association, stimulating them maybe to run for the Board; stimulating them to be more involved in organized medicine. And it's important. It's your life, it's their life. 
DR. BROWN: Since your term as president what has been your status in the Association? 
DR. OWENS: Well, you know that it is obligatory that you serve as past president as a member of the Board, and then I was an alternate delegate to the AMA for a couple of years. After my presidential year I realized that my practice was gone. That's one of the hazards of serving as president of the Medical Association. I did not have the privilege of having associates. And in being in solitary practice in OB-GYN, even though I had a large number of very, very dedicated women, they were the ones that stayed there. The younger women, and I could not blame them at all, went and sought medical service elsewhere. I finally realized, along with my wife, that in order to build my practice back up I had to go back to full-time OB, and I decided that that was not in my best interest. I left medical practice in 1985. I went to work for the joint commission for a year, and I found that I did not do well out on the road by myself. My wife did not want to travel 
with me. I finally decided that I'd just better get out of the joint commission and we 
would enjoy ourselves. And that's what we have been doing since. 
DR. BROWN: You've been doing a lot of traveling? 
DR. OWENS: We've been traveling. 
DR. BROWN: Playing with grandchildren? 
DR. OWENS: We've been having a good time. We've been to Alaska four times since I stopped and we've been to Australia and New Zealand and we've been to Germany and Austria and we've been back to England and Scotland three times. We found the full McMillan Castle out on the peninsula in Scotland. That castle was built in 945 A.D. and it was rebuilt in 1100 A.D., and then the Campbells destroyed it in 1200 
A.D. DR. BROWN: Sort of old? DR. OWENS: Well, it was old. It's just a pile of rubble now. DR. BROWN: Would you like to comment on any of the personalities during your 
time, any particular people that might have helped you or guided you or worked with you? I know there were so many of them, it is difficult to pick out. 
DR. OWENS: Well, I feel particularly indebted to Dr. Tucker Weston, Waitus Tanner and John Hawk, Don Kilgore and John Gilland for having stayed behind me and encouraged me to continue to be active in the Medical Association. There were times when my family and my professional associates would say, "Why are you doing this?" "Why do you continue to be active? Why are you sacrificing so much time on behalf of 
the Association? What do you get back out of it? What is your return?" My only 
answer was, "Personal satisfaction." It has nothing to do with any other kind of compensation; it was personal satisfaction. I thank those gentlemen, and I thank my wife and I thank my children for being so patient with me when I was, not only busy professionally, but busy on the Medical Association business. And I thank you, too, for interviewing me, on behalf of the Association. 
DR. BROWN: We have had some good times together in the PAC movement. 
DR. OWENS: Saw it grow from nothing. What did we have, 100 members? 
DR. BROWN: What do you think are some of the major issues facing medicine now, today? DR. OWENS: Hillary Rodham Clinton is the most scary part of the whole thing. DR. BROWN: It is difficult to know where things are going. 
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DR OWENS: You know, that mad 'part and the seeming lack of direction from the Presidency on down, because you deal with people who have not had that experience in Washington. He is getting some bad advice about where to go and what to do. I think he is being led, I don't know how much he is being led by his wife, but it sure appears that she is doing a lot of the leading. In the medical areal I think that the medical professionals have to be extremely cautious about how they approach whatever is to approach. I think Randy Smoak hit it right on the head: "It is not what comes out, it's what Congress does with it.'' It is what the Congressional Committees then decide to do with the decisions of the Congress. Too many people fail to comprehend that the President really does not have any power. The power rests with the Congress. If we have a good relationship with the Congress, we may come out with something that is beneficial, not only to the medical profession, but to the people that we are responsible for caring for. 
DR. BROWN: That is the whole thing in a nutshell. 
DR. OWENS: The public is going to get hurt by this if we are not very careful. There are other issues. It worries me that we get the Congressional people involved in the liability situation; that worries me. There are too many plaintiff attorneys in the Congress, just like there are too many plaintiff attorneys in our own Legislature and there are too many plaintiff attorneys on the bench. That has to be worrisome to every physician who appears in court, when the deck stacked against it. And yet, we successfully defend, what -78% of the suits that do go to trial. It is like certainly a compliment to the defense attorneys, is a compliment to the physicians who send their case on to trial. Our insurance providers, the JUA and the compensation fund, both have provided good coverage at reasonable costs for South Carolina physicians, but I think, what the Legislature is talking about from the compensation fund standpoint, has to be very, very worrisome. It has to be very worrisome. Legislators look at dollars and they kind of rub their hands in a rather greedy fashion when they see those dollars sitting there not doing anything. That will alarm me. It is alarming to a number of my peers. 
DR. BROWN: Of course it is. Dr. Owen, looking back, do you think you would 
do it all over again? 
DR. OWENS: Absolutely. I would have no hesitancy about it I would have tried to be the president when I was a little younger, I think. 
DR. BROWN: Oh, well. 
DR. OWENS: But that is not the way it turned out. But is was a very, very pleasant experience. I cannot measure it in any terms of anything but thankfulness that I was given the opportunity to serve.
DR. BROWN: I am one who appreciates your service as president and all of the services you have had during this time in the Medical Association. I know you have given a lot. A lot of us appreciate it and it will be in the Archives in a little bit. I want to thank you for this interview and thank you for the State Association. 
DR. OWENS: I appreciate the opportunity to come and talk with you. 
DR. BROWN: Well, good. All right. 
DR. OWENS: And thank you. Thanks gentlemen. All right.