Former Montgomery County Health Officer and Primary Care Coalition Board Member Emeritus Carol Garvey, M.D., M.P.H., will be awarded the Neal Potter Path of Achievement Award on June 26 as part of the Montgomery Serves Awards Ceremony in Bethesda. The award was established 25 years ago by then County Executive Doug Duncan.
What does it mean to you to receive the Neal Potter Award?
I feel tremendously honored to receive the award and also very lucky to be recognized for doing things that I feel so passionately about.
How did you get interested in Public Health?
It happened one evening during my first clinical rotation as a third-year medical student. I was called to the ER to do an admission history on a 36-year-old man admitted for a fever of 106 degrees and pneumonia in both lungs. Because he was uninsured and did not have a doctor, the admission decision was made by a first-year resident. This resident had seen him earlier in the evening, obviously terribly ill, and declared that bilateral or “double” pneumonia was not interesting enough for the man to be admitted to a teaching hospital. He had the patient loaded into an ambulance and taken to Harlem Hospital, where the admitting doctor sent him back to our hospital because Harlem’s beds were full. I was utterly horrified and angry about our resident's cruel and dangerous decision. At that moment, I decided to focus my medical career on equal access to care.
What prompted you to give up a private practice to take on a public health role?
Much as I loved my practice and my patients, my hope had always been to work on population-level issues, not just individual ones. My career in the federal Bureau of Community Health Services (BCHS), which I did half-time from 1977-1981 (seeing patients the other half-time), was interrupted by the illness of my son, who had to undergo heavy-duty chemotherapy for two years. My practice grew as his health improved, and by the time he finished chemo, my practice had grown and filled the time spent at BCHS before his illness. I joined and then chaired the Medical Society’s public health committee and served on some Montgomery County Health Department task forces. Still, I did not have an official role in the Health Department until I was offered the Health Officer position in 1993. I tried holding onto the practice while working for the County, but it quickly became apparent that there were not enough hours to do both County work and maintain a medical practice. At that point, I turned my patients over to my colleagues and devoted all my time to public health.
You’ve contributed a great deal as a public servant and as a volunteer. Tell us about your work in each of those roles. How different were they?
One word summarizes the difference between them – CHOICE. As Health Officer, I had to deal with whatever problems arose. That included the Beltway sniper shootings, Y2K and the fear of communication systems shutdowns, train wrecks, and the West Nile virus outbreak. It was interesting and often exciting, but crises could take us away from the basic work of public health, which was identifying and addressing threats to the health of County residents. Things like asthma in young children, cancer and substance abuse in almost all age groups, and the epidemic of obesity and its dangerous side effect – diabetes.
As a volunteer, I am much more selective, focusing on just a few topics. They include assuring access to care for low-income uninsured patients; improving pregnancy outcomes both for infants and mothers; and addressing obesity, starting in infancy. Of course, not all obesity is due to bad dietary habits; some is clearly genetic. But successfully managing obesity is challenging. Attempts by medical personnel to address obesity can be perceived as “body shaming,” and efforts by patients to make healthier food choices can be challenging, especially if they grew up eating less healthful food. School lunches provide an excellent opportunity to model healthy dietary habits for children. Obesity strains many organ systems and often leads to shorter lifespans, which is why we must find a way to overcome it.
What have been your favorite health projects and programs over the years, and why?
Without a doubt, the Primary Care Coalition (PCC) is my favorite. I started advocating for an organization to address access to health care within the Montgomery County Medical Society. With the backing of the Society, I shopped the concept around to the hospitals and the two free clinics in the County. It caught the attention of Dr. Bud Bernton, who was retiring from his practice and was looking for volunteer work. He assembled a board, started holding regular meetings, and even found us a volunteer CEO who eventually became a paid CEO as our resources increased. We now have 20 clinic sites run by 10 different organizations. The PCC provides various forms of administrative support, such as quality assurance and access to specialty care. Many others deserve credit for its success, but I launched and defended the concept.
My second favorite is the S.M.I.L.E. program of the African American Health Program as well as the County HHS Fetal and Infant Mortality Review Board. The S.M.I.L.E. program provides pregnancy mentoring to Black/African American women throughout their pregnancies and through the first year of motherhood. It was formed to address the horrifying Black infant mortality rate, which is 2 ½ times that of whites, Asians, and Hispanics – in Montgomery County and throughout the U.S. I take no credit for its management, but the impetus for it was generated by the data which I brought to the attention of County residents. I have also been and remain an active member of the Fetal and Infant Mortality Review Board, which closely examines infant deaths within the County and initiates efforts to reduce them.
My third favorite is The Tree House, where children who are alleged abuse victims can undergo physical and mental evaluations by experts and be prepared for court appearances if needed – and all of them get mental health care. Having seen many adult childhood abuse victims in my private practice, I became convinced that abuse must be addressed in childhood to reduce the lifelong impact many victims feel. A child welfare nurse and I had to work very hard to convince County leadership that funding to support a child assessment facility was appropriate and necessary.
If you could choose one thing that would have a positive impact on the future health of Montgomery County residents, what would that be?
I do not know how one could do it, but one thing which would benefit many people in life-changing ways would be to reduce obesity in all age groups. And ideally, that would be part of a more significant healthful living movement, including regular exercise.
You’ve had a successful medical practice. You’ve worked as a public servant. And you continue to actively volunteer. What drives you to still give back to the community in the way that you do?
I am passionate about a number of aspects of public health. I get great satisfaction from seeing beneficial change and from feeling that I have been part of it. It is very hard to say “no” to participating in something that interests me, but now that I am 80, I am pulling back a bit.
What advice would you give others about volunteering in the community?
Please do it! Choose your passion and figure out what you can bring to the table.
A vital role is educating politicians in the County or the State about why a particular service is necessary and should be funded. Getting a non-governmental perspective is very helpful to them. There are endless ways that the good things done by the County can be enhanced with input from County residents.
What does it mean to you to receive the Neal Potter Award?
I feel tremendously honored to receive the award and also very lucky to be recognized for doing things that I feel so passionately about.
How did you get interested in Public Health?
It happened one evening during my first clinical rotation as a third-year medical student. I was called to the ER to do an admission history on a 36-year-old man admitted for a fever of 106 degrees and pneumonia in both lungs. Because he was uninsured and did not have a doctor, the admission decision was made by a first-year resident. This resident had seen him earlier in the evening, obviously terribly ill, and declared that bilateral or “double” pneumonia was not interesting enough for the man to be admitted to a teaching hospital. He had the patient loaded into an ambulance and taken to Harlem Hospital, where the admitting doctor sent him back to our hospital because Harlem’s beds were full. I was utterly horrified and angry about our resident's cruel and dangerous decision. At that moment, I decided to focus my medical career on equal access to care.
What prompted you to give up a private practice to take on a public health role?
Much as I loved my practice and my patients, my hope had always been to work on population-level issues, not just individual ones. My career in the federal Bureau of Community Health Services (BCHS), which I did half-time from 1977-1981 (seeing patients the other half-time), was interrupted by the illness of my son, who had to undergo heavy-duty chemotherapy for two years. My practice grew as his health improved, and by the time he finished chemo, my practice had grown and filled the time spent at BCHS before his illness. I joined and then chaired the Medical Society’s public health committee and served on some Montgomery County Health Department task forces. Still, I did not have an official role in the Health Department until I was offered the Health Officer position in 1993. I tried holding onto the practice while working for the County, but it quickly became apparent that there were not enough hours to do both County work and maintain a medical practice. At that point, I turned my patients over to my colleagues and devoted all my time to public health.
You’ve contributed a great deal as a public servant and as a volunteer. Tell us about your work in each of those roles. How different were they?
One word summarizes the difference between them – CHOICE. As Health Officer, I had to deal with whatever problems arose. That included the Beltway sniper shootings, Y2K and the fear of communication systems shutdowns, train wrecks, and the West Nile virus outbreak. It was interesting and often exciting, but crises could take us away from the basic work of public health, which was identifying and addressing threats to the health of County residents. Things like asthma in young children, cancer and substance abuse in almost all age groups, and the epidemic of obesity and its dangerous side effect – diabetes.
As a volunteer, I am much more selective, focusing on just a few topics. They include assuring access to care for low-income uninsured patients; improving pregnancy outcomes both for infants and mothers; and addressing obesity, starting in infancy. Of course, not all obesity is due to bad dietary habits; some is clearly genetic. But successfully managing obesity is challenging. Attempts by medical personnel to address obesity can be perceived as “body shaming,” and efforts by patients to make healthier food choices can be challenging, especially if they grew up eating less healthful food. School lunches provide an excellent opportunity to model healthy dietary habits for children. Obesity strains many organ systems and often leads to shorter lifespans, which is why we must find a way to overcome it.
What have been your favorite health projects and programs over the years, and why?
Without a doubt, the Primary Care Coalition (PCC) is my favorite. I started advocating for an organization to address access to health care within the Montgomery County Medical Society. With the backing of the Society, I shopped the concept around to the hospitals and the two free clinics in the County. It caught the attention of Dr. Bud Bernton, who was retiring from his practice and was looking for volunteer work. He assembled a board, started holding regular meetings, and even found us a volunteer CEO who eventually became a paid CEO as our resources increased. We now have 20 clinic sites run by 10 different organizations. The PCC provides various forms of administrative support, such as quality assurance and access to specialty care. Many others deserve credit for its success, but I launched and defended the concept.
My second favorite is the S.M.I.L.E. program of the African American Health Program as well as the County HHS Fetal and Infant Mortality Review Board. The S.M.I.L.E. program provides pregnancy mentoring to Black/African American women throughout their pregnancies and through the first year of motherhood. It was formed to address the horrifying Black infant mortality rate, which is 2 ½ times that of whites, Asians, and Hispanics – in Montgomery County and throughout the U.S. I take no credit for its management, but the impetus for it was generated by the data which I brought to the attention of County residents. I have also been and remain an active member of the Fetal and Infant Mortality Review Board, which closely examines infant deaths within the County and initiates efforts to reduce them.
My third favorite is The Tree House, where children who are alleged abuse victims can undergo physical and mental evaluations by experts and be prepared for court appearances if needed – and all of them get mental health care. Having seen many adult childhood abuse victims in my private practice, I became convinced that abuse must be addressed in childhood to reduce the lifelong impact many victims feel. A child welfare nurse and I had to work very hard to convince County leadership that funding to support a child assessment facility was appropriate and necessary.
If you could choose one thing that would have a positive impact on the future health of Montgomery County residents, what would that be?
I do not know how one could do it, but one thing which would benefit many people in life-changing ways would be to reduce obesity in all age groups. And ideally, that would be part of a more significant healthful living movement, including regular exercise.
You’ve had a successful medical practice. You’ve worked as a public servant. And you continue to actively volunteer. What drives you to still give back to the community in the way that you do?
I am passionate about a number of aspects of public health. I get great satisfaction from seeing beneficial change and from feeling that I have been part of it. It is very hard to say “no” to participating in something that interests me, but now that I am 80, I am pulling back a bit.
What advice would you give others about volunteering in the community?
Please do it! Choose your passion and figure out what you can bring to the table.
A vital role is educating politicians in the County or the State about why a particular service is necessary and should be funded. Getting a non-governmental perspective is very helpful to them. There are endless ways that the good things done by the County can be enhanced with input from County residents.
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