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Excerpt from Oral History Interview with James Slade, February 23, 1997. Interview R-0019. Southern Oral History Program Collection (#4007) See Entire Interview >>

Deciding to return home to practice medicine

Slade considers the business of medicine. He discusses his decision to return to his home to practice medicine. At the time he made the decision, many physicians did the same, shouldering a significant financial burden to do so. As hospitals have stopped making incentive payments to lure newly minted doctors home, that tradition has faded. At the same time, however, black doctors can now find jobs anywhere in the country.

Citing this Excerpt

Oral History Interview with James Slade, February 23, 1997. Interview R-0019. Southern Oral History Program Collection (#4007) in the Southern Oral History Program Collection, Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.

Full Text of the Excerpt

So you didn't encounter that much fear of doctors even early in your practice?
No. The thing that has surprised me over the years, there's been a black physician present in Edenton for a good while, with Dr. Holly who preceded me. He started his practice I guess back in the '30s or late '20s. At one time, there were three black physicians practicing in Chowan County, Dr. Hine, Dr. Capott, and Dr. Holly, that's years back. The presence of black physicians in the county is nothing new.
But why do you think there were more a long time ago than there were all the time you were the only black physician?
A long time ago, a lot of the physicians were dedicated to coming back to their home, to practice in the area they grew up in. Those three doctors' roots were in this area. When I got out of medical school, I didn't have any debts, except $900. I went into the army, and paid it off, $100 a month. Now you've got doctors coming out with debts of up to $80,000, depending on where they go to school. When you've got that kind of debt on you, it's very difficult to go back to a small town and try to set up a solo practice. When I went to college, we paid as we went along. So I think that has made a difference with all these doctors who want to go somewhere they can get into a group and have an immediate income. I didn't have that pressure. By the time I got out of the army, I had paid my loan off, had a little bit saved, my car was paid forߞthe one out there sitting in the yard! [Laughter] We had four kids, and didn't owe any money on them, since a few were born while I was in the service. Financially, we didn't have a big burden on us like these guys coming out now. The difference is that now, the hospital is willing to supplement physicians' income. That was nonexistent when I came. The one black physician who is in town now came on that basis, with the hospital supplementing her income. They're no longer doing that now, but that's what got her here, she didn't come because Edenton was such a nice place. It's very difficult to recruit physicians unless you've got a reasonable amount of income. They want to be guaranteed a certain salary if you take them into your practice, and I'm not in a position to do that.
Do you think that's partly the result of a change in medical ethics, and do you think it had anything to do with black physicians being trained outside historically black institutions like Meharry? [END OF TAPE 1, SIDE A] [TAPE 1, SIDE B] [START OF TAPE 1, SIDE B]
Black physicians can pretty much go anywhere in the country, and have no real problems getting onto hospital staffs. As time has moved on, hospital staffs have opened up to black physicians in the larger places, although some maybe not as readily as others. Probably, that's part of the reason why black physicians don't think about going back home, because they have these other opportunities available to them. A lot of them become friends with white physicians, and in big cities, maybe even go into practice with them, which is something that years ago wasn't heard of. You might have had multi-specialty groups, but you didn't have multi-ethnic groups, which is no longer the case. I think all of these opportunities, plus the pressure of economics, makes it difficult, unless you get an unusually dedicated one who wants to come back to a smaller town. Even the ones who are dedicated, the pressure of finances can weaken that dedication. It's hard to pay off a $90,000 loan unless you're getting some definite income.