Born to serve at a community health center
It’s an accomplishment when anyone endures in a challenging job for a long period of time. But the more one talks to Dr. Carol Klein, the less remarkable it seems that she has served as a physician at Piedmont Health Services for 33 years.
Carol seems to have been born to work at a community health center.
“This is what I always wanted to do,” she said. “When I went to medical school, my goal was to work in an underserved area. That’s still what’s most important to me. In a community health center, we provide high-quality care despite having limited resources. I’m doing what I set out to do.”
She was caring from an early age. She recalls as a child worrying about children who didn’t have a warm bed. Her caring quality led her friends to encourage her to be a doctor when she was in college at Oberlin studying biology.
The Pittsburgh, PA, native is an alumna of the National Health Service Corps, an agency that helps bring health care to those who need it. She knew from the start of her medical education that she wanted to be a family doctor.
“I kind of thought it might be in a rural area,” Carol said. She came to the South to do her medical residency at Duke Family Medicine and ended up at Piedmont Health, splitting time between the Prospect Hill and Carrboro community health centers. Carol later worked at the Moncure Community Health Center which, along with Prospect Hill is one of Piedmont’s most rural health centers. Later, she shifted to working only the Carrboro Community Health Center, where she has served for the past 31 years.
At a community health center, Carol seems to be in her natural environment. One aspect that appeals to her is the family focus. She has served at Piedmont long enough that she provided care for four generations of one family; each generation led members of the family to her.
“Getting to know all family members and understanding their environment – that’s really important,” Carol said.
The fact that community health centers provide care on a sliding-scale basis – fees are assessed according to ability to pay, and no one is turned away – means that the centers will never be among the most lucrative medical practices. That, for Carol, is not a problem; it’s a challenge.
“We don’t have a lot of resources here so we’re forced to provide care in the most efficient manner,” she said. “We have always had to think about, ‘Well, if I prescribe this, will the patient be able to buy it?’ That seems to be a rather new thing in health care, ‘Do I really need to order this test?’ It makes you think carefully, and that’s a good thing.”
Carol is also proud of the innovative approaches Piedmont takes, such as team-based care. She also is proud of Piedmont’s efforts to foster a healthy environment for patients that lead to better health outcomes, such as the Veggie Van, which promotes healthy eating, and the Reach Out and Read Program, which promotes literacy to pre-school children.
“The more educated someone is, the more likely they are to take care of their health,” Carol explained. “Kids who do better in school do better in life.”
Carol has had to adapt to changes over the years. In the 1990s, as more Spanish-speaking patients came to the health center, she was troubled by her inability to communicate with them, having to pull people off their jobs at the center to get them to translate. She started taking Spanish lessons and immersed herself in the language at a language school in Mexico.
She continues to learn from her patients. A new challenge has been an influx of patients who are refugees from Burma and speak several different languages. “Thankfully, we have skillful interpreters who allow for good communication,” Carol said. “I never expected to have such an interesting exposure to different cultures in the South.”
She continues to get used to the change in the atmosphere of the examination room caused by electronic medical records. While she notes some advantages, she laments the way a machine can turn the focus off the patient. Likewise, she says many of the advantages of technology come with downsides, such as a potential decline in doctors’ diagnostic skills and greater expense for patients.
One of the biggest challenges and joys was raising children – including a pair of twins – with such a busy schedule. Working part-time made it possible, and she is grateful that Piedmont Health supports parents by allowing part-time work. Her three daughters are now grown and live in different states: Tema is a writer and farmer in Alabama, Hannah is a social worker in Virginia, and Sophia is working in a marketing firm in New York City. That leaves Carol and her husband Michael time to enjoy reading, hiking and finding local adventures.
When you ask Carol’s colleagues about her, the quality that stands out is her caring nature. Kim Christopher, a family nurse practitioner who works with Carol, said she does the kind of small-but-important things that show her dedication to her patients. For instance, Carol often calls patients on the phone at home to follow-up with them, Christopher said.
“She is helpful,” Christopher said. “She is wise in ways you would think of people being wise. She is a role model. She stays over. She does the hard work. She’s just the epitome of advocacy that we all strive for.”
Brian Toomey, CEO of Piedmont Health, said he often hears from Carol’s patients.
“It’s remarkable to work with a woman who, every time I go to a public place and mention where I work, everyone who has been a patient of hers – 100 percent of the time – says she just is the best,” Toomey said. “Her steadiness and commitment to patients has not waned but gotten stronger over time.”
Carol is careful to point out that it is not just the patients who give her satisfaction. “I also appreciate my coworkers,” she said. “There are lots of really dedicated people here – from providers to pharmacists to medical assistants and patient care coordinators —people who have been here a long time and do so much to help care for patients. They have given me great joy.”