Apr 7, 2014, 15:54
Before returning to college as a non-traditional student at age 26, Joel Baker, now a D.O. at Wayne County Hospital, was selling insurance, going door-to-door on occasion. He couldn’t have even defined osteopathy.
“I was totally disinterested with everything I was doing,” Doctor Baker says. “I wanted to make a difference.”
After graduating from Central Decatur High School in 1978, Baker attended Indian Hills Community College. He graduated from Central College, after studying communications and the Spanish language. He took the required science classes, but nothing more. Later, he met his wife, Kim, in Corydon. She is originally from Centerville. By the time he decided to return to college, they already had three children.
Baker went back to school and started taking science classes. The subject fascinated him. By chance, he was accepted into Truman State University in Kirksville, Mo., the birthplace of osteopathic medicine. He graduated from medical school in 1993.
“Dr. Hoch recruited me to come [to WCH] in 1993. I was impressed with the people who worked here. I was impressed with everything about the place. He said that I needed to know, before I signed up, that he was going to leave. But I liked it enough that I signed up anyway, because I also liked Dr. [Joel] Wells.”
Baker still had a couple of years left before he could begin. He conducted his residency at Des Moines General Hospital, where he received Intern of the Year award in 1994. He has been at WCH ever since, outside of the three years he spent at Hospice of Central Iowa in Des Moines, before he returned to Corydon. Hoch returned a few years ago as well, so everyone is back together.
Baker lives outside of Corydon on a farm, where he loves to fish. He owns 80 acres that he rents out to a neighbor. Baker grew up outside of Leon on a farm. His father was a rural mail carrier that raised cattle. Baker has tried working in a big city, but it didn’t take.
“I enjoy the relationships that you can develop here. You get to know people as people, and not just patients. If you live out in the country, you have dirty cars all of the time, but I still like it. There are more important things than a clean car.”
Baker and his wife Kim have three grown children, Jeremy, Danielle and Melissa. Baker’s mother lives in Corydon, and follows her son’s accomplishments faithfully.
From March 12 to March 16, Baker attended, as a state delegate, a conference in Philadelphia for the American College of Osteopathic Family Physicians; it was an extended stay, because he flew out a day early, and then inclement weather delayed his flight back. Baker has been state president for three years.
“I’ve been in practice for 20 years, and I’ve been involved in this organization for six years,” Baker says. “It’s done a lot for me, and I try to give back to the organization, as well.”
Osteopathic medicine began in the fall of 1892, when Dr. Andrew Taylor Still received a state charter to open a medical school. Still had introduced the concept of osteopathy in 1874; he was an M.D. before becoming a D.O. According to ‘Missouri Digital Heritage,’ the American School of Osteopathy was founded in a two-room frame building at Truman State. The first class of five women and 16 men included three of Still’s children and one of his nephews. They graduated in 1894.
“The basic principal behind osteopathy is trying to treat the body as a whole—spiritually, mentally and physically,” Baker says. “Not trying to treat a specific disease, but treating the person. That is the underlying philosophy.
“Medicine back then was obviously so much different—they had just completed the Civil War, where primarily you treated people with opium and with amputations. That’s all you could really do. [Dr. Still] thought there must be more than this, so he developed these principals of trying to treat the body as a whole unit. ‘Do no harm’ is a basic principal. Another principal is that the body has its own innate healing properties, and that it will heal itself. That seems pretty basic today, but back then it was radical. And also, the fact structure and function are interrelated. With that in mind, he developed manipulative techniques. Chiropractic was actually based on osteopathy, as well. Like everything through time, that has evolved.
“I went to Kirksville because it was an osteopathic school, but I didn’t know anything about osteopathy, quite honestly. When I started reading into the philosophy of it, I thought, oh man, this is what I want. It’s where I wanted to go, and I didn’t even apply to any of the M.D. schools like the University of Iowa.”
There used to exist a more definitive line between osteopathy and what was considered established medicine, which has blurred.
“Where we are today, there are more and more D.O. schools, around 20 now,” Baker says. “In the midwest, they are very common. There’s a school in Des Moines, Kirksville, Kansas City and Chicago.”
Dr. Wells and Baker are both D.O.s, and they both graduated from Kirksville. At the time, there were only 12 osteopathic schools. One in five physicians in the United States is now a D.O. Back then, it was around one in nine. In addition, Dr. Debra Neuharth of WCH is also a D.O.
When asked how the spiritual is incorporated into the practice of medicine, Baker says, “I think it promotes healing, that’s for sure. Just realizing that all humans have these components. Every individual physician has the freedom to realize that as they see fit—and as the patients see fit. It means different things to different people. Someone told me a long time ago, never underestimate the power of prayer. If you think it helps, then that’s good.”
Baker says that doctors must use a patient’s beliefs to the patient’s advantage.
As a physician in Corydon, Baker becomes by default a psychologist. He stops short of saying that D.O.s are superior to M.D.s in that role.
“I don’t know if [the psychological aspect] pertains specifically to osteopathy, but at least in these parts, we deal with psychiatric conditions daily. Just being in a small town, in a rural area where there’s poor access to that. Which is okay. We try to be here for our patients. There are enough mental health issues to go around. [Doctors] work with each other, not against each other.
“In some respects, [being an osteopathic doctor] has helped create some humility, because we are somewhat of a minority. I don’t know if it’s osteopathic medicine in general, I think it’s being in a small town—I don’t forget my roots.
“Historically, there was strong bias against D.O.s. Back in the Vietnam War was the first time a D.O. could serve in the military. You could go out on the ground and be a medic, but you couldn’t be a flight surgeon. You couldn’t admit patients in a hospital, in Des Moines, even. In those respects, there was a lot of bias and prejudice toward osteopathic physicians. A lot of the old D.O.s are still hurt by that, I believe. They forgive, but don’t forget.
“When this hospital was built, on the cornerstone, they listed the medical staff. Osteopaths were listed separately. That’s humbling, to me. It’s like all prejudice—it stemmed from a lack of understanding, and an unwillingness to learn.
“That has, I think, passed, certainly in this part of the world. As more osteopathic physicians are on medical staffs now, there’s a better understanding that we’re not so different.”
Baker says his osteopathic background helps him to treat the patient as a whole.
“Let’s say Jason has a problem,” Baker explains. “Let’s not focus on his heart, let’s focus on him. Let’s take care of his whole body, and heal him that way, as opposed to just a disease process. Everything is interrelated. Sometimes it seems really obvious, and that’s why it’s hard to understand why not everyone bought into that philosophy.”
From his time with Dr. Keith Garber to the present, WCH’s staff has been a binding force for Baker’s career.
“This medical staff gets along so well with each other,” Baker says. “We don’t care what letters are behind anybody’s name. We care about what you bring to the table. We keep working to keep [our good reputation] going. We like that. Because I do think we provide excellent care. I think that’s why [Dr. Hoch and me] came back—we knew it was a good place to be.
“[Dr. Garber] was a mentor and a great guy. He didn’t care whether you had an M.D. or a D.O. behind your name. He set the tone around here as far as interpersonal relationships. He taught us a lot. Just his experience and wisdom and compassion. Caring for people. He was always there.
“I was in the room when he died. I think of all the people who were in the room at that time—just the bond that we all shared, and I cherish.”
During Baker’s recent visit to Philadelphia, delegates voted on resolutions. The most important regarded continuing medical education residencies, which all doctors must complete after medical school.
“With residency programs historically, there have been more and more osteopathic students,” Baker says. “There had been some issues with that, as far as being certified by the boards. Basically what we’re trying to do is combine [osteopathic and non-osteopathic medicine]. It’s going to happen, but we’re still trying to keep the identity of osteopathic medicine intact.
“Another important discussion was about shortening medical education in recognition of the fact that there’s a shortage of family practice doctors, and that it’s becoming more and more expensive to train these people. Is there a better way to do this? The goal, if you’re able to decrease the number of years, in theory you’ll decrease the price, and then decrease the waiting time to train these physicians.”
When asked whether education standards could still be maintained within this shorter period of formal education, Baker replies, “Therein lies the rub. That was our big concern. The Blue Ribbon Commission was put together by congress to do a study to determine whether this could be done or not. They felt that it could be done. My organization—we have a lot of questions whether it can be done or not. There are a lot of things required, especially in family medicine.
“There’s change going on in healthcare. For better or worse, it’s going to continue. No matter what your politics are, healthcare is always going to change. If you’re afraid of change, you’re in the wrong profession.
“The one thing that I hope never changes, despite all this change in healthcare, is the patient and physician relationship that happens within four walls, where you can talk about whatever you want and feel comfortable doing that. And know that I’m not going to open that door and blab with flashing lights. Just that mutual respect we have for each other—that is the strongest thing that keeps me going. Because that is the most powerful trust that anyone could ever give to me. The willingness of someone to give me that respect.
“I think that is being challenged—let’s all sit in a room in Australia, and you sit in a room in Corydon, and we’ll talk about our health. Is that as effective? I’m not convinced it is. Let’s get on ‘WebMD,’ let’s diagnose ourselves. I think that challenges that relationship.”
Regardless of whether he is treating a patient in Corydon or in Australia, Baker will stick to his roots, and the unexpected places they have led him since his days as an insurance salesman.
“I’m proud to be a D.O.,” Baker says. “If it wasn’t for osteopathic medicine, I wouldn’t have become a doctor.”