On April 28, 2018, an era will come to an end at Piedmont Health Services. On that date, Dr. Carol Klein will retire after 35 years here.
Carol has been at Piedmont Health long enough that she has treated not only the parents of some of her current patients, but their grandparents as well.
There’s nothing special about her retirement date; it was just a Friday she chose that was about six months away when she decided in September to announce her retirement. She felt she needed six months to extricate herself from a profession and an organization where she has spent 3 1/2 decades.
“I was reluctant,” Carol said. “It’s still hard to think about stopping, so it was very hard to give an exact date. …I mostly feel it was the right decision – part of me is, ‘Why would I want to stop doing something that I love? I still have something to offer.’ But it’s also exhausting. It just feels like it’s time.”
It has not been easy for her to break the news, nor for her patients to hear it.
“Noooooooooo – I won’t let you,” Dr. Klein said, chuckling, recalling a reaction she got when she told one patient. “Don’t do it!…There have been tears. I’ve gotten a lot of gratitude.”
Carol is motivated to retire partly by the lure of experiencing all that life has to offer outside of work while she is still healthy enough to experience it. “I’ll have time to do the things I love to do – read and be outside and bike and swim and hike and garden,” she said. She also said she and her husband Michael Larter – who is a psychologist and will retire in July – will spend more time travelling.
Some of her travel will have a specific purpose: “Our family is scattered so I’ll just have more time to visit,” she said. “I have a grandson who lives in Alabama and my parents are elderly – my dad is 97 and my mom is 90 – and so I’ll be able to spend more time with them.”
She has three grown daughters living in Alabama, Virginia and New York City.
But Dr. Klein is not completely sure what life will look like in retirement. “I just want to take time to look around at what else I want to get involved in,” she said. “I have ideas – like maybe getting involved in refugee health. Maybe it won’t be anything medical at all…I feel like I want to survey the landscape and not jump into anything right away. There may be things I haven’t thought about because I’ve been preoccupied for the last 35 years.”
In some ways, it is not remarkable that Carol never left Piedmont Health Services; she is almost a template for the type of physician that thrives in an organization with Piedmont Health’s mission of providing a primary care home for all, regardless of ability to pay. She once said that it was the type of work that she “always wanted to do,” adding: “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.”
A native of Pittsburgh, PA, she attended Oberlin College, where she majored in biology. She returned to Pittsburgh for medical school. She knew from the start of her medical education that she wanted to be a family doctor.
She came to the South to do her family medicine residency at Duke. First employed by the National Health Service Corps, she began working at Piedmont Health in 1982, initially 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 since.
Community health centers – and medicine as a whole – have been transformed in many ways since Dr. Klein came to Piedmont Health in 1982.
The facilities at Prospect Hill were somewhat “primitive,” she said, recalling for instance that “everyone could hear everyone” in the office. The staff also, though they were equally dedicated as staff today, had less professional training back then, Carol said.
“A lot of them had learned on the job and came from the surrounding community,” she said. “That had its advantages but some of them didn’t have the same degree of professionalism that we have today.”
She has had to adapt to many 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.
A later challenge was the influx of patients who are refugees 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.”
Carol admits that there’s at least one change in the profession that she never really got used to — the transformation to electronic medical records that began in 2008. She acknowledges that electronic records have advantages, notably giving the doctor access to more information. But electronic records force doctors to always be hunched over a computer while treating patients, Dr. Klein said.
“It really detracts from communication with the patient,” she said. With the old paper charts. “you can look them in the eye.” Electronic records are “one of my greatest frustrations,” she lamented.
Dr. Klein’s retirement will mean a transition both for herself and for her patients, but she’s confident everyone will survive the transition.
“I think it’s really hard for patients when they not only have established trust but there’s a shared history – they don’t have to go back and explain things,” she said. “It feels like it’s going to be difficult to see someone else. But I also feel very fortunate that I totally trust and admire all of our providers here, so I don’t feel worried about my patients in that regard. I know they will be in good hands”
Just as Carol is preparing for her transition, so is Piedmont Health.
“I can’t imagine life without Carol Klein,” said Brian Toomey, Piedmont Health’s CEO. “I will have to get use to that change…. It’s rare to see people stay five years in an organization; a rarity to stay 35 years. … She has taken care of pregnant women, newborns, excited families, seniors, people on hospice. She has treated everyone with compassion, integrity, respect and wisdom.“
Toomey added: “I will miss her a great deal! It has been an honor to be her colleague.”
Dr. Klein hopes her 35 years of service leave a legacy of the value of continuity. “There’s a lot to be gained by patients and providers alike to having long, ongoing relationships,” she said. The loyalty that she (and other providers) have shown to community health centers “takes some perseverance,” Carol said. Continuing her legacy, she said, will take “continued dependence on good communication between clinical people and administration to make sure we’re on the same page and supporting each other.”
One thing that will not change is Carol’s desire to serve. She said she is sure she will do some sort of volunteer work – and will even come back to Piedmont to sub now and then, if needed. “It has just been such a lovely thing to be here for so long,” she said.