AMA member Keisha Renee Callins, MD, MPH, clearly recalls the series of events in her girlhood in Montego Bay, Jamaica, that inspired her to make a difference for her patients.
According to her mother, she had wanted to be a doctor since she was 6 years old, but at age 8, she had an unusually painful stomachache that a pediatrician dismissed as an attempt by the frequently ill girl to avoid school.
But the pain got progressively worse and when her uncle—a urologist—came to the house and examined her, he informed Dr. Callins’ mom that it was appendicitis and they needed to meet him in the operating room. She had an emergency appendectomy.
“If I had waited another day, it would’ve ruptured and that would’ve been a big mess. He really saved my life,” said Dr. Callins, an ob-gyn at the federally qualified health center (FQHC), Community Health Care Systems Inc., and an alternate delegate in the AMA House of Delegates for the Medical Association of Georgia. “I was disappointed that the pediatrician didn’t listen to me or my mother, so I decided … I’m absolutely going to become a doctor.”
“I still remember that night I woke up from surgery. That experience, along with the awful post-operative care from an overworked nurse became a directive for me, and the way that I practice medicine still stems from the lack of advocacy that happened on those two different levels. It helped to sensitize me,” Dr. Callins said.
In this exclusive Q&A with the AMA, Dr. Callins shared more about her journey and how she continues to advocate for her patients.
AMA: How do you address concern about the rise in maternal mortality, especially as a Black female physician?
Dr. Callins: I’ve been fortunate to be able to work in a rural community so I can really address maternal mortality and provide care to women who would otherwise not be able to access that.
Through our FQHC network, because we are in rural and underserved communities and we can see patients with insurance or those without insurance for a reduced fee, it sets us up in a unique position to overcome many of the common barriers to accessing health care. And when it comes to the maternal or women’s health crisis, it’s important for women to access care throughout their lifespan and especially in the pre-conception phase to ensure better pregnancy outcomes and in the postpartum phase, which is where we lose many moms.
I see a lot of women who are falling through the gaps in the health care safety net because they are working but are unable to access or afford care—and going to the emergency department for intermittent care is not the solution for that.
I consider myself a health catalyst and I’m involved in a lot of initiatives that address many areas where we need improvement. I’m involved in doing a postpartum hypertension project—Moms Heart Matters—and I created and chair a breastfeeding medicine committee with Georgia OBGyn Society—which promotes the perinatal and maternal benefits of breastfeeding, and I even created a toolkit for “How to Switch to a Plant Based Diet’” transitioning to a “Plant Powered Lifestyle” with Drawdown Georgia. I regularly participate and try to do educational speaking engagements and activities that promote women’s health at the congressional level and the community level.
I consider myself a health activist. For example, I did one where I talked about “circles of care” and the importance of—especially if you’re rural—being able to connect your patients to services. Then how do you expedite access to care, so you don’t have any further delays. There are lots of challenges but also lots of opportunities and although things are not pretty, I am confident in my ability to leverage resources to help the patients who are in my purview.
As a health advocate, I’m trying to use those experiences to drive the contributions that I can make at the policy level. That’s why I am very involved with our Medical Association of Georgia—because we can absolutely make an impact at the legislative level in ways that will be beneficial. I know I can advocate at the bedside, at the community level, but I also need to be at the capitol too.
The other big part of my work is workforce development, especially for rural and underserved populations. As a professor with Mercer University School of Medicine and adjunct faculty with other medical and nursing institutions across the state, I can teach, mentor and inspire the budding generation of health care clinicians and servant leaders. I am excited about the recent development of two electives—rural outpatient gynecology and women’s health advocacy. I am working on a third elective in postpartum care that will focus on perinatal mental health and breastfeeding.
Probably the most important part of my living legacy—next to patient care—is what I call my retirement plan, which is touching as many students as I can so that they can understand or appreciate the importance of taking care of people and not just their problems. As a former National Health Service Corps scholar, I continue to infuse my students and mentees with the mission to build health communities especially in areas with limited access to care.
AMA: Your LinkedIn states your personal mission statement is, “You may not be able to change the world, but you can change the world of everyone with whom you interact.” Tell us more about this.
Dr. Callins: That quote absolutely is something that I live by because sometimes it's overwhelming, especially in women’s health—you absorb, experience or encounter a lot of trials and tribulations and sadness but if you focus on the patient in front of you and you make a decision to try to improve her quality of life by addressing her concerns and needs, then you can rest assured that you will change her world by improving her physical and emotional heath.
One of the things that is helpful about that quote is that it becomes a guiding principle: If you help the mom, then her family, work, church community, everybody will benefit when she is closest to her optimal state of well-being. That's why I love women's health— because if women dazzle, everybody shines.
I think about those opportunities for care selfishly because I feel like we miss opportunities if we do not give the appropriate attention to care across a woman’s lifespan from adolescence all the way to post-menopause. We need to get the mamas and grandmamas to be well and stay well. While it is appropriate to focus on maternal care, a lot of times after a woman delivers, she is forgotten, so to speak. I’m of the mindset, if my patient, who is the mother of a 3-year-old and a 6-year-old, has symptomatic anemia and abnormal uterine bleeding, she may not have the energy to prepare a nutritious meal and read to her kids before bed at the end of her workday. Those conditions are fixable problems, which once resolved, she can do what mothers do best.
Speaking of reading, I have become very interested in promoting reading and literacy in my community, since invited to serve on The Sandra Dunagan Deal Early Language and Literacy Board, which was really genius for the former governor to add health professionals to the literacy initiative because it is crucial to health literacy and health outcomes. Research supports three major milestones that should ideally start even before school—families should be reading to babies in the third trimester, age 3, and then third grade. So, I incorporate that literacy initiative into my practice using programs like The Basics, which talk about the five principles for engaging the community and engaging the family.
There are just so many opportunities and potential to make an impact through the patient-physician relationship.
AMA: Women physicians—Black women in particular—face so many obstacles to success in medicine and as leaders. What have you drawn on in your career and practice to persevere?
Dr. Callins: I cannot end this without talking about the shoulders that I stand on and as I have overcome all the challenges that I’ve had. There have been people along this long journey who have encouraged my passion even when I questioned my pursuit of medicine. I must tell you that with God, the impossible can become possible. I must give credit, of course, to my faith for guiding me when I thought about giving up many, many times, like when I did not get into medical school the first time. My spirit did not let me do that, but the people around me didn’t either.
I did an article recently about women in health care leadership and I told them I would only do the interview if they interviewed all the women who I wanted them to talk to. Almost everyone in that article is one of my mentors, which is amazing, and those were just a few of the ones from Georgia alone. It really does take a village to grow a doctor.
My success is the sum total of many mentors, not just women, who have guided me in my personal and professional life as I tried to balance the multitude of commitments, especially medicine, marriage and motherhood. Over the last 10 years, I have carved out time to be a better servant leader through participation in programs like the Georgia Physicians Leadership Academy with the Medical Association of Georgia and the C.H.A.M.P.S. Transformational Healthcare Leadership Fellowship with Morehouse School of Medicine and leadership roles in local organizations such as the Bibb County Medical Society.
That’s the source of my unbridled persistence with which I mentor and try to recruit more ob-gyns and women’s health focused clinicians. I’m very unapologetic about that, but it’s because so much was poured into me that it just makes sense to keep paying it forward. I was a very unlikely success candidate with big dreams, and I tell my students all the time that the snapshot that you see now is truly a testament of a lot of resilience, but a whole lot of reinforcement. My recent honor as an Inaugural Rural Service Award Recipient is proof that women really do run the world while they change the world.