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Interview with Kathryn W. Gresham,  October 30, 2008 | UNCW Archives and Special Collections Online Database

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Interview with Kathryn W. Gresham,  October 30, 2008
October 30, 2008
Kathy Gresham is Carolina born and bred. Raised by a single Mom, but also with beloved grandparents and cousins in Hamlet, NC. Was "all everything" in HS,including editor of the yearbook and a runner up for the prized Morehead Scholarship. Attended Chapel Hill working through her four years as Sec. of Student Union. A Health Education Major from School of Public Health, she found emplpyment in 1985 recruiting physicians for various practices. Katthy's career began in Raleigh, and brought her to New Hanover County, to become head of two firms here, and to travel countrywide on behalf of physician recruitment. listen to her describe this highly technical profession, and the benefits of her field in the complicated world of patient/Dr. relations and the ever growing costs in healthcare. At present 11 North Carolina Counties use New Hanover Healthcare, serving about 500,000 patients. Kathy became Chair of the Hope Ball Gala for American Cancer Society in 2004, 05, 06, raising more than $230,000. She strongly believes the more fortunate among us should never overlook those in need. This spills over to her dedication to Domestic Violence Shelter and Services as a Board member for two years. She has witnessed first hand the needs of women and children in need, and some men, and is committed to doing her part wherever needed. She is a very proud mother of two teen age daughters who seem to have developed their Mother's work ethic, and call to service. We thank them for their service and committment.
Phys. Desc:

Interviewee: Gresham, Kathryn W. Interviewer: Jones, Carroll / Sweeney, Kate Date of Interview: 10/30/2008 Series: SENC Notables Length 81 minutes

Jones: Thursday, October the 30th, 2008. And I'm Carroll Jones with Kate Sweeney for the Randall Library Special Collections Oral History Program. We are in the Helen Hagen room in Special Collections. Our guest this morning is Kathy Gresham. Now Kathy is sitting right here and I've got to be correct, so she can interrupt me any time she wants. The director of physical relations.

Gresham: Physician relations.

Jones: Physician relations for New Hanover Medical Center, a member of the board of directors, domestic violence shelter and services, a devoted mother, in 2007 received a volunteer award from the YWCA?

Gresham: Correct.

Jones: And has helped fall chair for American Cancer Society for three years, 2004, 2005 and 2006, raised well over $230,000 in that time. You're a busy lady.

Gresham: Very busy.

Jones: Good morning, Kathy, and thanks for giving us the time.

Gresham: And thanks, it's fun to be here.

Jones: Let's just start from the beginning. In your own words, tell us a little bit about yourself, where you were born, what kind of education, do you have a mentor, what brought you from that point to being a whirlwind.

Gresham: Well, very small town girl, I grew up in Hamlet, North Carolina, which is about two hours away from here. My family's been in North Carolina for over three centuries. My mother's actually DAR, Daughter of the American Revolution. I'm in the process of going through that.

Jones: With our chapter here?

Gresham: Yes.

Jones: A stamp defying chapter.

Gresham: Right, correct.

Jones: I just came off that board.

Gresham: Fantastic. Well, she just delivered all the paperwork to me just in the past couple of weeks that I'll need to go through that process.

Jones: It should be easy since your mother was. You can go in her number.

Gresham: Yes, so I'm excited about doing that, but we've been here for a long time. Probably the thing that most defined my desire to drive, I guess, is my dad went off when we were pretty young, off to the war. He's had a mother-in-law as a single mother with three small children. We had to move in with my grandmother who had 11 children during the course of her lifetime.

Jones: Now, was that the population of Hamlet, North Carolina?

Gresham: Pretty much, it feels like it. So I went from being feeling like a pretty special, you know, little person to all of a sudden being thrown into a huge, huge family situation.

Jones: Was that more fun?

Gresham: In ways, it was. But I learned at a pretty early age that if I were going to be successful in my life, it would have to be because of me making that happen. So, really early having a drive to be successful and recognizing that I was going to have to be the person to make that happen. I did tease my grandmother about having so many children. My Aunt Phoebe said, "Well, for birth control she ran but she got caught most of the time." So, that's the kind of family I grew up in. Didn't have a dad at home, but my uncles were very involved in our life. They came and had lunch with my grandmother every single day. They all worked on the railroad.

Jones: Because she made lunch?

Gresham: She was a fabulous cook. She cooked three full meals a day, homemade biscuits and that type of thing. But she'd feed us and then rush us out of the kitchen and then all of her boys would come and sit and have lunch with her every day. And they were all big hunters and fishermen, so I grew up with hearing their hunting stories and fishing stories and it probably has a lot to do with my passion for fishing, which is my most favorite pastime.

Jones: Deep sea or fresh water?

Gresham: Any kind.

Jones: Any kind of fishing.

Gresham: I kind of grew up fresh water fishing but once I moved to Wilmington and started deep sea fishing, salt water fishing, I just have absolutely been literally hooked on it. But anyway, that was sort of my growing up. I was the oldest of four children. My mother did eventually remarry. We continued to live in Hamlet, you know, all my growing up life.

Jones: Now, tell us where Hamlet is located compared to--

Gresham: Hamlet is near Pinehurst.

Jones: Oh, what a pretty area.

Gresham: It's just south of there, it's sand hills, half way between here and Charlotte. It used to be a very, very busy railroad hub back in the day when railways were the way to travel. But it's now a pretty sleepy little town. Dr. Bill James delivered me and then set my broken arm when I was in the fourth grade. He owned the hospital.

Jones: He did everything.

Gresham: He did. He owned the hospital there. He was a--interesting.

Jones: That's kind of neat in a way.

Gresham: Very, very neat. He had five girls and the youngest was a good friend of mine growing up. Went to Richmond Senior High School where I got very, very involved with the activities. Was a cheerleader for three years. Had tried out in junior high for three years, never made cheerleading but made head cheer leader my tenth grade year there.

Jones: Good for you.

Gresham: Got involved with the annual and when I graduated I was editor of the annual there. President of several clubs, you know, cheerleading and that sort of thing.

Jones: You were always an activist.

Gresham: Yeah, I was very, very involved in high school and graduated I guess I was 11 in a class of 588, but did get the most outstanding senior award that was given by the teachers and just well-rounded. I was never the number one person in any class but I was number two in everything.

Jones: You probably didn't work at it either did you, or did it just come naturally to you?

Gresham: I really didn't have to study when I was in school. Just showing up attending the classes and pretty much absorbed it. I was a great student, I mean, I loved it. I loved school. I looked forward to being at school every day. I looked very forward to (inaudible).

Jones: We raised one like that, disgusting.

Gresham: Well, I was my parents little dream, I guess, and they really didn't have to worry about me too much, which is good because they had a lot of worrying with my other--my sister and brother. They kept their hands full. But it was a great place to grow up and a great time to grow up. I was a Morehead nominee. I did not make it all the way to the full scholarship. But that's where I set my trajectory for Chapel Hill.

Jones: Did you go to Chapel Hill?

Gresham: I did. I did, early admissions and loved it. I mean, they had three story buildings there so I was in the big city, you know, as far as I could tell. Freshman year, you know, just sort of enjoyed the transition, didn't really get involved in things.

Jones: I've got to stop you a minute. When you first entered, or when you were at Carolina what was the ratio of males to females at that time?

Gresham: It was probably four to one, probably girls to guys. Well, that's what it felt like.

Jones: It still is, it still is. Yeah, just wondering if it was any better.

Gresham: No, it was still sort of challenging there. I didn't have a date for the first couple of months and I thought, you know, guys should walk to school and be dating and then the very first date I got ended up having, like, two in the same night. So, I made them both work because it had been months without it.

Jones: Scheduling, scheduling.

Gresham: Time management, people.

Jones: Okay, didn't mean to get off on that but--

Gresham: No, no, not at all. But my--I did have to work to help, you know, support myself in school. So, my first few years I was secretary at the student union, which was a paid position, but because of that involvement I got very involved with the student union activities board and that was such a great experience because I generally had free tickets to the plays, the ballets, musical performances, concerts, which I probably wouldn't have taken advantage of just as a student just in the general population. But because I did get involved I had exposure to cultural things that I never had growing up in a small town, that I had a fantastic appreciation for them.

Jones: It's one of the great things about going away.

Gresham: It was. It was fantastic. I had dinner with Andrew Young. I had dinner with George McGovern. I had dinner with Maya Angelou, actually did a program with her. Got very involved with black/white relations. I did a program, a three-day seminar, with Dr. Charles King, who has since passed away. But what a great just cultural and sort of opening eyes experience for me, again, having come from such a small town. My senior year I was the director for human relations.

Jones: At Carolina?

Gresham: At Carolina, for the--

Jones: Senior year?

Gresham: Senior year. And I was on the student union activities board so we were the board that--

Jones: Okay, now give that to me again. You were a director--

Gresham: For the--I was the director for the human relations committee.

Jones: Human relations committee, okay.

Gresham: And served on the board for the student union activities. And we were the folks that, you know, planned the entire budget for the year, selected the speakers, the concerts, programs, that sort of thing, so I did.

Jones: Now, if you don't tell me that upon graduation you had 15 offers of jobs, I'm going to roll over right here.

Gresham: My degree was in health education in the school of public health. So, my goal was to go work in a health department for a few years and then go back to Carolina to get my masters in maternal and child healthcare.

Jones: Now, let me stop you. You were editor of your newspaper in high school.

Gresham: That is right, The Annual.

Jones: And you did all these other things, what caused you to become an enamored of health education?

Gresham: Well, I think initially I had considered medical school and my first several years at Carolina was heavy duty heading in that direction. Then I became aware of the maternal and child, maternal and fetal program in the school of public health and that really suited exactly what I was interested in doing, you know, in counseling women and helping them make good decisions about their health care and decisions about the child for child raising.

Jones: Isn't it amazing how our lives take different routes than we planned or think?

Gresham: It was amazing.

Jones: Because I was going to write the great American novel.

Gresham: And you still may.

Jones: No. Anyway, that's interesting.

Gresham: So, I got into the school of public health, which, you know, was a great program, you know, one of the top in the country and could not find a job when I graduated. I would have taken a job in any health department in the state for $9,000, which is about what the salary was at that time, but could not find a job. And I wanted to stay in health care. Some good friend of mine worked for a company that started in Chapel Hill placing physicians temporarily all over the country, sort of like a Kelly girl for doctors is the best way to describe it, but it's called Logan Attendants, and so she said, "This might be a good opportunity for you. You want to be in healthcare." I went and interviewed for the position. I think that's the last job I ever interviewed for in my life. When I think back on it, that was back in 1985. Got involved with that organization and pretty early on was tapped to become a physician recruiter within the organization.

Jones: Now, that is something that we need to hear about. I've never heard of a physician recruiter.

Gresham: Right, and now I've been doing it for 23 years.

Jones: All right, well, let's get to that in a minute because that sounds fascinating and I doubt sincerely that too many people out of the health profession know about it.

Gresham: If I could have written the perfect job description of the perfect career track for me, that's what it would have been in terms of pulling all the skills together and interests and my personality and that sort of thing. But I started out as a credentialing coordinator.

Jones: Now, this was in Chapel Hill?

Gresham: This was in Chapel Hill. This was the first job that I had with this company called Cryomedical. And it was my job to obtain medical licenses for the physicians that we were going to place around the country. The neat thing about that was it helped me to understand what a good doctor looks like, if you will, on paper, to understand the process by which one becomes a physician, becomes a specialist and then understanding, you know, the exams that they need to take and that sort of thing. But having done that in a very short period of time the recruiter said, "The doctors just love you. They enjoy (inaudible) what would you think about recruiting?" and I'm like, "Gosh, I'm not sure I'm really suited for that." And they said, "We'll take you under our wing and we'll bring you along."

Jones: The doctors that loved you were already in practice and they were looking for other physicians to join them in a practice?

Gresham: They had decided that doing this type of work was a good fit for them. And there were basically three kinds of physicians that would come and join us. There were folks right out of the residency training that know where they wanted to be or what kind of job they wanted to be in and so they could travel around the country, work in a lot of different practice settings and then, you know, during that year period of time get a better feel for the kinds of practices that were available and sort of what was a good fit for them. There were physicians who were sort of in their wind down years, if you will, not quite ready to retire, wanted to travel but didn't want to have to run a practice anymore. And then the third type of physician was somebody who was in transition for whatever reason, you know, leaving the military and who had had a bad experience and weren't ready to jump right into another job. So, these were the kinds of physicians that were a good fit for working for our organization. But I established good relationships with them and eventually was asked to be one of the recruiters to recruit those physicians. And it was such a fun, fun time in my life. I was newly married. My husband was in pharmacy school at Chapel Hill. We didn't have kids.

Jones: I was going to ask if you had married a doctor.

Gresham: Married a wonderful, wonderful man from Wilson, North Carolina. And his family's been in North Carolina for a long time, as well. His parents are just some of the honest people I've ever met in my life.

Jones: That helps.

Gresham: They're great folks. And I guess since, you know, my dad left, you're always looking for that sort of that replacement person (inaudible) is certainly that way. But didn't have children yet and part of the recruiting position was to go out to different universities and do lunches and dinners for these young doctors that were still in their residency training and talk to them about this job opportunity and help them identify whether or not it would be a good fit for them.

Jones: That's the main thing.

Gresham: So, for the first time in my life I was actually leaving North Carolina and going out to all these wonderful, wonderful cities across the country.

Jones: Now, this was across the country? You didn't do just a district? That's a big, big job.

Gresham: I was able to travel to Philadelphia, to St. Louis, to Iowa City, California, New Orleans, Texas, Kentucky and go to the universities and walk into a room with 20, 30 physicians and as a 26, 27 year old young woman--

Jones: That's pretty heady stuff.

Gresham: To see somebody their age, really, to stand up and talk with them about this job opportunity.

Jones: And you place people all over the country, as well?

Gresham: We did, we placed them all over.

Jones: But was it usual, for example, or you name any city, anywhere, California, for example, to--was it, you know, "have medical degree will travel" or did they want to stay put in one place?

Gresham: It was a little different. I mean, some folks knew that they wanted to, for example, they wanted to find a job in North Carolina so we would focus in that area for them. But there were some folks who really wanted to see the country. And so we would get licenses for them in different states. We provided care for this whole island off the coast of Alaska. It was Prince Edward Island, I think. It was either Prince Edward--

Jones: Prince Edward's off Nova Scotia, isn't it?

Gresham: Then this was Prince something.

Jones: That's okay.

Gresham: So, anyhow it was just this whole island and we were the only one doctor on the whole entire island.

Jones: Oh, my gosh.

Gresham: So, they would tell us really fun stories about those experiences. The doctors always had great stories to tell about going to these different places.

Jones: I can imagine.

Gresham: One had a physician who was just going on vacation for a couple of weeks. This one said, "Well, you know, they can come, they can drive my car, stay in my house, that type thing." But what they didn't say is that he had to, like, move the goat. There was a goat in the backyard. We had this pediatrician calling me, he's like, "You won't believe what I had to do. I had to pick up the stake and move this goat."

Jones: That is too funny.

Gresham: It was something like that all the time.

Jones: Like a movie.

Gresham: We should have. We should have made movies.

Jones: Well, now let me ask you this, there are some well-known teaching universities, medical schools across the country and did you work with them or did they have their own placement? I'm thinking like UCLA medical school, Cedars-Sinai is a teaching facility, Boston etc . . . Did you work with them, as well?

Gresham: Well, basically most of our--you mean in terms of the clients or classes that we went to recruit physicians?

Jones: Either way.

Gresham: Recruiting, we went out to all those types of places. But in terms of clients, ours were usually larger physician practices. Nowadays, there's a tremendous amount of that in that field. A lot of the universities will have (inaudible) come in and help provide those services. But I did that for 9 years. I was eventually vice president of the department of family medicine. So, I had recruiters that worked for me, marketers that worked for me and then folks that would place the physicians in these different locations. I had a team of about 12 people that worked for me and that was a neat experience, too, managing folks. It was about that time that I had my first child so the skills, I found that the skills that it took to be a great mother are the same skill sets that you could be a great manager.

Jones: Well, yeah, I guess.

Gresham: Patience and being respectful. With my children it was always being a benevolent dictator. That was sort of (laughs).

Jones: Exactly right.

Gresham: My strategy with them, but it was pretty much the same skill sets. I very much enjoyed my time there. We were later bought out by our largest competitors and so I had a six month period of time that I transitioned my team out to Salt Lake City, which is where our competitors were. So, that was a lot of fun, being able to travel back and forth between--

Jones: It's a completely different atmosphere there.

Gresham: Totally, totally different. That was a neat part of the country to go to.

Jones: It's beautiful but oh, wow.

Gresham: But after that, I felt that it'd be neat. I had a nice little stipend enough that I could have stayed at home for awhile, which I really wanted to do. All of my other friends were all stay-at-home moms, so I was one of the few that worked full-time. So, I thought I'd take advantage of that period in my life to be a stay-at-home mother. I had a child in kindergarten and another child who was one and a half. And what I found was all my friends were always looking for babysitters to take care of their kids so that they could do other things, go play tennis, get their hair done, whatever. It wasn't that the sort of quality mother/child experience that I had anticipated and because I have--I mean, I've worked since I was 13 years old. So, it was--

Jones: It became a part of your life.

Gresham: It really was such a part of my life that I found that after a couple of months I really craved to be back in an adult work environment.

Jones: Yeah, nee-nee, na-na, nu-nu's kind of gets to you after awhile.

Gresham: Yeah, yeah, so I really was ready to do something. And a friend of mine who was in my Sunday school class, he was a gastroenterologist in Raleigh. We lived in Raleigh at the time, said "I think we could use a part-time recruiter. Would you be interested in working for our group?" It was then Raleigh Internal Medicine. And they had about 28 physicians in that group and they were really looking to expand. And within ten months working part-time, just 8:30 to 2:30, while the children were in school, we'd recruited about 18 physicians, which was more than every agency in the country put together and twice to the size in North Carolina it seems. So, it was pretty amazing. And I was just working part-time, just being paid by the hour. If we recruited a physician, they gave me $500 for every physician we recruited. Today, for every physician I recruit you get $20,000 on the average. So, I was very cheap. That was very cheap.

Jones: Well, what year is it you're talking about?

Gresham: This is in 1994 when I first started doing that.

Jones: Just nine years after you started--

Gresham: Right, after I'd started in the industry. And because it's the first time I had done something like that I really wasn't sure that I was going to be successful. I wasn't sure how I should charge for my services and I loved doing it. You know, it was--

Jones: Kind of in a way you were wondering why you're getting paid for doing something you love?

Gresham: I've often felt that way before.

Jones: Yeah, because it was so easy.

Gresham: Don't tell the hospital that.

Jones: No, I will not tell Mary Ellen or Jack Bardwell anything. Let me ask you this, well, even from 1985, 1994, was this the time when there was a huge growth of what we see so much of here in Wilmington, and I began to see in northern Virginia before we moved down here, it was physician groups, medical groups that had their own, whether it was oncology, whether it was bronchial, you know, pulmonary or-- there seems to be that kind of mode and it works. There is no doubt that it works. And then all under, like, here we have the New Hanover Medical Group and instead of individual doctors striking out on their own and maybe taking somebody else in.

Gresham: Sure, it was hard to hang a shingle then and it's even harder to do that today. But there were a couple things happening at that time in the medical industry. First off, the HMO's were becoming very, very popular out in the western part of the country. I think there was almost a fear here in North Carolina that that was going to happen. It was a phenomenon that we were going to see and we did see it in Charlotte with what was then Kaiser. So, I think part of it was a way for physicians to sort of protect themselves and come together. And there's a lot of efficiencies of scale when you come together as a larger group in terms of your administration and business practices and buying power and negotiating power with the third party payers. So, that was one of the things that was going on at that time. But the other thing is that North Carolina was in a growth mode and we were one of the top ten states in the country to which people were moving and Raleigh had just come out as one of the top ten cities in which to live. So, that had just happened so I had the wind at my back, really, when I, you know, went to work with that group. Then after being with them for a year of so, it was neat because other practices in the eastern part of North Carolina started calling our administrator to say, "What are you guys doing? How are you growing so quickly?" And Parker Eeals [ph?], who was the administrator, said, "It's this chick." Sitting out here at the secretary's desk.

Jones: With a whip.

Gresham: But the exciting thing that happened was literally overnight I had my own consulting firm and I had never solicited a client.

Jones: It's just word of mouth.

Gresham: In those years, it was just word of mouth.

Jones: That's the best way.

Gresham: And so ECIM and New Bern called me and the LeBauer Group in Greensboro called me and Wake Med, the big hospital, asked for help and Rex asked for help. And I mean literally overnight I had all these folks that wanted me to come and work with them and including Wilmington Health Associates, which is the large group right here in Wilmington. And I brought a friend in, the one who had gotten me my first job in 1985. I brought her in and she became my partner with our business. It was called Carolina Physician Recruitment.

Jones: Now, are you head of this and own this now?

Gresham: At that point in time.

Jones: At that point.

Gresham: At that point in time. So, we, the two of us started our own business and worked as a tag team to help these other practices recruit physicians. And so I started working for Wilmington Health in 1996 as a consultant for them. It was easy. William's grandfather had a beach house here at Wrightsville Beach, so it was really easy for me to come down to Wilmington a couple of times a month to do the physician interviews and that sort of thing. But in 2000, they basically had done a plan and said, "We need to recruit 17 or 18 doctors over the next two year period of time."

Jones: Growth here has been phenomenal.

Gresham: It was and so at that point I felt like--and we were in Raleigh at the time and there was some issues that I sort of felt like moving to Wilmington might be a good thing to have a contract that hefty is going to require more of my time than I was going to be able to do transitioning from driving back and forth to Raleigh. So, we moved here to Wilmington in 2000 and Wilmington Health became such a big part of what I was doing that I eventually just worked exclusively with them. They asked me to do that and I was happy to do that and just focus on one practice. And so Dr. Katoby [ph?], Dan Katoby, was the medical director and Dan said, "Go home and write a job description and come back and tell us what you need." And then you've got here at this point I'm a single mom now and he said, "I know you've got these two children so I want you to plan to be able to leave every afternoon 3:00, 3:30, about the time they get home from school." And so I did. And I did my position there.

Jones: Not too many people have that advantage so but there was a need for it. You just happened, it seems like from high school on to be at the right place at the right time or make it the right place at the right time, which is even more of a gift.

Gresham: I think it's a little bit of both. I mean, what--that's the--

Jones: You could see and so took advantage.

Gresham: I could see an opportunity.

Jones: Right, which goes to prove something I've always said, and I've told my adult kids, "Don't tell me you can't, you're just lazy. You don't want to, you know. Anybody can. Fail if you want, but try it."

Gresham: Right, right, well, I guess where I always I've been able to find an opportunity or place that looked like an opportunity could occur. And sometimes I would volunteer to get my foot in the door. With Raleigh Internal Medicine I probably, you know, undersold myself in terms of what I was charging them to build up the experience, to be able to go out and start my own business and have more than one client. I've always believed if you do the right thing the money will follow and I've been very successful in that way.

Jones: Well, I congratulate you. I'm learning a lot here. And I'm sure that anybody who watches this and listens to this--let's get to the growth here that you've seen and certainly the growth of this medical center, is it because all of New Jersey and Long Island's moved down here? I joke about that.

Gresham: But that's certainly a part of it. But, I mean, part of it is where we are geographically. I mean, we have the advantage or the responsibility truly because we are the only large medical center really within a two hour drive. I mean, you've got East Carolina, Chapel Hill, Duke, Wake Med and then Charleston, Myrtle Beach. But we're responsible for the healthcare for all of the surrounding counties so we've got, I mean, they're probably eleven, anywhere from seven to eleven counties, depending on the specialty, that those folks really are counting on us to provide their medical care. And the last thing that we want to see happen is for our patients and their families to have to drive two hours, three hours to go to another place where they're away from their family, away from their support systems and away from their community. So, we felt like it's our responsibility and our privilege to grow and be able to provide those services and that's something that we're very, very committed to and we're going to continue to do and some specialty services. We probably have a catchment area of about 500,000 that look to us to provide those services.

Jones: 500,000, that's a good bit. I used to hear people, fortunately not too many friends of ours who, let's say, would be diagnosed with cancer and they would be given the option of a second opinion or say they wanted a second opinion and given the option of going to Duke it seems or Chapel Hill, but mainly Duke. And not until I was diagnosed with cancer and had the most wonderful doctors in the world, still do, and they said, "Do you want to get another opinion?" I said, "Why? Look at all you've got here. You're top in your profession. I don't want to do that, no."

Gresham: There's no reason that--need to leave--it's coming in.

Jones: And I found there is absolutely no reason to go anywhere. And now with the Zimmer Cancer Center and they're doing so much research. And Rhonda Zimmer, whom I've interviewed, has been passionate about this because her husband had been diagnosed and is cured, at least for now. And I have found that people are kind of coming here, when I ask them, "Why are you here in Wilmington?" They're retiring younger, they want to play but they also need this lifeline.

Gresham: They want to have the security in knowing that they're going to be provided for. Well, I've worked in the large universities and I, when I look at our medical staff and I see the quality of the physicians that we have, it's unmatched. You'd be hard-pressed to go anywhere else. I mean, part of it is we attract the best. You have to sort of be the best to stay here and be successful.

Jones: It's pretty good living here.

Gresham: And there's very few instances where somebody needs to go outside of this network, I mean, because of the quality of the physicians that are here. I think the other neat thing that's happened is Jack Bartow [ph?] who was the CEO of the hospital, we're so lucky to have that man in this community and he has got a commitment to stay here, you know, until he retires. And he's done such a great job of extending his reach outside of the hospital and into the physician community and that's something that's going to be critical to the success of our healthcare here, in this area. As physicians working with the hospital to make sure that we're all successful together.

Jones: Well, I think that that hospital, I happen to have been a guest of the hospital, obviously, when I had some surgery and so forth, and the nursing staff needed a great deal of attention. The hospital was dirty, etc. I'm not going to go into the whole thing. And I was so surprised because I used to be Eucharistic minister to the critically ill over there every Friday. Now, after Mary Ellen has really cleaned house and Jack Bartow has really cleaned house. Unfortunately, I ended up as a guest over there this summer and I was just absolutely amazed. I couldn't say enough good things so I wrote notes to everybody saying, "Forget that other thing. Take it out of the file." And the nursing staff, and I do credit Virginia Adams from UNCW, who was head of the nursing department, as having something to do with that. Her students here, I think, are among the best, too.

Gresham: Oh, fantastic. I had a friend that was there not so long ago so I got to see it from the other side. And the young nurses that took care of him who are UNCW recent grads were the best, the absolute best.

Jones: Absolutely. And I love the way they have their own little personal cards to give out and say, "If anything goes wrong, you can blame me." And I'm thinking, "Oh, my goodness."

Gresham: Yeah, we're doing great things over at the Hospital, so.

Jones: Is your office in the (inaudible)?

Gresham: I'm on the Cape Fear campus. That's where my office currently is.

Jones: Okay, fine.

Gresham: You know, again three year ago the hospital decided that they really wanted to take the department of physician relations up a notch. And, again, I think that's because of Jack's vision and his commitment. And so they sort of created a new role, director of physician relations, contacted me over at Wilmington Health. I wasn't looking for a new position at that time. I was very, very happy at Wilmington Health Associates and called and asked if I would consider applying for the position, so.

Jones: They asked you to apply? Well, maybe they had to.

Gresham: Well, I already knew quite a few physicians in the community because of my work with Wilmington Health. When I started with them we had 28 physicians and when I left we had 78. So, that had had a significant expansion by opening some new service lines, bringing in some existing groups into that practice and then recruited some doctors, as well. But it was an exciting opportunity and so I've been at the hospital now for about two and a half years. It's different from anything that I've ever done because I've never worked in a large organization like that. So, for the first year I had legal hitting me on one side and fiscal hitting me on the other. And, you know, you can't do this, you can't do it that way because I'm so used to somebody saying, "This is what needs to be fixed. Let's get it done." And I just, you know, take the ball and run with it. So, I wasn't used to having to consult with ten different departments and four different, you know, agencies or groups to make sure that we're doing it all correctly. But I'm getting there. I'm starting to figure that out. And I appreciate now why that's so important because one thing that you do has so many implications for other individuals in other departments. So, I'm learning to navigate that a little bit better than when I first got there.

Jones: I'll tell you something interesting. I'm a certified interviewer and I had to study for and take what amounted to a two and a half hour test online to answer five questions. And this manual came from medical facilities. It was because of the decisions that they have to make as end of life and many other things, to avoid lawsuits and which was fascinating reading. And after awhile it made sense. When I first got it I said, "What in the world?" And I realized that everybody in North Carolina who does interviewing and many other places now are using this particular mode, which became out of hospitals and doctor's offices etc. And I think many people don't know that, but it is amazing. So, when you talk about satisfying various factions, some of the case histories I read were mind blowing and I'm thinking, "How stupid is this? How much time is this being wasted?" And yet, when you have parents, maybe a spouse, an intern, a nurse, a this, a that, it's all there telling you what to do, you know what.

Gresham: It's bureaucracy but for a reason and I'm starting to get some of that. And Jack was so funny because when I first got there and I was going gang busters and reminded me, he said, "We can't turn this around like one of your John boats. This is a battleship."

Jones: That's a wonderful way to put it. I can relate to that.

Gresham: Looking at it like it's fishing and boating and that sort of thing. We can't turn it around like that. So, it's a little slower and for good reasons I'm certain. It's a great opportunity for me. I serve as a liaison between the hospital and the physicians and their practices. So, I've got great working relationships with the different practice managers. And they're such great communicators that it's sometimes easier to access than the doctors. So, that's part of my position there is to be that middle person to help solve problems.

Jones: Well, you must be good at it. You're still doing it and I think that could be an extremely difficult position to be in at times.

Gresham: Well, 500 physicians, 65, 70 practice managers. And I laughed, I told somebody the other day, "You would think having that many bosses would be the biggest challenge of your life, but I have two teenage girls."

Jones: Yeah, oh God. Two girls, oh--let me ask you this, do you ever get involved in malpractice suits?

Gresham: I do not. That's not, that's not part of my--

Jones: Fortunately. All right, let me ask you another thing, you mentioned early on that in your earlier part of the career you would place retired physicians. Do you do that here?

Gresham: Not as much. When you're recruiting for a position you sort of--it depends on whether or not it's an established practice with tenured positions or if you're starting something brand new from scratch. And if it's an established practice, then it makes sense to bring your newer residents into that because the older people are going to retire so you kind of want to keep that pipeline moving. Plus, when these guys come out of their residency training, their learning curve is straight uphill. And you want to make sure that they've got good mentors and good leadership in which for them to work. If you're starting a brand new practice, you're in someone's going to be out to settle situation, you really want an experienced physician. You don't want to put one of those residents out in a situation where they're going to be out there by themselves. So, someone who's transitioning from the military or someone who's not quite ready to retire but willing to, you know, put another five, six, seven years into it, that's where you put those experienced physicians.

Jones: I'm thinking of a couple of physicians. I know three of them and they're wonderful people. And one is about 110 years old. And Jim Hundley, God bless him, God bless him.

Gresham: He's wonderful. He's fantastic.

Jones: He is. And he keeps--I think he's retired three times. I'm not sure.

Gresham: But he's really involved in the community work, too, and that's probably starting to fill that void.

Jones: I know he is and I think Glenda is just very, very happy about that, you know. But he's the kind of person you don't want to retire. He says, "Well, I'd go back and talk to them. I mentor."

Gresham: Well, and those are the kind of--

Jones: Of course, he started his own and so he doesn't have to look around I don't think.

Gresham: Well, those are the physicians that do the Locum Tenens now. Several physicians (inaudible).

Jones: They do the what now?

Gresham: Locum Tenens, that's the traveling position.

Jones: Locum Tens.

Gresham: Locum Tenens, that's what it's called.

Jones: Well, I don't think I'm going to write that out there. I have to do an abstract on this so I try to get accurate, you know.

Gresham: But a lot of the physicians that do that are those retired physicians who are not quite ready to settle down, still want to provide some sort of assistance.

Jones: That's amazing. All right, now tell me about your involvement with the Cancer Society. Was this just an endeavor? Was there a reason for it, your becoming involved in that or are you just a volunteer who can't say no?

Gresham: You know, it's interesting, my first couple of years I was here in Wilmington I was so busy with work and with the girls that I really didn't dig into getting involved in the community. And I had done Junior League, PTA, those kinds of things in Raleigh, but really didn't have the time to get very involved in the community.

Jones: I don't wonder.

Gresham: But after being here for a couple of years I realized that, you know, I'm not going to meet a whole lot of people if I don't sort of put myself out there a little bit and do something outside of the work and doing the children. I attended the first Cancer Society gala that they had here. It was at the Cameron Art Museum, I think. I went as one of the corporate sponsors with Wilmington Health Associates. They might have had 40 people, maybe.

Jones: That was their fault.

Gresham: That was there for the event. And I mentioned to one of the girls there that night, I said, "You know, this could have been a fantastic event and it's just a shame that there weren't more people, that it wasn't, you know, as publicized, and it wasn't communicated as well." I said, "It really could have been great." So, she called me about three weeks later and she said, "Would you be willing to be on the committee?" So, timing was good. You know, I was in my mind thinking, "I want to start getting more involved in things." So, I said I would and--

Jones: Now, this is when the Cameron was really new.

Gresham: Yes, this was 2000--I guess this was like 2003 or 2004.

Jones: Well, that's when I started collecting patrons to sign up just so they'd get some money from them.

Gresham: Right. So, I said that I would and then after a couple of meetings she asked if I would chair it. So, a little bit more but--

Jones: That's a big job.

Gresham: A little bit more than I had planned on.

Jones: So, you did it for three years?

Gresham: But I did, I did. And I pulled in--we had a group of women that were the networking group and we used to get together every Wednesday for just networking. It started as a group of six and it really expanded.

Jones: Through the Cameron Museum, no?

Gresham: No, no.

Jones: Just period.

Gresham: This was a group of women who all did this and were all involved in physician recruiting. And then we brought a couple of realtors started coming and then everybody started bringing friends and then everyone stayed the afternoon and we were dockside throwing our business cards on the table and, you know, having a nice cocktail hour. So, I pulled that group of women together. I said, "Guys, if you're willing, I'd love for you to be my committee and let's make this happen." And so we had a wonderful year of planning. We had a very successful event. I think that first year we had 225 people and raised maybe $50,000 and it just continued to expand over that. But it's interesting, I mean, everybody who's been up there has had someone who's in their family who's been affected by cancer. But I never had a close family member or friend at that time of my life.

Jones: That didn't spur you on.

Gresham: So, it really wasn't that and I thought, "Here's something I can do. Here is an event that I can make successful." And that was really the approach that I took. What happened was that it changed me so much more than I ever could have imagined because when you sit down and you go and you talk to someone that you're asking for a sponsorship, you're asking for a basket for the silent auction or you're asking them to write a bigger check to be one of the sponsors, every time you sit down and you talk with somebody about that, you find out how cancer's touched them. They're willing to give that gift basket. They're willing to give that piece of art. They're willing to write that check because someone in their lives has been touched by it. And I never walked away from any of those conversations that I didn't hear a story about impact that it had on somebody else's life.

Jones: You know why? Because you always say, "It's not going to happen to me. It's not in my family." And you can't say that anymore.

Gresham: Well, I think you're just touched.

Jones: You are touched.

Gresham: You're just touched by--

Jones: It's a scary sound. The big C evolved into, let's say the whole word, and realize that it could happen.

Gresham: Right, so it really, it changed my attitude about volunteerism more than anything else. Because I feel like when you understand that, you're going to get so much more out of it than you put into it, it reinforces the commitments so much.

Jones: Yeah, Kathy, I'm going to ask you something that I've wondered about, and I know a lot of other people have, too. It's already begun. This year has not been as bad, but you know yourself, the end of August, you start getting 'save the date' things. They're elaborate that come out. And the prices have gone up, up, up. I remember when the black and white ball first started and one of the things they included was the little black book. And it was a little black book with 400 names in there. And I thought, "Oh, how ostentatious." And I was flipping through, I knew most of those people and I think, "There we are." But we didn't go for whatever reason. And we had been, you know, like a lot of people. They're worthy causes. So, and they're non-profits and you feel like, "Well, you know." I began to see after going to a few of these, that the--I know that the table decorations and the gifts are all donated. But how much money that is taken in percentage wise really goes to the purpose that these balls and these parties are held for?

Gresham: Well, we had a commitment to keep our overhead to no more than, I want to say it was like 20%. I don't think we ever reached that amount. In our first year we might have spent $15,000, $16,000 and raised over $50,000, and that's a pretty standard ratio. I think most of the non-profits have that.

Jones: Is that right? Because I know some people will donate, let's say, the printing or donate all kinds of things.

Gresham: And that's a big part of our job as volunteers, is to solicit as much as we can and to keep that as limited as possible so that the majority or the money goes to the organization. And I can only speak for the ones that I've been involved with but it's a small percentage that it takes to run the events that I've been involved with. Having said that, an organization, like Cancer Society, you know, Hardball, those kinds of things, those funds are going to the larger organization. And I've had sort of a transition in my volunteerism over the past two years. When you've done something successfully, like a gala or serve on a board and pull off some successful fundraising, a lot of folks start to tap you and ask you, "Will you be on this committee? Will you run my auction?" and that type of thing.

Jones: That is the old adage, ask a busy person.

Gresham: Right, and you get recognized for doing that. I've got several friends, I mean, Ashley Miller is in this boat with me, that you start getting tapped to do these kinds of things. And after doing it for a couple of years, what I realized was if you don't have a passion for it, it feels like work. And so I started turning just to, you know, after doing that full tilt bogey for a couple of years I really wanted to focus on things that I had a passion for because if you have a passion for it, whether it's your love of children or whether it's your love of animals or whether it's something that it impacted your life personally, or whatever, it is so easy to go to somebody and ask for something to--

Jones: Because it comes through.

Gresham: Oh, my word. You're so passionate about it, but it's really easy to solicit other people's help and support for your event. Having said that, I've never asked anyone for something that I have not--from someone who I have not already given for or to, and I believe in that. I believe if you are going to buy your shoes someplace or do your catering through a certain company, that it's okay to go ask for the sporting goods from these folks because you already spent $300 there this month or you're using certain catering companies to do your parties or that thing and that makes it easier, too. But I always try to give forward and then go to those folks to get their support.

Jones: You know, one of the things that we do have a high economic group that live here in this county, or the southeast, in the three counties, let's say. But it seems that there has been a huge growth of non-profits and they're--

Gresham: There are 400 in town.

Jones: And you know, you get deluged with them. And they all make you feel guilty because not a one--well no, I'll take that back. Most all are really necessary and they're worthwhile. And no longer can you go to, let's say, United Way or something and they have one size fits all. There's got to be an end to this somehow. And I find a lot of people feel the way we do. You pick your choices and stick with them and just have to.

Gresham: That's what you have to do. And for me sometimes, I mean, I can't always write the check so volunteering is a way to help support that organization, as well. But you have to pick your passions and for me, it was taking a look at things that are going to impact my neighbor and the mother of the folks whose children are in school with my children and in our community. So, I really started looking at Wilmington activities and I've gotten involved with, you know, with the hospital foundation because, you know, hospital is a place where, I mean, it's not just a place where I work, but it's a place where my child might have to receive care. I might have to receive care. I got friends, my mother, so that's something that regardless of what organ system, you know, we're talking about, you can find yourself there.

Jones: They have a committed working board. And in fact, when Gayle Van Velsor came along, she said, "Would you be interested?" And I said, "No, not one more thing." I fall apart seeing a sick child or a sick puppy, which is one reason I turned down the first time I was asked about domestic violence. I said, "I can't do it." But you know, you kind of grow up a little bit and so forth. How much time do we have?

Sweeney: We have seven minutes.

Gresham: For me it was Carousel Center, Domestic Violence Shelter Foundation, and I've just recently been appointed to the board for the Public Health Department Foundation. So those kinds of things.

Jones: Let's take a break for a minute because I want to get on to your involvement with domestic violence and some of these other things. I think that it is one of the most worthwhile. So, at the time I was trying to juggle, and I'm glad I did, although I find, and I was warned, they expect you to work. I thought, "Well, good." And this is fine, so when we have our names to give over, I'm thinking, "Oh, how many people do I know that really need to do something like this."

(crew talk)

(Tape Change)

Jones: Alright, this is tape number two, Carroll Jones talking with Kathy Gresham. Kathy, what you've been talking about so far has been really, really fascinating, but your involvements with so many other organizations, pick up on a couple and particularly Domestic Violence Shelter and Services. How did you--that is something that is a little bit different than going to a ball, a little bit different than giving two hours a week or two hours a month at a museum being a docent. It is an involvement and it touches the type--that part of life which is not pleasant, but unfortunately--and it crosses, evidently crosses economic and social type of boundaries too.

Gresham: It does. It does. I got involved with the Domestic Violence Shelter first in fund raising. I worked with the fashion show and headed up the silent auction, and did that for a few years and then was eventually asked to be on the board. My interest in it was, I guess, over the course of my life I hadn't personally experienced it, but you hear stories about it. And I did feel like it was something that was probably--it is affecting people, women, children and some men in our community. So I did have a passion for wanting to be a part of the board and to work on it. And it's interesting--

Jones: How many years have you been on the board?

Gresham: This is my second year on the board and I've been involved with it for four years doing fund raising and on the board. It was interesting because when you go on the board we did a training session and we were asked to make some choices whether we would-- we were given a scenario. You had to decide if you were going to stay in the home or if you were going to leave. And every time I left I always came back because it was easier to stay home in the scenario. It was easier to stay home in an abusive situation than it was all these unknown factors.

Jones: The unknowns.

Gresham: So once you go though that and you realize the challenges that folks have it's easy to commit yourself to helping to create a safe environment for those families, and then more important, as important is what happens after that and giving them the tools that they need to be able to go out on their own. And I would never want my children to ever be in a situation like that.

Jones: No, of course not. No, of course not.

Gresham: So that's how I got involved with it. And it's a great organization. Mary Ann Lama is just phenomenal, the Executive Director there. She has done a great job. I was also on the United Way board for selecting where the funds would go, I guess it was four or five years ago, and that's when I first became aware of the Domestic Violence Shelter and Mary Ann did a fantastic presentation to our committee. And it just--it was obvious that it was well run. The money goes to all the right places. The programs that they do were educational and supportive, and it seemed like a good place for me to put my energies as well.

Jones: Were you surprised, or are you surprised to find that there is such a huge need for this organization and that this sort of thing does go on in all classes.

Gresham: Uh-huh, it's shocking. The numbers are shocking.

Jones: Have you ever heard from being associated with physicians and so forth, that field, why this is growing, or is it just because the population is larger, or do you suppose it has anything to do with our culture, the way we live?

Gresham: Certainly the population growing has something to do with why we're seeing the numbers grow in Wilmington. I believe that's the case. I'd like to think that a few years down the road what we're doing is going to have a positive influence. But it's so important to catch these folks when, you know, we have to break that cycle. When children grow up in families that are in domestic violence situations this is all they know. The girls accept it as a way to be a part of the family and the boys accept it as a way to control and we have to break that cycle.

Jones: And it knows no boundaries, knows no class.

Gresham: Right.

Jones: That's just amazing.

Gresham: When we actually take a look at some of the victims of domestic violence that have been in the headlines here in the past several years it's been a nurse, a realtor, a student. These are people that we saw in our daily lives.

Jones: Yeah, that must be very difficult for a parent to leave what they thought was going to be a home forever that they helped build into a home with their children or with a child and move into--what happens after--Domestic Violence Shelter and Services can't provide complete rehabilitation. That's only a short term. What happens to most of these people, coming from the health industry as well, are they trained to get out on their own? Do they go back to the same abusive system after a while for the sake of the child? What do we expect?

Gresham: The Domestic Violence Shelter provides the immediate care and the immediate relief for those families to come out. Most of the families rarely stay in the shelter for more than 30 days. I mean, that's our goal, and so we work with other agencies to help whether it's education, whether it's helping those folks find jobs, childcare for their children so that they can find jobs, housing. So we work with other agencies to provide that. But the other thing that domestic violence shelters spend so much time on is education and prevention. And so we're working so hard with local churches and other agencies and other organizations, with the school systems to be able to provide education for the young adults to prevent this from ever happening in the first place. So we have to fight it at both levels.

Jones: Well I think that's very admirable and unfortunately, I hate to say it, but it's a needed organization and I'm sure that it makes you wonder when you're meeting people or in a situation, it knows no class and you wonder, "Is this person going on having problems," and you can't butt in. But anyway, I think that too takes a specialized kind of individual to stick it out, and yes the people who are like Mary Ann and Diane Lomax and so forth, they're special people to begin with.

Gresham: Right, absolutely.

Jones: Tell me about your girls. They're teenagers now?

Gresham: I have two girls. My oldest is 20.

Jones: You had a big smile when I said that.

Gresham: They are the delights of my life. They're the best thing I've ever done.

Jones: How old are they?

Gresham: Kathryn is 20 and she's in the process of transferring from state to UNCW, so...

Jones: And what is she interested in?

Gresham: In education, early elementary childhood education is what she'd like to do, and she would like to graduate from here and then she would like to go in the Peace Corp and do that for three years before settling down. When she was in the seventh grade she went to Italy for ten days, and what a great--

Jones: In the seventh grade?

Gresham: In the seventh grade they had that.

Jones: What program was that?

Gresham: Cape Fear Academy had a group of students that went. She was just at Cape Fear for one year and then went back into the public school system, but maintained some friendships with some girls and so she got a chance to travel. And she came back a different person, just the new appreciation for a different culture and a different way of thinking.

Jones: And of course that's a beautiful area.

Gresham: I've never been to Europe. My daughter has been. I've never been. I can't wait to have some of those opportunities. But ever since then she's really been committed to having an international experience in some way. So her plan is after graduating to--

Jones: That's good. I think it's necessary these days.

Gresham: Oh, absolutely.

Jones: This is a small world.

Gresham: It's so important to embrace diversity. So she's excited about doing that. She's absolutely lovely, very sweet, charming, lovely--

Jones: She's your oldest one?

Gresham: She's my oldest. It's just a joy. I mean, we have lunch together every week.

Jones: That's wonderful.

Gresham: She'll come over for dinner. She's absolutely a great child. My youngest is brilliant, I mean, straight-A student. She is on the varsity tennis team, varsity track team at Hoggard. She plays the violin. She was big into horseback riding for ten years. That was a real big part of our lives together.

Jones: Girls can go through that.

Gresham: She was really, really good at it, and to be as wonderful as she is she can be the biggest pain in the butt.

Jones: Is she a princess?

Gresham: No, she's the opposite. She's the tomboy who is already an attorney. I mean, she is right all the time at everything and is so hardheaded and just trying to--

Jones: Gee-whiz, I know one like that.

Gresham: Trying to open that little mind to seeing other people's perspectives on things. We work real hard to do that.

Jones: What direction do you think she's going? Is she out of Hoggard now?

Gresham: She's a junior at Hoggard and she can do anything that she puts her mind to whether it will be medicine or in the field of law.

Jones: And she has shown no particular direction yet?

Gresham: She really could do anything she wants to do. She's very, very driven, very committed to excellence. She really wants to be the very best at whatever it is that she chooses to do.

Jones: She's the Beta Society, Beta Club?

Gresham: She's in the Beta Club and a couple of other groups over there.

Jones: That's a good school.

Gresham: Mm-hmm, mm-hmm but the girls are--they're very different personality wise, but.

Jones: Well you know they have a role model. I can't imagine why they wouldn't be kind of driven and committed and all that kind of stuff.

Gresham: I always involved them in my volunteer work, and I mean, I've had to pretty much because when we were having auctions all the auction items were spread all over our house. When I had, you know, if we were stuffing envelopes and invitations and things like that the Gresham sweatshop was put to work and the girls would sit on the floor with me at night.

Jones: That's great, so you involved them and that was important.

Gresham: Absolutely, they were involved in everything that I was doing with my volunteer work. With the Domestic Violence Shelter Margaret wanted to, my youngest wanted to collect some animals, some stuffed animals and things to take down there, so she said, "I think I'll start an organization that collects animals for the Domestic Violence Shelter.

Jones: Oh really? Great.

Gresham: So we're on the way to take our first batch down there and I said, "Well what--

Jones: Now these are stuffed animals like those Beanie Babies or whatever?

Gresham: Exactly, that type thing because she had so many that were untouched and we collected some from friends as well. So we're on the way to the shelter and I said, "Well, do you think you could come up with a name for your organization?" And so she thought about it for a bit, and this has been a couple of years ago, she was 14, I guess, at the time. She said, "How about FLUFFY and it would stand for, Four Legged Unconditional Friends for You."

Jones: That's adorable.

Gresham: She just thought of it on the way up there. We're talking about maybe for her senior project maybe taking--really running with that and creating the organization to make it happen, do it on a bigger scale.

Jones: She could take that to a lot of the nursing homes or the retirement homes. When Carrie--she became one of these adopt-a-grandparents things in the retirement home and go over and play cards, checkers, fix their hair. And the woman one day, she came down here from New Jersey, her son lived here, moved down here. We were the grandparents. We raised her from the time she was practically born. And this lady said, "Carrie, do you have any grandparents that live close?" She said, "Do you have grandparents?" She said, "No, I don't. Oh, yes but they're my parents." She had forgotten, you know. And she had started a group that did this sort of thing and doing very well, doing very well. One of those charge-ahead I belong to everything mentoring and third grade teacher. So at any rate you've raised them well. And it sounds like you're going to be friends with them too.

Gresham: I'll get there with Margaret. We're not there right now because that benevolent dictatorship has worked a little stronger with her.

Jones: Well that's okay. It will happen.

Gresham: It's interesting. She just got her driver's license a few weeks ago so already I'm having to make more time for us to sit and visit, because that was happening so regularly in the car. So you have to be more conscious about making time to do that. But my older daughter she's even reaffirmed with Margaret, you know, "Mom's really cool. You'll find out one day she's really cool."

Jones: Well, Carrie said to me one day, I guess she was in her second year of college. She was home on break and out of nowhere, apropos nothing said, "Remember when I used to hate you?" I said, "Oh has it stopped?" And she said, "I'm so glad you didn't buy me a car at 16," because she threw a complete fit. And she said, "Because so many of my friends have had tickets and they've gotten their cars taken away from them," and blah, bah, blah. I said, "I know, and you really didn't need it because you had mine when you had to have one."

Gresham: Well, Margaret got a car when she was 16 and a half, but she didn't get her driver's license for three months. It sat in the driveway, because until I saw a pattern, a consistent pattern of making good choices the car is going to sit there and you're not going to drive.

Jones: Kathy, you're a perfect example of a parent who can also be a friend. I got to the point where I was tired, 'cause I'm ancient, I got to the point where I was tired of hearing mothers say, "I don't want to upset them because then they won't talk to me." They wanted to be their best friends. And I took the attitude with my daughter and my sons, "I am your mother, therefore I am a teacher. If God wanted you to have a best friend you'd have one, now go out and get one."

Gresham: Yeah. Well you know what I think with my girls it was not so much wanting to be their best friend, it was trust, and that started at a very, very early age. I mean, from the time that they were toddlers and if somebody spilled the milk I was like, "This is not a problem, we're going to clean it up." They needed to see how I was going to react in a crisis. To a toddler that's a crisis. And what happens over time as your children get older they know that you're not going to lose it. They know that they can trust you to be calm in the storm, share the correct information and--

Jones: And still be loved.

Gresham: And still be loved.

Jones: Get the discipline with love.

Gresham: And what I always told them is that, "Look, as long as you're honest with me and we know what's going on in a troubled situation, yeah, you might still get in some trouble if you've done something wrong, but not nearly as much trouble, I mean, we're talking tenfold more trouble if you're not honest with me, because under those circumstances I can't help you. We can't work through the problem." So that was really the way that I approached my attitude about my girls.

Jones: Pretty healthy, pretty healthy. Kathy, what is in Kathy's future? You're going to stay where you are until something else comes along?

Gresham: Yeah, I can't see doing anything else work wise right now. I love what I'm doing and the neat thing about this job is it's so vast. And right now I'm a department of one, so no two days are ever the same. No one is really--I meet with my boss John Gizdic who's fantastic. I meet with him every two weeks to make sure that my priorities and his are the same, that I'm working on the things that he needs for me to work on, but each day I've come in and pretty much set my agenda, and so I love that. There's a lot of flexibility in it. The other neat thing that's happened over the past years of volunteer work, and my work, and my social is that everything has come together, and so I'm not compartmentalized in my life. I mean my social life, my work life, my volunteerism has all come together and they all affect each other in such a positive way.

Jones: So you're feeling a little more complete.

Gresham: I feel very complete in that way.

Jones: That's great.

Gresham: So that's a great, that's a great place...

Jones: That's mental health.

Gresham: That's a great place to be. I love Wilmington. I can't imagine living anywhere else other--and certainly nowhere else other than North Carolina and specifically here. I really, really love this community.

Jones: Tell me about the 11 people you were raised with. Are they still around? Do you see them?

Gresham: The ones that are alive are all still in Hamlet.

Jones: Is your grandmother still cooking for the boys?

Gresham: Unfortunately she's passed away. Her husband was born in 1890 I want to say, because she was born n 1898. I still have his christening gown. I have it in a shadow box at home. My great grandfather was the Sheriff of Anson County and my great uncle was the Sheriff of Anson County. So all of the Martin family is still in that...

Jones: Were they part of that great, great number of people who came from Scotland, for example, to New York and because the Scotts, unlike the Irish and a few others, are very clannish came over the mountains and settled in North Carolina.

Gresham: Randall Halt was our first ancestor. He came over from England as an indentured servant when he was 18 years old and that was in, I think it was 16--gosh I want to say 1670, maybe was when that first ancestor came over.

Jones: Would that be around Bath up there?

Gresham: No, it was the Virginia outer banks and his family eventually owed what was then Hog Island, and then migrated down to the Anson County area. So that's where our people have been.

Jones: This state fascinates me as to how the people came here and such.

Gresham: Well, we still live in a place where it's all about, "Where are your people from?" So my family has been in North Carolina for quite a while. I don't see any of that changing. But my uncles that are still alive and aunts are wonderful folks, still fish, don't hunt, but still fish. I've got a couple of their taxidermied deer heads.

Jones: I was going to say, "Are they on the wall?"

Gresham: Yeah, we've got some of that, but my favorite antler set is from Hamlet and one that my uncle, a buck my uncle shot and it's got brass plaque on it that says, "Caught on the graveyard hunt in 1960 whatever it was, " but it's still around.

Jones: That's funny. That is funny. What do you, being a North Carolinian seeing everything from small town to big city, having a wonderful job, a high powered job, doing wonderful things in volunteer work socially and every other way, where do you think that New Hanover County, or Southeastern, or the three counties, Pender, New Hanover, Brunswick--and since this interview session and many of them were based on facts that we got from a census, where do you see us in another ten years, just take your own business, your own profession based on growth and where's the growth going to go?

Gresham: I would say that in the next five years our medical staff, for example, which is now a little over 500, will be closer to 600. I believe we are going to continue to grow our primary care significantly. I believe you'll see more physicians become employees.

Jones: Interesting. Are we talking socialized medicine?

Gresham: No, not that at all, but in order for physicians--the phenomena here is that physicians are working harder and harder just to maintain their same amount of income. They have to see more patients and do more procedures and that sort of thing, and have to extend their hours to be able to do that. And the reason for that is malpractice costs are going up, the cost of running a practice is so much higher because the employee's insurance is going up. Their overhead is becoming so much more and the reimbursements, Medicare, Medicaid reimbursements are going down. And so it's a hard time for doctors and a lot of folks are just saying I don't want to do it, I don't want to run a practice anymore. I just want to provide good care for my patients. And it's easier for larger physician organizations to negotiate with the third party payers to get better reimbursements, and they have more negotiating power and buying power for equipment and that type thing. So I think we're going to see more and more physicians choose that model, being employed and not so much of the private practice. I think that's a phenomenon that we're going to see. We're already seeing it at the hospital. A year ago we had zero employed physicians and now we have 30, and we've recently entered--

Jones: That's an interesting concept, but you've explained it.

Gresham: Yeah, we've entered into a relationship with Carolina's Physician Network in Charlotte so that our doctors will be part of their network which is a 1,200 physician network in the state. So I think that's what we're going to see change in healthcare is sort of the model under which physicians are working. In terms of the area at large, Brunswick is exploding, and that is--

Jones: Right. It was for a couple of years the fastest growing county in the country, but it's not now, but it's one of the top five.

Gresham: It's still one of the top. And that growth is happening from a lot of the folks from New York, and New Jersey, and Ohio and those areas that are moving and sort of taking early retirement and coming here. So I think that's going to have an impact on healthcare in this area. We're going to see a lot more physicians that'll be migrating there.

Jones: And the need.

Gresham: Mm-hmm, mm-hmm.

Jones: This I'm sure is just your opinion, you may not be able to speak for any groups, but there is so much talk about nationalized healthcare, socialized medicine and the only models we have that I know of would be Canada, Great Britain, the Scandinavian countries, and people are saying no, no, no.

Gresham: Right and I would agree with the no, no, no.

Jones: And I would agree with that too, but for certain groups they think, well their worries are over, but the doctors, I'm sure, don't want to deal with that because they would become very limited.

Gresham: Right. There's got to be a halfway point and I think Barrack Obama's plan actually is a pretty good one, in my opinion. I don't think government can do it effectively a hundred percent. I think it's got to be physicians and government working together to come up with a model that's going to work. But there are too many people that are falling through the cracks in our society when it comes to their healthcare and it's not fair and it shouldn't be happening. So we have to figure out a way to be able to catch those people. And it's mostly the working poor. Folks on Medicaid can still find access to care, I mean, physicians will see them. It's the private pay folks that we see come through our ED that are using our emergency department as their primary care, but this is the only place they can go to get care. And that is the most expensive way of putting your hands on a patient.

Jones: And yet I heard from a couple of doctors and some directors that nobody is turned away, and one sample was, take a look at your hospital bills. They're padded, yes, but they're padded, and the insurance companies know this, to pay for those people who have no funds.

Gresham: Yeah, hundreds of millions of dollars a year that we have to write off that we don't get reimbursed for because folks can't pay for it. And there's better models, there's better ways of providing healthcare for those patients than just using the emergency department. And there's some wonderful groups that are working diligently.

Jones: The Tileston Center.

Gresham: Tileston, the Health Department, the hospital, there are several organizations that are working hard. Scott Whisnant, who's head of our Public Affairs, is doing some great work with trying to take care of those patients that are falling between the gaps. And we need to have commitment as a community to take care of those patients.

Jones: That's just another--I think people, particularly older people who are on fixed incomes, they may be good fixed incomes because they wouldn't be living in New Hanover County if they weren't, but they say that's just one more thing to take care of. Well, unfortunately that has to happen.

Gresham: And I think or healthcare costs will go down when we effectively take care of those folks that are falling through the gaps and provide a better model for their care.

Jones: Kathy, thank you for coming. This has been really interesting. It's been a complete eye opener. I've learned a lot and you're one of those where when I go back to do the abstract, which is just a synopsis, I don't know what I'm going to do. I'll say, "Listen to her. Just read this and listen," but it's been very, very interesting.

Gresham: Thank you for giving the opportunity to.

Jones: And I have to compliment you. You do very, very well. I mean, the conversation has flowed. Kate, what do you think? Yeah, okay. Thanks so much.

Gresham: Well thanks. It was a pleasure.

Jones: Okay.

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