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January 14, 1999

An hour with Dr. Ralph Falk and it becomes clear why this man was hand-picked to lead a team of primary care physicians affiliated with CORE Physician Group in the new Bailey Medical Building, a division of Exeter Health Resources, opening soon in Hampton. His infectious enthusiasm, pleasant demeanor, and sincere approach to medicine is exactly what the organization was searching for. His goal for the building is simple: "To put together a really tight-knit crew that's going to be able to cover all the bases for primary care right here."

He's done it before and he'll do it again. Before coming to Hampton, Falk was affiliated with a successful primary care group in Connecticut. "The whole town gravitated towards one hospital, but as part of the all-star team [we put together for our practice], within a couple of years, everyone was coming in to see us." He reflects on the experience as one of hard work, of creating a strong sense of balance, and of "being able to say, Okay, I'm going to work hard when I'm here, but when I'm off, I can really turn off my beeper and jump in the ocean. One of the benefits of having a solid team is that you have docs that are really challenged. They're interested, they're having fun, and if that's there, how can you not do a good job?"

By the way, this jumping into the ocean is voluntary, year-round. Dr. Falk is an avid surfer. "You know, I always have to look," he says referring to the waves, even though I can't stay. I have to go down and take a look and see what I'm missing." After all, surfing is what brought him to the New Hampshire seacoast to practice medicine.

This isn't the first time geographical conditions have brought him closer to his chosen profession. It was his love of skiing in high school that lured him north to Burlington, Vermont. "I picked one college to go skiing at," he says. "I chose St. Michael's because there were the most ski areas per unit drive density surrounding the Burlington, Vermont, area. Then when I got there, everyone was getting really serious. I thought everyone came here to go skiing, but they didn't." What started out as a college skiing adventure turned into one of his toughest learning experiences. His goals then shifted. "A little taste of the idea of shooting high got into my blood then. So what the heck, let's see where it goes."

His desire to continually learn more and to then want to share it with his peers is one of his greatest strengths. "I've gotten involved with a teaching program just to stay fired up," he says. "It's nice to have someone chomping at your ankles and saying, 'What are you doing that for? Why did you do that test?' Making you think all the time. It's good."

What does he see as an ideal addition to the building in the future? "A surf shop," he jokes as he darts off to answer his third page in the last twenty minutes.

"When I came to work here at Exeter Hospital," she explains, "there was a need in the community for another doctor -- and I think that there still is a need for more doctors -- but there wasn't a space for me to come to.

As a result of this scarcity of space, Kelly found herself sharing an office with another doctor in Exeter. "We kind of juggle our schedules around, when we see patients and when we don't. Right now the amount of space that I have to see my patients in limits how fast I can see people and how many people I can see, and that's no good. If I had more exam rooms, I could see people in a more effective way.

Kelly is obviously excited by the fact that the new medical building will alleviate those woes. "In the new Hampton facility there will be room for all of us to work and see patients at an optimal flow, and [we will] really be able to serve the community better that way.

Kelly's passion for this project and her enthusiasm for her work are clearly enhanced by the prospect of working side by side with Ralph Falk, M.D. "He's sort of the cornerstone of the whole project. Dr. Falk is established in the community. He's been here for a couple of years and he's currently working over in Hampton. He's well-respected.

"Dr. Falk's a great guy to work with," Kelly continues. "We have a great working chemistry together, and that's something I think the patients also pick up on. When your doctors are enjoying what they are doing with you, I think you come away feeling better cared for and more interested in following the plan that they've suggested for you. And the more interested I can make my patient in what I'm going to do and how I'm going to help him be a healthier person, then that's a winning strategy."

Kelly hadn't always planned on a career in medicine. "My father was a doctor, and he kind of always wanted me to be a doctor. But I wanted to be an astronaut," she admits. "But I get motion sickness, so that wasn't going to work out. So I went to medical school instead." Kelly thinks about this for a moment. "And this was one of those situations where my parents were right. My parents are always right. It's very aggravating," she says, laughing.

After completing medical school at Boston University, Kelly went to work at Saint Elizabeth's for her residency. "I did my internship and residency there, and I loved it. It was wonderful. It was just the right mix. So I stayed there when I finished my residency and I worked at a clinic associated with the hospital, because I had had such good teaching [experiences] there and I wanted to continue with teaching. So I got very involved with the teaching program at Saint E's, and probably the biggest decision that I had to make in terms of leaving was that I was going to have to give up my teaching.

"I used to work with this group of students, and these students were so into what they were doing! Normally you spend your first two years of medical school in a class, and then you go to the hospital for the third year and the fourth year. They didn't want to wait. They set up a clinic on the second floor of a church, and they saw patients there. So some of the teaching I did, was I would precept these students."

And if she has her way, Kelly will continue to utilize her teaching skills in some capacity once she moves into her Hampton office. "I've also gotten involved in the physician assistant training program through Dr. Falk," she says. "He had a physician assistant working with him, a student, and she was so much fun. And she came and she worked with me while he was away. So I'm hoping to end up with a student of my own, to be able to really incorporate that into my practice. [Students] are always so excited because everything is so new to them; you can t help picking up on their excitement and being reminded of all the reasons why you do this job. And the patients, by and large, like to be a part of teaching. It's a win-win situation for everybody.

"A lot of people that you train, they come and they work with you. They're already part of your practice. The patients know them. It's a nice way to establish continuity."

So what lured Kelly away from the work she loved at Saint Elizabeth's Hospital in Boston? "I got here because of a blind date," she says with a smile. "Mv sister set me up with her best friends brother-in-law. I dodged this date for two years, and so did this other guy. Finally, I couldn't dodge this date any longer, and I went out with this guy. And we had a great time! Nobody could have possibly been more surprised then the two of us.

"On our third date, he brought me over to Exeter Hospital and said, This is Exeter Hospital. It's a good place. Why don't you just quit your job in Boston and come here?'

"I laughed at him. I said, 'Yeah, right. I'm going to do that!'

"And six months later, I did."

While the first step in providing health care information to the community will be to set up some kind of medical library in the building, the doctors foresee the internet as being an valuable tool in providing additional in-depth information to their patients. The goal here will be to set up a system where the patient can utilize his or her waiting time by accessing information about medications, conditions or treatments in an inviting, non-threatening setting.

As Dr. Ralph Falk explains it, "Some of the sites on the internet have been reviewed by peer groups of the medical profession so that there are certain sites that you can highly recommend, and we can set it up so that people can go right to those sites."

Dr. Kathleen Kelly also feels that internet access to medical information would greatly benefit the community. "Say you live in Hampton," she says, "and you're part of the practice — or maybe you're not even part of the practice, but your doctor just told you that you have myasthenia gravis. Well, maybe you have access to information about that and maybe you don't. We'd like to be available as a resource where you can come in and get some information about that, whether or not you're necessarily a part of the practice. And if that makes you convinced that we're terrific and you want us to take care of you, then that works. But even if it doesn't, the point is, you get what you need. It shouldn't be hard to get information about it. There's so much information available. This facility should be a port where you go to get what you need."

Kathleen Kelly, M.D., and Ralph Falk, M.D., have high hopes for the Bailey Medical Building. Both Kelly and Falk will be spearheading the Bailey project with some very specific goals in mind, goals that are reminiscent of the days of long ago when a young man named Charles Bailey made it his life's ambition to cater to the health needs of the residents of Hampton and surrounding towns.

When discussing their expectations and dreams for this new extension of Exeter Health Resources, Kelly and Falk mention the word "community" repeatedly. While one obvious objective will be to treat and maintain the health of individual patients, a more encompassing aim soon becomes clear as the doctors discuss what the Bailey Medical Building's role will be in Hampton: To improve and enhance the health of the community as a whole. "The community supports the Exeter Hospital," explains Kelly. "We'd like to be able to give back to the community and make it more than just a place where you go, say, to get shots."

Dr. Kelly explains that that commitment to the community will be demonstrated in several ways, which include providing expanded hours, less wait for an appointment, community education, increased diagnostic services, and specialty services.

One way to improve the health care of the general population, Kelly says, is simply to make it more convenient for the patient to get an appointment. "If we have this new building and we've got space, people won't have to wait so long to see you. It's very aggravating when people call in and you have to say, 'Yes, I can see you. How's the 4th of July?' It's kind of discouraging. When I want to see my doctor, I want to be able to see her this century. And that's part of our goal for what we can do over there."

As Kelly sees it, another way to increase health care accessibility is to provide more extensive hours of operation. "A lot of times the people who come in to see me for health care are working people," she says. "They had to take time off from work to come see me. We will have expanded evening and weekend hours to make it easier for people to get health care and not have to take a vacation to go to the doctor. And if I can then say, 'Okay, your mammogram is half an hour after your appointment with me,' then they don't have to take another day off from work to come and do this."

Providing on-site access to specialty services is also on the agenda for the Bailey Medical Building. Dr. Kelly explains. "We are going to have specialty services in the building, too, and try to turn health care into a one-stop shopping approach. So if I tell you that you have a bunion and you're a runner, we really need to give you an insert for your running shoes so that you can prolong your running career and not have foot pain when you run. I'd like to be able to say, 'Why don't you go to the next room and see the podiatrist?' We will be offering specialty clinics in an effort to meet the needs of the community and to support our mission as a comprehensive health center for Hampton.

Dr. Falk agrees. "There's some hope for having specialists rotate through, specialists that would fit in, coming down to Hampton once or twice a week, orthopedics, neurology."

But, Falk emphasizes, the focus is clearly on the elementary factors of health care provision. "My focus is really to build the primary care unit -- a good team of doctors, providers, nursing staff, and an administrative staff to do a really good job."

"We'd like to have the building be a place where we can serve the community in more than one way," says Kelly. "It won't just be a place where you go to see a doctor. We're trying to arrange to have an education space so that we could, for example, have an evening a month where we do community education about how to do a breast examination, or what sort of cancer screenings may be appropriate based on what your age and sex are, or how do you translate lowering your cholesterol into your actual lifestyle since most of us have fast-food as part of that lifestyle. We'd like to have some kind of community education so that if we're not having doctors' hours, well, then, this won't be just a totally empty building that's occupying space in the landscape. It would be nice if there could be AA meetings or nutrition classes or some other sort of forum where the community could use the building."

The doctors themselves hope to become involved in teaching some type of class or seminar in the Bailey Medical Building. "Some of us have spent time staying at the teaching hospital we trained at in order to do some teaching ourselves," Dr. Falk reveals. "And that's a lot of fun. So when we go forward into this new building, Kate and I want to integrate some of that teaching into this experience, as well."

Dr. Kelly enthusiastically agrees, saying, "I'd like to have a day every month or every couple of weeks where I could do a lecture for the community, a format where you can give people the information they want. Women have a lot of questions about health care. There's so much new information about the differences in being a woman versus being a man in terms of health care. Do I have to live my life differently in order to be healthy?

"I go to school a lot and I come back all excited about what I learned, and I want to pass that along to my patients.''

When the Bailey Medical Building opens this spring, Dr. Kelly, Dr. Falk, and the rest of the staff need only look to the name above the front door for inspiration. As Exeter Health Resources pays tribute to Dr. Charles Bailey, Hampton can look forward to a continuation of the tradition of community-based health care that was so much a part of this extraordinary man's life.

"Whenever you say the name 'Dr. Bailey,"' says Kelly, "people smile. That's a nice legacy to have."

As the story goes, Dr. Charles Bailey met his future wife, Virginia Carpenter, while working at the University of Vermont Medical School Hospital. The former Miss Carpenter was training to be a nurse at the hospital when they literally bumped into each other. "I was coming out of the bedpan closet," admits Mrs. Bailey, "and I bumped into him with a nice hot bedpan. It was just out of the sterilizer." Mrs. Bailey chuckles at the memory. "He was an orderly at that time, earning some of his way through college."

They went on to date for two years and then spent 61 years together as man and wife, until his death just a year ago. "I was real lucky," says Mrs. Bailey.

In 1939, the Baileys moved to Hampton and started up their medical practice, with Mrs. Bailey helping out as nurse whenever the doctor needed a hand. A few years later, in 1942, Dr. Bailey joined the Navy.

"All the while he was at the Navy yard," says his wife, "he was so upset. He said he sat there with nothing to do hardly, and thinking of all the patients he could be seeing at home. So as soon as he could get out of there, he'd come home and have office hours until 11 or 12 o'clock at night. Because there was nobody to see people. He'd make house calls on the way in and on the way out. That went on for quite a while."

His practice had become such a vital part of the community that in 1944 his patients mounted a petition for his discharge, which was, in fact, granted by the Navy just as he was about to be shipped overseas.

So what kind of man inspires such loyal devotion from his community? Well, if you ask those who knew him best, it's easy to see why his patients thought the world of their doctor. "He had a real knack of straightening things out, of making things right," his widow explains. "He was a great guy.

For 14 years, Dr. and Mrs. Bailey lived in Hampton on a road that led to the beach -- the only road at the time that led to the beach. "We got everything," says Mrs. Bailey. "The police would head for the hospital, and when it was an emergency, [they would] stop at our house. Many times the police would call and say they'd give him a police escort to the hospital."

Eventually, as the traffic on their street became a problem, the Baileys moved to Hampton Falls, buying a home that they would live in for the next 35 years. From this new address, Dr. Bailey continued to concentrate on the health care concerns of his community.

There are plenty of Dr. Bailey stories out there, if you just know who to ask. Take the one about the woman in Greenland who went into labor during a blizzard. Because of the snow, most of the roads were impassable. Dr. Bailey arrived. He walked into her house wearing his snowshoes, strapped her to a toboggan, and helped drag her through the storm to the hospital.

"He did a lot of stuff like that," Mrs. Bailey confirms.

And as if anyone needed evidence of the community's affection for their physician of over 40 years, Mrs. Bailey possesses innumerable letters written in appreciation of the services provided by her husband and in celebration of the friendships that had been formed during those years.

One such letter, addressed to his widow, reads: "I'll never forget the first visit I made to him when I suspected that I was pregnant with my daughter. My husband and I were in the hospital waiting. We waited quite a while, but Dr. Bailey finally came in. He was wearing rubber boots and apologized for keeping us waiting. He explained that one of the sheep had been having a difficult birth and needed help. To me, that was the essence of Dr. Bailey. No matter who needed help, he gave it... and while I'm sure [the long hours] often made life difficult for you and your children, those of us whom he treated will always remember him with deep gratitude and affection."

Another letter, this one written by a doctor, states: "I will always have fond memories of Charlie for his wonderful abilities to tell fascinating stories because of his warm personality, and most importantly, he meant so much to me when I first came to Exeter because he was so kind to me."

"I have so many like that," Mrs. Bailey acknowledges. "He would always look after [the new doctors], like a mother hen, or a father hen."

While it is clear that the Baileys did not have an excess of free time on their hands, they did manage to take three weeks each year in order to indulge their appetite for adventure and exploration. From Antarctica to Russia to Hong Kong to Africa, the Baileys virtually saw it all.

"He had all these places that he'd read about that he wanted to go to," says Mrs. Bailey, "so I'd go."

"He read everything," she continues. "You could ask him about anything, and he could tell you. If he couldn't, he'd know shortly; he'd find out. That's the way he was. The kids used to call him up from school to ask him questions about some strange country they wanted to know about."

Dr. Charles Bailey was the first official Chief of Staff of Exeter Hospital. To his wife's estimation, he delivered close to 2,500 babies. He made house calls, many of them gratuitous, and he loved his community as much as it loved him. Exeter Health Resources could not have chosen a more inspiring name to hang the reputation of its new medical facility on as they continue the legacy of community-based health care in Hampton.

"I do find that people will say that they are more comfortable with one person versus another," says Dr. Ralph Falk. "I know guys seem to have more trouble going to a woman to take care of primary care issues; but that's changing. I have a lot of guys that are my patients that are very comfortable now, after a little lead-in, a little hand-off time, with seeing women providers, either a nurse practitioner that had worked with me for a while or my physician assistant student or nurse practitioner student. No problem. I think that the apprehension has drifted way down. But having the option [to see either a male or female doctor] is nice."

Dr. Kathleen Kelly believes that women, likewise, prefer to deal with female doctors. As she sees it, "I think there's a strong gender preference in this community. A lot of women want to see a woman. They want to be able to have their physical and their Pap smear at the same time."

Kelly talks about some of the other advantages, as well. "The great thing about having your doctor be a woman is that you don't then have to wait until the chaperone is available to come into the room with the male doctor to do the gynecology part of the exam, which is an important factor. Anything that makes my patients have less delay in their encounter with me, makes them feel less intruded upon in their encounter with me, and makes them realize that I'm trying to pay as much attention to them as I can, then that's a good thing.

"Some people feel that women doctors ask more probing questions. And some people feel that men cut to the chase better. That's a style issue. And if we can offer both styles, then all the better."

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