Doctor Laurie Green delivers—and more
If Dr. Laurie Green had her own reality show, the title, no doubt, would be Married to Medicine. (And, yes, to all you Bravo TV watchers: I’m aware a show with this title already exists.) The day I sat down with Dr. Green in her sunny yellow office, she was coming off a 26-hour stint seeing patients at her practice and doing an overnight shift at California Pacific Medical Center—not an atypical day for this hard-driving, Harvard-educated OB/GYN.
For more than 35 years, Dr. Green has been taking care of Bay Area women and delivering their babies—now she delivers babies of babies she delivered, making her a self-described “grand-doctor.” Her practice is thriving, and her energy is infectious. She’s the president and CEO of the MAVEN Project, a nonprofit she founded when she ran the Harvard Medical School Alumni Association. Her goal for MAVEN, which taps retired doctors to provide free medical advice for patients in underserved areas, is to harness the valuable expertise of veteran physicians—a cause that fuels her drive to do good.
Meet this extraordinary MD—perhaps she delivered your child, grandchild, maybe even YOU!
I have known you for more than 20 years and I have seen how dedicated you are to your patients and practice—often at the expense of vacations and personal time. Where does this unwavering dedication come from?
When I first got into medical school, there were only 29 women in my class of 165. In the interview process, things were asked of me that would never be accepted today. They would say, “And how are you going to justify that you’re taking a place in this medical school class that could be occupied by a man?” And so, from the very outset, I think women had to really have motivation and purpose and drive to even become physicians.
Then, there’s that old saying that you make a life by what you give, and you make a living by what you get. Working in medicine, you never have to think about why you got up in the morning. You come home and feel like you’ve made a difference. I mean, that’s happiness.
Why did you decide to get into OB/GYN? Oh, God, that’s such a crazy story. So, when I started, there were very few women—like none in the field. In Boston, it was the field you went into if you couldn’t get a residency in general surgery. There was only one board-certified OB/GYN for all of Harvard University, and I went to see him [about some medical issues].
I started asking him about cramps, menstrual cramps. He handed me an article he’d written that said 50 to 75 percent of women with cramps, it’s in their head. And he wrote in my medical record that “with this kind of dysmenorrhea”—which is the medical term for cramps—he was not confident he would be “able to help this attractive youngster receive her M.D. degree.” That was in 1971.
So, that sort of gave me this insight and I realized two things: One was that I didn’t have to be that brilliant to be able to make a contribution in this particular field. It was a nascent field, with so much room for changing the dialogue. And then, having gone through a lot of medical issues myself, I think that helped. When you’ve been through some of these conditions while on the other side of the table as a patient, it really helps inform the way you treat patients and gives you an insight that male doctors may not be able to gain.
Almost 30 years ago, you and Dr. Joanne Hom founded the Pacific Women’s OB/GYN Medical Group. Tell me about those early days.There weren’t any women-only groups at the time in San Francisco and women were looking to have women doctors in this specialty, in particular, so we thought we would be able to fill a need.
What were some of the challenges you faced in starting the practice? Oh, gosh, starting a business, knowing nothing about business and having two kids under the age of 20 months. …
Getting a loan was a problem, because at that point with women-owned businesses, there was a lot of skepticism about success. But, in a way, we’re lucky in this specialty. It’s not like women trying to sit at the table, and all that stuff about women being talked over. We’re not sitting at the table with 19 men. This is probably one profession—one sliver of one profession—where you actually do kind of have an advantage by being female.
How has the practice of medicine changed over the course of your career? When I first started, I think doctors had a lot more autonomy and there was more time to spend with patients. And so you really got to know people, communities were quite a bit tighter-knit, and doctors were felt to be pivotal members of a family. As time has passed in the field of medicine in general, there are so many middlemen that kind of grab their piece of the action. And so now, medicine is so bureaucratic and corporatized that we feel like vendors.
In this new reality of medicine, how do you create community and get back to connecting with your patients? Well, I’m in a fulfilling specialty, so I’m really lucky. I think getting to know people and caring more about them as individuals is really interesting. That’s what we do in obstetrics. We take someone on for nine months and we’ll be by her side. It’s a huge life change. Imagine just being there for people at this time where not only does their personal life change in a profound way, but physiologically too. Birth is this overwhelming change of life, and to get to help someone through that is really wonderful. The community part, I think, comes from caring and getting joy out of that.
How many babies do you think you’ve delivered? Oh, I know. I have a table of all the deliveries from 2003 on. I had 7,000. I started delivering in 1981, so I’m probably up to about 17,000, something like that.
Wow, that’s a lot of babies. And every delivery must be different, of course. Well, what’s changed so much is the demographic. When I first started delivering babies, there was no IVF. When I went to Kaiser Honolulu on rotation, I was the only doctor in the hospital at night with a nurse and I probably had nine months of obstetrics experience. Your phone would ring, and they’d say, “Come get the baby.” Plop. I mean, nothing bad ever happened—I never saw postpartum hemorrhage—babies just got out. And I remember thinking that obstetrics would be a high-touch area, but very low in professional challenge. I thought, God, I have to really drink up the personal relations because the difficult professional challenge is just not going to be in this field. And then, 1978 was the first IVF baby.
And that’s when things really started to change? Yes. Just last week, I delivered a 50-year-old and a 44-year-old, and what’s come along with that is a lot more risk, a lot more pregnancy and delivery complications. It’s gone from being the kind of sleepwalk through the technical part of your profession to being an incredible challenge. And that isn’t to say that tons of people don’t have wonderful, unmedicated, easy deliveries. … It’s great we’ve pushed back the biological clock, which again is leveling the playing field of parenthood for women, not just men. But along with it has come a lot of challenge.
Meanwhile, there’s a huge national debate about healthcare. What do you think are some of the biggest challenges that need to be addressed? There are a lot of elements. You know, drugs are unconscionably expensive, and that’s a huge line item that outstrips other countries. Devices fall into the same category. Hospitals are under such regulation, which in some ways is appropriate, but there’s a massive administrative burden in medicine today, and a lot of money is going in the wrong direction…
And, in this country, physicians graduate from medical school usually $100,000 to $200,000 in debt. I think recruitment in major metropolitan areas will be as difficult as recruitment in the rural areas in the very near term, unless something is done about the cost of medical education.
Four years ago, you started a nonprofit called the MAVEN Project that recruits retired doctors as volunteers who give pro bono medical attention to patients who lack access to healthcare. What was your inspiration? It sort of came at the time when a lot of doctors were retiring. And what’s remarkable is that when you retire from a medical career, you lose this purpose we’ve talked about. You lose standing, you become invisible. And yet, you’ve got this wisdom, you’ve got this wealth of knowledge because so much about caring for patients is not what you’ve read—it’s what you’ve learned through experience. The other thing was the Affordable Care Act was coming online in 2014, when I was president of the Harvard Medical Alumni Association. We knew that a lot of people would be given coverage, but that they would have terrible access problems—they’d be getting tickets but there’d be no room in the tent.
And, telemedicine was finally coming into its own. We had this opportunity in that there was this untapped workforce of physicians who wanted to have engaging experiences, wanted to remain relevant. Being a little bit conservative, doctors just don’t do a Google search for “Where can I volunteer?” But these opportunities could be curated through an alumni association they trusted. And then you had technology to join the two, and this is how this idea came to fruition.
Who is your target audience for the program? Right now, we’re in Massachusetts, California and Florida. We’re targeting areas where there are big problems with access to specialty care. So long as you’ve got an Internet connection and a cell phone, you can do it. We have a responsibility to the community that’s greater than just our neighbors and the people we know in our own little areas. It’s a community of people who are working hard and are not as fortunate, not as privileged, and this is a basic need. Healthcare is a basic need.
So how do you recharge your batteries? What do you do for fun? This. MAVEN. I deliver babies for fun.
When’s the last time you took a vacation? 2000.
It’s 2017, Dr. Green. It’s time. I’m such a loser. I take Thursday nights all night in the hospital. So I get home, and there’s the Wall Street Journal with the mansion section. And the New England Journal of Medicine is there, and you know which one I read? It’s awful. I read the New England Journal. I could be reading the movie reviews in the Wall Street Journal. And I think to myself, This is so pathetic.
Anything else you’d like to add? I don’t know. If I had gotten more than two hours of sleep last night, I’d probably be better at this.
For more information on the MAVEN Project, visit www.mavenproject.org.