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Several years ago, Dr. James Bailey was among leaders in Memphis who set out to reverse the city’s upward trend in diabetes and obesity. They posed a deadline which, as it turns out, has crept up rather quickly: 2008.

“We set this big, hairy, audacious goal knowing that to change the tide was going to be very hard,” said Bailey, M.K. Callison Professor of Medicine at University of Tennessee Health Science Center and founding chair of Healthy Memphis Common Table.

This collaborative nonprofit group of business leaders, healthcare professionals and community representatives has since had success in engaging community dialogue, sponsoring health and healthcare improvement projects and compiling local resources for healthy living on a Web site, www.healthymemphis.org.

Although the group is hopeful that the rising trends are beginning to level off, the goal of truly reversing them has so far proven elusive. In the end, Bailey said, it means nothing less than changing an entire culture — a task as urgent as it is daunting.

“One thing that gives me real hope is when people do see the problem and are eager for answers,” he said, recalling a 2006 town meeting co-hosted by Shaping America’s Youth®. The event drew about 1,000 people to the Cook Convention Center.

“There was overwhelming support for more physical education in the schools, and we’ve also had the vending-machine legislation to get junk food out of the schools,” he said. “Those are small but important steps.”

The desire to apply his efforts where they would best produce positive change for people is what drew Bailey to medicine in the first place, by way of initial studies in public health. A native of Tuscaloosa, Ala., he completed his undergraduate work at St. John’s College before heading to the University of Alabama for medical school and a master’s degree in public health.

“I had thought that I might work in public health as a primary focus,” he said. “But when I did my clinical rotations, I just loved the personal interaction with patients.

“I really loved being a doctor, and I found that internal medicine exemplified what I thought of as being a doctor more than any other specialty.”

Searching out the best program in his chosen field, Bailey completed a residency in internal medicine at the University of Washington’s Providence Medical Center in Seattle. He stayed on an additional year there as chief resident and moved to Memphis in 1994.

Today, in addition to teaching medical students and residents, he spends two half-days a week in clinic, and two to three months per year on hospital duties at Regional Medical Center. Moving away from the old academic model where attending doctors didn’t always know their patients, Bailey and his UT Medical Group Inc. colleagues each have a panel of patients they know, and work with residents to give them the best possible care.

“In working with the university and I’ve been lucky enough to continue caring for sick people and practicing primary-care internal medicine, while also working with young doctors, and doing research and community outreach,” he said. “For me, variety is the spice of life, and I really get that in my daily work here.”

Typically, his days outside the clinic and classroom are spent meeting with colleagues for ongoing research and quality-improvement projects, or writing grant proposals and papers.

His current research is focused on the area of health literacy — finding ways to help patients understand the most important things they can do for their health and what they should expect from their doctors.

With the Healthy Memphis Common Table and other community partners, Bailey is among leaders implementing a grant from the Robert Wood Johnson Foundation. As part of the foundation’s program, “Aligning Forces for Quality: The Regional Market Project,” the goal is engaging consumers, providers and payers in improving the quality of outpatient care through public reporting and public education about what patients should expect.

“My perspective is that patients are generally in the dark about the most important things they should get from their doctor,” Bailey said.

A complementary goal for the Common Table group alongside local partners has been the Memphis Quality Initiative, which aims to develop citywide, noncompetitive quality-improvement initiatives.

At the heart of the effort, though, remains the Common Table’s first initiative — that of reversing the rising number of patients with diabetes and obesity. Even if the rate of increase is slowing down, obesity remains the “biggest plague of our generation,” Bailey said.

“We’re at a point where more than two-thirds of people in the Memphis area are overweight or obese,” he said. “It’s the norm now to be sick.”

Since the local collaborative began focusing its attention on this issue, more than 30 projects have spun off through partner organizations in businesses, schools, hospitals and the local media.

“We’re a city of real volunteers,” Bailey said. “It’s given me confidence to see how many people and organizations are trying to make healthier living a part of their business.”

Still, he said, governments have not yet really gotten on board with the concept.

Locally, Bailey said, priority should be given to city planning strategies that give people access to safe routes for walking and riding bicycles. At the federal level, he said, research funding through the National Institutes of Health should focus more on how to combat the trend in diabetes and obesity through providing the most effective care — not just developing new tests and medications.

“What’s come to the fore in the last five or 10 years is that all these diseases we used to think of as separate diseases — diabetes, hypertension, high cholesterol — are all connected by one inflammatory metabolic state, caused by inactivity and unhealthy eating,” Bailey said.

“A lot of research funding goes to drugs, and yet we know that drugs will only provide a small, incremental improvement. At the same time, we have proven approaches in prevention that are not being applied.”

At home, Bailey and his wife Sharon, an attorney, are parents to Claire, 17, and Spence, 12. As a family, they enjoy traveling, backpacking and other outdoor activities.



January 2008

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