West Tennessee physician tackles healthcare issues statewide
As President-Elect of the Tennessee Medical Association (TMA), West Tennessee's Dr. Ron Kirkland will be taking over an organization that has some significant momentum in its favor.
The physician's group, which last year was named most influential advocacy organization on Capitol Hill, recently saw passage of special-session legislation related to two key areas of concern: telemedicine and COVID liability.
"The insurance companies would not pay for telemedicine which allows patients the ease of remotely talking with their physician," said Kirkland, an otolaryngologist/head and neck surgeon who retired from The Jackson Clinic in 2015 after 31 years in practice. "Now the legislation requires them to pay for the service at the same rate as they would for a similar service in the office.
"It was on our plate before COVID, but we couldn't get anywhere. Then it was made necessary by COVID when we didn't want to have interpersonal contacts. Telemedicine is of great benefit to patients who don't have to drive to an office, sit in the waiting room, where they might get sick, and then drive back home. That's all eliminated with telemedicine. Of course, there are some things that require a face-to-face visit, but routine issues can be taken care of with telemedicine."
The second piece of legislation involved limiting liability for physicians, clinics, and hospitals that saw patients who later acquired COVID.
"They could bring suit and say you exposed them to COVID and you're liable for these damages," said Kirkland. "Now the law insists that there is grossly negligent behavior on the part of the physician, clinic, or hospital before they can be sued. That's a reasonable standard. Otherwise we'd be flooded with lawsuits."
But the new legislation says the grossly negligent standard only applies to suits that are filed after August 3, 2020. "So, there's still significant exposure," he said.
Kirkland is scheduled to succeed Dr. Kevin Smith of Nashville as TMA president in April of 2021, but there will still be plenty of issues to address on behalf of TMA.
"Another ongoing issue is the scope of practice regarding nurse practitioners, physician's assistants and others who, in our view, want to practice medicine without a medical license," Kirkland said. "They are essential to providing high-quality care to our patient population, but it's the position of the TMA that those professionals should work in collaboration with physicians who are available to help them in more difficult situations.
"It seems to me that it's not in the best interests of patients to have nurse practitioners and physicians assistants, who only have a small fraction of the training of physicians, making important decisions without the support of physicians. Before I retired, we had a wonderful nurse practitioner in our office who was very knowledgeable and she could do 99 percent of the office work I did, but she knew that I was there if she needed me and I knew she would call on me if she was in a situation where she was not comfortable."
Kirkland also would like to boost membership in TMA, whose 9,500 members represent about 60 percent of the state's licensed physicians. He has been a member since his medical school days and has been quite active the past 10 years.
His path into medicine was a circuitous one, though one marked by dogged persistence.
Kirkland entered the University of Tennessee at Knoxville as an engineering student, posting good grades before switching to pre-med. Then, while dealing with family issues, his study habits dissolved, he began skipping classes and by his junior year he was gone.
He was then "taken in" by UT-Martin, did well there for two years, spent a brief time in law school and then, with no more college deferment, enlisted in the Army.
"The recruiter suggested I go into military intelligence and said I would get to wear civilian clothes and I wouldn't have to go to Vietnam, so I said, 'Where do I sign?'" Kirkland recalled. "As it turned out, I went to Vietnam as a counterintelligence agent, but I did get to wear civilian clothes, so the recruiter was half right."
He was stationed in Nha Trang near Cam Ranh Bay, living in, and working out of two houses surrounded by concertina wire. His duties included making sure military units were handling classified documents properly, conducting background investigations on certain Army personnel, and conducting clandestine weekly debriefings of local confidential informants.
"My duties involved flying around the Central Highlands in helicopters and small airplanes," he said. "It could be risky, but I never had an incident that I knew about. It was kind of fun, as long as you didn't get shot."
Kirkland was discharged in 1971, worked a short time in a family-owned Ben Franklin Store, and then began to pursue medical school in earnest. He bulked up on upper division biology, chemistry and physical chemistry at UT Martin and graduate studies in molecular biology at Vanderbilt.
He was turned down twice for medical school before finally getting accepted on the third try to the University of Tennessee Health Science Center in Memphis. Kirkland, his wife of 52 years Carol, and their four children have some 10 academic degrees from the UT system from one side of the state to the other.
"I remember thinking when I got that medical degree in my hand, I'm going to be so smart," said Kirkland, who is a former president of the University of Tennessee National Alumni Association. "Then as I walked across the stage at the Mid-South Coliseum on graduation day, I was handed my degree and looked out at the audience and thought, 'Oh, no. I don't know anything.'
"I think every physician goes through that time period where they feel inadequate, but ultimately you build enough confidence and have enough training and experience that you feel you can handle just about anything. The most satisfying part of my career is having patients coming up to me years later and saying you did this operation or that operation and thanking me for doing good work. I think it's the relationships with the patients and the staff that I worked with that's been the most satisfying."