AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. July 2002, Volume 4, Number 7.

Profile of a Role Model

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The Non-Entitlement Principle: Garth Graham, MD

Garth Graham, who emigrated from Jamaica and became a physician-activist, is profiled for being a role model and an entrepreneur in the field of HIV/AIDS medicine.

Susanna Smith

The thousands of people who immigrate to the United States every year in search of opportunity face the hardships of navigating in a foreign culture and establishing a new life. It is the children of these immigrants who often reap the rewards, integrating themselves more readily, and benefiting from the American education system.

For Garth Graham, MD, recipient of an AMA Foundation 2002 Leadership Award, the work ethic his parents instilled in him through example drove him to succeed in the medical field.

"My parents emigrated from Jamaica," Dr. Graham explains in a gentle Caribbean accent. "They had to work very hard when they came to this country. Seeing them putting that amount of effort into sustaining our family and giving us the resources to reach our goals, inspired us to work twice as hard to reach those goals. It is the non-entitlement principle."

"Parental role models are the most practical kind of role models," Dr. Graham seems to be realizing the thought as he formulates the words. "They are not heroes, but rather real people you can actually pattern your life from."

Perhaps it was seeing the sacrifices his parents made for him while he was growing up that drove Dr. Graham into a profession that requires him to make constant self-sacrifice.

"When you are a resident you have less time to be physically active, participate in sports, educate yourself about non-medical issues. I have difficulty finding the balance between clinical and patient responsibilities and personal responsibilities like spending time with people who are not medically related."

But if you are lucky enough to be a person who is "medically related" to Dr. Graham, then you are spending time with a man who has been recognized not only for his leadership and community service but also for his innovation.

While in medical school at Yale University Dr. Graham became involved in the New Haven Mayor's Task Force on AIDS public policy committee.

"The mayor noticed that there was a significant impact on the public health system by those affected by AIDS/HIV," Graham says. " As a member of the committee of public policy I became an advocate for legislation at the state level to maintain the funding for existing programs for HIV patients."

Graham's work with HIV patients led to the establishment of a company called Medicompliance, aimed at developing a communication system to improve medical compliance through a reminder system directed at HIV/AIDS patients.

"I was taking a class where we had to develop a venture as an assignment of the class. I met two other guys in the class, one a lawyer, and another working in the pharmaceutical company; we thought this would be a good idea," Dr. Graham explains. "I had done a lot of work with HIV and AIDS patients so I knew the regimen, the 16 to 20 medications they can be required to take a day, some with food, others on an empty stomach. I knew the difficulties associated with the regimen, and the system [we designed] aimed at increasing patient compliance with their medication regimen."

In an annual Yale entrepreneurship competition Dr. Graham, along with his partners, won initial startup funding for the company, which he cites as one of his greatest accomplishments.

"I was most proud of this accomplishment as it was one of the first African-American-led companies to win a prize in this annual competition," he comments.

While at Yale, Dr. Graham also started the Yale chapter of Physicians for Human Rights (PHR), which later grew into a larger overseeing body known as the Health and Human Rights Committee.

"At Yale we organized a number of talks and speaker series from local and international experts in the field of health and human rights in an effort to educate the Yale community on the important issues occurring in the field," Graham says. "We assembled an energetic group of individuals that were committed to the cause and attempted to mobilize the student population around the many problems affecting marginalized populations around the world."

PHR's Board of Directors recognized Dr. Graham's early work in the human rights field with a nomination to the board as the student resident representative of PHR, a position that he currently holds. In this capacity, Dr. Graham was one of the youngest people to serve on the board of directors of PHR, an organization that shared the 1997 Nobel Peace Prize.

Now working in Massachusetts as a resident in internal medicine at the Massachusetts General Hospital, Dr. Graham serves on the Massachusetts Medical Society (MMS) Executive Public Health Council. He advocates for MMS's priorities at the state level.

"We pick a few issues of public health, such as this year, obesity, violence, and bioterrorism, and then bring them to the General Council for MSS to focus funding on," Dr. Graham explains.

Even with all his work in the public policy side of medicine, Dr. Graham still recognizes the need for compassionate and individualized patient care.

"You have to take each patient as a single patient with a pathology," Dr. Graham suggests. "When I see Mr. Jones, he is not a diabetic patient, he is Mr. Jones who has diabetes. Medical students learn a lot about pathology and physiology but they have to develop their own method of seeing patients as people by interviewing each patient."

When asked how someone like himself, who has accomplished so much, can be a realistic role model for other students and health professionals, Dr. Graham responds, "Personally I don't believe I have accomplished a lot as yet; there are still so many things I would like to do. But as far as the work I have done so far, I would say anyone is capable of reaching their goals as long as they are willing to put the time and the energy behind what they believe in, and be able to think outside of the box."

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