A closer look: Putting the puzzle pieces together

Vital Signs » Spring 2014
photo of Dean Marjorie Bowman and Boonshoft School of Medicine students

When Marjorie Bowman, M.D., M.P.A., became dean of the Boonshoft School of Medicine on October 1, 2012, she brought with her years of experience serving at some of the premier medical schools in America. But her inspiration to enter medicine, her dedication to hard work, and her natural inquisitiveness came from her earliest days growing up on a farm.

As a former farm girl, Marjorie Bowman is used to hard work. But what some may consider the drudgery of farm life, inspired in Bowman a natural curiosity about the world around her, an overriding desire to make a difference, and a common sense approach to medical care.

She grew up on a dairy farm in western Pennsylvania, surrounded by her extended family. “Being a dairy farm,” she said, “we all worked.”

Although she wasn’t an outstanding student in elementary school, she started to shine in middle and high school. “I did very well academically, and living on the farm, I was a very curious kid,” she said.

Her curiosity led her to keep a colony of rats in the basement of her home for research. Supported and encouraged by her high school science teacher and her family’s veterinarian, she began studying an anti-diabetic drug that gained attention statewide.

“I presented a lot across the state and won a fair number of awards for my research when I was in high school,” she said. As a result, she was asked to visit schools and enter science fairs to discuss her research.

As a country kid, she never felt like she was part of the “in” crowd in high school. But rather than let it get her down, it motivated her even more to excel. She played softball, ran track and field, competed in gymnastics, and was a cheerleader.

“I tried being on the basketball team one year, but that was really stupid,” said the petite Bowman, who barely tops five feet tall. She was also class valedictorian.

A decision to enter medical school

When she was exploring options after high school, she considered research, “but it didn’t have enough people interaction to suit me.”

“I didn’t know you could become an M.D./ Ph.D.,” she said. “If I had been introduced to that type of joint degree early on, I might have done that.”

She didn’t have much experience with the medical field growing up. “My mother always said she was against medical care, and I think actually some of it was just the finances,” she said. “They didn’t have the money, and health care costs money.

“I believe I saw doctors maybe twice before I graduated from high school,” she said. “But the doctor was wonderful to us. My mother would call, and he would give her answers as much as he could over the phone.”

What piqued her interest in medicine was her experience with the vet when he came to care for the farm animals.

“I once helped him deliver this calf that had a huge deformity,” she said. “We had to use chains to pull this calf out, and we thought we were going to lose the cow.” They managed to save the cow, but the calf didn’t fare as well.

“I wanted to do something that would help people, that would keep me intellectually stimulated,” she said, “and I didn’t want to be bored. So that’s how I decided to go into medicine.”

College and medical school in five years

She applied to an accelerated five-year program at Pennsylvania State University and got in. “So that helped seal the deal,” she said.

She entered the Penn State-Jefferson Premedical-Medical Program in 1971 and graduated with an M.D. from the Jefferson Medical College five years later.

Bowman remained as active as ever in college. She worked 20 hours a week in a lab from her second through fourth years of medical school. She became a master bridge player and a member of Alpha Omega Alpha, the national medical honor society.

She also joined the 1961 Society at Jefferson. “At first I didn’t know what the 1961 Society was,” she said. “But 1961 was the year that Jefferson admitted women after being cited by the Surgeon General’s Bane report as the last medical college in the U.S. to admit women. And it’s just sad to say that was during my lifetime.”

She thrived in medical school, and worked in a medical lab to help support herself. “I got to do a ton of stuff I would never be allowed to do today,” she said. “We had a supervisor, but we did all the CBCs, the urines, the chemistries for the hospital,” she said. “I didn’t even have a bachelor’s degree at that point.”

She credits her upbringing on the farm for her success in her surgery rotation.

“I sewed all my own clothes when I was in high school because I didn’t have any money,” she said. “I did surgery on the cows and the rats. Surgery was easy.”

The oral exams in surgery were a different matter. She recommended a lumpectomy rather than a total mastectomy for a woman with upper outer quadrant breast tumor with negative nodes. “As soon as I got out of there, I thought, ‘This is probably not what I should have said.’” She was sure she’d blown her chances because the physician who pioneered the radical mastectomy procedure was the chair of surgery at Jefferson.

Her fellow students told her she was sure to fail. Instead, she earned an A for the rotation. “They probably liked that I had paid attention, looked it up, was thinking about it,” she said. “I said what I believed, I read up on it, and I just thought there’s another way to look at this.” Since then, the more conservative procedure has become much more the norm.

She considered going into surgery, but, “I couldn’t stand not dealing with the whole person.” She finally decided on family medicine, “because I believed in prevention, liked psychology, and wanted to deal with people over the long term.”

Residency at age 22

Due to the accelerated program at Jefferson, she started her residency when she was 22. “I was so young,” she said. “I tried to dress like I wasn’t. I thought I was dressing older, but when I look back, I really wasn’t.”

Bowman went to Duke University for her residency. “I wanted to choose a good residency—one where you had a lot of options afterwards,” she said. So she looked at what the graduates were doing and was impressed.

Like many residencies, hers was sink or swim. “On my first day as an intern, I had 12 admissions out of the emergency room, and mind you, this is how many doctors were around besides me—zero. Zero,” she said. “You were just thrown to it in a way we don’t do now. It was the way it was. We didn’t think twice about it.”

As a resident she published research she conducted on setting up a computerized documentation system for all the residents in North Carolina. She also became president of the North Carolina Resident Society, and national resident representative for the American Medical Association and the American Academy of Family Physicians.

After her residency, she was looking for something different. She decided to join the U.S. Public Health Services as a medical officer in Hyattsville, Maryland, which did grants and contracts related to primary care. At the age of 28, she became director of the office of graduate medical education.

She still found enough time to play adult women’s soccer and earn a Master of Public Administration degree from the University of Southern California, which she found helpful in understanding politics and regulations. She also served as the federal representative on the ACGME, LCME, and National Resident Matching Program. “I’ve always been kind of high energy,” she said.

As a commissioned officer, she worked on one of the large graduate medical education studies run out of what is now the Centers for Medicare and Medicaid Services (CMS).

Her work resulted in a change to a Medicare regulation that required medical schools to return Medicare money if they received federal grants. That single change in regulation has saved medical schools millions of dollars.

“It didn’t make any sense,” she said. “Why would schools take a grant if they then have that amount withheld from their Medicare money?” she said. “It took a long time to get that changed.”

Although she enjoyed her time in the Public Health Services, she was ready to move on. She wanted to have a wider impact.

Making a difference in academic medicine

She considered her options and decided she could have the most impact in academic medicine and teaching the next generation of physicians. “Plus, I had that academic bent,” she said. “So I ended up in academics and stayed here ever since.”

She was interested in the dean of students position at Georgetown University School of Medicine, but it didn’t work out. But the dean at the time liked her and a year later hired her as assistant dean for Continuing Medical Education. He asked her to move to Washington, D.C., and serve as his liaison for the D.C. government. Within a year she became the residency director for family practice, and then director of the Division of Family Practice.

She also did research related to the HIV epidemic, which was just beginning to be understood. At the time, doctors were often uncomfortable asking patients about their sexual practices. Questions about the number of sexual partners, condom use, and HIV testing weren’t routinely asked. She collaborated with a colleague to research a way to retrain doctors in the new era of HIV.

She came up with a standardized patient intervention and conducted both blinded and non-blinded studies. The researchers found it was beneficial to have the doctors practice asking the questions of standardized patients. “They have to practice,” she said. “You can tell them all you want, but until they’ve said this to a standardized patient, it could be really hard to say these things to a real patient.” The National Institute on Allergy and Infectious Diseases (NIAID) funded it on the first round, and she published papers on it in several journals.

She decided to become a department chair while she was at Georgetown. One week she got called by three places about department chair positions, including a call from her former dean who tried to recruit her as chair at the school where he worked after leaving Georgetown.

She ended up deciding on the Bowman Gray School of Medicine at Wake Forest University, where she served as professor and chair of the Department of Family Medicine and Community Medicine for 10 years. She was 33 years old.

“I knew I was young, but I just went ahead and did it,” she said.

From Wake Forest, she went to the University of Pennsylvania to start the Department of Family Medicine, where she stayed for 16 years. As the first female clinical chair at the University of Pennsylvania medical school, she served as professor and founding chair of the Department of Family Medicine and Community Health in the Perelman School of Medicine, and director of the university’s Center for Public Health Initiatives.

After serving three six-year terms as department chair, her time as chair at Penn was coming to an end. She had already exceeded the school’s two-term limit, when her third term was made possible by a special presidential committee.

She was interested in deanships and looked at several positions nationwide. A friend suggested that she consider a newer medical school. When the deanship at the Boonshoft School of Medicine opened up in late 2011 it seemed like a good fit. “I liked the place, it had similar goals to mine. I was ready to leave Penn,” she said.

Sixth dean of the Wright State University Boonshoft School of Medicine

Bowman expects to see big changes in the delivery of health care in the United States. “I think we are in a time of change, and there could be very large upheavals in how medical care is provided and where the doctor’s role fits in that,” she said. “So things will be different. Some feel that means physicians will lose power. I think much more of what we do will require intense team work.”

As dean of the Boonshoft School of Medicine, Bowman wants to build a medical school that will flourish in a time of rapid change. “We may feel uncertain along the way,” she said of the path ahead. “We’re going to take some risks that may not pan out and we’ll take some risks that will. That’s who we are.

“We’re going to keep our eye on the goal of providing good community service with people who are excellent, thinking clinicians who know how to work well in teams,” she said. “Everybody is a part of making medical care a success.

“But I don’t think that will ever take away the need for the doctor/patient relationship,” she said. “I think sometimes we get away from that, but it’s still important, even with the changes that are occurring.”

Fostering inquisitiveness builds better doctors

She believes in the school’s basic values of providing excellent care for the community while advancing its research and academic enterprises. “I personally think that the best clinicians still think like researchers,” she said. “We need to be thinking about what we’re doing. Why is it like this? How could it be better? What could we do?”

Bowman believes that people with a natural inquisitiveness and lifelong curiosity make better doctors. “You can never learn everything in medical school, you have to have a thirst for knowledge that persists forever,” she said. “I think the worst doctors are the people who don’t think.”

That natural inquisitiveness should also extend to interpreting research. “You have to have enough of a critical eye for research to realize that some of it’s not good, and that you shouldn’t rely on it,” she said. Research findings can change, and “you also have to look at the lived experiences of people.”

She feels the Boonshoft School of Medicine instills and nurtures curiosity in its students. “I love the fact that we’re very intent on helping our students interact with people and understand the need for lifelong learning,” she said. “Because I think that’s a lot of the guts of medicine.”

Increasing access to medical care

Growing up in a rural environment, Bowman also sees the need for more rural health care providers. She believes it is not only important to provide students with experience in rural areas, but it also helps rural physicians with whom they rotate, “because docs learn from students.”

To that end, she is involved in helping to create the Wright Rural Health Initiative in the rural counties surrounding the Wright State University Lake Campus at Grand Lake St. Marys. The new program will expand the health profession pipelines that target underrepresented students, specifically students in rural areas and small towns.

Access to health care is something Bowman takes very seriously. “In sheer fairness and equity for people around the country, they all should have access to medical care,” she said. “I think we’re a school far more likely to make that happen.”

That’s one reason she’s so dedicated to service learning. “I believe in service-based learning. I believe in getting real-world experience,” she said.

Bowman is enthusiastic about the future of the Boonshoft School of Medicine. “Because we pay attention to who and what we are, we aren’t trapped by some of what large institutions have gotten trapped by,” she said. “We are a flexible school that will come out ahead.

“We will not always do exactly what we hoped to do,” she said. “We won’t get everybody out there into rural environments. But we will advance our research and try to embed it more into the every day lives of docs and their patients.”

Puzzling things out

Bowman is married to Robert Choplin, a radiologist. Their five children, “yours, mine and ours,” are all grown and out of the house. Up until the youngest left for college in 2012, she coached youth soccer every weekend. In her spare time, she bikes and enjoys tackling large jigsaw puzzles.

“My job is like that,” she said. “There are a lot of pieces out there, and they are all important. Trying to figure out, though, how they all fit and fit together and which color they bring to it is part of the fun.”

But truth be told, she admits she’s not very good at relaxing. “I’ve always got something else I want to do,” she said. “There is more to be done.” VS

—Cindy Young

Last edited on 04/18/2016.