Knott County, Ky. has two things in abundance: coal and poverty—neither likely to attract sophisticated medical practitioners to the area. Thus, until 1973 the county could muster only two overworked doctors to care for its 20,000 inhabitants. Then two young sons of the mountains—Dr. Grady Stumbo and Benny Ray Bailey—opened the East Kentucky Health Services Center in tiny Hindman.
In the six years since, the clinic has become a model for some 250 other rural health centers around the nation. Stumbo, 33, a University of Kentucky-trained family physician, is the medical director. Bailey, 34, uses his Ohio University doctorate in administration to run the business side, where attention to the bottom line is informal at best. “We would like everybody to pay something,” Stumbo explains. “But if people can’t pay, we still treat them. Our business is to practice medicine.”
The nonprofit clinic faces some unique challenges—lung disease among miners, primarily—but most complaints, says Stumbo, are those “you see everywhere, like hypertension and cardiovascular disease.” “Obesity is common too,” adds Bailey. “You can’t cook anything in east Kentucky without two cups of pork fat.”
Preventive medicine and education are stressed. Observes Stumbo, “Our use of drugs in childbirth has dropped 75 percent since we’ve been educating mothers in the Lamaze method, and people aren’t asking for penicillin shots for colds anymore.”
The clinic’s annual budget is now $550,000—$549,947 more than Stumbo and Bailey had when they decided to open. It was an audacious move for coal miners’ sons. Stumbo’s father died early; his mother was a hospital cook. “We never knew we were poor,” he remembers. “We lived on what we raised and hunted game and sold it.”
Bailey’s parents divorced when he was 16, and in high school, he admits, “I was a bad student and got kicked out.” He once spent three days in jail for ripping up parking meters. Frightened by the experience, he had sense enough to enroll in Alice Lloyd College, a two-year privately supported school, in Pippa Passes, Ky. The basic tuition is a promise from students to return and work in Appalachia. Stumbo arrived at the school a year after Bailey and found that Bailey “was the godfather of the place. He always understood the politics of every situation.” That instinct helped when they went home to fulfill their promise.
Both men worked in government anti-poverty programs and learned fund raising from their own private community effort, which they set up as college students. Even so, finding clinic financing was difficult. “When you talk like we do,” drawls Bailey, “most people think of the typical hillbilly, the uneducated person they show on TV. They had no guarantee that we would not run away with the money.” Eventually, however, three foundations did chip in $625,000. Now fees make up 90 percent of the annual budget; the rest comes from contributions.
Stumbo draws $43,000 a year in salary from the clinic and says he never wants to leave. Bailey, who earns $24,-000, won a Democratic primary in May for state senator and is unopposed in the November election. But he vows he’ll continue part-time at the clinic.
Last December the two men won the Rockefeller Public Service Award (and $10,000). “It was nice,” Bailey says, “to get honored for something besides being poor.”