Roll with the punches and respond to the changing environment as creatively as you can is Norman Chenven’s life philosophy. Quietly brilliant, Dr. Chenven has calmly followed life’s prompts since day one. So how did he decide to become a physician? “I was majoring in physics at Brown University,” he explains. “But I knew I did not want a career in physics. I also knew I didn’t want to go to Vietnam.” He opted to apply to medical school and thus potentially receive a deferment from the draft. Although he wasn’t entirely sure he wanted to be a doctor, he was accepted at the State University of New York Medical Science Center.
He says that his uncertainty was short lived. “The minute I experienced direct patient interaction, I was hooked!” Chenven says with a smile. “It was magic.” Basically, he stumbled into his life’s calling—and he’s managed to be in the right place at the right time over and over—resulting in a life full of rich, unique experiences.
Take his two years working for the US Indian Health Services in a 20 bed hospital located in Tuba City, Arizona on the western side of the Navajo Reservation. Chenven and 14 other doctors cared for a population of nearly 40,000 Navajo and Hopi Indians. Many of the Navajos over the age of 40 did not speak English. “The two tribes did not always get along, but co-existed in their overlapping reservations,” he says. “Historically the Navajo were warriors and herders, very austere and with a guttural sounding language, while the Hopi were villagers and farmers, living in pueblos who spoke with a melodic lilt. The two tribes were a study in contrasts.” Practicing medicine with these cultures was extremely enlightening with regards to both cultural diversity and human nature. Even as late as the early 1970s, some traditional Navaho men, and in particular Medicine Men (who were quite active and respected), wore their hair long. “Some of us younger docs would emulate them by wearing our hair long and tied up with yarn in a bun called a ‘tsi’ (tsiiyeel). I still had my shoulder length hair when I arrived in Austin in 1973 to begin work in the Brackenridge Hospital ED.”
A fond memory of his time on the Reservation was treating a Hopi woman named Gertrude. She was a lovely person in her 80s with lymphoma. From time to time her family would invite him and his wife Dinah to be guests at traditional ceremonies and dances held on the Third Mesa.
Dr. Chenven notes that his experience in the Indian Health Service was his first introduction to the group practice format. “It was very efficient—all specialties working shoulder to shoulder in order to provide superb access and care to our patient population.” He considers this formative experience to have played a role in his decision to found Austin Regional Clinic a decade later.
Escape From New York
While in college, he met Dinah and they were married during his first year of medical school. SUNY Downstate Medical Center was located on the edge of Bedford-Stuyvesant, a tough neighborhood in the middle of Brooklyn. During their four-year stay, murders occurred on opposite corners of their block.
So how did he and Dinah end up in Austin? “We were invited to visit by a high school buddy of mine—Don had come to Texas with Vista (the domestic version of the Peace Corps),” Chenven explains. “We had a great time—he took us honky-tonking and we actually saw Willie Nelson playing to a near empty room at Big G’s in Round Rock.” Like everyone else who comes to Texas, Chenven was charmed and surprised by what is commonly known as “Texas friendly” especially coming from New York. “I guess this was my version of ‘I got here as soon as I could.’ ”
Trading his East Coast thermals for cowboy boots, Dr. Chenven did post-graduate training at Bexar County Hospital in San Antonio. He and Dinah eventually settled in Austin where she attended UT and he took a job in the Brackenridge ED. “Back then it was the only facility open after 5 pm in the surrounding 10 counties,” he remembers. “Virtually every physician volunteered to provide specialty coverage and/or office follow-up. There were fewer than 400 active doctors in the community. It was a different time and place then. The ED was hard work and sometimes scary, but I loved it.” Subsequently, Chenven spent three rewarding years in a four physician group. But in 1980, he left that practice and founded Austin Regional Clinic (ARC).
Launching Austin Regional Clinic
Dr. Chenven never lost his appreciation for the Indian Health Services’ multi-specialty format. “I was inspired with the opportunity to coordinate accessible care for people. I had a multi-specialty dream,” he chuckles.
Howard Marcus, MD, recalls his ARC recruitment experience, “In 1981 I answered a recruitment ad for an internist. At this time, Norman was pretty much a one-man administration. He did all the interviewing. The first thing I notice is that this Jewish guy from Brooklyn is wearing cowboy boots—which absolutely made no sense to me. I took the job anyway!”
Another early recruitment anecdote demonstrates Chenven’s casual manner. Dr. Russ Krienke laughs, “My best Norman story is when he was recruiting me. He took me to the ‘glamorous, upscale’ Thundercloud Subs on Guadalupe, forgot his wallet and I ended up paying for my recruitment lunch. I must have been desperate, because I still signed on!”
There are now 21 ARC locations in the Austin area, employing 350 physicians and providing care to approximately 420,000 patients. In addition to the daily operations of the clinics, Dr. Chenven oversees even more. He is president and CEO of Covenant Management Systems (CMS). CMS is a practice management company that provides technical support and services to hospitals, medical groups, provider networks and governmental and employer health plans.
During what must be rare free time, he loves to visit his three daughters and five grandchildren in Oregon. Running, photography, travel and reading about ancient Greek and Roman history are also favorite pastimes.
Triumphs and Concerns for Medicine
There is no doubt that technological developments in medicine in recent history have been astounding. “The breakthroughs in the past four decades have resulted in the ability to treat (and often cure) conditions that in the past would have meant nothing but ongoing misery for patients” Chenven says with passion. “Sometimes we lose sight of that.” An example of something that will eventually pay off in ways we can’t yet imagine is the data captured by electronic medical records (EMRs). He is excited about the eventual compilation of data that will reveal unique patterns of subpopulations for every type of disease paving the way for more customized treatment plans.
As for what is wrong with medicine? Chenven cites the progressive regulatory complexity and the ongoing fragmentation of the health care delivery system. The lack of consistency, measurable quality and relentlessly escalating costs are going to hinder a physician’s ability to provide high quality care. “I am concerned that our country’s political dysfunction will make these problems impossible to solve.”
This brings up the subject of advocacy and TCMS. Chenven sees organized medicine and advocacy as being absolutely vital. “There is a quote by Benjamin Franklin made after the founding fathers signed the Declaration of Independence that I love,” he says. “We must all hang together or assuredly we shall all hang separately.” Translated, one cohesive voice and strength in numbers are key.
So how does Dr. Norman Chenven feel about being named TCMS Physician of the Year? “Old,” he says without hesitation. Why does he think he got the award? “Ditto,” he says with a laugh. “But in all seriousness,” he continued. “Receiving an honor like this, from my colleagues and peers and in a community where I’ve spent most of my career, is recognition that my life’s work has been meaningful. It makes me feel appreciated and grateful.”
—Travis County Medical Society
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