by Dr. David Brown
Starting in 1976 (now 40 years ago!) I was a counselor at Falling Creek Camp, where I was hired to teach canoeing and kayaking. I loved the job, and continued working there in the summers even through medical school and, as possible, my pediatric residency. While there, I became good friends with one of the camp doctors. Bill Costenbader, an otolaryngologist from Asheville, spent a couple of weeks at camp each summer, where his favorite activity was canoeing. While on one of our many trips together, I mentioned that I had decided to do a fellowship in allergy. As soon as he heard that, he told me he knew of the perfect partner for me when I completed my training. Not only that, he arranged for us to meet while we were headed out of camp for yet another paddling adventure.
I still remember clearly parking the truck, loaded with kids and canoes in tow, in Spencer's parking lot. I was wearing a swimsuit, T-shirt, and river shoes, and Bill took me in and introduced me to Spencer. I told him I planned to do an allergy fellowship, and as I had another year of residency left, would be looking for a job in three years. He wrote my name on a yellow sticky note, pinned it to the bulletin board, and left it for three years. I came back, said I was ready, and against his better judgment he hired me. From then on, we never looked back. (Well, maybe he did!)
We knew building a practice was important. We needed to raise awareness. Back in the day, the TV station would air the pollen counts for free along with our practice name. So, we bought a pollen counter and began counting, but the counts weren't high enough to satisfy us. Fortunately, Spencer had a pickup truck and shovel, so one evening after work we drove around town hunting for all the best ragweed plants. We dug them up, put them in the truck, and transplanted them underneath the pollen counter. That was Asheville's first record pollen season!
I was busy for the first couple of months, and attributed it to my marketing genius. Then, the frost hit, and my patient visits dropped to zero. It was then I realized that I had been living on Spencer's leftovers. It was time for action, so Spencer and I decided to hold an open house at our office. We were already thinking about expanding our reach, so we invited Austin Hyde, an allergist in Rutherfordton, N.C., about 40 miles away, to the event. While he was there, we planted the seed of working together. It didn't make sense at the time, as he was part of a multispecialty clinic. But, as we have seen so often in multispecialty clinics, the doctors end up arguing with each other and the group falls apart. And that is exactly what happened with them. So, about two years later, Austin called us and said he would like to join our group. So, that is where we cut our teeth on running a multiple location practice.
About two years after that, Austin was ready to retire. At that point, we had a decision to make. We could continue to provide extract to his patients and shut his practice down, or try to build on what he had created. We decided on the latter, and brought in Jeff Wagner and Patti Kirchoff, who built what had been satellites of the Rutherfordton hub into full-time locations. Now Jeff and Patti have been with us for over 24 years!
When Austin retired, he moved down to the North Carolina coast. Retirement lasted a couple of weeks, after which he went stir crazy. He started working part time with Don MacQueen in Wilmington, North Carolina. Don was facing many of the issues familiar to small practices, and told Austin he would welcome outside help. Austin told him of his experience with us, and that we didn't do such a bad job. So, Don met with us, and Wilmington joined shortly thereafter. After the usual learning curve, we discovered it made sense to have practices work together, whether they were 40 miles away or 400 miles away.
From there, slowly, gradually, the word spread. First, people felt we were relevant only for aging physicians in small communities in the Southeast. As we have gained experience and delivered value, that mindset has changed, as evidenced by our presence in 24 states, with offices from small towns all the way to some of our largest cities.