Professor Emeritus Charles Ponte reminisces about time with WVU

By Charles D. Ponte, BS, PharmD,
BC-ADM, BCPS, CDE, CPE, FAADE, FAPhA, FASHP, FCCP, FNAP
Professor Emeritus, Departments of Family Medicine & Clinical Pharmacy
West Virginia University

When I speak of a Family Affair, I am not talking about the comedy sitcom that ran from
1966 to 1971. I am talking about a 42-year soirée as a clinical pharmacy faculty member in
an academic Family Medicine department at a large tertiary medical center. The one
definition of family that resonates with me the most is a "group of people united by certain
convictions or a common affiliation." There is an adage that one cannot choose your
family. However, when it comes to professional affiliations, sometimes you can choose
colleagues to accompany you on your career journey. So why did I make Family Medicine
my traveling companion? The answer is simple. I learned via my experiences as a PharmD
student that family medicine attracted physicians and resident physicians who exhibited
similar traits and values that I held. The specialty emphasized primary care and managing
health across the life continuum; it was truly a family affair! Importantly, Family Medicine
physicians were intelligent, competent, compassionate, willing to learn and open-minded
without being arrogant. These were the kinds of colleagues I wished to align myself with
moving forward.

When I was nearing completion of my PharmD program, my interest in Family Medicine
was evident. My advisor suggested that I interview for an academic faculty position and
such a position was open at what would become my institution. The position was a joint
appointment in the Departments of Clinical Pharmacy and Family Medicine, Schools of
Pharmacy and Medicine. It was a nightmare scenario. I would have to interview with two
groups of faculty and chairs, not to mention the dean of the pharmacy school. In addition, I
had to present a lecture to the faculty and guests involving my PharmD research project.
Suffice it to say that I survived the interview process and managed to escape the seminar
unscathed. Importantly, one of the highlights of the interview involved being driven to lunch
with the chair and the residency director of the Department of Family Medicine at a local
Middle Eastern restaurant. What made this unique was the mode of transportation to the
eatery, a classic Willys-type Jeep! Picture a Jeep CJ-5 hardtop and you get the idea. The
chair drove, and I sat in the back wondering how I found myself in this situation. Little did I
know that those two individuals in that Jeep would have a profound influence on my
professional and personal journey as a member of my adopted professional family. As I sit
years removed from that Jeep ride, it stands as a metaphor for the journey I was about to
embark upon as a member of my adopted professional family.

When I joined the faculty, I was fortunate to have two offices, one in the school of
pharmacy (home base) and a carrel in the resident physician's room of the Family Medicine
department. At that time, the entire department occupied a hallway in the hospital wing of the health sciences center. At the end of that hallway was a conference room and a room
with the resident physician carrels and a bathroom. I occupied that carrel for many years,
and I would not want it any other way. Credibility notwithstanding, I believed that visibility
and availability to my physician colleagues were important ingredients to maintaining an
active role in the department. Over the ensuing years, that room became a place for
educating learners (medical and pharmacy), sharing stories and laughter, and providing a
respite away from competing obligations. That carrel provided insight into the discipline of
Family Medicine, the kinds of learners it attracted, and the trials and tribulations
associated with residency training programs. What I did not realize was that our shared
space fostered collaboration among healthcare professionals with the goal of improving
the health outcomes of our patients. Also, unbeknownst to us, the seeds of team-based
care and interprofessional education had been planted long before it was embraced by
Family Medicine residency educators and later required in ACGME program requirements.
Those colleagues who shared space in that room became my first Family Medicine family.
Outside of that space, the faculty, nurses, and staff of the department also became a part
of my extended Family Medicine family. Everyone took pride in our small department and
displayed those traits that I had found endearing of Family Medicine colleagues as a
student. There was genuine concern for each other and optimal patient care was central to
our mission. A family atmosphere existed for years in that hallway. There were countless
holiday parties where everyone brought a covered dish. The main hallway of the
department became a long tabled receiving line filled with favorite dishes to share with our
Family Medicine community. Of course, there was always cake for dessert among other
treats. One of my colleagues and mentor was an attending physician small in stature yet
large in reputation and accomplishments and loved by all in the department. He was triple
boarded in family medicine, pediatrics, and pediatric endocrinology. He was an Army
veteran and had served in Vietnam as a MASH unit commander. He piqued my interest in
diabetes which became a lifelong passion and clinical focus over the years. Among his
endearing qualities, he had a well-known sweet tooth. During the holiday parties, he would
call out to "cut the cake" when it became obvious that dessert was on everyone's mind. It
was a sad day when he left the department to assume a faculty position at Mercer
University. I can still hear him saying "cut the cake."

Like all families, our department had its share of joy and sorrow. We reveled in personal or
departmental success, celebrated marriages and births and grieved for the loss of loved
ones and colleagues. One of the hardest things I had to do during my tenure with the
department was to tell my pharmacy student on rotation that her research mentor and
professor had died the day before. The look on her face remains imprinted on my mind to
this day. We also lost residents over the years to accident and illness. One must wonder
what would have become of their lives and their impact upon patient care if they had lived.
I befriended one of our resident physicians during his intern year. He was a big burly man
with a jovial persona. It's important to know that I was never a fan of the Physician's Desk
Reference, and I made it known to the learners in the department. It was a compilation of
package inserts and offered little as a therapeutic guide, or so I thought. This physician
relied upon the book because he had not trained with a clinical pharmacist, and it was his go-to for prescribing and pharmacologic information. We sparred (albeit friendly) over the
merits and shortcomings of the book, and I am sure he cringed whenever I broached the
subject. He made a badge for me that had written across the face the word "PDR" with a
line struck through it. He either "saw the light" or was trying to appease me. We will never
know because after leaving the residency he contracted viral myocarditis and would
eventually die from congestive heart failure on Christmas day, fitting for a man of faith. I
still have that badge, and it has become one of my favorite pieces of memorabilia from
those early days of my career.

Another attending had a nickname like a famous beer. Let us just say that it began with
"Bud." He was a talented physician and educator with an amazing bedside manner. He was
also a gifted whistler. His whistles were legendary. He was also a train enthusiast and kept
a scale model train on a ledge near the ceiling of his office. What endeared me to him was
his humanity, another one of those traits that attracted me to Family Medicine. It was
during hospital rounds, that I saw this grown man, physician, and army veteran cry in the
hallway after seeing one of our ward patients. That was the first and only time that I saw
this during my 42-year career. It left a lasting impression.

We referred to my first Family Medicine chair as the "boss." Remember, he was the driver
of the Jeep during my interview. He had come from private practice and had a wealth of
experience including having delivered several thousand babies. He too had exceptional
bedside manner and still retained the physical diagnostic skills all but lost with the advent
of modern diagnostic tools. I still marvel at those physicians who can make diagnoses
employing inspection, auscultation, percussion, and palpation! Oh my!

Since those early days, the department has undergone changes in personnel and even the
physical location of the department. At its inception, the clinic was a part of the School of
Medicine and with the passage of time, the clinic became a part of the larger health system
enterprise. Not surprisingly, the clinic became indistinguishable from the rest of the health
systems clinic structure and lost its autonomy and its unique identity. Department chairs,
faculty and staff have come and gone, new residency classes begin every year, and the
resident physicians eventually graduate. Through the years the department has weathered
the challenges and embraced opportunities for growth and development. Importantly, the
focus and commitment to primary care and the tenets of Family Medicine have remained.
The names have changed but the residency still attracts individuals who subscribe to the
philosophy and mission of Family Medicine. The first class of residents consisted of four
individuals and now the program has graduated over three hundred residents who provide
care to the people of the state and beyond. I was honored to have had a role in their
education and consider them members of my "extended" family.

The department has grown through its 50-year history and now occupies a substantial
portion of a free standing 110,000 square foot ambulatory care building with an additional
clinic located outside the city. The clinical, research and educational missions of the department have grown in importance and productivity and continue to set the standard for the state. To restate another adage, we have come a long way baby!

You may be wondering what happened to my "office" carrel during the intervening years of
growth and change. I enjoyed that shared space for many years but eventually I moved into
my own office (albeit at various locations) during the remainder of my association with the
department. I embraced the privacy and quiet but there was a part of me that longed for
the camaraderie of being in the same space with the resident physicians and other
learners. There is no better way to foster team-based care than to have team members
located in the same space or vicinity whenever possible given the reality of programmatic,
space and fiscal restraints faced by many departments.

When the department moved off-campus to the ambulatory care building, I opted to stay
at the health sciences center since I had morphed into a clinical pharmacy "hospitalist"
and needed to be near the hospital and the teaching programs of the health sciences
center. And I still needed to maintain my "home base" office in the school of pharmacy.
Contact continued with the residents during daily ward rounds with the team, via
scheduled therapeutic lectures and occasional meetings and conferences. These were the
next best things to being there!

Even though the only constant is change, I have certainly seen my share of change and the
road had its share of potholes along the way. But I could not think of a better group to
navigate the route than my Family Medicine colleagues. You cannot pick your family, but I
am sure glad that I picked this family to share my career journey.

References
1. https://www.merriam-webster.com/dictionary/family Accessed February 8, 2025
2. Arenson C, Brandt BF. The Importance of Interprofessional Practice in Family
Medicine Residency Education. Fam Med. 2021;53(7):548-555.
https://doi.org/10.22454/FamMed.2021.151177.
3. https://www.acgme.org/globalassets/pfassets/programrequirements/2024-
prs/120_familymedicine_2024.pdf. Accessed February 25, 2025