The fall 2017 issue of The Ohio Family Physician depicted stories of family medicine in communities. Many of you serve in volunteer positions in your community because you are family physicians. You chose family medicine as your career because you wanted to help people with all aspects of their lives. Helping people means more to you than seeing patients in the office during appointments.
One of these stories illustrates family physicians serving their community with honor as coroners. This article is featured in the following segment. Look for other examples of family medicine in communities in upcoming editions of the Weekly Family Medicine Update, on the OAFP website, and on the Academy’s Facebook and twitter pages.
In 1985, the Ohio State Buckeyes upset the No. 1 ranked Iowa Hawkeyes during a rain soaked football game at Ohio Stadium. Twenty-one tornadoes tracked across northeast Ohio during the evening of May 31, 1985. Ohio Governor Richard Celeste declared a banking holiday in 1985 to halt a rush on deposits due to the collapse of a Cincinnati savings and loan. And, the world’s first mobile phone weighed in at nearly 11 pounds and required a large bag for the haul and a car for any and all recharging opportunities. With limited technology, it was hard for authorities to find the Auglaize county coroner while a child that was hit by a car laid on the rural roadway for two hours. Technology had not advanced to the point where it was easy to notify the parents of the child in a timely manner.
What did law enforcement eventually do to attend to this horrific event? They called one of the most caring and compassionate health care professionals in the local community—a family physician.
Tom Freytag, MD, vividly remembers the phone call from the authorities that day in 1985.
“What a travesty to have anyone, much less a child, lay on the road deceased without the parents knowing. At that moment, I made the decision to run for coroner; and once elected, I carried a pager to make sure I could be reached at all times,” said Dr. Freytag.
Today Dr. Freytag still serves as the Auglaize county coroner, and is the longest serving coroner in the state of Ohio. He, along with 51 other family physicians, serve their community as coroner providing empathetic care for the citizens of their county. These physicians are committed to being available 24/7 to families affected by unexpected death.
Breadth of Family Medicine
The breadth of family medicine prepares family physicians well for service as coroners. Every day in the office is different—a child might present with strep throat symptoms followed by an elderly patient with COPD and depression. The next day might include giving well-visits and delivering a cancer diagnosis. Just as the family physician shifts gears from patient room to patient room, so too does the coroner from call to call. The breadth of knowledge and experience, along with the diversity to which family physicians are accustomed, are the perfect background for being a coroner.
“As a family physician, I am very well prepared to deal with all aspects of the office of the coroner. From pediatric to geriatric deaths, from accidents to suicides, we family physicians know how to evaluate causes and contributors,” said John Gabis, MD, the Ross county coroner.
Family physician coroners can also rely on the continuity-of-care in family medicine to help them in their coroner role. Sometimes the deceased is a patient or family member of a patient; this allows the family physician coroner to rely on medical history when determining the possible cause of death.
“A lot of deaths that are natural fall to the coroner and, as a family physician, I can review medical records to get a very good idea of what likely caused a person’s death,” said Melinda Fritz, MD, the Henry county coroner.
Family physicians are experts in working with teams. Thus, it is no surprise that not only do family physician coroners enjoy working with the law enforcement team, they also oftentimes provide medical education to fellow team members—EMS, fire department, state fire marshal, police department, sheriff’s office, State Highway Patrol, Bureau of Criminal Investigation, and others.
“I work well with the local EMS and sheriff. They are my eyes and ears on the scene as to a suspicious death or one that needs investigated. We work together in that regard,” said Dr. Fritz.
Coroners are in charge of the scene of a death, so they use their family medicine leadership skills to work with the first responder team. In turn, coroners rely on law enforcement for compassionate support during what can be a very emotionally draining job. The entire team helps and educates one another.
“I love to educate medical students, residents, and law enforcement personnel at the scene about the body’s response to disease, trauma, or the elements,” said Dr. Gabis.
“At very traumatic death scenes, at times, we are physicians to those who respond. It is important to make sure that someone who has just seen their first trauma death is able to talk to someone about their experience. We never stop being a family physician,” said Dr. Gabis.
Community Education & Impact
Family physician coroners impact their communities every day.
Early on, Dr. Fritz knew that she wanted to someday serve as coroner in rural northwest Ohio.
“I was a forensic chemistry major in college, but went on to medical school knowing that I wanted to do family medicine back in rural northwest Ohio. I knew I would use my undergraduate degree as the county coroner some day and when the position opened it was a good time in my career to add that role,” said Dr. Fritz.
Coroners help families through difficult times and bring closure to the death of a loved one.
“I answer questions from family, and help them as much as I can to understand what happened in the death of their loved one. I realize that families deserve to know, as best as we can tell them, how their loved one died. For what I do, they thank me. I know that I am doing a pretty good job,” said Dr. Freytag.
Sometimes these experiences are opportunities for coroners to educate the community.
“My ability to positively impact the overall health of the living and to sound warning alarms from the dead has been very satisfying. One winter there were three male deaths from shoveling wet, heavy snow. I was able to educate our region through media channels about safety in cold weather conditions. That impact is what keeps me going as coroner,” said Dr. Gabis.
“Being a coroner certainly gives you a wakeup call about what’s important in life. I consider myself fortunate in that I am reminded about what is truly important in life several times a year. Others may only experience that profound ‘jolt’ once, maybe twice in a lifetime,” said Dr. Freytag.
Elected Ross county coroner in November 1992, Dr. Gabis spoke with the previous coroner about the time commitment of the position and was assured that the time responsibility was minimal.
“Then, the phone starting ringing and hasn’t stopped since,” said Dr. Gabis.
Dr. Gabis receives many calls as coroner because of the opioid overdose crisis in Ross county. The county holds records for the number of opioid overdoses over the past five years, each year outpacing the previous year.
“Since 2009, I have formed, organized, or led our community’s response to this major health problem. Currently, I am the chair of the Heroin Partnership Project (HPP), a coalition of local, state, and federal agencies that provide a coordinated regional approach to the overdoses occurring in our county. I am passionate about reversing this trend of overdose deaths in young people. While this is satisfying on one hand, it is incredibly draining on the other hand. Trying to stay energized when the problem continues to grow, is very difficult and those folks in the HPP provide energy to those whose energy is lagging. We cannot give up this fight,” said Dr. Gabis.
The Family Physician Coroner Leader
It is clear that family physicians make great coroners. Their skills as leaders, communicators, knowledgeable physicians, and compassionate caregivers make them well-suited to serve their communities in this important role.
Times and technology sure have changed since 1985, but the level of care provided and the dedication of family physician coroners have not.