Learn more about HMG founder and president Jerry Miller: "With Single Determination" The story of Jerry L. Miller

How HMG formed; how it grew and the challenges it faced

In the mid-1970s, Kingsport, like much of the Tri-Cities, was facing the incredible challenge of recruiting primary care physicians to care for an underserved population. Though a noble task, recruitment was by no means easy. The location, combined with the volume of sick people, would drive physicians away.

"Whereas we were getting $4 for an office visit, physicians could practice with colleagues in Richmond and get $12," explains Jerry L. Miller, MD, HMG Founder & President.

According to John Dodson who served as the hospital administrator of Holston Valley Community Hospital for 34 years, the hospital was becoming increasingly concerned.

"It looked as though much of our medical staff was going to be retiring at about the same time," explains Dodson. "At that time, we had not been successful in our recruitment. In working with a planning firm out of Chicago mapping out the hospital's future, we knew the recruitment of family physicians would be crucial."

Dodson says it was shortly after this, in 1975, when he became aware of the Robert Wood Johnson Foundation - a foundation established in 1972 as a national philanthropy devoted to improving the healthcare of all Americans.

One of the goals of the Robert Wood Johnson Foundation was that of "assuring that all Americans have access to basic health care." With this goal, the Foundation would provide hospitals with grants to be used for recruiting, and, to a limited degree, for operating expenses in underserved areas.

According to Dodson, a physician survey sent out by the hospital regarding the need for recruiting physicians received an 85-90 percent response with most answering "yes" to the hospital needing more primary care physicians.

"Under the rules of the grant, you could use one physician on your existing staff," explains Dodson.

At that time, Jerry L. Miller, MD, served as president of the hospital's medical staff. With a busting-at-the-seams private practice in Nickelsville, Va., Dr. Miller was well aware of the physician shortage and had already begun formulating a vision for a uni-specialty group of family physicians.

Dodson says he was keenly aware of Dr. Miller's vision and was equally pleased with his decision to take on the challenge.

"I felt it would be easier to recruit groups of doctors - a uni-specialty group offering family practice services with a base clinic located near the hospital and static clinics in rural areas," says Dr. Miller.

At this same time, a physician by the name of Robert Geer, MD, fresh out of residency, was searching for where he could begin private practice. Though originally from the Midwest, Dr. Geer and his wife wanted to become "southern by choice, not chance."

As it happened, in 1976, Drs. Miller and Geer met at a University of Kentucky Family Practice Review Course. Striking up a conversation, the two discovered that their view of medicine was the same.

"It was the vision that really solidified our decision," recalls Dr. Miller. "We both loved people and could laugh and cry with them. Our backgrounds were the same - meager to the degree. We felt a family practice that was physician-owned, physician-driven and physician-led - and that would nurture compassionate relationships with the goal of providing one-stop shopping - would be extremely successful."

Upon a handshake, the deal was solidified. Dr. Geer packed up his family and moved to Kingsport.

At the time he arrived, Dr. Miller, John Dodson and George Dawson, the hospital's assistant administrator, were in the process of applying for the grant. Dr. Geer jumped in with both feet and began working alongside them in pursuit of the grant.

"I remember telling the Foundation that, ‘we are going to make a success of this. Your only choice is if you want to join us,'" laughs Dr. Geer, revealing his confidence of the Group's mission, even from the very beginning.

In October of 1976, the Robert Wood Johnson Foundation awarded $476,000 for the recruitment of family physicians. Then, on January 3, 1977, Holston Medical Group saw its first patient at the Group's Market Street location. Almost immediately, HMG experienced tremendous success, becoming self-sustaining within three years and - as originally agreed upon - spinning-off from the hospital.

By 1984, the Group had grown to twelve family physicians, practicing in five locations with a tremendous patient volume. Shortly after, in the mid-1980s, a "difference of philosophies and direction" became apparent within the Group. This "difference" reduced the Group to seven family physicians.

According to Robert Lee, MD, who had only joined HMG in 1982, three years prior, in many ways the division served to solidify the mission, vision and direction of Holston Medical Group.

"This transition was a very emotionally-wrenching time for me personally," explains Dr. Lee. "Yet, now, looking back, I see our ‘growing pains' as a crucial time for Holston Medical Group. If we were going to be successful in our vision of becoming more comprehensive in our care and the services we offered, we would have to be unified in our oneness of philosophy and direction."

By the close of the 1980s the Group had triumphed in its goal of "becoming more comprehensive," growing to 14 family physicians, establishing the region's first "after-hours" clinic (1985) and adding its first specialist - orthopaedic surgeon Steven Krein, MD.

According to Dr. Miller, with a common vision of providing the best medicine available, much of HMG's success has been "a lot of flying by the seat of our pants."

Each of the four original family physicians - Robert Geer, MD (19977); Joel D. Gonce, MD (1978); James L. McCoy, MD (1987); J. Bryston Winegar, MD (1981); and Robert C. Lee, MD (1982) agree that a great deal of HMG's success has been that of flying by the seat of their pants and yet never losing sight of a common vision.

"For me, it was the mission of the Group that kept me," says Dr. Geer. "While there were times when I might not always understand the direction Jerry wanted to go, I came to realize that 99 percent of the time, he was right. He's an extraordinarily gifted physician, humanitarian and businessperson. I would trust him with my life."

Dr. Miller says throughout HMG's early years, the Group faced challenges with everything from dissuading politics in the medical community and trying to steer neutral to the challenges of hospital systems - and even the challenge of determining the composition of the group.

Dr. Lee agrees that HMG has been faced with many enormous decisions, especially those regarding the Group's direction - decisions like that of becoming a multi-specialty group. The 14 family physicians of HMG knew a multi-specialty direction would change the Group as they knew it. According to Dr. Lee, "we knew we weren't adding physicians for the sake of making it bigger for bigger sake; it was to make it better for the patient's sake."

Such were the early years of Holston Medical Group. Facing tremendous challenges and enjoying successful growth, with a oneness of vision and mission, the Group grew from a handful of family physicians to the largest multi-specialty physician practice between Knoxville, Tenn., and Roanoke, Va.