When the late Dr. Richard Butcher was a young man growing up in Cleveland, he was told to go into social work or be a teacher, not try to be a physician. Medicine was too hard for a black man.
Racism was preventing black doctors from admitting patients to hospitals in many parts of the country; they had to turn their patients over to white doctors. In various states and counties, medical societies refused to let black doctors become members.
White medical schools balked at admitting blacks, instead routing them to one of four black schools like Meharry in Nashville, Tennessee, where Butcher trained. Segregation policies at the American Medical Association prevailed.
But Butcher, who acknowledged the tensions in that national discord, didn’t let it get to him. He graduated from Meharry Medical College in 1964, and after his internship rotation at the U.S. Naval Hospital in Great Lakes, Illinois, and time on transport ships to Vietnam, he came to San Diego in 1969 and set up practice near Lincoln Park.
Butcher died unexpectedly at age 77 on Nov. 12 in Orlando, Florida, while attending a meeting of the American Medical Association, where he served on an influential committee.
One of only a handful of African-American doctors in San Diego in the early 1970s, Butcher focused on underserved populations, which few doctors wanted to treat. Medicaid, now called Medi-Cal in the state, reimbursed patients at lower rates than Medicare or commercial plans and still does.
Despite that, or perhaps because of it, Butcher became a leader not just in San Diego, where he was the first black president of the San Diego County Medical Society representing some 8,000 physicians and founded a multicultural network of doctors.
He also served as president of the National Medical Association, an organization of black doctors across the country that formed in 1895 because the American Medical Association refused to admit blacks.
He partnered with Dr. Rodney Hood at Care View Medical Group, a medical complex they own on Euclid Avenue near Lincoln Park.
In a recent interview, Butcher explained how hard doctors who want to treat the underserved have to work, saying that may be why more blacks don’t choose medical practice today.
“Even today, for Dr. Hood and myself, our physician patient ratio is one to 2,000. You go to La Jolla, it's probably one to 200. That impacts the numbers that I see and how much time I can spend with individuals and what I can do to get them help,” he said.
Until about a decade ago, he was seeing about 50 patients a day, although lately he had been keeping it to 25. He made rounds at Alvarado Hospital where he had served as chief of staff in 2014, worked to streamline office practices for under-resourced minority doctors, and helped manage a network for physicians to improve their bargaining power with health plans.
Hood said Butcher taught him that providing good public health and medical care wasn’t just about treating patients, but “getting involved in the community to understand how they needed to improve the environment.”
For both Hood and Butcher, “serving the underserved, especially in private practice, is rather a mission than a business. You have to love it, be committed to mission in the community.”
Hood said his partner never seemed to get angry about racism and bureaucracies that obstructed the path to providing quality care to the underserved.
“I get angry all the time,” Hood said. “But he was my calming force. We were yin and yang. I have a tendency to be, what you see is what you get. And sometimes, after certain encounters in meetings, I’d go to Dr. Butcher and he just quietly said, ‘I agree with you, Rodney, but you could have said it differently.’”
Butcher’s calm leadership over the decades helped other doctors in the area show their respect for black doctors, Hood said.
At a memorial Saturday at the Point Loma Community Presbyterian Church, hundreds came out to shout his praises and say goodbye.
A parishioner at Bethel AME Church on K Street, Debbie Hedgern, said Butcher was a devoted Sunday school teacher.
“If no students were in the class, he’d be there anyway. He’d read the lessons for himself, waiting for people to show up,” Hedgern said.
Dr. William Norcross, director of the UCSD physicians’ assistance evaluation program, called Butcher a “pioneer in family medicine.” In the early days of the UCSD residency program in 1974, he was on the volunteer faculty and was “one of the most brilliant doctors I ever knew … and a warm sense of humor.”
Dr. Jerome Robinson, a cardiologist and colleague of Butcher’s for decades, said Butcher “loved taking care of patients and particularly those who were underserved and disadvantaged. He was never going to quit. He was doing what he loved to do when he died.”
Dr. Ted Mazer, an ear, nose and throat physician who worked with Butcher at Alvarado and now is the president-elect of the California Medical Association, credited him for his national involvement to “make sure hospital medical staffs had a say in how medical staffs are run — independent from hospitals — making sure they weren’t run for the benefit of the hospital but for the benefit of patients.”
Mazer, who was with him at the AMA meeting in Orlando, said “he continued to do that right up to the time of his death.”
Mazer noted that Butcher — to the endearing amusement of his colleagues — used one expression repeatedly: “He would pepper every sentence, ‘and so forth and so forth.’ And all I can hope is that now that he’s in a better place, that he gets to do everything he wanted to do, and so forth.”
Diane Watson, a former congresswoman who also represented a Los Angeles district for two decades in the state Senate, said she relied on Butcher for advice during her stint chairing a state health and human services committee.
“Bills came to my committee and I would have to have them analyzed for the members of the committee. And whenever there was a question that I had, I’d call Dr. Butcher,” Watson said.
Aaron Graham, a Granite Hills High School football player in 1976, flew from his home in Connecticut to remember Butcher, who had helped him come to terms with the spinal cord injury of Mount Miguel High School football player Kip Hayes. Hayes was hurt in a game between the two teams that year that paralyzed him from the neck down. Hayes died in 2000.
Graham felt terrible.
Butcher was the Granite Hills team doctor, and ran out to help Hayes as he lay on the field. “Dr. Butcher just made the point, ‘Nobody’s responsible for this. You’re not responsible,’” Graham said.
Because of that, Graham has kept in touch with Butcher over the last 40 years. He’d ask “How you doin?” in a casual way, but he was really asking, “How are you doing?” Graham said.
Hood, his partner at Care View Medical Group, said that after Butcher’s death, many doctors volunteered to help out in the practice, and nurse practitioners have been hired to step in while they search for a full-time replacement.
“We have two folks identified who are willing to come in the next couple of weeks, and then we were going to spend our time trying to find a physician on a more permanent basis," Hood said. "The problem is replacing Dr. Butcher is going to be difficult.”