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Historical Information on Henry Lee “Buddy”
Treadwell
Although generally recognized as the originator of the physician
assistant concept, Dr. Eugene A. Stead, Jr. is the first to note that the idea
was not his exclusively. Prior to the development of the physician assistant
program at Duke University in 1965, many physicians were training their own
assistants on the job. Stead was aware particularly of one such proprietary
trained assistant, Mr. Henry Lee “Buddy” Treadwell, who was trained by and
worked with Dr. Amos Johnson in general practice in Garland, North Carolina.
This relationship crystallized Stead’s vision of how a physician’s assistant
could be used to help over-worked doctors deliver healthcare services.
Treadwell was a young African American whom Johnson employed in 1940 as an
office “orderly” to escort patients to examining rooms, prepare the rooms for
the next patient, and clean laboratory equipment. Johnson gradually taught
Treadwell to perform many of the routine tasks in his office, such as taking
vital signs, suturing, conducting laboratory test, and developing x-ray films.
By 1950, Treadwell was recognized as Johnson’s assistant and managed the
practice while Johnson was away on trips to attend medical meetings and later to
promote Family Medicine as a specialty. There were backup physicians in nearby
communities available if Treadwell needed help. By 1960, Treadwell was
accompanying patients to the Duke University Medical Center for diagnostic
referrals and treatments. In additions, he was interacting with Duke University
medical students sent to Garland for community-based clinical training. So his
role was known within the Duke Medical Community.
A newspaper article written in 1967 by John J. Synon titled “Two Men: Two Souls”
describes Dr. Johnson’s testimony for the prosecution at the court martial of
Capt. Howard Levy. Dr. Levy was sentenced to 3 years in prison on May 10, 1967
for refusing to train Special Forces medical aidmen and for inspiring
“disaffection” among enlisted men during the Viet Nam War. Johnson was called to
defend the training of clinical personnel who were not doctors. According to the
article, Johnson stated that he had employed a “Negro helper” in his office for
27 years and that “He is in a position of complete trust by me and my patients.”
When asked if he would allow his medical aid man to work unsupervised, Johnson
stated, “I’m here and he is home in my office working.” Johnson completed his
testimony by saying that “The richest man in town would rather have Buddy sew
him up than me because he can do it better than I can.”
The May 1967 issue of Medical Economics contained an editorial followed by three
articles on the topic of using non-doctors to do doctors’ work. One of the
feature articles described the working relationship between Treadwell and
Johnson. Johnson stated in the article that “He (Treadwell) works for me much as
a resident in a hospital works for an attending.” Johnson, a past president of
the American Academy of General Practice, indicated that he could not
participate in activities of organized medicine without having someone
coordinate patient care while he was away from the office. At Johnson’s request,
Treadwell “routinely prepared and gave injections, inserted catheters, applied
splints, took superficial sutures and removed stitches.” Johnson sent Treadwell
to see certain patients and treat certain conditions in the patients’ homes,
using the telephone as a means of consultation. “He’s saved me many a trip into
the country that Henry “Buddy” Treadwell would have broken up an entire
morning’s office work,” confides Johnson. When asked about fees charged for
Treadwell’s services, Johnson indicated that when they both worked side-by-side
in the office that he charged the patient “my regular fee – the same as if I’d
done the work myself.” When Johnson was away, the fee was reduced to half. When
asked about liability, Johnson acknowledged that he was at risk, but that the
risks were offset by the advantages. He indicated that the people in the
community knew him and his assistant, some were third generation patients, and
in a place like this, “suing their doctor is the furthest thing from their
minds.”
In April 1969, James C. Mau, first administrator for Duke University PA Program,
sent a letter to Robert Howard, first program director of the Duke University PA
Program, saying that the PA Program should honor Henry Lee “Buddy” Treadwell at
some upcoming event at Duke and invite his employer, Dr. Amos Johnson, to
attend. Mau indicated in his letter to Howard that "I believe that he (Buddy)
has played a very significant role in the evolution of this Program, for it was
through Dr. Stead's contact with him and Dr. Johnson that nurtured the notion
(PA concept)." Treadwell was recognized as a prototype PA and was made an
Honorary Physician Assistant by the Duke PA program in 1970. Dr. James Gifford,
a medical historian from Duke University, interviewed and wrote several articles
about Treadwell that were printed in the North Carolina Medical Journal and the
Physician Assistant Journal. Gifford noted that “Johnson’s success with Henry
Treadwell helped shape Stead’s prototype definition of the PA role and win
federal support for PA training.”
Epilogue:
Johnson served as a physician advisor to the Board of Directors of the American
Academy of Physician Assistants in the early 1970’s. When he died in 1975,
Treadwell decided not to continue practicing as an assistant although he was
offered jobs by physicians in surrounding communities. He did not attempt to
take the National Commission on Certification of Physician Assistant certifying
examination which was open to proprietary trained assistants in the 1970s. He
had started a restaurant in Garland before Johnson’s death and decided after 30
years to leave medical practice. Treadwell died on October 4, 1990 at the age of
68. Interestingly, Stead launched his PA program at Duke on October 4, 1965 – 25
years earlier to the day.
Source: http://www.pahx.org/pdf/BuddyTreadwell.pdf#search='Henry%20Lee%20treadwell'
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