[piano intro] - Hello, I'm Nido Qubein.

Welcome to Side by Side.

My guest today considered becoming an ordained Episcopal minister but his dad talked him out of it.

And like his dad, he became a pediatrician.

And like his dad, he became a selfless public servant and a servant leader in eastern North Carolina.

That was just the beginning.

For nearly 50 years, he has advocated for children and their families everywhere.

Today we'll meet Dr. David Taylor Jr. - [Announcer] Funding for Side by Side with Nido Qubein is made possible by... - [Narrator A] We started small, just 30 people in a small town in Wisconsin.

75 years later, we employ more Americans than any other furniture brand.

But none of that would've been possible without you.

Ashley.

This is home.

- [Narrator B] For 60 years, the Budd Group has been a company of excellence, providing facility services to customers, opportunities for employees, and support to our communities.

The Budd Group.

Great people, smart service.

- [Narrator C] Coca-Cola Consolidated is honored to make and serve 300 brands and flavors locally.

Thanks to our teammates, we are Coca-Cola Consolidated, your local bottler.

[upbeat music] - Dr. Taylor, welcome to Side by Side.

You come from a whole family of pediatric doctors.

Where did it all begin?

- The first Dave Taylor settled in Little Washington during the war between the states and was whatever doctors did back then.

And then I'm the fifth generation of Dr. Dave Taylor, MD.

- You're the fifth generation.

- From Washington but I did not stay in Little Washington.

I settled in Goldsboro where I've had my practice.

- So the first Dave Taylor was your grandfather.

- Way back.

- Even before that.

- My great great grandfather.

- Really?

And at one time you considered being an Episcopal minister, I read somewhere.

- I think most pediatricians are social worker-type people.

And if we happen to go to medical school, which my father was pretty decided on for me, you find what you wanna do that makes you happy.

And pediatrics is a combination of doctor, social worker, minister, teacher, coach.

And so it's been perfect for me.

- Because you're working with children all the time.

- Exactly, and you're working with their families and mainly with the community, which will determine most child outcomes.

It's not so much the medical care at the bedside.

It's what happens to this child in the home, the community, the school.

And that's what we've learned.

And I've been very fortunate to have such a great community to help me wrap the services around at-risk children that might really make a difference.

- So tell me more about this.

I'm not sure I fully understand.

If one of my grandchildren goes to a pediatric doctors because they got an ear problem, they're not breathing right, they're sick in some way.

But you're expanding this to be concerned about what happens with them in school and at home.

What does that mean?

- Well, pediatricians do spend at least three years learning how to be really good hands-on doctors.

And I went to a community that really needed me to give them up-to-date pediatric care at the bedside.

So I developed a level-two newborn unit.

I developed a hospital service.

We have a four practice, four-office practice that covers parts of seven counties in eastern North Carolina.

And we operate seven school-based health centers in this community.

So the hands-on has been significant.

But let's say your child comes in and we get off this topic of the ear infection, we find out they're failing in school.

Then my job is to know who in the community can help this family improve the academic outcome, which will really make a huge difference 'cause we know that one-half of US fourth-graders aren't reading at grade level, which is embarrassing.

Tremendous research on how we're not talking to our birth-to-three children.

That can play out in the community through coalitions.

And so that's an example of what a visionary pediatrician can bring to a community.

- Wow, what an honorable pursuit.

I never thought of it that way.

You've just expanded my mind about the role of such a doctor in a community.

You know, you've operated and you grew up in Washington, North Carolina.

I hear so much about the need for medical care in rural areas.

You agree that that is a challenge.

- [David] Tremendous challenge.

- And what are we doing to fix that, to solve that?

- Our state, which is the reason we wrote this book, has partnered with the North Carolina Pediatric Society over these five decades that we talk about in the book and developed a healthcare system that does it all: the immunizations, the mental health, the Medicaid program, the CHIP program.

And most all pediatric programs are funded by the federal government.

But the state has tremendous latitude and it's really necessary for people who understand the nitty-gritty of what goes on in the community to work with the people at the state level who determine how all this money is gonna be spent so that we end up with a good healthcare system that's user-friendly for children, for parents, and for their physicians.

So this has been the biggest challenge is to get the powers that be to say, "Yes, "we need to pay doctors who work in rural areas.

"We need to educate doctors in a way "that exposes them to rural areas."

So we have medical students in our office all the time, introducing them to rural practice.

And I think that's the best way to go is from the ground up.

- So it's not just that doctors wanna live in metro areas where they can have, you know, a life-work balance and all of the amenities.

It's more than that.

You're saying there's more.

There's a government role here.

- Well, because so many children depend upon Medicaid and CHIP, which are mostly federally funded for their healthcare, then the state in this situation.

In adults, most all of it flows right from Medicare in Washington, DC to the office of the physician.

Here, it goes through the state and the state decides how they want to run this program.

And what the North Carolina Pediatrics Society has done in a big way is help the state make sure that these dollars are spent on programs that work for children, families, and physicians.

And slowly but surely, I think we're getting this right.

But I think the biggest change during my career has been when we recruit a physician, we also recruit a significant other or spouse.

And today, nearly all these spouses have careers, whereas back in the day when I first came out, most physician's spouses really were not interested in their own professional careers.

That's not fair to say completely, since all three of our daughters have, you know, major professional jobs but it adds a challenge.

If you're in a rural area that doesn't have the jobs that the metropolitan area has, then we have to do something about it.

And our schools suffer because of the funding base.

When we lost tobacco in eastern North Carolina, that was huge; we hadn't recovered from that.

So it's just a very complicated problem.

But I'm the cup is half-full for us at the North Carolina Pediatrics Society.

- I'm glad you feel that way.

Nothing is more important to a family than their children.

So your work is very important.

It's at the heart of all that we care about as parents, that's for sure.

Listen, you went to the University of North Carolina Chapel Hill on a Morehead Scholarship.

You're a Morehead scholar.

- Correct.

You graduate Phi Beta Kappa.

You're a pretty smart guy.

- I worked hard.

- Yes, and you went on to become president of the North Carolina Association and the president of the National Association of Pediatrics, right?

- [David] Yes.

- That's pretty impressive.

- [David] Thank you.

- And then you wrote a book.

About obviously you're very passionate about this work.

What is the book about?

- The book, I really wrote it and I didn't write it by myself.

There are 71 co-authors.

- [Nido] 71 people helped to write that book?

- But one of my pediatrician friends suggested we go to a meeting of the National Academy of Pediatrics and talk about a couple of things we've done with government, like we have a wonderful immunization program.

We have an amazing Medicaid program, an amazing CHIP program.

And so I wrote a couple of essays and sent 'em to her and she sent 'em up the line.

And the people at the national level just didn't appreciate the importance of our work in North Carolina.

And so Kathleen Clarke-Pearson, this pediatrician who's retired, said, "Let's just write our own book.

And I said, "Well, Kathleen, I'd really like to do that.

"I owe it to my late father to write that book "since he was the stimulus for a lot "of what we've accomplished within government "in the state of North Carolina."

And so we just went by the seat of our pants and started doing what we thought felt right.

And then we ended up with this amazing collaborative effort by friends in government, pediatricians, people who don't even live in North Carolina who saw the work we were doing here and wanted to have a few nice things to say about it.

And the focus of the book is what?

- It's advocacy for children.

How do you really advocate for children at multiple levels, especially the practice, the community, the state?

We don't talk so much about the federal level here, although I've been in the middle of that over the years.

- Your dad was also a pediatric doctor.

And I believe it was in 1985, there was some controversy.

He was sued for something.

And that led to all kind of legislation that helped children of North Carolina.

Fill us in on the details.

- It goes back to 1982 when national news showed pictures of developmentally disabled, severely developmentally disabled children, 11 of them in Great Britain, that were supposedly injured by the whooping cough vaccine.

The vaccine was called DTP.

Well, attorneys and families saw that and began to bring lawsuits because a lot of children have high fever and they're irritable after they get their shots.

And so a family that had gotten their shots at my dad's office from his partner's nurse in 1974 sued my dad and his partner.

And in a jury trial in Wilmington in 1985, my dad and his partner were found liable for three and a half million dollars at a time when my dad was the immediate past president, probably the most respected pediatrician in North Carolina.

Today they give an award every year in community pediatrics that's named for my dad.

And I think pediatricians realize if this could happen to this exemplary pediatrician, it could happen to me.

And so there was a meeting within several days of my dad's verdict in Pinehurst and it was just electric.

And I came out of there being the chair of an ad hoc committee to go to Raleigh because we knew that if we could be sued for giving childhood vaccines that were required by the state, that just wasn't gonna work.

And so we were able to pass a law with the help of infrastructure my dad had actually put in place when he was the president of the Pediatric Society.

We passed a law in 1986 that said basically you couldn't go to a jury trial for a problem related to a state-mandated vaccine but you could receive compensation through the industrial commission like workman's comp.

And the attorney general could review the case.

And if there was wanton and willful negligence on the part of the doctor, the doctor could lose his license.

And we were ahead of our time with that.

But later in '86, the federal government put in a program for everybody in the United States like that.

It probably had nothing to do with what we were doing 'cause we were clueless as to what was happening at the federal level.

We were just passionate about fixing our system.

But the momentum pediatricians gained and the North Carolina Pediatric Society gained flowed over into our work with Medicaid, our work with CHIP, our work with mental health, our work with child abuse, our work with the schools.

That's what the book's all about.

We have a section in there with just a variety of topics where pediatricians have stepped up as advocates and brought in friends in government to get really neat things done for kids.

- Well, that's important work and thank you for doing it.

I'm looking at your pretty tie, pictures of children.

Obviously you've given your lifetime for this pursuit.

You're still practicing, aren't you?

- Oh yes, I'm passionate about my practice, as long as my health holds up.

I work about half-time, a little more lately 'cause it's wintertime and we're busy and we're having trouble recruiting providers, physicians, nurse practitioners, physician assistants to rural North Carolina.

- Is it because it's rural North Carolina?

- Yes, sir.

I think mainly.

- Do you believe that there are real energy behind fixing this challenge, attracting medical professionals and assistants to rural North Carolina?

- Oh yes, we're in a partnership now with Medicaid, I'm on a couple of oversight boards with Medicaid, and then the University of North Carolina School of Medicine.

And we work closely with the Campbell University School of Osteopathic Medicine.

The students at Campbell, many of them do their pediatric clinical work in our office.

So we are slowly but surely getting many, many students.

Of course, Greenville ECU Health is what we call that institution now.

They're in our backyard and we constantly work with them.

I'll do their grand rounds tomorrow morning on advocacy, actually.

So sure, we're gaining on it and I think slowly but surely we'll get there.

We're not gonna let the health system die for children in eastern North Carolina just because we're rural.

We'll figure this out.

- You were born in Philadelphia actually, is that right?

- When my dad was in medical school up there.

- Right.

And then you grew up in Washington, North Carolina.

And now you operate in Goldsboro, North Carolina.

When you look forward, what is it that you see?

You see improvements.

There's improving legislation for sure, improvement in attracting professionals to rural areas of North Carolina.

What else worries you about in this age where social media plays a big role, this age that we're in that parents are a little different than perhaps your time or my time.

For whatever reason, they're being exposed to so much more.

They're influenced so much more by social media.

Perhaps they have different approaches to doing things, maybe even, you know, rearing children.

What is it as an expert, as someone who's lived long and well, what is it that you see as you look forward five, 10, 15, 20 years?

- I think the biggest challenge we have in our communities right now with regards to children is mental health.

- That goes to what age?

I mean, teenagers I understand.

- Well, pediatrics is birth to 21 years old.

- Really?

- Yes.

- I see.

- So we work with the schools because that's the captive audience.

If you can bring the mental health professionals into the schools, then the schools can work with you.

And we've had tremendous success with that.

25 or more years ago, I began doing school-based health center work.

And in our community, these centers use the same electronic medical record that we have at our office.

And no money changes hands.

It's just the right thing to do.

And so we're giving children access to mental health services in the schools with parental permission because the number of children today who suffer with anxiety, depression, substance abuse, suicidality, is just through the roof.

- And COVID aggravated that.

- It did not help a bit 'cause people sat home and didn't mix up.

You know, the best thing you can do for your mental health is have conversations with like-minded individuals, so to speak.

But you're not gonna be able to do that in the office setting very well.

It's not very friendly to teenagers and young adults.

- What do you think is why are we seeing so much more mental health occurrences with these young people?

Is it that we now know how to locate it, find it, focus on it, deal with it?

Have we always had it at this level?

Is it some societal changes that caused that?

What in your view is causing this significant increase?

- I think from a pediatrician's perspective, if you look at the history of my practice, I was totally consumed with disease, medical disease, not mental health, when I came into practice because we did not have vaccines for bacterial meningitis, for hepatitis.

We barely had vaccines for measles, polio, and whooping cough.

So as more and more vaccines came out, it just took care of a lot of disease.

Like the rotavirus vaccine eliminated 87% of the hospitalizations for diarrhea, vomiting, and dehydration in children.

And so pediatricians actually have time to look at the big picture a little more.

At the same time, you've got an evolution of American society into, as you said, all this social media and screen time.

And we don't think too much of that is all that good for children.

And you've got tremendous percentages of loneliness in the youngest adults, which means they can't name one really good friend.

So I think our culture's moved toward the facilitation of mental health problems for children and then pediatricians have focused on that because they finally have time to focus on that.

- But when you say focus on that, pediatricians cannot treat that necessarily.

They refer it more to psychiatrists, psychologists, counselors.

- We do something called collaborative care or integrative care.

In other words, in our practice, we built a wing in the parking lot where we have had two mental health professionals who work closely with us.

Neither of them can prescribe medicine.

So if you've got severe depression, anxiety, you're gonna do better if you've got a combination of talking therapy and appropriate medication.

So this partnership is just great.

And then there are plenty of mental health professionals who don't work, that calls for pediatrics, in our community.

But we're constantly working with them.

We'll have an education program tonight over Zoom at eight o'clock and we'll have a counselor from the community talk to us about how we work with kids with autism.

And we'll bring the director of exceptional children's programs for the schools onto the Zoom session so we can make sure she has the information she needs from us and the counselor to serve the children appropriately in the public schools.

So that's the kinda work that pediatricians can do as advocates in their communities.

- Yeah, that's really wonderful.

It's probably an unfair question to ask you but children who are on medication become dependent on it, do they not?

I mean, I think of people, for example, children who have ADD or they have not necessarily mental health but some of these issues and they go on for years taking this medication.

- They do and if you looked at the numbers, as your brain matures, probably 30% of these children who are given medicine for ADHD along the way actually still have the symptoms as an adult.

So I know adults who take medicine to sit at their desk jobs.

So I think ADHD is real.

But a lot of these kids, as their brains mature and they gravitate to jobs that they really enjoy, you know, the ADHD kinda fades away.

The medicines have not been shown to be habit-forming.

In other words, it's not a narcotic-type drug.

And I think these children will not take the medicine if it doesn't help them.

So we see these children every three months to help manage their medicines with their mental health professionals, whether it's ADHD, anxiety, depression, whatever.

And I feel good about that.

I didn't do it when I first came into practice.

Except the ADHD, that's always been with us.

But I manage, co-manage, a lot of anxiety and depression today and I have this partnership with the community and the schools that makes me feel cautiously optimistic that we're on the right track but we're not there.

- One has to admire your spirit, your energy, your commitment to your profession, your love for community, certainly your desire to be a person of nurture for these children.

And I'm certainly impressed the fact that at this stage of your life, you're still going full blast.

You still speak about all this with such enthusiasm.

And you think you'll keep doing this as long as you can?

- Sure, I mean, there's always more things, you know, that come along to do.

And I have great energy right now.

I've got a very supportive wife and family.

And the community is wonderful, you know.

I really have thoroughly enjoyed it.

I think the experience with my dad's lawsuit and very early on when I went to the legislature, I looked around and I said, "Nobody up here knows "as much about child health than a good pediatrician."

And we have to share that with people and then we have to step up and take leadership roles that we never imagined we would take because we're on the side of the angels.

- Yeah.

And you've done exactly that.

And we thank you very much.

- [David] Sure.

Thank you.

[upbeat music] [upbeat music continues] - [Announcer] Funding for Side by Side with Nido Qubein is made possible by... - [Narrator A] We started small, just 30 people in a small town in Wisconsin.

75 years later, we employ more Americans than any other furniture brand.

But none of that would've been possible without you.

Ashley.

This is home.

- [Narrator B] For 60 years, the Budd Group has been a company of excellence, providing facility services to customers, opportunities for employees, and support to our communities.

The Budd Group.

Great people, smart service.

- [Narrator C] Coca-Cola Consolidated is honored to make and serve 300 brands and flavors locally.

Thanks to our teammates, we are Coca-Cola Consolidated, your local bottler.

[upbeat music]