[The family doctor who taught the first U.S. self-care class describes that class and the subsequent rapid growth of the self-care movement.]
I always find myself explaining Keith Sehnert as the George Washington of self-care. Keith graduated from Western Reserve School of Medicine in 1953. After working as a General Practitioner and later as Medical Director of Dorsey Laboratories in Lincoln, Nebraska, he joined the Reston-Herndon Medical Center in Herndon, Virginia. There, in 1970, he taught—and largely invented—the first of the modern breed of self-care classes, classes in which laypeople learned basic medical skills formerly reserved for doctors only.
The class drew wide media attention. In 1972, Keith became a visiting professor at Georgetown University and in 1974 founded the Center for Continuing Health Education at Georgetown.
The Center for Continuing Health Education did self-care research, taught health professionals from all parts of the country to conduct self-care classes, and prepared course materials for these classes. In 1977, Keith became Vice President and Director of the Health Promotion Group at InterStudy, a health-policy and health-futures think tank in the Minneapolis area, and joined the University of Minnesota School of Public Health as clinical professor.
It is in large part because of Keith's efforts that there are now self-care classes in forty states. He is the author of How to Be Your Own Doctor (Sometimes).
TF: You were saying that you were a student of Ben Spock's at Western Reserve.
KS: Yes, back in the early fifties. Spock was just starting out as a teacher there, and his book, Baby and Child Care (reviewed on page 207) was just out. Of course, no one had any idea then it was going to become so popular.
Did he have a big influence on you?
He did. He was very concerned that most patients were getting a great deal of treatment but very little teaching. He felt that was a mistake.
I don't think there's any doubt but that his book planted a seed for me. I've always thought of my book as a kind of Dr. Spock for adults.
Were there any other experiences at Reserve that nudged you in the direction'' of self-care?
Yes, the influence of another very important teacher, T. Hale Ham. In those days the whole business of a doctor's empathy for the patient and communication skills were spoken of as one's bedside manner. We were all very concerned about our bedside manner. Dr. Ham used to say, "Keith, you just talk to your patients in whatever way is most comfortable to you—but keep in mind that if you're a good teacher, your patients will think you're a good doctor."
How did you happen to end up teaching that first self-care class?
Well, you know, serendipity plays such a big part in these things. I'd just joined a family practice group in the Reston area of Virginia. The guy who'd actually planned the class was leaving to join the Family Practice Department at the University of Wisconsin. One day he just casually asked me, " Look, as long as you're going to be here, would you mind picking this thing up for me?" And of course I said yes.
How many students were there?
I think there were forty, maybe forty-two. About 80 percent women. Almost all of them were patients at the Medical Center.
What was the first class meeting like?
It was an interesting experience. Many of the people in the first class were women whose husbands had been recently laid off by a reduction in the Johnson administration space program. Some of them were living on unemployment insurance for the first time in their lives.