Valley Doctor Takes National Award: Cathy Baldwin-Johnson of Wasilla Was Named The 2002 Family Physician of The Year By The American Academy of Family Physicians.

Cathy Baldwin-Johnson always knew she wanted to be a doctor. Even as a young girl she was interested in the biological sciences and was inspired by her aunt, who was a nurse.

"My parents always encouraged me to follow my dreams," Baldwin-Johnson said. "My father said 'You are smart

The East High School graduate went to undergraduate school at Arizona State University in Tempe, medical school at the University of Washington in Seattle and then spent three years in residency studying family medicine in Seattle. Shortly after finishing her residency, she made her way back to Alaska where she worked for a practice in Anchorage for two years. She opened her own practice in Wasilla in 1985.

On Oct. 1, 2001, Baldwin-Johnson was named the 2002 Family Physician of the Year by the American Academy of Family Physicians at an awards ceremony in Atlanta, Ga. She was the first Alaskan to ever receive this national award, sponsored by one of the largest medical specialty organizations devoted solely to primary care. The AAFP has more than 93,000 members.

"My first reaction was disbelief when I learned I received the award," said Baldwin-Johnson. "It's an incredible honor. It really is."

The 48-year-old doctor was nominated by the Alaska Chapter of AAFP, which had presented her with the Alaska Family Physician of the Year award for 2001. Letters of recommendation came from a variety of people, including the mayor of Wasilla and a commissioner for the state of Alaska.

Nominees had to prove they were worthy of the award by demonstrating excellence in a variety of ways. Not only do they have to be compassionate in their work, but also they have to be directly and effectively involved in community affairs that enhanced the community they live and work in, according to the AAFP. Nominees also have to be credible role models and must be in good standing in their medical communities.

Baldwin-Johnson was nominated for her work as a family physician; as co-founder of The Children's Place, also in Wasilla; and as a founder of the Sexual Assault Response Team in the Valley. She recently received the Alaska First Lady's Award for outstanding volunteerism.

"Dr. Baldwin-Johnson is very dedicated to her family medical practice," said Alaska Commissioner Karen Perdue. "But what makes her extraordinary is the countless hours she volunteered toward starting a children's advocacy center in the Mat-Su Valley.... Dr. Baldwin-Johnson is known throughout the state for her great volunteer effort to establish this center in her community."

"She has demonstrated her gentle passion, deeply rooted strength and commitment in ways that would stretch any physician," said Margaret Volz, program director for The Children's Place. "Along with running a busy family practice, which includes a high percentage of obstetrical patients, she helped to write 11 grants, 10 of which were funded for the start-up of The Children's Place."

Today, Baldwin-Johnson spends most of her days at Providence Matanuska Health Care center, a 38-employee facility she founded, but which became affiliated with Providence three years ago. She also spends at least a hall-day per week volunteering at The Children's Place, a nonprofit organization with six paid employees that opened in March of 1999 after two years of planning. The Children's Place is modeled after Children's Advocacy Centers around the country, using a team approach for the identification, evaluation, treatment and prevention of child abuse and neglect. The Children's Place, which saw 130 clients in 2000, provides free services to children and families in need due to abuse or neglect. (The center relies on grants to pay for the services, or bills insurance, the Alaska State Troopers, Medicaid or Denali Kid Care if applicable. Denali Kid Care provides medical insurance coverage to children from low-income families.)

Much of her work there involves working with children coming from physical- or sexual-abuse backgrounds. Baldwin-Johnson has received special training in working with children of abuse. Her interest in working with abused children stemmed from what she was seeing in her medical practice.

"Family physicians not only see children that perhaps have been physically or sexually abused or neglected, but also they see the long-term effects (of that abuse). There are a lot of pregnant and parenting teen-agers with a history of maltreatment, especially sexual abuse.

"And you see adult women with depression, anxiety, panic attacks, chronic pain syndromes ... you see a correlation with their childhoods. What things happen in childhood have lifelong health effects. They carry that burden (of abuse) with them for the rest of their lives. Often they blame themselves."

The doctor said Alaska has the highest rate of substantiated child abuse in the nation: three times the national average. Reasons are multiple and include isolation, a transient population, and a high incident of alcohol and drug abuse. "The Valley's No. 1 cash crop is marijuana. There are a lot of methamphetamine labs out here. It's easy to make and inexpensive. It's a huge problem. Also, there's a lot of folks under financial pressure. About 40 percent to 45 percent of my practice qualifies for Medicaid or Denali Kid Care."

Baldwin-Johnson sent out an anonymous survey about six years ago that asked people whether they had ever been physically or sexually abused. Most of the surveys that were returned were from adolescents or adult women. About one-third of those who returned surveys reported a history of physical or sexual abuse.

She said preliminary studies released by Kaiser Permanente, an HMO in California, and the Center for Disease Control, showed that abuse in childhood often correlates with poor health outcomes in adults.

"They found that there is definitely a correlation between bad things that happen in children and their health as adults," Baldwin-Johnson said. "(Those with a history of abuse) are more likely to smoke. They are more likely to drink. They are more likely to abuse drugs. They miss more days at work and are less productive in the work environment. They are more likely to have heart disease, or a stroke, or cancer. So it's important to intervene at a young age. It's hard to reverse the ill effects on the body."

Aside from a free medical exam, The Children's Place gives young people the opportunity to speak safely about what has happened to them. The children are interviewed by either a law enforcement officer, social worker or staff member while being taped. The interview can be watched from another room by the other members of the team involved in the protection process. Police, Division of Family and Youth Services staff and others can request certain questions be asked during the interview process. This prevents the child from going through multiple interviews, which can be traumatic for the child. This process also provides a permanent record for future reference.

"When children first disclose what has happened to them (to family members or friends), many times they are not believed," Baldwin-Johnson said. "It takes a lot of courage for the child to start talking about sexual abuse or physical abuse. Oftentimes they have been threatened by the person who hurt them-threatened (that the abuser will) hurt their mom, kill their dog or hurt their Barbie (if they tell).

"Oftentimes they are reluctant to tell at first. There are some techniques we use. We try to let kids know they are in a safe place and that we are there to try to help. We talk about secrets and the different kinds of secrets there are. Some secrets are a surprise. Like a birthday present is a nice secret. We tell them surprises make a person happy. But if somebody is doing something hurtful to someone and it makes them feel bad it is not a good secret. We want to follow the children over time. Stay in touch with the family."

Frequently, when the child tells of physical or sexual abuse, their lives temporarily get worse. "Say the abuser was the father figure," said Baldwin-Johnson. "He is also the breadwinner. The family may be split apart. Now the children are in a home with a single mom and increased financial stresses. The mom may blame the child. For awhile the child may perceive things as worse. Being abused is horrible, but on the other hand the family is together and mom isn't mad. Sometimes the whole family will turn against the one who told. We try to be there for the children and do follow-up."

Follow-up involves hooking the family up with various support groups in the community. "We try to strengthen the family and help parents do a better job," she said. One of the ways they do this is through a program started by the state of Alaska and funded by the Division of Family and Youth Services.

The Mat-Su Valley DFYS office receives more than 1,600 reports of harm to children each year. Those reports of harm are broken down into three classes: Priority One, Priority Two and Priority Three. Priority Three incidents-which may involve drugs in the home, children witnessing domestic violence, a parent with a mental health problem, etc.-often get filed with little follow-up from DFYS because of heavy workloads. Now, thanks to the new program, Priority Three reports are referred to a family assessment worker at The Children's Place.

"We make contact with the family and are able to go out to the home," said Baldwin-Johnson. "We discuss the report with the family-interview the family members and the person who made the report. We develop a plan to address the problem." For example, families with financial difficulties might be referred to the food bank. If an adult has a mental health issue, that individual would be referred to counseling. A substance abuser would be referred to a substance abuse counselor. Women who are being battered are referred to a battered women's shelter.

"The idea is to figure out what can be done to reduce the risk factors to the family," said Baldwin Johnson.

The University of Alaska is doing a study on this pilot project. After gathering first-year data, the results showed a 50 percent reduction in the rate of recidivism and a 50 percent reduction in the severity of incidents in new reports of harm.

The study proved the staff's efforts are working.

"We have to be optimistic or it's hard to get out of bed in the morning," said Baldwin-Johnson. "We do believe most parents, with the exception of those involved in sexual abuse, do want to be good parents. They don't wake up in the morning saying 'I am going to beat my child today.' Most want to do a good job. They just don't have good role models."