Their humanitarian bent has its basis in Quakerism. The family lived in Haddonfield, New Jersey, a suburb of Philadelphia. Dr. Caughey’s maternal grandfather was Henry J. Cadbury, Ph.D., a distinguished biblical scholar, author, and founder of the American Friends Service Committee (AFSC) in 1917. AFSC was awarded the Nobel Peace Prize in 1947 for its work in the American peace movement and its involvement in humanitarian causes such as settlement houses, black schools in the South and depressed areas of Appalachia, and for its work with the children of coal miners. Dr. Cadbury spent the last 20 years of his professional career at Harvard as Hollis Professor of Divinity, the oldest and one of the most prestigious academic chairs in the United States.

Michelle Caughey’s early education was in Friends schools and Westtown School, a Quaker boarding school in Chester County in southern Pennsylvania. She received her undergraduate degree from Wellesley and came out to Stanford for medical school in 1975 with her then new husband George Caughey. Dr. George Caughey is a full professor of pulmonary medicine at UCSF, chief of the Pulmonary Division at Veteran’s Affairs Medical Center, and has an endowed chair at UCSF for research, his first love.

Neither of the Caugheys had ever been to California and made their decision to come to Stanford strictly for professional opportunities. But from their first exposure to now, they feel, "this area is one of the most beautiful places on Earth!"

Dr. Caughey explained that in the early seventies, as she was figuring out how to become financially independent and self-supporting, many professions were not eager to accept women. Medicine was just opening up opportunities for women, even though in 1970 they represented only 10 percent of medical school classes. "I knew I needed to work at something I could be passionate about and I thought I could be successful," she said. "I’ve never regretted going into medicine. I can’t say that I really knew what being a doctor was, when I made those decisions, but I love being a doctor."

Even on the "progressive" coast, there still was some prejudice in medicine. Dr. Caughey said that she chose internal medicine as her specialty because she is comfortable with it and enjoys the patient contact. "A couple of my women classmates did become surgeons, but the doors were closed and you had to knock really loudly to go through. I like to tell my surgery story to symbolize the climate toward women at the time. There was a doctors’ locker room and a nurses’ locker room—not men’s and women’s—for changing clothes for surgery. Female medical students had to change in the nurses’ locker room, but there were no lockers for us. So when I was all scrubbed down on a case, what I was really worrying about was that someone might steal my expensive stethoscope. The message to female medical students was ‘You’re not welcome here.’ The chief of surgery at the time was very open about the fact that he felt women didn’t belong in surgery."

The Caugheys returned to Philadelphia for residency at Pennsylvania Hospital, the oldest hospital in the country. After her residency, while Dr. Michelle Caughey was in private practice for a year, she was also a clinical instructor for the residents at Pennsylvania Hospital, but said that she never considered a career in academic medicine. "I think it is the obligation of physicians to teach all the time—your successors, patients, nurses, physician assistants—to further understanding of disease processes and disease prevention; it’s just what physicians do, especially internists and pediatricians. If patients understand what’s happening to them, they are much more likely to comply with their treatment regimen."

After residency the couple headed back to Stanford, where Dr. George Caughey had been awarded a pulmonary fellowship. By then they were the parents of two small children. As the breadwinner Dr. Michelle Caughey went job hunting and found her way to The Kaiser Permanente Medical Group in South San Francisco.

As she begins her presidency of the San Mateo County Medical Association—only the third woman in the organization’s 100-year history to do so—Dr. Caughey has some 20 years of clinical practice in internal medicine. She also serves the dual role of physician-in-chief of The Permanente Medical Group, South San Francisco, (first elected in 1997 and now in her second term) and of chief-of-staff of the Kaiser Foundation Hospital at South San Francisco.

After being a mom, her first love is clinical medicine and she does not plan to extend her venture into administrative medicine. "I want to go back to clinical medicine," she said. "That’s what I love to do most. It never occurred to me that I would be running a hospital in my career. I love being a doctor. It is such a great privilege to have an active mind and intellectual stimulation. Medicine is sort of like solving puzzles. And seeing that the process also benefits others is a sort of natural altruism and idealism. It is the human contact that ultimately sustains you in practice. Although they are formal relationships, they are very satisfying human relationships."

With all she is doing and all her accomplishments, Dr. Caughey does not describe herself as "having it all." "No, not really," she is quick to say, "I guess because I never started out with the ambition of seeking a super high-powered position. I felt it was my turn to contribute to the organization. It’s been rewarding but it comes at a price. There are things you can’t do with your family and I regret that. It’s a hard question, but I really want to spend more time in clinical medicine and this position takes me away from that. My husband doesn’t think I will be happy just doing clinical medicine, but I do. I never want to become stale or ineffective; I always want to be looking forward to the next stage. I hope that when I see something that needs doing, I can do it; there will be time for that, but not something so all-encompassing as PIC."

Of medicine in general, Dr. Caughey is concerned about, "the nation’s ability and willingness or unwillingness to pay for the care the American people expect. That’s the crux of the issue. Good care saves lives so that makes it good. But there has to be the resources to pay for that care, and it has to be done in an ethical way. I don’t think that now or in the future we have, as a country, the resources to pay for everything, and we simply have not confronted that situation."

On becoming president of SMCMA, Dr. Caughey is looking forward to the experience. "The really wonderful thing is that we have parallel health systems in this county, whether Kaiser, Mills-Peninsula, or wherever you happen to be, and they’re all vital for our citizens. If you work in just one of the systems, you have a narrow view of how things work. By learning from the other members of the Medical Association, I have broadened my own view and that really appeals to me. What I have learned informs my own work for the better. I think our organization and our medical groups can, if we all work together, begin to confront some of these difficult issues. Working separately, we can’t"

"The SMCMA has a tremendous history. When you think it has been a vital organization for 100 years, it speaks to the fact that the organization has value for its constituents who are the physicians of the community. It’s had different kinds of value over the years. To me, its current value is providing a number of resources to physicians who are not in a group practice setting or affiliated with large organizations. One of its main roles is as an advocate of health issues and physician practice issues.

"As president I don’t anticipate making major changes, but I’d like to change the emphasis just a little bit. What I have in mind is emphasizing the health of the citizens of the county. I want to involve the Medical Association in a more visible way in improving the health of the citizens. If we build that as a foundation for the Association, we will be seen as better able to advocate for any issues that might be related to physicians’ practices, not just self-serving and trying to increase overall wealth of physicians. One example of what I mean is the County Childhood Obesity Taskforce, on which I serve. I really think we need to participate in these kinds of activities and there are many from which to choose."

Another big issue on the minds of the Caugheys is the empty-nest syndrome, which they will be facing this September. All of their four children have gone back to Westtown boarding school and now the youngest, Willa, will make the trip. They have four children: Devin, the oldest, was graduated from Yale last year and is taking a year off to work in Arlington, Virginia, developing educational software; he also sings in a professional cathedral choir and is a cellist. He’s applying to graduate schools now (Mom and Dad are thinking Berkeley or Stanford, something on this coast!). Robert just finished at Haverford College and wants to be a doctor; he is taking a year off and is doing lab work with animals at Harvard; he also sings. Bennett is a junior at Westtown; he sings and plays viola. Willa just finished at Woodside Elementary and is on her way to Westtown; she plays violin. Somehow the family also finds time for various athletic pursuits, especially soccer (Michelle Caughey plays on two women’s soccer teams), hiking, and various other sports.

Mom is sure she will be teary-eyed when Willa leaves. This empty-nester thing is no joke to her. "I miss my children very much. I’m a mom first and a doctor second. I’ve enjoyed each of them as they’ve grown up. They’re great kids. I told my husband that we can just go see the kids every weekend. That’s what money is for; going to see your kids!"