Joseph Patrick Connelly Jr., MD

Dr. Joseph Connelly, Jr, M.D, 65, passed away June 10th, 2021 with his wife by his side in Bel Air, Maryland. He was the beloved husband of Carla J. Connelly for 41 years; devoted father of Catherine Connelly Graham and her husband Jacob; cherished grandfather of Oliver J. Graham; dear brother of Kevin L. Connelly, Sr. and his wife Louise, and Michael K. Connelly and his wife Brenda; loving uncle of Marianne K. Stupalski and her husband Justin, and Kevin L. Connelly, Jr. and his wife Alexandria.

Joseph graduated from the University of Maryland School of Medicine in 1982, and has been practicing Family Medicine for over 40 years.

Relatives and friends are invited to gather at the Schimunek Funeral Home of Bel Air, 610 W. MacPhail RD, Bel Air, MD 21014, on Tuesday, June 15, 2021, from 3-5 PM and 7-9 PM. Funeral services will be held on Wednesday, at 11 AM, at the funeral home. A link to the live stream of the service can be viewed under Joseph's funeral service information on our website. Interment will follow at Parkwood Cemetery. In lieu of flowers, memorial donations may be made in Joseph’s name to the Kennedy Krieger Foundation at KennedyKrieger.org/Tributes. Condolences may be left for the family at www.schimunekfuneralhomes.com

Joe was born October 4, 1955, in Baltimore, Maryland to Joseph and Mary Connelly. He attended Parkville HS (Class of ’73), UMBC (Class of ’77), and University of Maryland Medical School (Class of ’82). He met the love of his life, Carla, in college and they married September 20, 1980. Joe then specialized in Family Medicine following a residency at Franklin Square Hospital. He went on to selflessly dedicate his life to improving the health and lives of his community.

Joe had a deep sense of work ethic instilled in him by his mentors in residency and early private practice with Rombro, Castro and Connelly in Middle River. He was currently serving as the lead physician of GBMC Hunt Manor in Phoenix, Maryland. Joe also served as the President of the Maryland Academy of Family Physicians in 1993 – the youngest physician to serve at the time.

Most knew Joe as Dr. Connelly, but few got to witness his loves outside of medical practice. In Joe’s younger years he would enjoy scuba diving, windsurfing, or sailing his catamaran on the Chesapeake Bay. He was even asked to sail as an extra in a movie called Violets are Blue starting Sissy Spacek and Kevin Kline (1986). Joe was also a skilled craftsman. He could fix anything in the home from plumbing to electrical. He amazingly drew up the blueprints for his dream home in Fallston, Maryland where he lived for over 25 years. Joe was an amateur photographer, techie, and bargain hunter as well – sometimes known as Joe “make a deal” Connelly. It always seemed like there was nothing Joe couldn’t accomplish or fix.

More than anything, Joe loved spending time with his family. Holidays, like Christmas, were his favorite because it was time he could step away from the office and focus on the love around him. He was known for his holiday light and decoration displays – things he did to emphasize the warm spirit of the season for his family to enjoy. Joe enjoyed supporting the Kennedy Krieger Institute Festival of Trees every year. He also enjoyed family vacations to Orlando, watching his daughter’s college field hockey and lacrosse games, and theatre nights out with his wife. In 2019, Joe was blessed as a Grandfather with the arrival of his grandson, Oliver Joseph Graham. Oliver looks just like his Granddad and Joe loved him deeply.

The Wonderful Practice of Family Medicine - A perspective after 30 years of practice by Joseph Connelly, Jr. MD (Fall 2014 article MAFP magazine)

As I reflect the current state of family medicine, I would like to begin by sharing some of my memories from my younger years. I am in my 29th year, since completion of residency. I lived in Parkville for my premed school years and stayed in Baltimore for all of my training. I went to UMBC, University of Maryland Medical School and Franklin Square Hospital for Family Medicine Residency. My entire career has been in suburban Baltimore. Once our office was closed for repairs and I shifted to an affiliate office where I was actually able to see the rooftop of the house where I spent my first year of life.

Two established doctors allowed me to join their practice near Franklin Square Hospital upon completion of my residency. We stayed open 7 days a week and closed when the last patient was seen. This could be until midnight and even until 2 AM during flu season. We were open all holidays. Dr. Rombro covered Sunday, Dr. Castro and I covered Friday night and Saturday. We rotated coverage on the weekends, which afforded me to have Wednesdays off. My wife and daughter usually went to bed by 10 o'clock so I didn’t mind working so late. Except for the extended office hours, my practice was pretty typical of a family physician, which included treating all patients, all ages and all problems. We had a gynecologist in the office and they provided the additional care for women.

When Dr. Rombro retired at age 80, we entered discussion with two organizations to buy our practice. For me, it was a solution on how to avoid having to buy out my two partners. Ultimately, we joined with MedStar Physicians. To this day, I am indebted to my two partners for teaching me good work ethic, learning how to gain patient respect, and providing a good community service by having such extended office hours.

In order to attract new physicians to our MedStar office, the schedule was adjusted by first eliminating Sunday hours and the Friday night session. A few years later, Dr. Castro retired and four other doctors came and went during the remaining six years I was with MedStar. My wife and I had already made our home in Fallston and occasionally shopped in Hunt Valley area where we passed a medical practice that I had silent wish to join. Some of my colleagues and graduates of my residency program started this practice in “Four Corners" as it was called north of Loch Raven reservoir in Phoenix, Maryland. This office is affiliated with GBMC. Due to the retirement of one physician, I was invited to join the practice. It was a very difficult decision to leave so many of my Middle River patients that I had cared for over 24 years.

There is a huge difference between old-school office hours and current office hours. In our privately owned practice we were able to see patients until the last sick patient was seen. Under corporate ownership, there is an advertised closing time and the office staff expects to leave. During my years of private practice, I did hospital rounds for additional income to supplement my office work. When we decided to forego inpatient care, I visualized I would be able to stay at the office a little later and see a few extra patients. As we transitioned to corporate ownership, staying late was not allowed because the office staff objected. Administration agreed with the staff, not wishing to pay overtime, so the office was open from 8:30am-5pm. However, the tide is now changing. As part of our Patient Centered Medical Home (PCMH), extended hours are now expected. Some Physicians start at 7 AM and others finish their shift at 7 PM, allowing for a 12 hour extended day. Saturday hours have been reinstituted and one GBMC practice offers Sunday hours. Finally, some of the philosophy of my original practice style is coming back; we had it right twenty-five years ago, offering extended hours for patient service.

Over the years, the biggest change I have experienced has been with methods of documentation. There is an inherent difference between paper charts and electronic records. At Medstar, I survived uploading data for a prolonged nine-month period before we went “live” with the EMR called “Centricity”. This included comparing the paper record with the EMR version and consumed many hours of my free time. Since there were no electronic patient records, everything had to be created from accounts used for billing. Part-time personnel loaded problem lists and medication lists and it was the physician’s duty to take the charts and assure information was entered correctly. At GBMC, where after dictating notes for two years, our paper records were converted to electronic using “eClinical Works”. Similarly, blank charts were created using billing records. Personnel were assigned to upload medication and problem list during the week prior to the patient’s scheduled visit and we went “live” with an instructor over our shoulders as we completed an office visit. We saw fewer patients turn the introductory phase but in contrast to my first experience, no loss of free time occurred.

Since GBMC has embraced the Patient Centered Medical Home philosophy, I am excited to be part of this new style of providing care to our patients. As a result of the Affordable Healthcare Act, physician groups are responding by creating Accountable Care Organizations (ACO) in which multiple specialties are under one management using one EMR. In this ACO, the primary care doctors are central in managing the patient. This is where I think primary care has finally arrived at the top of the totem pole and moreover, family medicine certification in my opinion is undoubtedly the best. Our training is more extensive than internal medicine and this allow us to treat the entire family, which includes pediatrics. There was a time as a family physician when I felt I was the portion of the totem pole buried in the dirt. Now this is not the case, it seems our time has come.

Apparently, our ACO is saving the insurance companies money. New contracts are being offered to GBMC and this encourages me. However, it seems there are increased overhead expenses using an EMR and meeting requirements of being a PCMH such as having supporting personnel to help extract data for meaningful use. I don't think this style of practicing medicine is going to go away. In our practice, we have a nurse care manager and access to a care coordinator that helps with referrals, accessing records and patient’s admissions. We use the Chesapeake Regional Information System for our Patients, (CRISP) for learning if our patients have been hospitalized.

Our practice at GBMC attained Level 3, in PCMH certification. A problem of documentation is recording patient information in the correct place and in the correct manner so reports of our “Meaningful Use” of the EMR is accurate. Our learning curve includes a lot of unexpected nuances and from studying my reports, I have made improvements on how I document. I guess I missed typing class in med school; I never thought I'd be typing more than the staff at the front desk. I wish I had a scribe to document and type for me. Dragon software requires proof reading and correcting errors and does not work well for me. Overall, I have to give so much more time and attention to the detail of patient documentation than ever before. Today’s EMR allows the patient to have Internet access to their chart and improve communication between their Family Physician and consultants.

During an office visit, focus on preventative care is required which takes more time for each patient. Because of this, fewer patients are seen in the workday. There are reports that this problem is universal just when there is a growing need for more access to primary care physicians. This is creating barriers for patients trying to have access to healthcare. Overall, I feel that I am offering better care by giving patients appropriate time with a focus on preventive medicine. I think the delivery of health care has improved. We work with and supervise nurse practitioners and physician's assistance in the office and at remote locations. Years ago, I was opposed to nurse practitioners petitioning for approval of independent practice. I now see their contribution as a solution for primary care access.

I never envisioned this to be my current practice style 29 years ago. Although, there are the same patient-doctor relationships, there are so many things I would never have predicted. For instance, using a computer in the exam room. . I do not type well and need to look at the keyboard often while documenting patient information. With the old style of charting, I could maintain eye contact. On the other hand, I have the benefit of applications like Epocrates in the exam room and use the computer for teaching and instructional material. The EMR keeps us up to date with disease guidelines, preventive care, counseling and educational materials while we are face-to-face with the patient. It just takes a lot more time than it did 2 decades ago.

• I love being a family physician and would choose that career again. One of my biggest joys is treating families of multiple generations. I recall Mrs. L, in her 9th decade, who came in with her great-granddaughter and boasted she was Mrs. L’s 102nd offspring. They often came together and I could see how happy they were sharing this time together.

• I love taking care of difficult problems, sorting out the symptoms and ordering tests and coordinating consultations trying to solve puzzling problems, but wish I had more time.

• I love the feeling of gaining the patient's trust sorting through problems ranging from anxiety, heart failure or even cancer, but wish I had more time.

• I valued those patient experiences of doing the right test at the right time and really saving a life. For example, we used to have an X-Ray machine in the office and did Chest X-rays intermittently with annual physicals. Some nodules, although found incidentally, were proven to be cancers, removed and the patient’s life was extended. Even though the patient was referred to a specialist, I know that I was the one that started the process. When they thank you, there’s no better feeling. There are joys, but there are sorrows (and possible lawsuits)…..

Do I worry about lawsuits? Yes, well, no, at least I don't have to translate my handwriting because it's typed. We do practice at some level of preventing medical legal problems then and now. Once, I was sued for delayed diagnosis of a torn pectoralis muscle. It was a nightmare for 2 to 3 years. I was a bit gun-shy managing shoulder pain for a few years after. When I think back, for all the good I’ve done, this memory invades.

Yes, we all have good reason for practicing defensive medicine. There is a greater focus of using evidence-based decisions in practice. My fear is that with increasing guidelines could be less of the art of practicing medicine. Changes in the frequency of mammography and prostate surveillance have changed over the years and patients are confused and do not know what to do. When dispute arises, dissatisfaction occurs and lawsuits are now inevitable in today's society. We need to weigh the needs of the patient when instituting some of these guidelines. There are some guidelines that may not be successfully defended.

The US Preventive Services Task Force now recommends against the use of the PSA and digital rectal exam for detection of prostate cancer. When a cancer diagnosis is delayed, it doesn't stop the possibility of a lawsuit. This is where the “art of medicine” needs to be preserved in our doctor-patient relationship. We need to do what is right for the individual patient even though population studies may show an appropriate alternative. In this past year, there are new guidelines offered by the USPSTF, ATP-4, and JNC-8. Some of these recommendations are not currently used in our EMR and our PCMH quality of care benchmarks because they have not been updated. In time, hopefully these differences will be resolved and repaired.

Predicting the future is as unpredictable as projecting the changes in the last 25 years. What will the practice of medicine look like in 20 years? It's hard to predict what it will look like in two years, let alone 20 years. Hopefully, some part of the Affordable Care Act will survive. For my patients that have come in with newly obtained insurance, the change has helped them. With the electronic medical record, the ability of patients to communicate with their physician has improved. The EMR allows communication through a portal and this access to the physician is obtained without office visits or phone calls. Will the practice of medicine change to the point that the patient will no longer have to see their doctor face-to-face? Patients expect to see their lab and imaging results as soon as they are released as well as a lab letter or phone call from me. With the EMR, they can request their medications, make their appointments, and ask about their healthcare, a given test or any other question. This adds to my list of things to do. Some days, the catch-up time is up to three hours to complete my documentation. In time, there could be electronic media that puts us face to face through a screen rather than in the exam room. Though, there are certain types of interaction such as counseling for diabetes care that can be done over the phone, these could be provided through Skype or some other type of electronic media. Could there be devices, like a Dick Tracy wrist telephone that put patients vitals in front of us? Wait a minute; we nearly have that with downloadable telemetry. Will there be implantable chips in patients that alert us to their acute illness and diseases? This seems likely. However, I would still miss being in the exam room with my patients.

I enjoy the bond made between the doctor and the patient behind the door of the exam room. However, I do not enjoy the paperwork after hours once the door opens and the patient leaves.

Past President MAFP 1993, and now President of the Foundation of the MAFP