Guest Editorial, March 28-31, 2012
March 28, 2012
My mother gave me a print of a horse and sleigh bringing a country doctor on a house call to a snow-covered farmhouse. But the artist made the doctor and horse appear transparent as if vanishing from the rural scene.
My great-grandfather, Nicholas, graduated from medical school in Nancy, France, came to this country and became a prominent country doctor in Dyersville, Eastern Iowa. He died at the old age of 61. His sons, John and Emil, both became prominent physicians and eventually practiced in his house-clinic which he built in the 1870s. But John was killed in 1913 by a train while he made a house call in a horse-drawn sleigh while crossing the tracks in a blizzard. My grandfather, Emil, was summoned from Chicago where he was training to be an obstetrician and returned as the country doctor.
I spent my very early childhood in Dyersville. When I was small, my sister and I would jump on the clinic beds and play at the doctor’s desk, wearing his stethoscope and playing with his surgical instruments.
I guess it was natural that I went into family medicine despite my mother’s advice. She said that I should specialize like her two brothers or my dad, two psychiatrists and an urologist. My sister, Ann, listened to Mom and became an internist and later an emergency medicine physician. In 1979, I completed my family-practice residency at the University of Utah (see, I specialized after all) and joined Tom Schwenk and Winnie at the Holy Cross Family Health Center in Park City with Carol Santy, our medical assistant, x-ray and lab tech extraordinaire, and Pati Colvin, our DJ, front office and clinic manager-in-training.
Tom is now the dean of the University of Nevada Medical School and Health Sciences. Pati, as the office manager at University of Utah Health Network Clinic at Redstone, keeps everyone there together and still "picks out the music" to which they must dance. Carol worked at my side for twenty years, running the lab, the x-ray and training all our staff until her retirement. Winnie continues as medical director for the Canyons and Deer Valley resorts, providing emergency care to their clients.
We delivered babies, cast fractures, made house calls in snowstorms, and took care of injuries and illnesses of all ages. We were the paramedics, eye doctors, emergency doctors, or just about whatever you needed that day (or night or weekend). We grew with the town, changing our location a few times from the initial trailer/clinic by the old Mount Air Market, eventually to our present clinic on Bonanza Drive.
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We survived our share of crises. It was never the best business model because it was simply not about that. It was about living in a community and providing whatever it needed for health care. We had to take the clinic over from Holy Cross Hospital because they said we were losing too much money to stay open on weekends, or deliver babies, or attend to emergencies at night. After nine years of being independent, the University of Utah Hospital became our next owner. When they closed us at night, we publicly challenged them and were promptly fired. The court did not look favorably on the termination of thousands of doctor-patient relationships and they quietly left town.
The surviving medical group remained independent but worked with Intermountain Medical Center to reopen at night. This eventually helped lead to the Park City Medical Center with 24-hour emergency care.
Now I am at the young age of 61, the age at which my great-grandfather died an old man. I have seen my share of snowstorms while making house calls; I have not been hit by a train like my great uncle John, but have often felt that way. After 33 years, I am resigning from the Park City Clinic.
I will miss the loyal and kind patients who have chosen me to be part of their lives. You have always been more like family and friends than relative value units (RVUs), which is the currency in today’s health-care reform. As much as I wanted to know it all, I feel bad for the cases when I could have known a little more; as much as I wanted to do it all, I feel bad for the times when I lacked time, energy or resources. I would like to thank you for trusting in a country doctor and sharing the most private and personal aspects of your life with him.
But I remain convinced of these two things after practicing in Park City for 33 years: Everyone needs a primary-care provider, even if you have a team of 12 specialists who claim to know it all. You will receive better and more coordinated care, and be subjected to fewer unnecessary tests and procedures; all this at a fraction of the cost. And take good care of your knees; you will miss them when they are gone.
See you on the trails, but you had better speed up or stay out of my way.