Thursday, October 4, 2007

Notes from the daily life of a "specialist for the poor"...

When I entered medical school, my father would often offer me his advice about the choice of a specialty. He would say, with a chuckle, that I should specialize in "diseases of the rich." (Perhaps this was not just a joke - he was paying for college and helping with medical school costs, and I owe him a debt of eternal gratitude for the gift that he and my mother gave me in allowing me this life.)

I recall during my application for medical school that I, like many of my competitors in the interview process, responded to that expected question by saying, "Of course, I want to be a family physician, so I can serve the community, the needy, relieve suffering,..." But, perhaps unlike many of my colleagues, after enjoying each of my rotations, I did decide on family medicine. And, I had no idea that it would lead me here.

I took my two-month anesthesiology elective rotation first, so that I could force myself to get over my fear of poking people with needles. I achieved that goal, and enjoyed the intellectual stimulation of the daily physiology experiments, and considered that as a great option for a career.

I took rotations in cardiology, and pediatric oncology, and psychiatry. Each with the excitement of learning from remarkable men and women, becoming part of a truly noble profession. And, imagining myself as wise and compassionate as these mentors. But, ultimately, it was family medicine that kept me. I completed my residency, as Chief Resident, at the University of Kansas School of Medicine in 1992. With much of my education still to come...

I am the Chief Medical Officer for Peninsula Community Health Services, a "safety net" provider in Kitsap County, Washington. And, despite my father's repeated advice, I now know that I have since specialized in "diseases of the poor."
I'm starting this blog so that I have a place to tell the stories of my daily work. It is named for the book "Health Care Meltdown: Confronting the Myths and Fixing Our Failing System", by Robert LeBow, MD. Dr. LeBow was a Peace Corps doctor in Bolivia, the Medical Director for the Terry Reilly Health Services in Southwest Idaho, and a past President of Physicians for a National Health Program. As described in this USA Today article, Dr. LeBow came to know about the Health Care Meltdown from "both sides of the bed", having suffered a head injury from a bicycle accident which ultimately resulted in his death. I had the great privilege of getting to know him and his wife Gail via email after his accident, and consider his book an excellent primer on the issues of our failing health care system.

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