Tuesday, June 23, 2015

Evolutions and Retirements

In the past couple of months I have gone to 2 retirement parties - for two people I could never actually imagine retiring.

One of the parties was for one of my my first bosses.  He and his wife were the model that I try and manage people from.  At his retirement party his daughter mentioned how she learned to eat fancy from one of her dad's doctor friends - I learned to eat fancy from her mom and dad.  They encouraged me to be more than I thought I could be and believed in me when I was my best and even when I stumbled in my life.  I owe my career choices and much of who I have strived to be to them.

The other retirement party was for another doctor that I worked for later on in life.  He also taught me about ambition and goals.   As he became my friend and we shared interest in books, wine, music, art he also became my mentor and someone whose counsel I seek all the time.  He never has been too busy to listen to me ask him a career or personal question.   He also introduced me to his daughter who has become one of my closest friends.

I learned to appreciate how awesome it is to know a renaissance man and it has in many ways influenced the way I am raising my boys to be men who are well rounded, curious knowledge seekers.

I think what I have seen with these two men was an evolution in medicine, which has had leaps and bounds in the things we could do and have done to keep us living longer and longer, that changed the doctor patient dynamic and is taking it's leave with them and their generation.  They are the doctors who returned phone calls, listened to the patient, understood that sometimes you were a pain in the butt that needed that millionth reassurance, that a test that cost thousands wasn't always warranted yet other times absolutely necessary.  Of course among them were the ones who as in the famous quote said " I do not have a god syndrome - I am god - for it's me you pray to when I am in operating room - to me to not make a mistake" (Alec Baldwin gives a rockin' speech in Malice) but am sure those will always be around.  

They learned to be better doctors and their patients cried as HMOs told them they could no longer see these healers because they were not on the list of doctors they were trying to not pay.   Their patients stayed with them for years when they could and referred their families to them, nothing says I trust you like referring a friend or family member to a doctor.  They got more rushed too as their payments got smaller so they needed to see more people to keep up with their expenses, their time spent more on paperwork and explanations to someone who had at best walked by a medical school but was making decisions on cost alone, they spent more money on staff who handled billing insurance and learning coding and had to make tough decisions about not being able to write off a balance in a tighter economy.  They paid high rents, they paid for staff and in the end while the money they made ensured they too led a nice life they worked harder and harder to just maintain it.  Their patients' never felt the wrath of their anger with what became a witch hunt pitting them against their patients - because after all the insurance companies even had some woman in the NY Times op ed say "the poor insurers" - their malpractice high even when they had no claims against them, their judgement challenged by people who write a blog or are actors as if they knew anything about medical treatment.   Being informed patients was good for them, dealing with so many who think going to WebMD means they now are just as well trained to diagnose must be frustrating.

This is the evolution of medicine - or is it the retirement of good medical care that took care of the whole rather than the disease? We will have generations who will know nothing of private practices but only groups - who will not get personalized attention but technology and medicine that may save their lives.  We will complain that costs go up even though it was the HMO introduction that has cause much of this much more rapid cost growth and wonder how we can have it all, which we cannot.  There will always be good healthcare providers and we will continue to live longer due to pharmaceutical and technological evolutions.  Yet is bittersweet for we will retire our expectations along with the remaining doctors of that generation; to have doctors who take care of us as much as they take care of our bodies.  They practiced the art of medicine rather than the treatment of the disease.

I learned much from these men and I am fortunate to have had them in my life for so many years - they deserve their retirement and I thank them for setting the bar so high in my expectations of what I can accomplish, what to expect of medical care and most of all in what truly special people can do when you have them in your life.  I am lucky I will always have them in my life, and my memories, but I am sad for the patients who will not get to experience this art of  medicine, such is evolution.

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