Wednesday, October 22, 2008

Should I get personal?

There should be a time to stop being the last angry man and periodically write something light. Several years ago in a self egotistical mood I wrote a short remembrance of my WWII experiences for my children and grand children. It was at their request, honest, since this was the time that Brokaw was honoring the WWII generation. With ideas of grandeur I called it "Olddoc's War" and even obtained a copyright for it.

The Courier did print a portion of that document several years ago.

Subsequently I did about 60 pages of my sheltered life up to WWII which I titled "AGE OF NAIVETE". In many ways life in America and Plainfield before that war did reflect an universal innocence. The final 100+ pages are still in draft form. I had named what I called BookIII, "THE AGE of MATURITY". This dealt with my professional, social , and civic activities after the war. Either as part of this "book" as or a separate short booklet was a recounting of the trips that we took not only in America but also abroad. I titled this as 'Voyages of Discovery". When we started travelling in the late 50s we Americans were just beginning to find the world.

This leads up to the subject of today's blog; even though the contents of these writings were for personal purposes, would some be of interest to my readers?

A short excerpt follows. I would skip around to different subjects that I felt to be of interest. What is your opinion? I only need two yes comments.

Proffesional Life
When I returned from service, Helen and the two girls were living with my folks. We stayed there for several years. I first took a refresher course at Mt Sinai. I wanted to resume a Residency in Pediatrics, but due to the time of year for my separation from service, there were none available. All hospital internship and residency programs started in July after medical school graduations.

The GI Bill of Rights educational benefits had created preceptor ship programs financed by the government.Unfortunately, veterans returning earlier that fall had immediately filled all the worthwhile ones. There was still available a preceptor ship with a pediatric allergist in NYC associated with Beth-El hospital. I was offered the position, however it was apparent that he was only interested in someone to do all the “scut work”, while he benefited from the government GI education subsidy.

I was faced with a problem of supporting a wife and two children, so since my father wished to retire I assumed his practice. This is not always a good choice. When people have a choice of doctors, they choose the one with whom they feel comfortable. Father and son are never the same personalities, so it is a rule of thumb that between 1/3(33%) and 1/2 (50%) of the patients will be unhappy and drift elsewhere. After the first year as long as they stayed in the area, most became lifetime patients Some were still with me when I retired 45 years later.

This patient-physician relationship is the basis of good medicine. Unfortunately, since the advent of Medicare and the HMOs this type relationship has been destroyed in favor of which doctor your plan requires its subscribers to use. Dollars and cents now drive medical practice not patient welfare.

On the other hand, in those days when advertising in the media was unthinkable, there were periods when I was so inactive that I considered myself as a failure. I did become a member of the VFW and the Lions Club in an effort to become more widely known. I also began to pick up patients in my peer age group. I could not stand the VFW or the American Legion and soon left the veterans organizations.

I was only in practice for a little more than 6 months that first year, having taken a course at Mt.Sinai in NYC for six weeks while also looking for a residency program in Pediatrics.

I maintained strict records of every dollar I earned, and thought my books were good until after filing that year’s (1946) tax return the IRS audited me. The field auditor remarked that no doctor could make as little as I had reported, a little over $5000.00. When I protested, he said, “You mean you never forgot to enter a fee after a nighttime house call? I am going to penalize you $100.00 tax due. You can appeal this at the offices in Newark. He had a quota to make.

One of the senior surgeon boasted about the camera he had given an agent and had had no penalty imposed. Of course the one who had reviewed my taxes knew that I would not find it cost effective to be away from my practice long enough to appeal. The next year I had an accountant prepare my tax return, a policy that I still follow. I was only subject to an audit one more time, in1947 and since then the IRS has been satisfied with my records.

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