My Annual Checkup

Yesterday I went for my annual physical at Cityside Family Practice, which is now part of Northside Hospital Health Systems. I have been with Cityside for years, but never really seemed to get a doctor there, who stayed with the practice or cared much for me as a patient. Dr. Wilford Brown was great, but he retired and later came to my own clinic, both as a patient and a part time physician; Dr. Royson became a Hospitalist, and Dr. Washburn seemed to be longing for the beach.

My blood pressure medicine needed to be renewed, and I was overdue for a checkup, so I called for an appointment several weeks ago. Dr. Washburn didn’t have any openings, but Dr. Bill McIntyre, one of the clinic founders, did. I took that appointment, and made arrangements to take the whole day off. This way, I could also get my car serviced, take care of some banking issues and get a new set of passport pictures.

Friday morning’s newspaper had a front page article about Medicaid reimbursement cutbacks and delays in payments to hospital-owned physician practices. There was also a story about layoffs at a small, rural hospital that was taken over by Northside Hospital Health Systems just a few years ago.

The last time I visited Cityside, they were an independent group. The waiting room was cold and uninviting, but the front desk area was buzzing with activity. This time things seemed to move a lot slower. The woman who took my insurance information appeared to be laughing at something. Finally she told me her computer was acting up, and this was a daily occurence since the new management put in a whole new system when they took over the practice.

In the exam room there were a few new posters on the wall and a laptop computer. Dr, McIntryre appeared without a paper chart in his hand and we took care of our introductions. We had met only once or twice before before, were well aware of each other’s professional reputations, but didn’t know anything about each other as human beings.

Bill quickly understood that I really didn’t need a lot of high-tech interventions from him. I am up to date on my health maintenance, and he agreed with me that my cholesterol isn’t high enough to worry about with my high HDL. Our conversation instead drifted toward the business of medicine in America today.

My annual checkup turned into more of a checkup on the status of primary care physicians today. Two mid-fifties physicians, one rural and one in a small city, compared notes. He had always been fiercely independent, and was now taking marching orders from a hospital Vice President and reporting to a Medical Director whose training and experience are in a subspecialty and not in primary care.

He surprised me a little by telling me that during all the years he had been working and building a practice in the small city north of my home town, he had actually lived near the ski slopes west of here, and “camping out”, as he put it, in the city.

“A year or two from now,” he confided, “I won’t be here. I’d like to start a small housecall practice and work out of my home in the mountains. I’ve had it with beureaucrats, insurance companies and big organizations.”

I quietly counted my own blessings, dealing only with a small beaureaucracy in a small town clinic five minutes from my home. I also made a mental note that, once again, I’d be looking for a new personal physician for my next checkup.

3 Responses to “My Annual Checkup”

  1. 1 elaine January 24, 2009 at 7:17 pm

    Oh yes, you just find one that you like when he/she is shortly leaving the area.

  2. 2 Feathers January 24, 2009 at 10:57 pm

    I like your blog because of the way you have been there for your patients a long time, like the comment above you find someone and shortly they are leaving.

    My GP is leaving and after two years (have high anxiety and depression)
    he had become my safe place kind off, it has taken some adjusting too
    the fact that have to seek out someone else now that will feel can trust and of course start the whole process over again off whoever getting to know everything and so on.

    It would be nice to just have the same GP throughout, but they seem to
    come and go….often the good ones seem to move on, will be changing
    practice and have one in mind to go too, but the whole process find is
    unsettling for a while.

    Think when you have an ongoing illness of some sort your GP becomes
    quite important and of course even if you never see them you still like to know that they are there when needed and they are the person you can trust and so on.

  3. 3 Cathy January 31, 2009 at 7:43 pm

    We have recently went through finding a new family practice Dr. after being with the same one for years. It is taking a lot of getting use to and I am still not comfortable with him. On first visit nurse informed me not to EVER talk to doctor about any woman issues. Don’t mention cervix or breast to him because he is not comfortable talking about these things with women. I don’t quite know how to take this. I find it odd to say the least as we women have those parts, Well most do, I don’t because of past cancer, they are a big part of our anatomy and it feels strange having a doc who wants to hear nothing about them. Its not really a big issue as I have a good GYN but still I find it odd. Not anything at all like a family doc I once had who one day grabbed my hand and told me “Today is the day you get to learn about your own body.” as he guided my hand in the ways of self breast exams.

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