Thursday, September 02, 1999

Whose fault is it when we lose doctors?




BY LAURA PULFER
The Cincinnati Enquirer

        Eddie Saeks held the dress up, a little worried about size. “Do you think this will fit me?” he asked the startled clerk at Kmart.

        He was getting outfitted to emcee this year's jokefest for cancer survivors at the Wellness Community. Eddie — that's Edward Saeks, M.D. — will do just about anything to help sick people get well. And if that includes dressing up like Monica Lewinsky to make them laugh, well, he figures it's worth a shot.

        A character. A genuine human being. You've gotta love a guy like that. And his patients do. Some of them are still reeling at the news that he is going to retire. But it's understandable, really. Eddie will be 70 in October, has been practicing medicine here for 39 years.

        “Oh, it's not my age,” Eddie says. He's not tired, he says, but he's tired of medicine the way it is today. And he has something to say on his way out. It's not funny.

        “I am totally frustrated by my inability to care for people the way I want to.” A general surgeon and former president of the medical staff at Jewish Hospital, he has waded into medical politics and served on boards, plus the usual good doctor stuff — getting up in the middle of the night to see patients, cancelingvacations, eating cold dinners.

        He's through. He's closing the door on his practice. He sent out an announcement this week:

        “The changes inherent in medical care today no longer allow what I consider the highest quality.”

        So, whose fault is that? And my pen is poised for what I assume will be a diatribe about managed care. Or lawyers. He does not oblige.

Tired of fighting
        “The blame goes in a lot of directions,” Eddie says with a weary smile. He has a well-used face, a little rumpled like an unmade bed. Notable ears. And thoroughly wonderful eyes. Blue, huge, kind.

        “There are just too many people between doctors and their patients. The connection is being lost.”

        And he's tired of fighting. Again, understandable.

        But what about Terri Brody? An internal medicine specialist, she's just 44 years old and she too sent out a letter notifying patients she is leaving the practice of medicine.

        “I am consciously walking away. Not retiring. I don't have the money to do that. But I ran out of steam.”

        She might work as a gardener, she says. I think maybe she's serious. “It's like being in a war. I'm not a good soldier,” she said. “I have a rebellious streak. Think of me as a conscientious objector. I will not work for managed care anymore.”

        Then there's Nick Gates.

Who's in charge?
        Nicholas Gates is 33 years old and has been working as an orthopedic surgeon for a year and a half. “My dream job. I love fixing people. I love talking to them, too, seeing them at the office.”

        But not long ago, he found himself driving home from work, dreaming of doing something else. He'd spent the day fighting with insurance companies and wondering who is in charge of healing the sick. He doesn't think it's doctors anymore.

        “Decisions are being made by people who don't ever lay eyes on my patients. They're not villains.”

        Just cheap, right? Well, maybe no cheaper than a person who is willing to pay $35 for a haircut, but complains about a $10 co-payment for an office visit.

        So, what's the answer?

        Nick says he wishes that we medical consumers would enter the fray. “Tell your employer you want a health-care plan where the doctor is in charge of your care. Put some pressure on. Fight.”

        When you think about it, we patients don't really have a choice. You can retire from being a doctor. But you can't decide you will never get sick again.

        E-mail Laura Pulfer at lpulfer@enquirer.com or call 768-8393. Author of I Beg to Differ, she appears regularly on WVXU radio, NPR's Morning Edition and InterMedia's Northern Kentucky Magazine.

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