A doctor’s father’s perspective

January 25, 2021

I’ve been doing a lot of thinking about why a doctor would move to a concierge practice model. I’ve read the letters and heard the comments speculating that greed was the primary motivation. But, I can’t buy that because my son is a primary care doctor and I know my son... and I know my doctor.

My son has always had a passion for helping people. It’s been over 20 years since he graduated from high school. He thought about becoming a pastor when he entered college. Actually, he was all in for a couple years.

That was his destiny until he took a course in kinesiology. He became obsessed with the human body and got into becoming a personal trainer. Again, he was all in. One of his clients was a prominent doctor who encouraged my son to go into medicine but my son lacked the confidence... until he met his future wife. She too had the passion for helping people, particularly women.

They married shortly after graduating and together they entered medical school. Now, going to medical school is expensive and rather intense. You absolutely have to be all in. Committed. Motivated by what lies ahead. A fulfilling and rewarding career in medicine. I remember the idealism that was driving them both. They are going to help people live healthier lives. That simple. That was, and still is, their passion and primary motivation. There was very little concern about the debt they were accumulating in student loans. They knew that if they worked hard, and did the best job they could, that money would not be an issue.

In medical school, my son became enamored with osteopathic manual manipulation, acupuncture, and a few other methods of natural healing. He loved practicing these modalities on his family and friends... and they worked! He was excited about the prospect of using these modalities in his profession.

After graduating medical school, my son and daughter-in-law were able to do their residency at the same hospital. One of the things you learn in residency is the business-side of medicine. Idealism can only take you so far. You have to make a living! So, you have to learn how the system works (or doesn’t work).

I just need to mention that during my son’s last year of residency, he and his wife had my first grandchild. My son’s residency for primary care ran for three years while his wife’s residency for OB/GYN ran for four years. That last year was very hard for them. My son joined a practice in Lewes while his wife finished residency in Allentown. Mothers, imagine being separated from your baby, and your spouse, for several days at a time.

So, after four years of college, four years of medical school, four years of residency, and lots of debt, my son and his family were ready to settle down and live a somewhat normal life making a living helping people live healthier lives. Now, just stop here and appreciate that for a minute. I started making money after five years of college (I’m being honest). My son and daughter-in-law delayed making money so they could help others. They delayed starting a family, too. Granted they had hoped to make up for it after becoming doctors but that’s expected. It has become a lot tougher for a primary care physician to make up for it these days. Medicare and insurance reimbursements are declining. Patient loads and reporting requirements are rising. And there are still only 24 hours in a day. What if you were being asked to do more for less year after year? What if you were not allowed to do your job the way you know it should be done? Wouldn’t you look at alternatives? What advice would you give my son? I would tell him to find a way to stay passionate about his work. To find a way to be fulfilled. I would tell him that I am proud of him and that I love him.

Larry Monack 
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