OPINION: A Medical Journey

I would like to thank the Maricopa County Medical Society (MCMS) for asking me to write a short comment about my experience in Arizona covering 50 years in medicine.

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I started my practice at the old Camelback Hospital off Camelback Road and 34th Street in 1971. I was told I would lose patients when I asked them to do their own insurance billing, but that didn't happen. I was on many hospital committees, and became president of the Phoenix Psychiatric Council, the Arizona Psychiatric Society, and the Arizona Chapter of the American Academy of Child and Adolescent Psychiatry. I was also a delegate or alternate delegate to the American Psychiatric Society on two different occasions. One period was interrupted when I entered a two-year Child and Adolescent Fellowship at UCLA in 1980.

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My initial medical training was at the University of St. Louis Medical School, followed by a one-year internship and three-year adult psychiatric residency at Michael Reese Hospital and Medical Center in Chicago.

I returned to Arizona and, after nine years of practicing in the valley, I decided to expand on what I was doing by getting credentials to treat children. I co-authored a book with my UCLA supervisor Gary Emery, PhD, titled Rapid Relief from Emotional Distress, which described the type of therapy I had developed and used over the previous years. Part of the reason for wanting to add children to my practice was the rapid improvement patients were making.

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I went on to write four other books: Psychological Therapy in a Pharmacological World, intended for therapists; Parents, Teachers, and Mental Health: The Art of Accurate Speech and Other Ways to Help Students (Children) Not Become Psychiatric Patients; Blame and Anger: Their Relationship, Their Extinction; and Academia, Psychiatry, and the Elite Left, which among other things discusses a rational approach to what is called a gun problem.

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From Scottsdale to Sun City, I was on staff of most of the valley hospitals. At Thunderbird Samaritan, I admitted the first psychiatric patient when the program opened. I gave up hospital practice when it became impossible to get the necessary medications to help people the way I wanted, and the rules regarding treatment became unacceptable to me. I then served as Medical Director to an outstanding program at Phoenix Memorial Hospital dealing with abused children and later was Medical Director of Charter Hospital in Peoria.

Knowing smoking was harmful, I stopped patients from smoking in my office around 1973 and became a pain to program organizers who did not provide non-smoking areas for participants. On returning from UCLA, my practice center moved to St. Luke's Hospital, where I worked until giving up in-patient practice. I was the first psychiatrist for a hospital's chemical dependency program in the early 1970s.

The greatest changes I have seen in psychiatry have been manifest in all areas of medicine. Examples are the price increase in medications and a change in emphasis from patient to paperwork. A report suggested psychiatric medication prices increased 15% more than other medications. I enjoy working with patients but would not have stayed in practice without my wife Sharon's competency in running my office for the past 45 years. Her work week continues to be five or six days a week, even though I reduced office hours to three days a week over ten years ago. At one point in my practice, it took Sharon, a second full-time office assistant, a part-time person, and a billing service to take care of the high-quality service Sharon alone had provided to me and another psychiatrist when I started practice.

It would be easy to fault some of our medical organizations for allowing the changes in medicine to flourish, but we individually constitute those organizations, so we must accept our roles. I have the luxury of working with patients, while Sharon helps by filling out the constant flow of precertification requests, errors in billing, and other patient issues.

My goal for the next stage of my life is to share what I have learned from practicing psychiatry for 50 years. Some people may think what we learn in our academic programs is critical. Of course it is important, but I think many physicians would agree it is what we learn while treating patients that makes the real difference.