'Medicare Changed It All'

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Reflections on Medicine - November 2007

 

By Harold R. High, MD

I was born in Canton, Tex., on May 20, 1924, educated in Canton schools, and graduated at age 15. I knew I wanted to be one of two things when I grew up: either a doctor or a minister. After talking with my mother (who was a minister's daughter), I decided on my own that I wanted to be a doctor of medicine. Doctors stood out as smart, kind, leaders of the community, and compassionate people who took care of and made sick people well. This I liked.

I started college in Arlington. In 1941, my freshman year, the Japanese attacked Pearl Harbor. I finished that semester and the one that followed and then volunteered for the armed services. At the classification center, I was told I could go to the Air Force if I wanted, and, boy, did I! In three months, I was in flight training.

After primary, basic, and advanced training, I chose twin engine, and was placed in B-17 school. The war was then over in Europe and I was transferred to B-29 school. The day before we were to leave for the islands, the atomic bomb was dropped and the war was over.

I went home and finished my BS degree in chemistry and biology at Baylor University. Shortly after, I married my childhood sweetheart, Paula Grubb, and moved to Houston to start medical school the next year in Galveston at UTMB.

After medical school, I felt very proud to be a medical doctor. We then moved to Fort Worth to John Peter Smith Hospital for my internship. We worked many hours a day, which I wanted and enjoyed because I was learning many things about medicine.

One day, a 6-month-old baby was brought to me with acute diarrhea and dehydration. It looked as if death was eminent. I stayed up all night at the baby's side administering antibiotics and fluids. A little after daybreak, the baby looked up and smiled. I realized that was what medicine was all about.

During the 11th month of the internship at the hospital, I was stricken with poliomyelitis and was confined to bed. Fortunately, I had very little residual paralysis and was due to go to practice medicine in Cuero.

When I set up my medical practice in Cuero in 1955, there was one specialist between San Antonio and the Gulf Coast. He was Gillette Burns, MD, a Mayo-trained surgeon who taught me surgical techniques over the next five years. In those days, family physicians performed most all of the general surgery. Dr. Burns was most helpful, a great friend, and a marvelous teacher to whom I shall always be very indebted.

Dr. John C. Davis joined me in practice. We were very selective about the patients upon whom we operated. Dr. James Pridgen, from San Antonio, would come and help us with complicated cases; Dr. John Hinchey, also from San Antonio, came to do hips and orthopedics. He was an inspiration. He would do a hip in 20 to 30 minutes and would tell us to send an x-ray in two to three days.

Those were rewarding days. We were operating our own clinic; we charged what the patients could pay. We saw all patients, pay or not.

Medicare changed it all.

President Johnson signed Medicare into law in 1965. This changed caring physicians into businessmen.

The patient-doctor relationship began to erode, and that has continued to this day. The future of physicians and their patients is in a serious situation. With the cut in payments and other restraints, the number of primary care physicians is decreasing steadily.

Physicians must join under strong leadership, organized under the same roof, and take a united stand; we must formulate a plan and do whatever is necessary to fight for survival. We have to wonder what ethics are taught to new physicians coming into practice. Medical practice, under the control of government and lawyers, is not "caring medicine" and needs to be changed to put the doctors back in control. Doctors, wake up!

Editor's Note: This is the latest in a continuing series of essays by members of the TMA Fifty Year Club. Dr. High is the immediate past president of the club and a member of the TMA History of Medicine Committee.

 

 

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