Fossil at the Starting Line

Hello,
I'm Dr Synonymous, a family physician thirty years into my medical career feeling like I just hit the starting line. Wow! It reminds me of running the Marine Corps Marathon in 1980 with my friend Larry Bauer (and 10,000 others). It was about two minutes twenty seconds into the race before we got to the starting line.
With the medical career, at eleven years of practice I started to hear the music and enjoy the patterns of health, illness and disease. At twenty years, I hit a snag but found holistic practices that freed me to better allow patients to tell their story and to become themselves. At thirty years sometimes I am the music or find myself dancing with the patient's story to find a way to validate their humanity and to help them to know that they matter. That's one of my main jobs: letting people know that they matter. The medical stuff often isn't the real agenda: the human quest is.

I've started four practices from scratch and directed three others along the way. I've been in small town (3,100 people) and urban (Columbus, OH) and suburban practices and directed two campus health centers part time. I went full time academic at Ohio State for four years in the '90's to help restructure the Dept of Family Medicine. I've admitted my own patients to the hospital for thirty years. Still do house calls and newborn circumcisions and manage my own patients in home hospice mode at the end of life. I might be a fossil and definitely have gray hair. I am still having fun as a suburban, independent family physician.

Financial hurdles have arisen now as payors pay less and less for more and more services. Patients pretty much expect to pay little (about what they paid in 1984 at present) and the government is dangling a 21.2% Medicare/ Tricare pay reduction in front of doctors repeatedly. We're all broke at one level or another.
Patients and their stories are generally quite interesting. They are getting better at using the internet to prepare for their visit to my office or to avoid needing a physician's help. I congratulate them for using available resources and often list a useful web site for them to review (hot item now is "the didgeridoo and snoring" via google). After 148,000+ patient encounters, I'm learning some things and seem to have some understandings about people that are useful to others and me.
Just a brief intro about the blogger who is initiating the blogging career at the starting line for my holistic medical career. More later as we become synonymous with who we are. Greetings from the starting line.
Dr Synonymous