My dream, while in high school, was to be a professional musician in a rock band.
I had started taking lessons and playing drums at 10 years old and was so in love with and inspired by music that it fulfilled all my fantasies. When I started college back in 1971, I went as a music/theatre major. I got into a band. It was a lot of fun. But college at that time felt too structured for me. So, after my freshman year, I dropped out to pursue my dream as a rock star (makes me laugh to admit it).
A year later, beleaguered by frustration and unscrupulous people in the music world, I was exhausted. My father was a practicing podiatrist and he began encouraging me to become a podiatrist. I never had any interest in being a doctor but his constant nagging made me think about it.
So I went to his office often to experience his day with him and I was surprisingly drawn in. In most cases, patients came in with pain and walked out feeling better and there were lots of thank you’s and appreciation communicated. And no one was dying. I watched him perform surgeries and it seemed like something I would enjoy.
So I went back as a pre-med and ultimately went into practice with him after training. It was such a colossal disaster I could write a book about it. I left and went out on my own and started my own private solo practice.
After a few years in practice, something went wrong.
I developed all kinds of troubling symptoms and was suffering daily. I had severe headaches, dizziness, heart palpitations, and loss of appetite.
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I went to doctors and all they told me was I was suffering from “stress” (made sense to me) and gave me prescriptions. The meds didn’t really work and gave me side effects I did not like. So I went to other doctors, got different prescriptions and had the same experience. I then began to break out in a rash all over my face. Through all of this, I was still practicing and seeing patients daily. It was very difficult, but I had to surrender to my condition. I needed to work. I already had a daughter to raise and needed to provide for my family.
Somewhere along the line, I was introduced to a doctor who told me he practiced “holistic medicine”.
I don’t think I ever would have given him any credibility, but conventional docs had already failed me, so I began sharing my issues with him.
When he started talking to me about what needed to be done to help me, I was very skeptical but intrigued. Long story short, after some lab work, dietary adjustments and supplements, my symptoms began to melt away. I was astounded. I wanted to know more. I wanted to practice more holistically. I was not only symptom-free, but I was empowered and reinvigorated.
I joined every holistic medical association I could find.
I went to lectures and seminars. Nothing related to podiatric medicine directly, but I soon was able to see that you MUST treat the whole person and not just a body part. In the early “90s, I went to my first Jeffrey Bland, PhD lecture and although I didn’t understand a lot of what he said, I was sure this was the way of the future and exactly how I wanted to practice. That evolved into functional medicine. Over time, I was able to determine the most likely underlying mechanisms in the pathology in front of me and would order appropriate lab work to uncover immune burdens that were making it difficult for these patients to heal. I still did foot surgery, but I would do a functional medicine work-up pre-op and more than 50% of these patients never went to surgery.
I was still doing conventional medicine and surgery, but when I had a patient that consented to a functional medicine approach, I was thrilled. I soon found out that insurance companies wouldn’t pay so I began privately contracting with these patients. And I totally fell in love with that part of my practice.
The problem was I needed more time with these patients so I would block out lots of time to properly assess and examine them. On top of that, I was still seeing 50-60 patients daily because reimbursements began to decline rapidly, and I was stressed and burnt out.
Some nights I would get home to eat dinner at 9:30-10:00 PM.
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It wasn’t sustainable and I was beginning to fight with insurance companies, had to hire staff to fight with insurance companies and my expenses began to go through the roof as I added more staff to handle the increasing number of patients.
In 2000, I just hated going to work and dealing with insanity. I decided it was time to drop out and stop accepting insurance.
I was so encouraged by the results I was achieving with my functional medicine patients, that I decided to specialize in that paradigm. When I informed my patients that I was no longer accepting insurance, it was met with rage by some, sadness by some, disappointment by some and embraced by a few.
“In 2000, I just hated going to work and dealing with insanity. I decided it was time to drop out and stop accepting insurance.”
My patient volume fell by 80%.
What I forgot was that I didn’t need the large staff and the big office. My first year practicing as a direct-pay doctor was enlightening AND frightening. I had to start marketing the new practice model. I started letting staff go. I downsized my office. And that first year made me feel like I was going to go bankrupt. But even though my gross income went way down, my net only dropped about 30%.
My patient volume fell by 80%. What I forgot was that I didn’t need the large staff and the big office. Click To Tweet
Over the years, I know I became a much better clinician.
My outcomes were so much better, my doctor-patient relationships became deeper and more potent and as I became better at marketing and decreasing unnecessary expenses, my practice began to succeed and grow. As expenses decreased, I was able to provide superior care that my patients could afford. Now, 23 years later, I still love going to work. I love what I do, and I love my patients. I cannot imagine retiring.
The BEST part is that as a direct-pay doctor, I can see a low volume of patients and still have time to pursue my other passions. I have been writing music since 1995 (I’ve had a bunch professionally produced) and I founded a blues band that is a limitless source of joy for me. We have recorded an album and we play gigs in the Long Island area.
