Family Doctor

Nearly 2,400 Carroll members of the state's largest health maintenance organization found a surprise in their mailbox earlier this month -- their family doctor was being changed.Because Carroll Primary Care Associates servered its ties with the Columbia FreeState Health System several weeks ago, patients of the Washington Road facility must choose another of the HMO's Carroll County doctors."Carroll Primary Care had become closed to new Columbia Freestate members," said David Wolf, the HMO's president.

You do not have to look far to understand why U.S. health care is so expensive and uneven in quality. A recurrent offender advertises walk-in ultrasound testing of blood vessels and whatever other asymptomatic part you may choose to pay for. Worried older folks can feel lucky that it appears that Medicare would reimburse for the tests. But in fact, the whole course of tests and treatments encouraged by these ads will not improve your life expectancy - and could even have some chance of decreasing it. Shouldn't we read these solicitations as symptoms of a very readily eliminated illness that plagues our health care system?

Dr. Milton Schlenhoff, a retired family practitioner, internist and physical fitness advocate, died Sunday at Sinai Hospital of complications from diabetes. The Northwest Baltimore resident was 81. Dr. Schlenhoff was born in Baltimore and raised on Park Heights Avenue. He was a 1945 graduate of City College. "He was a superb athlete in school, excelling in basketball and track, and setting a state record in the 220-yard dash as a high school senior," said his son, Dr. Marc D.

Nearly 5,500 calls came in to the Towson office of Dr. Sarah F. Whiteford in the month of October - more than twice the usual number. And even with extra staff manning the phones, about 1,000 patients grew tired of waiting and hung up. It's a flu season like the office has never experienced. And despite the nearly overwhelming volume, Whitefordand other primary doctors saythe phone has become their most essential tool in not only managing the first pandemic in decades but tamping down the widespread anxiety about the swine flu virus that has killed 13 people in the state.

You do not have to look far to understand why U.S. health care is so expensive and uneven in quality. A recurrent offender advertises walk-in ultrasound testing of blood vessels and whatever other asymptomatic part you may choose to pay for. Worried older folks can feel lucky that it appears that Medicare would reimburse for the tests. But in fact, the whole course of tests and treatments encouraged by these ads will not improve your life expectancy - and could even have some chance of decreasing it. Shouldn't we read these solicitations as symptoms of a very readily eliminated illness that plagues our health care system?

LIKE SO MANY Elkridge residents, Neal Sybert was a "Brumbaugh baby." So were four of his six children. These days, Sybert -- a former lawyer, judge and state's attorney -- is president of the Elk Ridge Heritage Society, which has its headquarters in the former home and office of Dr. Benjamin Bruce Brumbaugh. The building serves as a museum of Elkridge history and pays homage to Brumbaugh, who worked as a family doctor in Elkridge from 1919 to 1980. After Brumbaugh died in 1985, the society, which was founded in 1980, bought the building.

He was always there, for 27 years, at work in the stolid brick building on a forsaken block in East Baltimore."He was our family doctor, the only family doctor we ever had," says Bradley Thomas. "So much of what I remember from my childhood is Dr. Huang."And so much of what Dr. Shi-Shung Huang remembers is: boys like Bradley Thomas who have grown into successful men, mothers who now send their grandchildren to see him, children who left the projects and went to college and are rearing healthy families.

BOULDER, Colo. -- At the age of 28, Greg Wiatt was living in Boulder, messed up and abusing drugs.He had been a gifted student in his Midwestern school, with an IQ of 167. But the disparity between him and his father, who had an IQ of 90, and was shorter and thinner than his tall, strapping blond son, was causing acute anxiety for the boy.The feelings intensified as Greg got older. His parents drifted apart and eventually divorced. When his father had a stroke, Greg became his sole guardian.

If you enter the hospital with pneumonia today, there's a good chance you'll be treated by a new kind of specialist - a hospitalist - instead of your family doctor. More than half of all large U.S. medical centers now use hospitalists, and new programs are springing up across the country. Fifteen years ago, the situation was far different: primary care doctors were in charge of treating many hospital patients. "It's a sea change in the nature of health care," says Dr. Bob Wachter, a hospitalist and researcher at the University of California at San Francisco.

How many times have you shown up for a doctor's appointment and been handed a stack of multicolored double-sided forms to fill out? You scan the information and realize that you don't remember when you had your tonsils out or the name of the medicine that caused you to break out in hives five years ago. Having complete and accurate records for everyone in your family isn't just a nice thing to have, it's essential. The good news is that getting them in order is a straightforward organizational task.

Like many medical students, I proudly wear Obama T-shirts and yearn to reform medicine. While watching the president speak, I envision myself working in primary care, on the vanguard of health care reform. Then, a little later, reality hits. With the number of senior citizens rapidly growing, by 2020 we will likely lack 200,000 physicians. So why do only 2 percent of medical students choose family medicine? Medical students undervalue family medicine residencies in comparison to programs such as dermatology.

Every mom and dad has a huge, very basic question that he or she might feel embarrassed to ask out loud. It's "how can I be a good parent?" The American Academy of Family Physicians has answered this question on its Web site with a concise set of guidelines: * Show your love. Hug and kiss your kids, and tell them you love them every day. * Listen when your children talk. It helps them realize you think they're important. * Make your children feel safe. Comfort them when they're scared, and show them you've taken steps to protect them.

Dr. Milton Schlenhoff, a retired family practitioner, internist and physical fitness advocate, died Sunday at Sinai Hospital of complications from diabetes. The Northwest Baltimore resident was 81. Dr. Schlenhoff was born in Baltimore and raised on Park Heights Avenue. He was a 1945 graduate of City College. "He was a superb athlete in school, excelling in basketball and track, and setting a state record in the 220-yard dash as a high school senior," said his son, Dr. Marc D.

When his colleague departed in December, family doctor Charles Bennett thought he would soon find a new partner for his private practice in Lusby. But he has had no luck for the past eight months. "I'm still trying to find someone, but I don't think it will get any better in the foreseeable future," said Bennett, whose Calvert County practice employs four staff members. "The process is very time-consuming, and I am already very busy as it is." Bennett's troubles stem from the fact that the United States faces a serious shortage of family physicians, especially in rural and poorer communities.

Dr. Donald W. Mintzer, a retired Hamilton family physician, died Feb. 1 of Alzheimer's disease complications at the Presbyterian Home of Maryland. He was 86. Born in Somers Point, N.J., and raised in nearby Ocean City, he was a 1938 graduate of Ocean City High School and worked as a lifeguard. Family members said he decided to pursue a medical career after he nearly died of complications from an appendectomy at age 9. He moved to Maryland in 1939 and earned a pre-med Bachelor of Science degree at the University of Maryland in College Park.

How Doctors Think By Jerome Groopman, M.D. Houghton Mifflin / 320 pages / $26 I often see undetected fear in patients' eyes as they traverse our complex medical system trying to figure out how to get their worries, aches and pains heard and cured. I work with doctors every day as they interact with various patients and families. But only after reading How Doctors Think, by Jerome Groopman, M.D., did I realize that I saw only their actions and reactions. Never was I privy to the reflecting, reviewing and even, at times, soul-searching that doctors do over their patients and diagnoses - the roads they mentally travel and the effect it can have on their patients.

Bethlehem, Pa.-- With her family doctor on vacation and her knee swollen after an ill-fated outing in an inner tube, Jeannette Shelesky took the advice of her husband, a retired Bethlehem Steel Corp. employee, and visited the company's new health clinic here.She hasn't given up her family doctor, but Mrs. Shelesky, 68, was satisfied enough to return to the Bethlehem Steel Family Health Center several times for her knee, which was found to be arthritic. Last week, she was back again, for a skin problem.

How Doctors Think By Jerome Groopman, M.D. Houghton Mifflin / 320 pages / $26 I often see undetected fear in patients' eyes as they traverse our complex medical system trying to figure out how to get their worries, aches and pains heard and cured. I work with doctors every day as they interact with various patients and families. But only after reading How Doctors Think, by Jerome Groopman, M.D., did I realize that I saw only their actions and reactions. Never was I privy to the reflecting, reviewing and even, at times, soul-searching that doctors do over their patients and diagnoses - the roads they mentally travel and the effect it can have on their patients.

How many times have you shown up for a doctor's appointment and been handed a stack of multicolored double-sided forms to fill out? You scan the information and realize that you don't remember when you had your tonsils out or the name of the medicine that caused you to break out in hives five years ago. Having complete and accurate records for everyone in your family isn't just a nice thing to have, it's essential. The good news is that getting them in order is a straightforward organizational task.

Across the country, increasing numbers of very short children are taking human growth hormone in hopes of eventually reaching normal, or near-normal, height. The treatment, which takes years and costs tens of thousands of dollars, will help a significant number of these patients grow at least a few inches taller. These children and their families say this added height can make a huge difference in quality of life. It can boost kids' self-confidence, help them avoid being teased or bullied, and later make it easier to drive a car. But some doctors and researchers say that in many cases, growth hormone therapy is unnecessary and wasteful, closer to cosmetic surgery than essential medical care.