September 19, 2015 • By Dennis Beaver
Over 40 years ago, fresh out of his second residency in internal medicine —as he was a foreign medical graduate — Internist “Dr. Lee” and his family traded hot and humid New Orleans for the equally hot, but dry, California Central Valley.
Then, as today, this agricultural powerhouse has been unable to attract an adequate number of physicians, so when a doctor moves here — especially to the more rural — areas it is a headline-grabbing event.
However, despite the obvious need, foreign-trained physicians in the 1970s often received a frigid reception, bordering on outright bias, prejudice and discrimination.
This hostility did not originate in the general population, but from American doctors, notwithstanding the fact that the foreign medical graduates completed an internship or residency in their home country, learned English, did a second residency in the U.S., and passed the same tests as U.S. trained physicians.
In reality, it was mostly about competition, but the stated reason for trying to keep foreign docs out was, “their lack of competence,” as we learned, invited to a lunch meeting where several highly regarded physicians met to discuss ways of “discouraging” foreign medical graduates from moving to the Central Valley.
Through clouds of cigarette smoke, it had the feeling of a Mafia sit-down, as a cardiologist, came clean:
“We do not have the population to accommodate all of these specialists. Also, there is more to being a good doctor than passing a test, as language skills are critical. Often patients and nurses simply cannot understand them.
“Can we legally make their lives miserable so they understand we do not want them here?” he asked.
Our answer had one word: No.
A thriving practice quickly grew
“Dr. Lee” quickly overcame these challenges, earning respect from colleagues, love from his patients, and becoming “the doctor’s doctor,” treating other physicians and their families. Deeply caring, he often spoke of, “The joy, the wonderful gift in being the family doctor for second and third generations of patients.”
Within a few years, his thriving practice added two physicians and a large support staff. Unfortunately, an unwelcome by-product of his success was the development by “Mrs. Lee” what is referred to as “The Doctor’s Wife Syndrome,” the main characteristics of which are an air of superiority and entitlement through marriage to a doctor or other well-paid professionals.
Automotive service writers know this difficult personality well.
Even when clearly wrong, she was a powerful force few would challenge. With the spotlight of respect and popularity shining on the doctor, she bathed in its reflected light, living through him, as meanness and need to control everyone around her took root.
“Do not ever disagree with ‘Mrs. Lee,’ ” was the mantra of all who knew her.
When the doctor himself was hospitalized with a life-threatening illness, only one family from their church spent time, offering her support. “Ungrateful users,” she proclaimed, not hearing the message sent by the congregation.
Years later, this attitude would have dramatic legal and economic consequences.
‘Your patients are at risk’
In early 2013, “Dr. Lee” was having trouble recalling dosages of commonly prescribed medications, and the names of patients with him in the examination room. “Just getting older,” he would joke about these lapses.
A neurologist friend examined him, bluntly stating: “You are exhibiting the first stages of Alzheimer’s disease and your patients are at risk. I am not reporting you to the Medical Board, but you must stop treating patients. Quietly retire and sell your practice.”
Rejecting the diagnosis and claiming that the neurologist was incompetent, “Mrs. Lee” insisted that her husband not retire. Consequently, he continued to see patients until late-2014.
When “Mrs. Lee” was visiting friends in San Francisco, daughter Stephanie, concerned about her father’s appearance and changes in personality, took dad to a neurological clinic in Los Angeles where an angry physician said, “You are a danger to your patients and should have quit a year ago. I am reporting you to the Medical Board today!”
Dr. Lee’s practice had value
“The value of the practice of a sole practitioner — doctor, lawyer, dentist or CPA — resides mainly in that person, the business having much less value without the professional.
“With other physicians employed and a large patient base, a practice remains a valuable asset as long as nothing is done to cause patients to leave before a sale,” observes Lake Oswego, Oregon-based management consultant Gary Goldstick, author of Business Rx, a book that in our opinion should be on the shelves of every business owner.
If you were a patient, how would the following line from “Dr. Lee’s” very sad “Letter to My Patients” affect you? “I am retiring immediately.”
Next time: Fire Sale!
Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.