The Healthcare System needs a Doctor. It needs a checkup, tuneup, turnaround and it needs support and planning to do so. I can't fix it, but I can do the right things to try to make it better. I can model a better way, be a part of the solution and not part of the problem. I can prescribe changes that I am sure will improve the health of the healthcare system. What qualifies me to do so? 35 years in this business (not counting 4 years of Medical School) where I participated in many aspects of this system. Academic s, where I recruited, selected, taught and mentored numerous medical students and residents. I learned that selection of future doctors and guiding them into careers that were meaningful, productive, progressive, and humanitarian in addition to scientific was the reason for me to be there. My career path mirrors the lifecycle, I guess that was by design but it wasn't by my design. When I started this journey, I learned that it all begins with preconception care, through pregnancy and delivery and care of newborns and postpartum mothers with the CONTINUITY that is so important to the health of the healthcare system. I learned that a Family Doctor could take care of families as they grew into a family with the birth of a child with the assistance and guidance of THEIR Family Doctor (many don't even know we did that). I learned that the early childhood years were times of most importance when habits and personalities were developed and that this was the most critical time in the lives of those who will be our future. I learned that support, education, contact and relationships with trust were what made guidance possible from the Doctor (team doctor, school doctor, father and coach, sometimes father/coach/doctor all at once). I learned (and sometimes recalled) the angst of adolescence as a person committed to the community he lived and practiced in creating relationships with teens that even today causes full grown adults (where did the time go) to stop me and ask if I'm the doctor that took care of them when they went to (fill in the blank school and played whatever they played), and took care of that turf toe or headache or whatever it is that I usually still remember. I learned from the transition to practice after ten years to a more adult oriented system associated with a hospital. I did "regular" care for a diverse population with diverse needs, many of them "special needs" and learned that people with special needs needs special people to care for them, not that special, just caring--that's all it takes. People with sickle cell, cerebral palsy, developmental disabilities, and mental illness are just people with special issues, and they were being treated like outcasts, but not by me. I learned that they deserved good healthcare just like everyone else. I found House calls next, and took a deep dive into that in 2010 and spent ten years perfecting the science in ways that would be foreign to the average doctor trained like me. I learned that our training and methods of care missed the boat entirely when it came to taking care of people in a truly meaningful way. The first day I made house calls I realized that I had been doing a terrible job at relating to patients in the office. It wasn't entirely my fault, it was the setting that created obstacles that most providers still don't recognize. I learned that the setting for care had a lot to do with the success of the care being delivered. I accomplished more in my first day of house calls than I did in a month in the office. I learned that the "office model" was inadequate to care for people. I learned that the elderly were burdened with health issues in ways that I never fully understood until I went into the homes and could see and appreciate the lives of older people from the perspective of their homes, their kitchens and living rooms and bedrooms. Their communities: neighborhoods, apartments, nursing homes, assisted living, senior living communities. Their farms and condos, retirement homes away from home. I learned the burden AND the value of living a long hard life. The stories behind 60 and 70 year marriages, courtships and widowing. The effects of the depression era upbringings. I learned how losses of spouses, children, health, homes, jobs and function affected those who had more than their share of losses, and had more losses to go. In learning about losses, I learned about value and thankfulness. I elected to be involved in hospice, as I learned that our aversion to dealing with death and dying was more perverted than embracing the idea that we should talk about it and deal with it like grownups. That SOMEBODY in the medical community had to be the one to tell the truth about life and death, had to be the one to admit what we knew and what we didn't know. That the reality is that none of us will live forever. That it's OK to say whats important to you in this life (and the next) and to have someone who will use their medical knowledge and experience to help reach those goals. That accepting death is not about giving up, it's about having goals that acknowledge what is important to YOU. I've learned many things (so far) and I hope I can help us change the healthcare system to make it more healthy and make all of us have long, productive, healthier lives and be willing to change the way we do things to accomplish that goal. I'm starting with a new practice that will be designed to provide healthcare with dignity, respect, science and caring. This concludes our first appointment and I want to follow up with you to make a plan for your health and for the health of our system.