Eighteen Years

Eighteen years ago today, I hung out my shingle and began the practice of family medicine, solo.

I had graduated from residency and worked for a few months for a pair of other docs who, much to my surprise, indicated that they did not intend to hire me to join their practice on a permanent basis. Their practice was full, though, and they had no objection to my setting up shop in the same town. At the time, it actually seemed like a lot less work to open up on my own instead of seeking out employment somewhere else.

I sat down with paper, pencil, medical and office supply catalogues, mentally reviewing everything in the "office" at my residency program. I priced everything out, generated a shopping list, and wrote out projections for growth and revenue. Then I found a little two-exam room basement office, and went looking for financing. It took four banks, but I finally found one that gave me the $25,000 credit line I was looking for. On October 2, 1989 I opened for business.

I saw three patients that day, but none for the rest of the week. Still, the practice grew slowly but surely. After two years I moved out of the basement office into an old surgeon's office building. Two years after that, when we couldn't negotiate a sale, I moved to my present location.

A lot has happened over those eighteen years. I've been through an embarrassing number of staffers, learning hard new lessons every step of the way. I look back at a 1989 H&P with more than a little embarrassment; they really do call it practicing for a very good reason.

I've been through a divorce, the hell of dating, and found my way into a wonderful second marriage. And my children have gone all the way from infancy and toddlerhood, through elementary, middle and high school, morphing into three sturdy college students who still light up my life.

On the flip side, my income peaked in 1996. It's been a slow but steady slide downward since then. That trend may actually be reversing itself over the last year or so; can't tell if it's just a temporary plateau on the way down, or things are really turning around. I'm trying to remain optimistic.

I'm not at all certain what the next eighteen years will bring, but I can still honestly say that I'm looking forward to it. And -- bottom line -- isn't that what life is all about?