What is your hometown?
I was born and raised in Waterloo, Iowa and lived there until I graduated from West High School and left to attend college.
What is your official title?
I am a founding Partner and President of ElderAdvocates, Inc., a consulting company that provides education and support for seniors and those who care for them.
How/when did you become interested in science and medicine?
I have always had an interest in learning how things work, and like most little boys, took things apart to satisfy my curiosity. When I was young, my favorite model was the “Visible Man”. I spent hours taking his organs out and putting them back into the model. They even fit back in…most of the time. Science was one of my favorite subjects in school and I majored in Zoology in college, which put me on the pre-med track.
What interested you to pursue a career in medicine and medical education?
I was fortunate to have a family doctor much like “Marcus Welby” who made house calls, took care of people in his office and hospital and was kind and supportive of his patients’ needs and problems. He was my ideal of a good doctor, so he set an example for me to follow. He had no children and when he found out I was interested in medicine, he took me under his wing. He helped me get summer jobs as an orderly in a Waterloo hospital and invited me to follow him around on his hospital rounds. I suppose I became the son he never had. I certainly benefited from his support and interest.
The other career I considered was teaching. I was fortunate in high school and college to have some truly dedicated teachers and for a while I considered becoming a college professor. But medicine won out. When I attended the University of Iowa College of Medicine from 1968-1972, I was extremely fortunate to learn from some of the best medical educators of the times. Those men and women had a strong influence on me as examples of fine practitioners, as well as educators of future doctors.
After practicing as a family physician for a few years, I decided I really wanted to teach other doctors to be family physicians. That’s when I joined the Davenport, Iowa Family Practice Residency Program; initially as its Associate Director and later as the Program Director.
Please highlight your major career achievements, awards, discoveries, etc.
I am most proud of my work as a teacher. I began my medical teaching career as a volunteer faculty physician for my residency program, Broadlawns in Des Moines. It was an honor to serve as the Program Director of the Davenport Family Practice Program from 1982-1988, graduating 80 exemplary family physicians. I have also enjoyed mentoring a number of geriatric fellows and geriatric nurse practitioner students through the years.
In the past decade and a half, I’ve enjoyed serving as a lecturer and consultant about dementia issues for medical personnel as well as family caregivers throughout the country. Taking the expertise gained in my Memory Diagnostic Center, I’ve helped fifteen communities throughout the country to establish a Memory Diagnostic Center, many of which are situated in states that have had scarce dementia services.
In recognition of my work with persons with dementia and those who care for them, I was honored to receive the 2005 Special Service Award from the Wisconsin Alzheimer Association Chapter Network.
Is there a teacher, mentor or University of Iowa Carver College of Medicine faculty member who has helped shape your education?
I had the pleasure and privilege of being taught by many fine physicians at the University of Iowa, including Drs. Lewis January, Robert Rakel, Maurice Van Allen (42MD) and Adrian Flatt, to name just a few. Although it’s hard to single out one individual, I think the most influential professor for me was Dr. William Bennett Bean, Professor and Head of the Department of Medicine. I spent a considerable amount of time with Dr. Bean because I was active in the Osler Club at Iowa. Dr. Bean and Dr. Palmer Howard were both very involved with the Osler Club and the History of Medicine Club. Dr. Bean’s father trained and worked under Osler and Dr. Bean was a world expert on William Osler. We spent many hours in his office and home talking about clinical medicine, research, teaching and writing. William Bean, for me, is the ultimate example of a clinician and teacher. I often think of him today and feel very lucky that I had the honor of knowing him when I was a student.
How or why did you choose the University of Iowa for your education and medical training?
I attended the University of Arizona for college and initially thought I would enroll in the Arizona medical school, which was brand new in 1971. When my professors learned that I was a resident of Iowa, they said there was no better medical school in the country than Iowa for a broad, high quality medical education, and that I should apply to Iowa. I’m very glad I took their advice.
What kind of professional opportunities or advantages has your University of Iowa medical training provided?
Being a graduate of the University of Iowa was certainly an advantage when applying for residency programs. When I interviewed at different residency programs in Family Practice, I always received a favorable response from the interviewer when I discussed my training at Iowa. As I lecture to different groups across the nation, physicians often ask where I went to medical school. Their response is universally positive when I say “Iowa”. There’s a strong level of respect around the country for Iowa graduates.
Please describe your professional interests.
At this point in my career I am devoting my time to helping people with dementing illnesses such as Alzheimer’s disease and also non-Alzheimer dementias. Using the expertise I gained as the director of a Memory Diagnostic Center in Madison, Wisconsin, I have developed a team approach to diagnose, treat and support patients and their care providers who are living with dementia. Using this knowledge my wife Gail and I, who is a Cognitive Specialist, have provided training for Memory Diagnostic Center teams throughout the country. There is an enormous need for more diagnostic and support services for persons with dementing disorders, but traditional medical providers are lagging in providing these vitally needed services. It is extremely rewarding to help physicians, nurses and other professionals learn how to accurately and compassionately diagnose and manage patients who have dementia, and then watch them put this training to good effect in their own Memory Diagnostic Centers.
My wife and I have authored a number of training materials for persons with cognitive impairment and their caregivers, including activities for mental stimulation, and a DVD and training manual for caregivers. We currently have texts on journaling and reminiscence therapy for persons with dementia in press.
I also am active with the Alzheimer’s Association. I am on the Board of Directors for the South Central Wisconsin Chapter and work with many state chapters to provide programs for professional and lay persons dealing with Alzheimer’s disease and other dementias. My wife and I give about 100 seminars per year to various groups interested in dementia.
What are some of your outside interests?
I’m a strong believer in keeping the mind and body active as prevention for dementia, thus I have many outside interests. I enjoy working in our extensive veggie and flower gardens and recently have joined some friends raising Highland beef cattle on their hobby farm. I am active in our artisanal, locally- raised food program and organic movement. I enjoy bicycle riding, camping and fishing, especially with our 6-year old granddaughter. In the winter I do hand weaving on a loom, snowshoeing and cross country skiing.
Do you have an insight or philosophy that guides you in your professional work?
I came of age during the idealistic 60’s and 70’s when social programs and noble professions, like medicine, existed to help people. I went into medicine motivated to improve people’s lives—as did most of the medical students in 1968. I will always believe that as altruistic professionals, physicians should constantly ask themselves, “How can I help this person?” I’ve tried to use my excellent training and 35 years of experience to understand what’s wrong with patients who come to see me with changes in their cognition, and work with them to best manage their condition and preserve their dignity and quality of life.
If you could change one thing about the practice or business of medicine, what would it be?
Oh don’t get me started!!! I think the one thing I would change would be to get rid of the corporate structure of medicine, where doctors are essentially working for the company. I would like to see the return of smaller, M.D. owned practices, where the doctor runs his/her own practice and makes decisions about the number of patients seen per day, time spent per patient and reasonable financial rewards.
What is the biggest change you've experienced in medicine since you were a student?
I think it’s the loss of the long-term relationship between physicians and patients. Insurance plans and the health care industry have eroded the one-on-one relationship between doctor and patient. Your doctor used to be your trusted confidant and advisor. I’m not sure patients feel that way today. I’m glad that most of my practice life was spent before the age of corporate medicine.
What one piece of advice would you give to today's medical students?
Enjoy what you do. Select a specialty of medicine that fits your personality and life wishes. Then become the very best in that field that you can. Enjoy your practice and your patients. Treat your patients like you would like yourself or your family treated. Don’t get trapped by wanting and needing the “good things that money can buy.” If a time comes when you’re not enjoying your professional life, figure out what’s wrong and change it. Life is not a dress rehearsal, so make the privilege of being a physician count, for yourself and for your patients.
What do you see as "the future" of the medicine?
We’re at a sea change time. We can go either direction—more dissociation from our patients and our principles, with others making all the decisions, or we can take back control of our profession. The future of medicine can be bright, but it will require physicians to change their behavior and become activists for their own interests and those of their patients. I’m hopeful that the current medical students will change how medicine is practiced in order to help this profession regain its altruistic mission.
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