The evolution of medical practice in the USA over the past century has been nothing short of remarkable. One of the most vivid illustrations of this transformation can be found in the life and career of a country doctor in southeastern Kentucky.
A Glimpse into the Past
As a new pharmaceutical sales rep, my journey took me to the heart of Appalachia, where I had the privilege of meeting an 80-year-old practicing physician/surgeon in Albany, Kentucky. The experiences and lessons I gleaned from this small-town doctor turned out to be invaluable.
Upon entering his office, I was greeted by a glass case in the waiting room, a mini museum of sorts. It was filled with old medical and surgical tools, a mortar and pestle for mixing treatments, and an old doctor’s bag with various medicine bottles. Among these artifacts was a desiccated left arm, the doctor’s first amputation, preserved for posterity.
The Country Doctor: A Tale of Dedication
Dr. Hay, as he was known, shared tales of practicing medicine in the early 1900s. He spoke of making house calls, delivering babies in patients’ homes, and traveling across the county to treat the sick. His stories painted a vivid picture of a time when the doctor was a central figure in the community, a far cry from the impersonal nature of modern healthcare.
According to an article in the Journal of the American Medical Association (JAMA), the concept of a traveling doctor has evolved into what we know as locum tenens. These physicians temporarily fill vacancies in high turnover multi-practice groups and rural practices, a stark contrast to the house calls of Dr. Hay’s era.
The Changing Face of Medicine
Locum tenens physicians meet all clinical standards of practice and often travel to rural areas to provide care. However, their temporary nature can be a barrier to establishing the close relationships that Dr. Hay believed were crucial for a successful doctor.
Dr. Hay’s definition of a successful doctor was not solely based on education. He believed that a doctor’s rapport with patients was equally important. In his book, The Country Doctor, Hay states, “It doesn’t matter how much education a doctor has, if the patient doesn’t like him [or her], he [or she] will fail”.
The Legacy of the Country Doctor
This series will delve into the contrasts and similarities between Dr. Hay’s era and modern medical practice in both rural and urban settings. Much of the content will be drawn from Dr. Hay’s book, The Country Doctor, and from our personal conversations.
