April 4, 2012

Changing doctors

Practice of medicine evolves over the decades

Rachel Brown
rachelbrown@daltoncitizen.com

— When Dr. Don Thomas first began practicing in Dalton in 1960, he charged $3 for an office visit and $75 to deliver a baby.

In those days, there were no big insurance companies, no Medicaid, no Medicare. Payments and treatments were worked out between patient and doctor, the cost of malpractice insurance was low because few people ever sued, and intermediaries were out of the picture.

“It was quite different,” said Thomas, who is still practicing medicine at Whitfield Medical Professional Association on Cleveland Highway. “There were 24 doctors in Dalton when I came into practice in 1960, and four of us came at the same time.”

One is Dr. Murray Lumpkin, a retired surgeon who recalls his childhood days when there were only four doctors in all of Dalton. Not only that, there was no ambulance service. Back then, residents had to take care of each other as best they could until someone more qualified was available. Lumpkin remembers being a teenage Boy Scout when he and some friends came on the scene of a gory automobile accident near Spring Place.

“In those days, they didn’t have an ambulance service here, so we stopped cars on the highway (to give injured victims a ride to the hospital),” he said. “Some of them wouldn’t even let you put the victims in the car because they were so bloody.”

That experience inspired him to become a surgeon. Now, Lumpkin said he’s proud that Hamilton Medical Center is a Level II trauma center, meaning it has around the clock staffing trained to treat patients with acute injuries. The highest achievement is Level I, and it requires the hospital to also conduct research.

Dr. Paul Bradley, the surgeon for whom the Bradley Wellness Center is named, said he began practicing in Dalton in 1949. His own experience as a patient was considerably more rustic than the way he practiced medicine. As a teenager, he was put to sleep with ether when he had to have his appendix out, he said. He said the ether made him feel like he was “smothering to death” even though he wasn’t.

The hospital didn’t have air conditioning in the 1960s, he said, but he remembered hospital staff rigging up electrical lines to run an air conditioning unit to one of the patient’s rooms to make her more comfortable. He said Rosa Brook, then the head nurse, ran day-to-day operations at the hospital when there was no hospital administrator. He said he remembers her picking out fresh produce for the day’s meals out of the back of a truck that came to the back hospital lot each day.

The first doctor’s office he had was a little frame house on Pentz Street, he said, and the second was a two-story house he bought on the corner of Selvidge and Waugh streets near where BB&T Bank is now.

Bradley said he was the eighth doctor to begin practicing in Dalton affiliated with the hospital. He would set broken legs, take out appendices, deliver babies and so on.

“We had some interesting stories over the years,” he said. “You saw most everything.”

He said years ago a young man came up to him at his home in Varnell, introduced himself, and said he wanted to get to know the doctor because his mother said he had delivered him. The man would later learn Bradley had done more than just deliver him. He operated on his mother, who had a fractured pelvis from a car accident on Waugh Street, many years earlier. After the surgery, Bradley had told her she would need a cesarean section if she ever wanted to have a baby. She remembered, and Bradley was the delivery doctor.

Bradley said he also remembers doing his residency at Grady Hospital in Atlanta and witnessing something extraordinary. A head doctor there had learned of a young black boy in south Georgia who was unable to use his legs because of severe burns. All he could do, Bradley said, was scoot around on his rear end. The doctors didn’t wait to get paid or to get his parents to sign permission papers. They just took him and operated on him. Bradley said he learned years later that the boy got better and grew up to work in automobile construction for 30 years in Detroit.

“Whenever you’re working on somebody what you’re doing for them may be strictly routine to you, but it may be the biggest thing that ever happened in their life,” he said.

When Dr. Sherwood Jones, who retired in 2001, arrived in Dalton in 1964, he said he liked the size of the town and the fact that all the doctors seemed to get along well. Back then, he said, there were just a couple dozen doctors in town.

“One thing I liked about the medical community was there were no large groups of doctors in one clinic,” Jones said. “We had looked at some other communities in Georgia and Alabama, and most of those had one large clinic and the doctors were either in that clinic or out. Here there were several practices where there were two or three doctors together but none where there were a large number.”

In the few years after Jones arrived, Dalton would begin attracting more specialists. Before, almost everyone was a family doctor, he said.

The landscape has changed in other ways, too.

“Very few people had insurance (in the 1960s), and it was just between the doctor and the patient, and it worked out well,” Thomas said. “You had a close relationship with your patient, and we really saw the entire family then in family practice — or general practice (as) they first called it.

“Insurance is so involved, and Medicare and Medicaid are so involved now. There’s a lot more paperwork now, and you didn’t have the paperwork back then, and all the forms to fill out. Now you have to fill out forms and sign prescriptions and fax for you to sign the prescriptions for refills. Medicare and insurance companies are wanting you to justify everything that you do.”

Thomas said there may be benefits and justifications for those measures, but they nonetheless make medicine more complicated.

Doctors also used to routinely make house calls, he said. Most patients still had to come to the office, but Thomas said he would visit patients who were too sick to get out or if they needed to be seen after hours.

Local doctors took turns staffing the emergency room and made the rounds twice a day at Hamilton Medical Center to see their own patients. Now, there are hospitalists — doctors assigned to patients in the hospital — who take care of their patients for the most part, Thomas said.

Doctors also used to rotate delivering babies for patients who couldn’t pay so that no one doctor had to bear all the financial burden, he said. All family practitioners delivered babies, he added.

“It worked out a lot better than it does now,” he said.

Jones said that while technology has steadily improved, “the basics of medicine,” that is, the relationship between doctor and patient, has remained basically the same.

Lumpkin said he enjoyed learning about medicine even when he was a child. As an eighth-grader, he said, he made a health book.

“I think even way back I always felt like I wanted to be a surgeon because it was not only the anatomy and the operations, the technique part, but the diagnosis part,” he said. “Medicine is very fulfilling, and you get more out of it than you put into it. We worked hard, but your patients are very appreciative of it.”