Dr. Curtis Burke is retiring from medicine.
His letter was sent to his patients a few weeks ago. Observing his past thirteen years of serving as a family physician in Sevierville he wrote “many things have changed in those years, including the very nature of the practice of medicine and my personal convictions about practicing medicine.”
He continued. “I believe that the foundation of quality primary medical care is the unique, personal relationship between the patient and the physician.”
Those words could not have been more accurately stated, nor backed with more credibility from the person who wrote them.
Dr. Burke is in the same age range I am - circling 50 and wondering where the 40’s went. He arrived in Sevierville a few years after I did in 2000. He took the reigns of a full practice from Dr. Sonner and hit the ground running with thick charts and busy days.
We shared many times in the hospital hallways, physician’s dictation room, and late nights making evening rounds. We shared call which means he would care for my patients (and the other physicians in our group) during the night and on weekends.
A lot is learned by observing how a physician writes his orders, thinks through problems, dictates a history and physical, and then a discharge summary. My residency hammered this into us, no matter if it was 3 AM, the structure had to be good, assessment logical, and plan concise. This is how you learn if a physician knows what he is doing.
(I worked very hard in residency to craft my dictations so that they would be structured, numbered, indented, and full of pertinent facts. This, of course, was a chore for the dear ladies in the transcription room in the belly of the hospital. Therefore, I would occasionally dictate with a thick accent or with my best Elvis impersonation. They have not missed me.)
I quickly learned Dr. Burke was a great physician managing orders and paper charts, but came to appreciate that he has that hidden quality some physicians possess, and some don’t.
When he looks at a patient he sees more than the problem. He cares more than the moment. He is there for the patient’s long term well-being.
I saw him take nineteen admissions on one weekend (typical was six) and never say a negative word. I have witnessed Dr. Burke serving the local hospital with countless hours on committees required to keep a hospital staff in order. He also served as Chief of Staff over all the physicians.
It takes a physician to straighten out physician behaviour, and he did that, too. With kindness.
He was the quarterback on the physician team that beat the hospital team in a fund raising football game. He was an automatic choice for the job, and rarely did a throw miss the mark. His son, showing the same grit, made an interception for Sevier County in a high school game - while wearing a cast on his broken arm.
But, according to his letter, he is leaving a profession he trained for the majority of his life, to now farm.
What has happened to the practice of medicine that a solid, hard-working, talented and dedicated physician would walk away in the prime of his career? Who, or what, did this?
Ironically, as I sat down to write my notes for this column, a five page letter from a Big Health Insurance Corporation (“Big HIC”) came across my desk. Big HIC had determined that my patient needed a certain test and so they dispatched a technician and the machine to her house. Oh, you her personal physician who has seen her for ten years, might like a copy of the result. Why, thank you, Big HIC.
This was followed by another letter that has my “Report Card” in it. Measurements of my average labs for diabetic patients, percentage of patients screened, percentage of patients getting colonoscopies, etc., for Big HIC were included.
The data is always flawed. Its collection is flawed. Therefore, the results are flawed.
I will show the Big HIC representative that a number of the patients on the list I have never even seen. That is usually when the attractive female Big HIC representative will become uncomfortable and want to end the meeting. I actually caused one to leave my office crying once. My wife and my office manager made me apologize - which I did. I did not apologize for standing on the facts, though.
The relationship between a physician and patient has been irreparably wounded by the laws written by the government connected with the strings of money controlling puppet insurance companies. We, the physicians, began allowing this to happen in the 1960’s. There is enough blame to go around, but the laws create the field the game is played on.
And so this community - already needing physicians - loses an excellent young one. Dr. Burke’s ambition in life has been for the better health of his patients. I am confident that his farm - neat rows, clean tools, vibrant plants - will provide healthy produce and, in a roundabout sort of way, continue contributing to the good health of those who consume it.
Curtis, thank you for your devoted service to this community and your friendship to me. I look forward to seeing your farm someday. You will be missed.
Eric J. Littleton, M.D. (@DrEricLittleton) is a musician and Family Physician in Sevierville, TN. Topics covered are general in nature and should not be used to change medical treatments and/or plans without first discussing with your physician. Send questions to askdrlittleton@gmail.com
