Professional Choices

When I launched into private practice I was a practicing Sunday Catholic physician who did not contracept and did not perform vasectomies. However I was also overweight, had never exercised a day in my life, and was not furthering my spiritual development. Shortly thereafter I was “blessed” with a kidney stone (poetic injustice for an urologist…) that got me to take a long hard look at my lifestyle and resulted in my joining an exercise class and embracing a healthy diet. About the same time I was introduced to two extraordinary physician missionaries (Herb Sorensen, MD, and David Frelinger, MD) whom I met when I was a board member of the Mission Doctors Association in Los Angeles. By example they showed me how developing one’s spiritual side reinforces the discipline necessary for good “body maintenance” and vice-versa. This ultimately led to embracing a daily morning routine of Liturgy of the Hours recitation, a rosary, and Mass before the office and/or surgery.

A short time later the fruit of much prayer and reflection was that I do something positive for the pro-life movement to supplement not doing sterilization procedures. This led me to take several microsurgical courses augmented by lots of dissecting microscope practice so I could offer vasectomy reversals to couples…with a twist: I would do them for free. The patients were instructed to pay the hospital and anesthesiologist but my fee was waived. I asked only that they make a donation to our local pregnancy counseling center. Unfortunately this drew patients who couldn’t care less about my philosophy or theology–only the price–and who were not necessarily married. So I changed the format to one of a low all-inclusive fee, from which I pay the hospital and anesthesiologist. All who inquire about vasovasostomy are told that I offer this service only to the married, since they must commence marital intercourse a few weeks post-operatively to propel sperm through the vasal channels to help keep them open.

Shifting gears…The current medico-economic environment is a disaster for most physicians and ultimately will be for patients as well. Because the “tail is now wagging the dog”–medical insurance companies and the government pay most of the patients’ medical bills and are therefore increasingly strident in their demands of physicians–many doctors are either retiring or fleeing to the embrace of their local hospital. A very small number have chosen Dr. Harris’ path of a truly independent practice (congratulations!) and have returned to “it is customary to pay for services when they are rendered” all cash practice or some variant thereof, e.g., primary care physicians segueing into a “concierge practice”. But the majority who remain in practice do so under the aegis of their hospital’s chief medical officer. Space limitations prevent discussing all the implications of this but, suffice it to say, the care rendered tends to be less individualized and more impersonal.

I saw this unpleasant sequence of events unfolding years ago and realized I had only two choices: Move to a location that would allow me to survive with a practice free of third party constraints or stay put in the Los Angeles area knowing full well that in effect I was going to be subsidizing third party payers and patients. I chose the latter for many reasons, the paramount one being my wife and I wanted to remain close to our parents as they aged. So although the payment methodology certainly limits my income I accept this situation as my “urologic apostolate”. I continue to treat everyone who walks through my door regardless of their socioeconomic status, insurance, etc. No one is turned away. Each is treated to the best of my ability.

My recommendations to all, and physicians in particular: Spend a reasonable amount of time in prayer as you start your day and ask for the grace to cooperate with our Father’s holy will. Relish the opportunity to interact positively with each person you meet throughout your day since all are made in the image and likeness of God and Our Lord resides within. God bless!