Column: Doctor provided kind of service that HMOs can't

Change never comes easily, but sometimes it is harder than others. It seems that lately things are constantly changing and, generally speaking, I am against it.

One of the most recent changes in my family's life is the retirement of Dr. O'Shaughnessy from his family medical practice.

He has been our family doctor for most of 25 years. In 1974, when we moved to Carson City, we asked around about a good family physician. The name Dr. O'Shaughnessy with Family Medical Services kept coming up but unfortunately he was not accepting new patients.

Finally, someone said, "I know Dr. O'Shaughnessy. I'll call and see if he will take you." With that introduction, we were admitted to his practice. We were in our 20s, with no children, so our visits were few and far between.

Later, the doctors at Family Medical Services disassociated and Dr. O'Shaughnessy opened a practice by himself. After a brief hiatus, we joined his new practice.

What set Dr. O''Shaughnessy apart was his willingness to take the time to listen to us talk about our complaints and then to provide a careful medical explanation for our ailments. While we have been fortunate in that we have not experienced any life-threatening health problems, he has always taken our concerns seriously.

Rather than just writing a prescription, he undertook to educate us as to how lifestyle changes in the area of diet and exercise could provide a remedy. On one occasion, he made an appointment with my husband and I on a Sunday afternoon so that he could spend time with us explaining how exercise can lower blood pressure.

It took him two hours, but when he was done, we were ready to go directly to the gym. Since that time, exercise has been a way of life in our family; no medications required.

With PPOs, HMOs, cost control and managed care, it is unlikely that we will ever receive that type of medical care again. I suspect that under these new systems, in order for a doctor to cover his overhead and to make a profit, he or she can spent only a finite number of minutes on average with a patient.

Like anyone, doctors deserve to make a profit. They make enormous sacrifices to complete training, they undertake enormous life and death responsibilities, and they work an incredible number of hours.

Experienced doctors have already taken a substantial cut in income and young doctors complete their training burdened with huge educational loans. In many respects, the new systems make it difficult for doctors to provide the level of care they would like to without going broke. While I understand the reasons for the changes in our medical system, I am not convinced that either the patient or the doctor have benefited.

In any case, we owe Dr. O'Shaughnessy a debt of gratitude for all the years of excellent medical care, for all the time that he took with us when he should have been seeing the next patient and for his interest in our general well being, not just in our specific illness.

Our family will miss Dr. O'Shaughnessy. We will miss his direct and practical approach to medicine. We will miss his grin and his sense of humor. Most of all, we will miss his kind concern and his willingness to spend the time required to make us well. I am sure that there are many of his patients who share our feelings. Here's to your good health, Dr. O'Shaughnessy! Thank you.

Linda E. Johnson is a wife, mother, attorney and a 26-year resident of Carson City.