I've been looking over my dad's ledger book from his first year in private practice. Prior to this he was in an accelerated Med School track for the Army, then spent a few years as a base physician in Germany. On return he went back for a couple more years of training, then hung out the shingle. I still have that shingle btw.
Let's take a peek at this bygone era of medicine.....
Obviously long before the age of electronic office management and accounting software.
This records not the actual appointment schedule, just charges and receipts. But you can fill in the gaps fairly easily. At this point in time I think my dad had not one but two offices, in different parts of town. And did house calls, nursing home calls, minor surgeries, etc.
It makes for fascinating browsing. Office calls were usually 2 or 3 dollars. Delivering a baby? $85.
He worked seven days a week. Saturdays were just as busy as Monday through Friday. On Sunday he took it a little easy, his office(s) must have been closed. But even on the Day of Rest there were Hospital Calls ($3) and Home visits ($5).
He kept very detailed records. In an average month he took in about $1500 and had expenditures of around $500.
Needless to say this is a world of medicine long forgotten. Although to put things into perspective a bit, it was a time when as I understand it there were price controls on what physicians could charge. And, if you take his total profit on the year of $12,813 and multiply it by the inflation since 1953, you get just over $150,000 in actual equivalent purchasing power. Everything was a lot cheaper back then. He was still making about four times the average wage for 1953.
Picking through a ledger book you find little details. His office rent was $50.50. As I'm only finding one such expense perhaps the second office came later, or perhaps I got that story wrong. At the start of the year he had one employee, a certain Marianne Peterson. She made about $190 a month. By the end of the year she was sharing the work load with a certain Mariel Hanson.
Interestingly, M. Hanson became M. Wolter and drops off the payroll in 1954. But by then I'm sure she was de facto Office Manager!
Dad's generation had a different attitude towards work. He grew up on a dairy farm, and an old fashioned one at that. There were still a few horses around when he was a young lad. He did chores. Oh, so many chores. Somehow he found a way to be Valedictorian of his high school class, so there must have been a fair amount of studying after all the work was done.
College-Med School compressed into, I think, 5 years instead of the usual 8. Then his Army doctor service, most of the time being the only post doctor on a base that was essentially a small town of GI's and their dependents. Maybe starting out in his own practice seemed easier, as he was nominally his own boss.
Eventually even he got tired. He had a well concealed literary streak. Once he wrote a lengthy poem entitled "And the Patients Lose their Patience". He got to where he felt as if the work was in charge of his life. And it was.
I did learn from dad, but sometimes learned what not to do. I worked hard, and was no slacker in my generation of physicians. But I spent more time with my boys. And I was a much better businessman. So when it came time to retire I could do so on my terms. It's been good years since I hung up the stethoscope. Dad, not so much. Work was his life. He eventually joined a group practice that had a mandatory retirement age of 70. He worked right up to the end, and so did not get the enjoyable decade I've had since 60. Sadly, after retirement he was idle, a bit lost. And what he'd lost was the thing that structured his schedule, his days and his nights. I think he genuinely enjoyed being a doctor; helping people. To some extent he also used work as his way to avoid difficult things at home.
As is sometimes the case I start out writing one story and end up somewhere unexpected.
No comments:
Post a Comment