Lughnasa                                                                                                  New Harvest Moon

NB: prophet is a gender neutral word as I use it.

Kate.  Always ahead of her time.  When Kate was in high school in Nevada, Iowa, she arranged a deal to take most of her senior classes at nearby Iowa State.  She’d run out of classes in the high school, at least classes that could keep her interest.  In her senior year, just as the deal was to kick in, the high school changed their mind.  Later, as a nurse anesthetist, she insisted on better pay for her position at Mt. Sinai.

After that, too long in the role of helper, she decided, at age 34, to go to medical school.  The medical school thought that since she was already a doctor’s wife, she should be happy with that.  She graduated and became a board certified pediatrician in the best medical delivery system in the US.

After a serious illness and poor treatment at the hands of her then partners at Metropolitan Pediatrics, Kate moved to Allina, its Coon Rapids’ clinic.  While there she became frustrated with corporate medicine and chose to become lead physician for her group.  Over her time there she integrated pediatric and family practice offices, initiated (by doing it herself) after hours care and agitated for a better deal for primary care docs in general.

Now, several years after she pioneered it, Coon Rapids’ peds has regular after hours clinic and the Clinic has an urgent care unit providing after hours non-emergency medicine.  Kate works in the urgent care, part-time.

She has been tireless in haranguing me about the stupidity of pediatricians treating psychiatric problems for which they have little to no training. (see today’s Star-Tribune)  The arguments about vaccine that I read in this months Scientific American I first heard over the breakfast table.  She also campaigns against the overuses of anti-biotics, the over prescription of pain-killers and, most passionately of all, the need for a single-payer health system.  An equitable distribution of health care services has been at the top of her need list for a long time.

She is a prophet in a system that, though excellent in its care, has become sclerotic in its administration.  The current over managed (way too many administrators with way too much power) model, corporate medicine as she styles it, focuses its efforts on the bottom line (money), on standardization (easier to manage), on patient satisfaction (results would be a better yardstick) and on turning physicians into employees.  Those who run these systems should listen to this practical, intelligent critic and change their ways.