Magazine article Medical Economics

"I Can't Accept Doctors' Excuses for Not Being with Their Kids"

Magazine article Medical Economics

"I Can't Accept Doctors' Excuses for Not Being with Their Kids"

Article excerpt

He has a booming pain management practice, but this FP-a divorced father of five and a confirmed soccer dad-says, 'My family is my whole life."

Like his hometown of Evansville, IN, 45year-old family physician Randall Lee Oliver isn't stuffy or pretentious. On a typical spring day at the office, he wears khaki pants, black tennis shoes, a shortsleeved shirt, and a favorite bolo tie. Pictures of his five kids hang in each exam room. Photos of his parents, as well as of his siblings and their families, line the hallways.

He considers himself a hard-working family man, plain and simple-like the folks he grew up with.

"The west side of Evansville is a real tight community," says Oliver, whose clinic is only six blocks from the house where he was raised and where his parents still live. "Most families have been here for generations. Everyone knows everyone. In fact, when I was a kid, I used to pick up the newspapers for my route right in front of the building that's now my clinic."

That familiar, homey feel keeps a strong hold on Oliver. His ties to Evansville, a city of 125,000, run as deep as the Ohio River, which it borders. "The worst years of my life were when I was at med school in Indianapolis, three hours away," he says. "I was homesick, and I still get that way. Even though I travel every other month on average and enjoy nearly every place I visit, the best part of the trip is coming home."

After receiving his degree from Indiana University School of Medicine in 1980, he returned to Evansville to complete his residency at Deaconess Hospital. He then went into solo family practice in addition to seeing patients a few days a week with Howard Burg, a pain management specialist he'd known during residency. When Burg died in 1992, Oliver bought his practice for $125,000. Since then, the Oliver Headache & Pain Clinic has prospered. It billed about $1.5 million in 1998.

Of that amount, Oliver netted $416,183-more than three times the typical FP's net in 1997, according to our latest Continuing Survey. His expenses ran a whopping 72 percent of gross income, almost twice the 1997 median expense ratio for his family practice colleagues nationwide. A 14-person staff that includes two full-time nurses and a nurse practitioner explains much of the disparity.

"I hire good nurses and pay them well," Oliver says. "By the time I see the patient, one of them has already taken his vital signs and history, and answered most of his questions." This fine-tuned system allows Oliver to see an average of 50 patients a day.

Treating patients whom "no one else understands"

Oliver stopped delivering babies four years ago. And though he still does basic primary care, he focuses on patients who have chronic pain from non-life-threatening conditions-migraines, arthritis, fibromyalgia, and degenerative discs.

"I relate to these people." Oliver says. "I suffer from migraines, as does my son Jake. I also have back pain and heel spurs that bother me when I get up and down." In fact, Oliver's exam rooms are equipped with angled shelves, mounted at chest height, so he can write his notes without having to sit.

Oliver enjoys working with patients who've been labeled chronic complainers. "You have to understand that most pain patients are depressed or anxious. As a result, they usually don't sleep well, which creates other health problems. Even if I can't do much to alleviate or eliminate their pain, they rarely leave here unhappy, because we treat them with respect and take their complaints seriously."

Oliver credits much of his practice's success to his head nurse of six years, Trish Wulff. "We're like an old married couple," he quips. "We can read each other's mind, we have a good flight every so often, and we never have sex" Wulff makes a face and shakes her head. "I've become hardened to him;' she says.

That kind of easy interplay is typical of life in Randy Oliver's office. …

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