A Physician’s Call for Help – Rewarded by the Best Payment of All

My wife and I were sitting down to an uncharacteristically late dinner for us Friday at a local eatery when my cell phone rang. Caller ID identified it as Dr David Rosenberg, a family physician practicing concierge medicine about one hour north of my home in Jupiter, Florida.  We had not spoken in months and after some pleasantries and catching up he said, “Steve I just saw a story on the TV News that there is a back to school community fair in Pearl City in your community tomorrow morning and the doctor they had counted on to perform the required school exams for new students had cancelled due to a personal crisis.

Dr. Rosenberg wanted to know if I would join him for a few hours at the Wayne Barton Learning and Community Center and perform the physicals. He told me he had phoned fifty physicians and no one had yet agreed to come. He was prepared to do them himself.  I gave my wife that “duty calls” look and she nodded back approvingly and I told him it would be my pleasure. I agreed to meet him at 10 a.m. at the center.

Wayne Barton is a former City of Boca Raton police officer who is now a community leader and activist. He created a nonprofit agency and, with generous philanthropic support, has built an educational and community center for students from poor homes. He provides year-round learning and tutoring for students and has an annual “Back to School Jam” where new students receive the required school physical plus receive backpacks filled with school supplies that their working parents have great difficulty affording.

Mr. Barton greeted me at the entrance as I walked in and thanked me for coming on short notice. The regular physician who cancelled due to a family crisis has been volunteering for years and is my personal friend, mentor and is my patient. Trying to fill in for him is a tall order and made the experience even more special for me. Dr. Rosenberg, who organized this last minute physician participation, was there as well and with him were two other concierge physicians and a wonderfully warm physician’s assistant.

For the next several hours, with the help of a large dedicated volunteer staff, we saw numerous lovely children with their families. A mother and her high school age daughter and son, who had escaped the ravages of the earthquake in Haiti, were among the first.

A young woman and her two children who had escaped Communism and Castro’s Cuba nine months ago came through my station.  I saw a young man with lead poisoning requiring treatment and follow-up and another lad who wanted permission to play football despite the jaundice in his eyes tipping me off to his history of sickle cell anemia that he had conveniently left off his form.  I was able to stay for three of the four hours and I received the best payment of all – beautiful smiles, blessings from several and a thank you from all.

The degree of appreciation coupled with the level of need leads me to believe it’s time to discuss with Mr. Barton a regular free clinic at the center.

Once last thought, I couldn’t help but notice that the physicians who responded to the call for help were all practicing in a concierge medicine model.


I Work For T-Shirts

Every April my colleague and friend Joe Forstot calls to ask if I will do volunteer physicals for Boca Hoops and I always say “yes”.   Dr Forstot is a rheumatologist by trade, but to me he has been a senior resident and teacher when I was an intern, a mentor and now, the preceptor and teacher for my niece, a second year medical student. Most of all he is my good friend.   I am always intrigued by physicians who find a way to help others outside their normal professional role.  Dr Forstot is one of those individuals.

Twenty four years ago, his younger son, a wonderful basketball player and fan was cut from the school basketball roster on the final day of tryouts.  There were no alternatives. Boca Raton, Florida was a sleepy college town with one indoor basketball court inside the city’s oldest elementary school. The local universities and colleges still did not have an indoor facility and there were certainly few, if any, youth leagues.  Out of necessity, Dr Forstot and his friend Mike Doyle, a Broward County public school teacher, started Boca Hoops.

Everything about Boca Hoops was done correctly for all of the right reasons. Teams were formed by random selection after open tryouts were used to rank the childrens’ abilities. Teams were constructed for parity purposes.  Every child had to play the same amount of time in a rotation system for the first thirty minutes of a 32 minute running time game. Since there were not enough girls to start a girl’s league immediately, most teams were co-ed.  Sportsmanship, having fun and learning the game were the goals of the program.

To finance the costs, the organizers sought sponsors for teams and advertising banners. They came up with the idea of requiring a pre-participation physical exam and charging a fee for it. The fee from the physicals went to offset league expenses. Community physicians were asked to volunteer their time and perform the benchmarking physicals on participants.  In the first few years I was a sponsor of a team, a coach of a team and a volunteer physician.

The physicals were fairly basic discussing vaccinations and immunizations, age appropriate growth landmarks and some screening for cardiovascular diseases and congenital orthopedic problems. Inflation over the last 23 years has driven the cost of the physical from the original $5 to this year’s cost of $25.

From a physician’s viewpoint, we have moved from an elementary school cafeteria where we sat in little chairs and worked at little desks, to a high school teacher’s lounge where the chairs are kinder and gentler to our aching backs. The patients are still young and enthusiastic. The parents are still warm and appreciative. It’s a great opportunity to meet the young parents and children of the community and learn about what is going on in their schools and lives.

The league has grown over the last 23 years. It now encompasses almost a thousand players with separate boys and girls leagues.  There is a travelling competitive program for boys and girls plus three modestly priced summer instructional day camps. They play at indoor facilities at the local public and private schools as well as universities and city parks.  The shining jewel of the program is probably the High Five Division created for special needs children to learn the game and have a chance to play and have fun.

I have continued to sponsor a team each year since my children moved on to college and adult life. Many of the coaches in the pictures on the plaques I receive of my team either played for me as children or on opposing teams. Their children are now old enough to play in Boca Hoops.

I am running out of room on my office walls to hang all the team photos from my many years of sponsorship. The true prize of participation however is my Boca Hoops “Doc” T- shirt presented annually to each physician who volunteers. Over the years, the shirts have evolved from a plain blue t-shirt to a collared golf type shirt with a unique logo for Boca Hoops. The name “Doc” is printed on the front pocket.

I work for T shirts.

Fight Doctor – A Rich Experience in a Non-Traditional M.D. Role

I received a phone call from the Broward Sheriff’s Office Police Athletic League Youth Boxing Program asking if I would help them out on short notice and be the fight physician at their large youth boxing tournament. Their usual physician, a member of the Boxing Hall of Fame, had another commitment.  He was willing to train me in advance and show me the ropes on the day of the event but had to leave before the matches got started.

State law and the Boxing Authority require a physician to be at ring side and perform the pre and post fight exams.  I have worked with athletes in contact sports at all levels during my 32 years of medical practice but have no experience with boxing. It had been years since I have worked on a sideline so there was a bit of anxiety over wanting to have the skills, experience and expertise to help them and be able to make judgments and decisions that would help not hurt the participants.  I agreed to meet the fight doctor.

To help me with the project I enlisted my niece, a medical student who had just completed her second year and happens to be a fifth degree black belt in one of the karate disciplines. She was thrilled with idea.  We filled out applications and were accepted into the US Olympic program boxing medical team.  We then did a literature search to bring ourselves up to date on the latest articles on evaluation of head trauma in competitive youth sports.  Then, with some trepidation, it was off to Deerfield Beach High School and the bouts.

The Broward Sheriffs had done a remarkable job of transforming a gym into a regulation boxing ring with seating for about 1,000 people. As the fighters marched into the training room, we performed the fight physicals on enthusiastic and polite 8-14 year olds.  It was an opportunity for a medical student, my niece, to examine healthy patients for a change and be exposed to an unusual area of medicine that is certainly not discussed in the four year curriculum.

Dr. Allen Fields, a surgeon by training and board member of the Association of Professional Fight Doctors, was on hand to explain our duties and the fine points.  This gentleman, in his mid- seventies, clearly had the trust and respect of all those in the boxing program. Despite his easy going down to earth manner, it was apparent he was current and up to date in his knowledge of the medical aspects of evaluating and treating athletes at all levels of competition.  He is a source of experience and knowledge that my niece and I took full advantage of.

When the physicals were completed, we were off to ringside where we met numerous champions and Olympic boxing team members who were present to assist in the program. We were shown to our ringside seats. The National Anthem was played by a saxophone player and the show began. The referee prepped the first boxers, turned to the judges and timer and then turned to the fight doctors and asked our permission to begin the match.

At the conclusion of each bout, the participants shook hands and hugged. When the decision was announced it was difficult to distinguish the winner from the other boxer. There were no losers. The sportsmanship and camaraderie instilled in these youngsters by their coaches was apparent.  As they left the ring, we met them at courtside for the post fight checkup followed by a handshake and a hug.

The adults organizing and supervising the tournament could not have been warmer or nicer. These were high risk disadvantaged children using “Gloves Instead of Guns.”  They were expected to excel in school, be disciplined and play by the rules.   Six hours later the last bout was completed.  All the participants fared well with no injuries and no need for our intervention.  I can not express just how appreciative all the organizers and participants in this event were for my niece and I spending a day with them so that their tournament could take place.

It’s a funny thing; I think my niece and I are far richer for the experience and exposure to these wonderful volunteers trying to give these kids an opportunity to succeed in their lives. It was a pleasure to again see the value of a physician in the society working with healthy individuals in a nontraditional role. For as much as we gave, we received much more in return.