ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Thursday, March 28, 1996 TAG: 9603280010
SECTION: EXTRA PAGE: 1 EDITION: METRO
COLUMN: Beth Macy
SOURCE: BETH MACY
Almost as soon as the letter went out announcing Dr. J. Hayden Hollingsworth's career change last month, the return calls and letters started pouring in.
Dozens of cardiologists from across the state were shocked that one of their best-known colleagues - indeed, the dean of Roanoke cardiologists - was turning in his stethoscope to become, of all things, a writer.
Hundreds of patients responded with cards, letters and phone calls - many of them tearful.
``One guy was so choked up, he had to put his sister on the phone to talk,'' recalls Linda Shevlin, Hollingsworth's secretary. ``He was the only doctor this man had ever seen, and he feels like the doctor saved his life - and now what's he going to do?''
Shevlin figures she stacked some 50 medical charts on Hollingsworth's desk that week. Hollingsworth spent all day Saturday and Sunday talking to fretful patients, reassuring them they'd be OK without him - and reassuring them he'd be OK without the practice of medicine.
But what the 60-year-old physician failed to explain was the reason underlying his career change:
That sick people are no longer considered ``patients,'' but ``clients.''
That the oath of Hippocrates is being replaced by the oath of the almighty dollar.
That he sees little room for ``care'' in ``managed care.''
Hollingsworth remembers his decision to enter medicine some 38 years ago. He was working college vacations at a Roanoke hardware store, run by Roanoke's then-Vice Mayor Johnny Waldrop. A Davidson College student at the time, he had planned to be a marine biologist.
He remembers the impression it made when Waldrop took his father, the Rev. A. Hayden Hollingsworth, aside and told him, ``He'll do well at anything because he's a hard worker - but what he's really good at is people.''
``That's when I thought, maybe I do like people more than I like paramecia,'' he says.
Up until about a year ago, Hollingsworth hadn't looked back. The first board-certified cardiologist in Roanoke, he built a thriving practice with Dr. Philip Shiner called Consultants in Cardiology, which now employs 12 physicians. Over the years, he figures he's seen some 5,000 patients.
His consultation room is lined with relics and gifts from his medical years: a Russian statue from an 85-year-old man who survived two open-heart surgeries; a patch off the Roanoke Locomotive Shop uniform of another heart-attack survivor; an Incan sacrificial tray from an agricultural agent who suffered a heart attack while dodging gunfire in Guatemala.
``All he had was the sack on his back and the tray; he had no money,'' Hollingsworth recalls. ``That tray was his payment.''
After 38 years of helping save lives, Hollingsworth looks back nostalgically on his career, calling it ``an exciting ride.'' What he won't remember so fondly is this patient's story:
A 45-year-old Giles County man with unstable angina awaited transfer from an outlying rural hospital to a Roanoke hospital for intensive cardiac care. It was a Friday; a cardiac catheterization was scheduled for the following Monday.
The insurance company refused to allow his transfer, unless the catheterization was performed that night. Hollingsworth argued on the phone with the insurance adjuster - a Minneapolis doctor - saying the patient was too unstable to stay in the rural hospital. The insurer refused.
``The man had a humongous heart attack that night,'' he says. ``They had to fly him down here in the middle of the night.''
Asked if it ended up costing more, Hollingsworth snapped: ``Yes, it cost more. It cost the man half his heart - and it could have been prevented.''
Consultants in Cardiology employs three people who do nothing but negotiate with insurance companies - ``trying to get nonphysicians to agree to procedures. Most of the time they'll agree, but they put all kinds of stipulations. They might OK a cardiac catheterization but not allow a hospital stay, totally disregarding the fact that it's an 80-year-old lady who lives in West Virginia.''
It's the great untold story, Hollingsworth believes, complete with bedside intrigue and backroom decisions: Insurers withholding payment to doctors, doctors withholding procedures, employers withholding benefits that extend beyond the insurer's list. ``The patient is standing in the middle of the triangle yelling - and nobody's listening.
``People's lives are at stake; their freedom is at stake. The medical community has bargained away patients' rights so gradually and slowly that no one's even noticed.''
If John Grisham can make the legal system dramatically inviting, Hollingsworth figures he can use his own insights to pen a novel on the health-care crisis. ``You can't be in this business 38 years without seeing and feeling and understanding how people live,'' he says.
``And don't live.''
Beth Macy's column runs in Tuesday and Thursday Extra. She can be reached by phone at 981-3435, or by e-mail at extrainfi.net, or even the old-fashioned way at P.O. Box 2491, Roanoke, Va. 24010.
LENGTH: Long : 107 lines ILLUSTRATION: PHOTO: CINCY PINKSTON/Staff. 1. A collection amassed from aby CNBlifetime in medicine: ``People's lives are at stake, their freedom
is at stake," Dr. Hayden Hollingsworth says of the profession he's
leaving. "The medical community has bargained away patients' rights
so gradually and slowly that no one's even noticed.'' 2. Memorabilia
fills Dr. Hayden Hollingsworth's consultation room: One item, an
Incan sacrificial tray, was given to him by an agricultural agent
who had suffered a heart attack while dodging gunfire in Guatemala.
``All he had was the sack on his back and the tray; he had no
money,'' Hollingsworth said. ``[The] tray was his payment.'' color.