Tuesday, May 8, 2007


This article was written by family physician David H. Hopper MD, from Princeton, WV, upon the occaision of his premature withdrawal from Family Medicine practice. It is an eloguent testimonial to something that is happening all over the United States. The article appeared in the Bluefield Daily Telegraph.


Change is always difficult, yet as it says in the Bible, Ecclesiastes 3:1 There is an appointed time for everything. And there is a time for every event under heaven.” After almost 30 years of serving the people of Princeton and the surrounding region, change took place in the lives of many in this community with my closing of Total Life Family Practice.

This decision was not an easy one, for my partner and I have enjoyed many good years caring for our patients through this practice. However, despite the governor’s logo, we are no longer “open for business.” With this closure over a dozen jobs have been lost and many thousands have lost their family doctors.

The demands of the practice of medicine are continuing to grow. Managing piles of paperwork, dealing with drug formulary and insurance issues, meeting rising overhead with inadequate reimbursement from Medicare, Medicaid and insurance companies, paying high WV malpractice insurance premiums and handling numerous other issues make private practice increasingly difficult. These problems are nationwide, but seem to be even worse here in WV.

Over the years 8 physicians came and left the practice, all of whom moved out of state. Recruiting and retaining doctors became increasingly hard. It became progressively harder to take time off to follow other callings such as my medical mission trips to Sudan or other misfortunate places. Finally I made the extremely tough decision to close my practice.

My decision was an individual one and certainly does not apply to all primary care doctors, but it is one that seems to be increasingly common. The private practice of family medicine has become less and less appealing. The joy of long term patient care relationships, the fulfillment of knowing that you had been able to manage multiple problems which would have required visits to numerous specialists, and the pleasure caring for the children of children you delivered is still available to the family doctor. However the stress of the system, which has persistently undervalued primary care services, has led shrinking percentage of new graduates to enter these fields.

In a recent issue of CA: A Cancer Journal for Clinicians, Dr. Richard Wender, President of the American Cancer Society said: “Adults with a primary care physician as their personal physician are 19% less likely to die prematurely than individuals who utilize a specialist as their personal physician.” And “Despite the striking evidence of the critical role played by primary care clinicians in the cancer fight, the future of primary care services in the United States is uncertain. Several high profile publications have questioned whether we are facing ‘the end of primary care.’ ”

Change will continue to take place in American healthcare, and it must. However it is sad to see the most personal aspect of the healthcare system die off. Be thankful for your family doctor, and support a system that allows whole person medicine to survive.