Paynesville Press - April 10, 2002

Community Perspective

Medical care has grown in Paynesville since 1949

By Dr. Ray Lindeman

It seem like only last July that I decided to settle in Paynesville to engage in the practice of medicine. Wow, has it really been 53 years?

As we came from St. Paul and drove over the five-mile bridge on Highway 55, we noticed Lake Koronis. After that sight, it would have had to have been a very dismal little town to have changed our minds about moving in. To this day, I have never regretted that decision.

I grew up on a farm near a town the size of Paynesville in east central South Dakota. German Catholics settled the area north of the town and German Protestants settled the area south of town. Sound familiar? That difference has also changed the past 50+ years.

Dr. C.R. Myre recruited me to practice in Paynesville. Dr. Myre and Dr. Nels Sandven were the only physicians in town on July 1, 1949. My training had been centered on family practice medicine, having graduated from the University of Tennessee Medical School in Memphis and completing my internship at Ancker Hospital in St. Paul.

I had delivered about 40 babies in my training prior to coming to town and since that time, until I retired, the deliveries didn't stop. More than 3,600 deliveries if anybody wants to count! Obstetrics had progressed to where home deliveries were rare and it was acceptable to go to the hospital and stay for seven to ten days after a delivery.

Most of my deliveries before Paynesville were in the slums of Memphis. That would be another whole story, but it did prove to me that necessity was the mother of invention.

Dr. Myre and I had a busy general practice. We made home calls frequently. My first office was on the second level of the First National Bank building, 24 steps up. Patients that could not make the stairs were seen at their home. The building still exists in downtown Paynesville next to Wishin' Well Cafe.

The Myre hospital was in the house on the corner of Washburne Avenue and Mill Street, across from the ambulance garage. Our delivery room was on the second floor, as was the surgery. After surgery, during recovery, the anesthetist, the doctors, and the nurses cradled the patient in their arms and carried them to the first level, down two flights of stairs. It worked very well.

Anesthesia was drip ether or chloroform, administered by a doctor from Eden Valley. For major surgery, we called in a surgeon from St. Cloud or Willmar.

Patients stayed in the hospital for a charge of $10 a day plus charges, such as $2 for penicillin shots. Food and IV solutions were covered in the $10 room charge.

The next big step was the building of the Paynesville Hospital in the 1950s. Dr. Myre had agreed to close his hospital. The new hospital received federal funding as well as local support. Federal funding carried with it many regulations and requirements.

For example, no patient could be refused care on the grounds of not being able to pay for it. Before the days of Medicare and Medicaid, the indigent needed to apply to the township board or the county for financial assistance. Township boards were usually well aware of the financial status of residents.

Medicare arrived as a real blessing for physicians. We no longer had to spend a lot of time and energy collecting medical bills from the senior population. Little did we realize that there is no such thing as a free lunch and we gave up a close relationship with our patients.

People still believed that the rapid increase in medical care cost was entirely physician induced and Medicare, who paid the bills, became the patient's friend. Today the reason for the rapidly increasing cost of medical care is the increase in technology and greater demand for care. We all want the best for less and we want it now!

The availability of medical care seems to be more difficult now than it was 50 years ago. Why? The demands for care are greater, more forms of treatment are available, people expect perfection and frequently sue if a perceived result doesn't happen, million dollar machines need to be paid for, the best is not often good enough to produce a miracle, the medico-legal climate is such that many tests are done as a defensive measure because "failure to make the right diagnosis" is still the basis for many malpractice claims, and the list goes on and on.

I have recently become involved in a program called "Patients as Partners." This was the idea of Dr. Donald Etzweiler, M.D., at the International Diabetes Center. Dr. Etzweiler is a world-renowned specialist in diabetes care and believes very few things can change in health care until patients become more than just the recipient of care. They must accept more of the responsibility toward early diagnosis and adequate treatment.v The Paynesville Area Health Care System has recently formed a foundation to accept financial gifts that can be used in developing and expanding the care facilities of the hospital. A foundation board, which I serve on, has been formed to accept and allocate funds for much-needed improvements or new developments.

For many years, funds have been received by the hospital and, unless specifically designated, have been disbursed by the administration to areas of need. This will now be the task of the Paynesville Area Hospital Foundation. Outright gifts, bequeaths in wills, and any other contributions will be carefully allotted by the foundation board, whose membership includes four at-large members from the community.

I think this is yet another step forward for the health care community. In 1949, there were three medical doctors in Paynesville and Dr. E.J. Olsen, a chiropractor. Today there are nine medical doctors, two physician's assistants, one nurse practitioner, two Pharm.D.s, one doctor of psychiatry, and two chiropractors. Quite an increase in providers, and if you'll forgive me a small nudge, I hear it is harder to get an appointment now than it was 50 years ago when we did "first come, first served" until all had been seen.

Time marches on, or dare we call it progress. We, in Paynesville, are the envy of any community our size as it relates to medical care. I would be remiss if I didn't say that Willie LaCroix, PAHCS administrator, has been responsible for most of the innovative growth of our medical community. He will leave large shoes to be filled when he retires at the end of 2002.

Lindeman delivered over 3,600 babies during 50 years of medical practice in Paynesville.

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