David Wolfe, MD, knows how politics can affect rheumatology. As part of the Washington, D.C.–based practice Arthritis and Rheumatism Associates, he is right next door to the movers and shakers who decide everything from insurance costs to how much reimbursement might be expected for bone density scans. But he’s a bit of a mover and shaker himself. Making partner while still in his 30s, Dr. Wolfe is young enough to understand the importance of changes but old enough to realize these suggestions must be made with passion tempered with patience. “If you’re in a position where you’re given a voice, you should use it,” he says. “The strength of our practice when you make partner is being a full voting member so you have an equal stake. Older members don’t always think of new ways of doing things procedurally, but you have to be patient with them and appreciate their experience.”
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Explore This IssueDecember 2007
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Care of Many Kinds
As you enter Dr. Wolfe’s office, you notice his own unique experience. Beyond pictures of his wife, Jeanne, and his three children, there is a photo of a proud Native American man who was a code talker with the U.S. Marines long ago. Medals strewn on his body, he stands in front of the American flag that overlooks canyon country in Chinle, Ariz. You might also feel the Navajo rug under your feet, with signatures of many from this proud tribe. These were all once his patients. After medical school in Georgetown University School of Medicine in Washington, D.C., Dr. Wolfe decided he needed to know our country’s roots, ones that ran deeper than Washington.
“[When you work] on a reservation, your patient’s English won’t always be great. But I found other ways to bond with them,” he says. “I still correspond with them and visited many of their homes. Their traditional ceremonies are able to transcend so much—like ethnic differences—and reinforced why I went into the clinical relationship.”
One ceremony he fondly recalls is referred to as the night chant. “It took place on a winter evening and there were people who dressed up as spirits and gods,” he says. “They danced and chanted. There was a big bonfire and a person who is sick got treated by a medicine man. There were images of sand paintings to heal the patient at night and dancers danced and there was very little natural light. This is their form of medicine—our medicine uses syringes and medication; their medicine is ceremonies. I learned a great respect for what they did and it taught me how to be even more in tune with the spiritual needs of my patients.”
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Today, life isn’t quite as otherworldly. It starts sharply at 8 a.m., with patient appointments until noon. Depending on how many patients are new, he could see anywhere from five to sixteen before lunch. The afternoon brings more of the same. In between, he tries to develop other progressive interests within the context of the practice. “I’m involved with two half-days of developing electronic records for our offices. We’re trying to convert the entire medical record to wireless electronic records … so we have to create infrastructure and get everyone trained to make that happen without cutting back on patients.”
Even as Dr. Wolfe leads the way, he doesn’t allow his early accomplishments to keep him from seeking the counsel of his older partners. “Early in my career I had a patient with systemic vasculitis and I actually called a mentor from training and discussed it with local experts. I couldn’t have successfully done treatment without them. I wasn’t afraid to ask for advice then, so I wouldn’t hesitate to ask associates now who have been preeminent for decades. Textbooks can’t provide the answer when you’re dealing with medicines that could be potentially toxic to the patients.”
On his way home, Dr. Wolfe passed the popular K Street and drives along the gleaming Potomac River. Riches abound and power seeps through every turn, but it’s the opportunity to treat the poor in Washington that gives him the most satisfaction at the end of the day. “If you want to just make money, it’s easy enough to do it,” he says. “But exposure to different backgrounds changes you and makes you a better person. … The worst part about working on the reservation was seeing the poverty and how hard it was for them to afford medical treatment. Those are proud people and they shouldn’t be forgotten.”
Eric Butterman is a freelance writer based in New York City.