Internal Medicine focuses on thinking through a problem. This is the main reason I chose internal medicine as my specialty – I like thinking about medicine. My father was also an internist and that of course helped me make my decision when it came time to choose. I’ve been practicing for 30 years and it is the challenge of thinking about the issues I come across that has kept me engaged and moving forward.

Many of my patients are older and often present very complex medical issues to consider, continuing my excitement about my specialty and my patients. With each new issue I have more to learn. And, since medical research plays a big role in internal medicine, I am continually presented with more information, new protocols, medicines and approaches. While keeping up keeps me busy, each new discovery gives me a better chance of helping my patients by offering more options to consider.

Dr. Scot Lewey says gluten disorders are far more widespread than many realize. Full-blown celiac disease affects 1 in 100 people, yet it is frequently missed or misdiagnosed as irritable bowel syndrome. Celiac disease is contributing to the rising tide of autoimmune conditions: type I diabetes, lupus, rheumatoid arthritis, early-onset osteoporosis in women and osteoporosis in men. It causes untold misery for patients, who may suffer infertility, recurrent miscarriages, unexplained loss of sensation in the hands or feet, fibromyalgia, rashes, malnutrition ...

I wanted to become a family physician from a young age. It may seem strange for a child to know not only a profession but a specialty as well, yet I had a wonderful role model in my own doctor that started me on my path. I was a climber as a kid and inevitably I went to the general practitioner who treated my family often. As a young physician he made a tremendous impact on me to the extent that I never really considered the other specialties. He helped to shape my future choices – if not necessarily the immediate ones to stop climbing.

Change is hard. I’ve been practicing medicine for 30 years. I’ve seen many different changes in medicine, especially in the way physicians are reimbursed. These changes have greatly affected the way we practice and how our patients view us as a profession. I began my career with fee for service, then went to a discounted fee for service, followed by managed care with HMO’s, and back to a fee for service based on RBRVS, a relative value scale which pits doctor against doctor to split the shrinking health care dollar. Although I can long for the day when our contract was with our patients, and not with huge third party payors, we can’t force that toothpaste back into the tube.

Oculoplastic surgery deals with the reconstruction and cosmetic surgery of the eyelids, eye sockets and surrounding structures. I find it an exciting field because of the numerous challenges it presents. As an Oculoplastic surgeon I see people of all ages from infants to geriatric patients with a wide variety of issues. The specialty is particularly fulfilling because I can literally see the outcome of my work, as can my patient. For many specialties the changes happen inside the body whereas oculoplastic results are easily recognized and present me with instant feedback on the operation.