More than 30 years after arriving here on the rumor of work, Dr. Len Feldman is closing his local practice.
The last day he’ll see patients at his Mud Bay Road office is Sept. 19. The Haines SEARHC medical clinic will keep his patients’ medical records.
Feldman, 65, is moving his family to Port Townsend, Wash., where he expects to have more time to pursue his passions – including sailing and music.
“I don’t like winters here. I don’t participate in winter sports. I know how to ski, snowshoe and ice skate, but I don’t do them voluntarily. I do them to keep up with my kids,” Feldman said in an interview Saturday.
Feldman said he’ll keep licenses to practice in Alaska and may get one to practice in Washington. “Whether I’ll use them, I don’t know. I don’t know what I’m going to do, (but) I don’t think early retirement is in my cards. I’ve always been open to adventure, so we’ll see what the future holds.”
A change Feldman has witnessed in three decades of doctoring here is a growing number of older patients. “The town has aged, so there are a lot more chronic medical problems to deal with.” Feldman said there was a time he could name all the town’s octogenarians off the top of his head. “There was nobody in their nineties back then.”
If he’s learned more about treating older patients, it’s because “you get good at what you see a lot of,” he said.
“Haines has, I think, a very hardy population. People here tend to be active and independent and not so worried. People in Haines tend to try to fix what breaks themselves before they ask for help, which I think is great,” he said.
Another change is an increase in care providers. A few years after Feldman arrived in Haines, the closing of the local clinic raised doubts about the future of doctor care in Haines. “I don’t think there should be difficulty in people finding care here. There’s three or four providers at SEARHC (clinic) and there’s (private practitioner) Dr. (Linda) Keirstead for a town of 2,400. The town wasn’t that much smaller in 1997, when we had one doctor at a time handling the whole load.”
Feldman said one of the best parts of family medicine is getting to know people. “It’s an amazing privilege to be a doctor. Basically, you become a family member of all these different people. You get to understand people and families. That’s a privilege. But it’s hard to put my finger on what’s the best part. There are lots of nice parts.”
Feldman took a circuitous route to doctoring in Haines. He grew up in Miami and dropped out of the University of Chicago after freshman year, where he’d been majoring in physics and philosophy. He traveled for three years. A talk with a former high school math teacher who was switching careers to pursue medicine also changed Feldman’s course.
“I went back (to college) as a zoology major. I started thinking, ‘Become a doctor.’ That’s all about biology and science (and) it’s a job that will never be boring. I thought about it for about a month.” Feldman entered Johns Hopkins University Medical School in a five-year program for students who didn’t have an undergraduate degree. “Once I made the decision to become a doctor, every door opened for me. No regrets,” he said.
Feldman’s interest in rural medicine was sparked by a summer as a medical student spent shadowing a doctor in small-town Maine. “His office was in his basement. He had no nurse. No receptionist. No assistant, and had just recently gone to the appointment system. He taught me a lot about medicine, how to do vasectomies, I delivered my second baby there. It was just a brilliant experience. With it, I felt very comfortable starting a practice of my own. I’d seen how it can work.”
After working as a doctor at a Seattle HMO, he came to Alaska in 1982 to fill in for a friend working at a Juneau clinic. He also worked in Haines for Dr. Stan Jones, who operated the private clinic here but took time off to gillnet.
In the mid-1980s, Feldman fulfilled a dream by working as a traveling doctor in remote communities in northern Southeast. “In May, I’d leave Haines on the sailboat. I’d equip the sailboat with a bunch of basic medical supplies and I sailed around to communities that didn’t have a doctor. At that time there were lots of small logging camps and fishing communities all over the place, and I’d make my rounds. I’d stay until it didn’t seem like there was anyone else to see.”
He saw patients in mess halls, vacant trailers and homes, charging $25 for seeing an adult and $15 for a child. He accepted no paperwork. “I’d tell people, ‘If you can’t pay me, don’t. If you have paperwork, I won’t do it.’ I didn’t have any insurance. I just treated people. I was making as much money as I needed to cover expenses. I thought I could do it forever, but life had other plans.”
With his wife pregnant, he settled into Haines and found work as an emergency room doctor in Juneau. In 1989, Dr. Jones said he was closing his private clinic here. Citizens formed a non-profit corporation to keep medical service available and asked Feldman to serve as its medical director. He accepted, on the condition that a second, full-time doctor be hired.
He left there in 1996. A short time later, patient Dale Campbell asked Feldman if he was interested in opening a private practice here. “He said he had two or three thousand dollars I could have if I started my own practice. That idea hadn’t occurred to me.” After a month of doctor work in Seward, he decided to take Campbell up on the offer.
Feldman bought a $1,000 examination table, some basic equipment and a rudimentary pharmacy and turned a downtown house into his office. “The practice has flourished. One of the biggest problems I’ve had is how to limit the number of patients I have.” He now takes off Wednesdays and Friday afternoons.
The downside of practice, he said, is the paperwork involving Medicare reimbursement – “an endless stream of frustration” – and few opportunities to teach what he’s learned to younger doctors. “I enjoy teaching. It’s a part of the (doctor) experience that should be passed on, and not just kept to yourself.”
Over the years, Feldman said, he developed the perspective that being a successful family doctor is like gardening.
“The object is to have a garden full of beautiful, healthy, thriving individuals who are looking beautiful and feeling good, which is not done by doing emergency CPR. A gardener is out there just doing routine maintenance – keeping the bugs off, watering, thinning, pruning, doing whatever the garden needs. Then someone comes along and says, “Wow, you sure have a beautiful garden.’ It’s not exciting medicine, this maintenance business, it’s just attending to every little thing that might be a threat down the road and trying to nip it in the bud.”
Feldman served on the board of directors of public radio station KHNS and served on the Haines Arts Council board for about a dozen years. During a stint as “set doctor” during the filming of “White Fang” here in 1990, he whiled away the hours learning to play concertina.
Port Townsend has active sailing and music scenes he’s looking forward to being a part of, he said.
Feldman said he’ll miss the friendships he’s made here and his “musical buddies.” “I’ll probably miss the smiles you encounter when you walk down the street, knowing everybody. It’s nice to be somebody in a small town.”