Heartache: The challenge of replacing a country doctor

By ANNEMARIE SCHUETZ
Posted 10/13/21

CALLICOON, NY — “When I first came here,” said Dr. Paul Salzberg, the now-retired doctor for patients in a broad stretch of the Delaware River corridor, “the hospital had 30 …

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Heartache: The challenge of replacing a country doctor

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CALLICOON, NY — “When I first came here,” said Dr. Paul Salzberg, the now-retired doctor for patients in a broad stretch of the Delaware River corridor, “the hospital had 30 beds. No ambulance service, no MobileMedic.”

He’s talking about the Grover M. Hermann Hospital in Callicoon, which marks its 50th anniversary this year. He’s also talking about the changes he’s seen over his 38-year career here.

Back when he started here in 1983, “the [three] doctors who worked there came to the ER from home.” In other words, they were on call; doctors didn’t staff the ER around the clock.

There was an ICU with two beds at Grover Hermann, but no large central hospital system elsewhere in the county. The vast majority of the county’s doctors were independent, not employees of a large group.

A shortage of country doctors

Salzburg “always wanted to be a country doctor,” he said, but he’s in the minority these days. “There’s still a doctor shortage.”

The salaries aren’t as high, often, and young doctors need to pay off student loans. Some want higher-profile jobs. And independent practices can be extremely demanding.

For Salzberg, “I came up here with the dedication to practice rural medicine. My focus was to be a country doctor and be in this area.”

Only 11 percent of the nation’s doctors practice in rural areas, where over 20 percent of the country’s people live, according to the Association of American Medical Colleges.

Rural medicine is different. “You have to know about everything; you can’t be a specialist,” Salzberg said. “You have to treat everything that comes into your office.”

When he started here, there were no computers, no digitized patient records. “You looked the patient in the eye, you didn’t stare into a computer.”

And the demands of the job? “Younger doctors don’t want to work like I did,” Salzberg said, sounding sad. “I was on call 24 hours a day, seven days a week.”

What matters in rural medicine? “The main thing you have to do is listen to the patient. You have to listen to what the patient tells you.”

In retirement

During the long years of his career, he said, his family was phenomenal, always supporting him and his work, patient with the hours and the demands. So now “I’ll spend time with my family.”

Maybe there’s time for travel. Time for music—he plays bass guitar and writes songs. And, the voters willing, he’ll still be on the town board in Cochecton.

The future, here

There are no doctors to replace him yet, at least none of which he’s aware. There had been interviews “but it didn’t work out.” Maybe a group would be good, to adequately serve the people along the river corridor.

Now there’s a nurse practitioner at the hospital, and a new practice in Barryville.

He worries about his patients, that they’ll have to travel further to get care. Will they skip care? What if something happens?

There are so many challenges here. The opioid epidemic “is something I’ve been dealing with for a long time.” He works with Catholic Charities as they combat the other pandemic. “We have a lot of elderly people here,” including widows “without much help,” who become homebound. Or younger people, caring for multiple others, unable to leave one vulnerable person to take another to the doctor.

He lauds the nurses of the county’s certified home health agency and others who make home visits. He himself made house calls. Sometimes that’s the only medical care the homebound receive.

There’s such need. “I hope that people will step up to the plate,” he said.

‘We will miss him... immensely’

Salzberg has retired, and now there’s a great gaping hole, both in the hearts of his patients, and in the community he served.

“Moving from Manhattan to Callicoon 25 years ago, we never imagined how pleased we would be with our ‘country doctor,’” said Joan Rafferty, one of Salzberg’s many patients. He “was a breath of fresh air. He always made room in his schedule for our family’s medical needs, whether it be an emergency or for routine care. We never took for granted his dedication, knowledge and kind demeanor. We will miss him and his practice immensely.”

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