Small-town family physician happy right where he is

Dr. David Hagan, board chairman and immediate past president of the Illinois Academy of Family Physicians, has been practicing medicine for 28 years.

Since his residency, he's had a family medicine practice in Gibson City.

On Dec. 15, he spoke to News-Gazette health reporter Debra Pressey about being a doctor in a smaller community, his views on health care reform, and the issues facing patients and doctors.

Here is some of what he had to say.

On being a family physician:

"I take great joy in being a family physician," Hagan says. "I wanted to be a doctor my whole life."

Family medicine physicians treat children and adult patients, and Hagan said he enjoys the variety and long-term relationships with his patients.

"It's the best kind of medicine to practice," he says.

On practicing medicine in a smaller community:

Hagan, 57, went to medical school at the University of Illinois, and did his residency at St. Elizabeth Medical Center in Dayton, Ohio.

A native of Niantic, he chose Gibson City because it was close to his family and his wife's family, he says.

But projections for more doctors establishing their practices in smaller communities in Illinois aren't great: Hagan quotes from a 2010 Illinois physician work force study showing only 1.5 percent of medical residents plan to practice in rural communities.

Hagan says doctors' reservations about practicing in smaller communities are often based on myths, such as: Small-town doctors don't have a private life, don't see any interesting cases and don't have adequate access to technology.

"It's a myth that all you'll see are colds, sore throats and hemorrhoids," he says.

He's got all the access to medical technology he needs in Gibson City, he says, and as for having a personal life, he can walk through the grocery store any time without being approached for medical advice.

"My home phone number is published. I seldom get a phone call after hours," he says. "In 28 years, I've had three occasions when someone's come to the house, and on two occasions I told them to, and had to convince them it was OK."

On health care reform:

Hagan says his state and national organizations support the Patient Protection and Affordable Care Act, but speaking strictly for himself, he isn't a fan of this national health care reform legislation.

Here are some of the reasons he gives:

"A health care plan which involves hiring 160,000 IRS agents and the associated bureaucracy that would entail, that's not a health plan. That's something else," he says.

A Congress that won't mandate English as the country's official language shouldn't mandate that everyone purchase health insurance, he says. (Hagan says he believes everyone should have health insurance but he objects to anyone being forced to buy it.)

It doesn't address the Medicare payment shortfall to physicians.

It doesn't adequately address the primary-care workforce shortage and imbalance.

It doesn't address medical professional liability reform.

It doesn't do enough to promote "medical homes" that would provide a regular source of medical care for patients.

It doesn't adequately address quality measures that would reward health care providers for safety improvements.

Does he like anything about the Affordable Care Act?

Hagan acknowledges it does impose some health insurance reforms he agrees were needed, and continues funding for graduate medical education.

On the U.S. adopting a single-payer health plan system:

Hagan says he never wants to be a doctor, a patient or a taxpayer in a single-payer (funded by a single insurance pool) system.

"I don't think the people in Washington can manage something like that without terrible waste," he says.

On how patients can communi- cate better with their doctors:

Hagan says he asks his patients to bring in their medications or put them on a list and bring it in.

Beyond that, he advises: Be honest. Be engaged, and don't be afraid to ask questions.

On the big issues for doctors on the horizon:

Payment reform and too much paperwork.

How much time does he spend on paperwork? "I try not to think about it," he says.

The biggest issue for patients:

"Paying the bills," Hagan says. "That's probably the most common concern I hear in the office."