Primary care doesn’t mean lower pay, alum says

Addiction medicine a “niche” subspecialty of family medicine

By Richard Heck

April 22, 2009 

Forget the perception that entering a primary care specialty means lower pay, Ohio University College of Osteopathic Medicine students learned from a visiting alumnus during a Minority Health Month lecture.

“The whole notion that if you go into primary care you will not do well financially is not true,” advised Robert Polite, D.O. (’99). “No matter the specialty, you can do as well as you want to, and be busy as you want to.”

Polite, who currently has a private practice in family medicine in Columbus, also subspecializes in addiction medicine, which he became interested in after leaving his family medicine residency at Mt. Carmel Health Systems in 2002. He spoke to students  Tuesday, April 21. Besides his private practice, Polite practices addiction medicine at two Columbus-area agencies--Maryhaven Drug and Rehabilitation Center and CompDrug--and the Recovery Center in Lancaster, Ohio.

Forgoing a formal lecture format, Polite told the students to keep an open mind and to learn as much as possible about themselves and many specialties while on rotations. “I learned a lot about myself during rotations, and medical school will challenge you to find out about yourself,” he said. 

Set upon becoming a surgeon after graduation, Polite described how, during his third and fourth years and his internship at St. Vincent Mercy Medical Center in Toledo, he discovered that life as a surgeon was not suited to either his personality or his life as he had envisioned it. 

“I love to talk to people and am a family physician in my heart,” Polite said. “I reluctantly went into a family medicine residency, but it grew on me. I figured out late who I was.” 

Encouraged to subspecialize in addiction medicine, Polite found his calling. “I’ve helped people get off drugs, managed to keep people out of jail and saved a lot of lives,” he said. 

Addiction is a serious problem today, Polite said. “It is a huge problem, a secret that America has--and is swept under the rug,” he said, noting that a lot of the patients he treats are using prescription medicines often prescribed by fellow doctors.  

He estimated that more than 85 percent of his patients are Caucasian males, many in high powered positions such as chief executive officers, lawyers and business owners who have become addicted on prescription drugs. “You are going to see a lot of addiction,” he said, advising the future physicians to look for the warning signs of addiction in not only their patients, but their colleagues as well.

Polite also advised students to learn as much about the business of medicine as possible, which can contribute to making a good living even in primary care specialties. “But you have to have a good business mind,” he said.

In his own case, Polite’s private practice is based upon “fee for service,” meaning he does not accept private insurance and instead maintains a sliding scale flat fee for services. Patients then can seek reimbursement from their insurance providers. As such, Polite said, he can take time to get to know and talk with his patients, who in turn help generate additional business.

“I call it the ‘Marcus Welby, M.D.’ approach, and people love it,” Polite said, referring to the popular 1970s television show of the same name about a folksy family physician. “When you have the time to take care of people right, word gets around fast. If you talk to your patients, they love it.” 

The business model also contributes to a quality lifestyle, Polite noted. “I enjoy my life.”