A dying breed: When the perfect consultant retires

Marc Lachance is the perfect consultant. Ten years my senior, he had more than mastered his specialty by the time I came to the area. He had also established himself as a mentor to Cityside Hospital’s residents and many young physicians who sent him referrals or called him for curbside consultations.

Marc used to live in a rambling farmhouse not far from where I live. But then his elderly father, widowed and suffering from macular degeneration, needed more help in order to stay in his own home. Marc moved to the opposite side of the city to be closer to his father. Marc’s wife was able to look after her father-in-law while Marc commuted to his office downtown. When his father passed away, Marc and Elaine stayed put, even though Marc’s commute was long.

Marc would follow some patients through the decades, but more often he would do a consultation and perhaps a follow-up. Then he would dictate a letter, right in front of the patient, to the referring physician with a detailed care plan. Marc welcomed follow-up calls from his colleagues and he insisted on getting continued updates on patients he had seen in consultation.

Unlike many specialists, he prided himself in his broad knowledge of medicine. I often ran into patients who had seen Marc for a consultation pertaining to his specialty, but had been diagnosed with cancer, hepatitis C and other conditions by Marc.

Whenever I called Marc for curbside advice, he told me exactly what I needed to know in order to move forward with my case. He never put me down if my call was disorganized and less than well prepared. But his own clarity of reasoning and exquisite mind for detail always made me feel I had been to school or a motivational seminar: “This is how a physician should be,” was the thought that lingered after getting off the phone with Marc.

Marc’s partner, whom I had fewer dealings with, retired a year ago. Many of us primary care physicians quietly wondered what was going to happen now.

Recently, a patient I shared with Marc brought in a letter she had just received. It was a printed letter that read:

Dear patient,

After more than 35 years, I will be closing my practice on December 30, 2013. For many years I have commuted a great distance to my office. As I am soon turning 70, and hoping to avoid retirement, I have made the decision to relocate my practice to Meadowview Hospital in Cornish, which is closer to my home. I will be an employee of Meadowview Hospital without the concerns of managing the business of a medical practice. By making this move, I am hoping to be able to practice medicine well into my eighties if I continue to enjoy the good health I have been blessed with.

I would be happy to continue seeing any patients who wish to transfer to my new location, but understand if most of you will want to find a specialist closer to where you are. Drs. Jonathan Bard, Sheldon Mintz and Ravinder Pran all accept new patients in their Cityside Hospital Clinic.

I appreciate the confidence you have placed in me and wish you the best future health. Your primary care doctor has always received copies of my notes and your complete medical records are available for transfer by contacting my office at the above telephone number … 

I slowly handed the letter back to my patient.

Marc, I thought, you are teaching me something every time. How to be an up and coming young doctor, how to conduct yourself when you are in the prime of your career, and how to stay in the most fascinating job in the world as long as you possibly can. I know you love medicine, possibly even more than I do. I also know that you are at least ten years wiser than I am about being a human being, a son, husband and citizen of the world.

Bonne chance, mon ami, and may you never retire.

“A Country Doctor” is a family physician who blogs at A Country Doctor Writes:.

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