Medicine: A Doctor for Vinton County

There has been no big medical emergency in Vinton County, Ohio, recently—no epidemics, no multiple accidents. Still, the 10,000 residents have been apprehensive. In February their doctor and neighbor of 22 years, Richard Bullock, left abruptly. No other physician lives or practices in the county seat of McArthur, and the closest hospital is 25 miles away. At last, an intensive search for a new general practitioner has succeeded; a new doctor will soon be at the consulting room desk on which Bullock left his stethoscope nine months ago.

Though the people now feel a sense of relief, the pressures that drove Bullock away will still be present. Vinton’s problem since February has been typical of some 2,000 rural counties and towns now without doctors, just as Bullock’s burden was representative of that borne by thousands of physicians who struggle to maintain one-man country practices.

Patient on Call. In 1948, when Bullock first came to McArthur, there were three other doctors to help meet the area’s medical needs. By 1959, the death or departure of his colleagues had left him the sole physician. Vacations, even days off, became luxuries beyond his reach. “I had office hours six days a week,” he recalls now, “but there wasn’t a Sunday I didn’t have to go into the office for one thing or another.” Bullock attempted to give up work at the hospital, which consumed a large part of his time, only to discover that he could not practice the kind of medicine he wished without operating. “Surgery and obstetrics were important to me personally, not just my patients. And besides, I’d never know just what happened to them in the hospital if I wasn’t there, so I had to do it the old way.”

Office appointments stacked up until they sometimes reached an impossible 50 a day. To avoid having patients wait in vain for several hours, he often had those who needed just a routine checkup wait at home. Then he would summon them—occasionally late at night—when an opening in his schedule occurred. He knew that he had too many patients and admits now: “I wasn’t strong enough to say no.” Nor was he able to find a colleague to share the practice.

Broken Marriage. Bullock’s medical monopoly did not bring him large financial rewards. “My income was static for almost 20 years,” he says. The charge for a typical office visit was $4, including medication that he prepared himself. Some of his patients say that he was lax about collecting bills.

Bullock’s routine, which left him scant time for his wife and five sons, contributed to the breakup of his marriage. Finally, the pressure proved too much for him. In late January, he bought space in the county newspaper to announce that at the age of 53 he was closing down his practice. Three weeks later, he became a 9-to-5 clinic physician at Virginia Polytechnic Institute in Blacksburg, Va. “I couldn’t go on like I was,” he recalls. “Emotionally it was the most difficult time of my life.”

Convinced that Vinton County needed its own doctor, local citizens formed a ten-member search committee. Working with the Ohio State Medical Association, the group placed ads in the “doctors wanted” columns of medical journals, and printed a brochure extolling the advantages of practicing in Vinton County. Fifty doctors replied to the ads, but only half were serious enough to schedule interviews. Most pursued the opportunity no further. Many were uninterested in practicing 25 miles distant from the nearest hospital. Others reported that their wives vetoed the idea of settling in a tiny town in the sawmill country of southeastern Ohio.

Flattering Stories. But one physician found the prospect appealing. Dr. Altaf Hussain, 39, a strapping (6 ft., 180 lbs.) Pakistani, had been looking for a chance to give up his job at a United Mine Workers clinic in the Pennsylvania coal country and establish a private practice. “The people needed somebody,” says Hussain, “and there’s no competition, which is important to a foreigner.”

Neither Hussain’s nationality nor his color should present any problems. McArthur has already hired a Pakistani schoolteacher, and townspeople are taking steps to make their new doctor welcome. The Courier has published a series of flattering articles about Hussain, and the weekly paper’s editor, Mrs. Gerry Frye, has introduced him to a group of local women. Businessmen are also helping. A contractor who bought Bullock’s clinic is letting Hussain use it rent-free for the next six months, and promises to charge only a minimal amount after that. Hussain and his family are also getting a house at modest cost.

Still, Hussain says: “I’ll have to win the people’s hearts and build up my practice.” The transition will be eased by the presence of the former Mrs. Bullock, a registered nurse who will work for Hussain. She is now ready to make appointments for people wishing to consult the new doctor.