Chapter 7

Practicing Medicine

After finishing my one-year internship and passing my boards, I went into private practice with Dr. David McSwain on Warren Avenue in Detroit. By my second year with him, I became a full and equal partner in the McSwain and Orr Clinic P.C. We had a great working relationship for 27 years. We were both hard workers and did whatever had to be done. I worked Tuesday, Thursday, and Saturday in the office. He worked Monday, Wednesday, and Friday in the office. On our days out of the office we would make hospital rounds and manage approximately 12 patients per day in the hospital. We also performed tonsillectomies, circumcisions on adults and children, breast biopsies, and assisted other surgeons on any major surgical cases we had. We also delivered babies when any of our patients went into labor. After any or all of these things were done, the day was ours to do with what we wanted to do. In our hay days we would deliver approximately 12 to 16 babies per month. During the initial 10 to 15 years after starting practice as a General Practitioner at that time, I was able to provide almost all aspects of medical care. I became certified in Family Practice in 1973 when certification for family practitioners started. Having had very detailed training in school and in the internship, I felt very confident and competent in performing certain surgeries in the office and some in the hospital. We performed deliveries, pre- and post-natal care. We also read x-rays and treated fractures which included reducing fracture, casting and performing follow up care. We did all aspects of infant and pediatric care, mental health, and most other aspects of medical care.

I treated all people equally and completely, and I always felt a close connection to all of my patients. I believe in treating the whole person. The “whole person” approach to medicine embodies the premise that you treat the entire person rather than just their symptoms. This premise is one of the main philosophies of osteopathic medicine. A Doctor of Osteopathic Medicine (D.O.) focuses on preventative healthcare. DOs often help to develop healthy lifestyles to fight or prevent illness.

When a patient comes to me with a medical complaint, not only do I want to do a complete blood work up, but I also conduct a complete exam and explore information from them that may contribute to the onset or longevity of their condition. The treatment may include evaluating any other condition that they could have associated that can contribute to or exacerbate their present condition. Many other factors may be considered, including non-medical factors. An example is if that patient comes in with a complaint of a chronic cough. I consider the following: Do they have allergies? Do they have cats or dogs in the house? Do they smoke? Are they living next to a factory, etc. ?   I may not have seen quite as many patients per hour as other physicians, but I always had a much larger patient load. Besides that, I always felt good at the end of the day that I gave good care to patients. I can remember making a house call on a long-time patient of mine who said he needed to see me but just could not make it into the office. In visiting him (well before I started a house call business), I learned that his wife had recently died, and a sister came from out of state to stay with him.

His main complaint was that his asthma condition was getting worse. While visiting his home, I found dogs, cats, a parakeet, clutter, dust everywhere, and old cloth furniture all over. He was sitting in a chair and next to him was a large oxygen tank, a small respirator with a nasal cannula connected to a smaller mobile oxygen tank. He was having marked wheezing and labored breathing. I immediately requested that the relative clean the whole house out, get rid of all the clutter, all of the furniture, carpet, and pets, etc. I prescribed some additional medicine and came back to see him in one month.

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