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Newest Surgeon Offers High Praise for MRMC

10/21/2014

Originally published in Magnolia Banner News
Written by Dixie Edington

Magnolia Regional Medical Center welcomed general surgeon Dr. Robert Buchanan to the medical staff earlier this month. He is the hospital’s second surgeon.

Buchanan comes to Magnolia from Georgia, where he had practiced for around 21 years. He was raised in Blossom, Texas, did his undergraduate work at Texas A&M University in College Station, Texas, went to medical school at the University of Texas Southwestern in Dallas and did general surgery residency at the University of North Carolina at Chapel Hill, N.C.

He and his wife Frances are getting settled in their new home. Frances is a nurse and Buchanan said he expects that she will eventually join him in his practice here. They have two grown children.

As general surgeons, Buchanan and Dr. Moises Menendez are housed in the newly-renovated surgical clinic on East Columbia Street, formerly the McMahen Clinic. He and Menendez are currently rotating schedules, a system of being on call every other day and every other weekend.

A general surgeon, Buchanan explained, does such surgeries as gall bladder, hernias, breast biopsies and masses, thyroid, colonoscopies and endoscopies. Surgery is done at the main hospital; however, minor procedures such as removal of moles or skin biopsies may be done at the surgical clinic.

Trauma surgery is an entirely different arena. “Obviously, it’s emergency. That’s one of the difficult things when you’re a general surgeon in a smaller rural area. You sort of have to be prepared to do about anything,” he said. “You get somebody in a car wreck and a ruptured slpeen, or get somebody with a gunshot wound to the abdomen that has a hole in the aorta that you have to fix. You may not see that like you would in a big city but still you have to be able to handle it.”

“It’s high-stress surgery,” he continued. “Patients are usually pretty severely injured and you’ve got to deal with the issue quickly. And it usually happens at 2:00 in the morning.”

Like most medical professionals, he does not like the Affordable Care Act.

Buchanan said he finds that the entire area of health care reform — along with the Affordable Care Act — restricts what doctors can do for patients. He holds to the old adage that “any time you let the federal government into anything they are going to mess it up.”

“In Georgia, where I came from, the reimbursement there was under what Medicaid paid so our hospital there would not take it. That’s not the case here. You have to be very careful about being sure you get everything pre-certified; if you don’t they (insurance companies) won’t pay for it,” he said.

“I don’t like the Affordable Care Act.” he went on. “I think we were doing pretty good with what we had. Everybody in the world wanted to come here for medical care. It wasn’t a perfect system, but it was a lot better than what a lot of the other countries had.”

“I remember when I first came out of residency, I practiced about five years in Paris (Texas). There was an old surgeon who had been there practicing since the 1950’s — this was 1988— and he said, ‘the biggest mistake we ever made was taking that first dollar from the federal government. They’re like a camel. Once they get their nose in the tent, they just keep coming in. All their regulations and everything follow’.”

After getting out of residency in 1988, Buchanan began his practice and since that time has witnessed a lot of change in the medical field. “There were no computers at all when I started and now it’s virtually all computers,” he said. “Technology is a wonderful thing when it works; when it doesn’t work, it’s the most exasperating thing on the planet.”

“When I was in high school — this was back in 1974 or 1975 — I was working in the lab in the summer to get some medical experience. There was a pathologist there in Paris, he oversaw five or six different hospital labs. This was back at the time when pathologists billed for every CBC (complete blood count), urinalysis, and every single test done in the hospital labs. In ‘74 he was making about $1.5 million a year. That’s a lot of money; that’s probably three, four, five million dollars now. It was just a blank check from the federal government back then.”

“But that’s how they got everybody reeled in and once they got them reeled in and hooked, then they started cutting back on reimbursements and going up on the regulations,” he continued. “That’s how the government works. Now you’ve got all these mandatory regulations that they hit you with but they keep cutting back on the reimbursements.”

Buchanan feels the impact of the Affordable Care Act will eventually decrease the number of doctors and medical professionals. “When you hear doctors that were practicing in the1970’s, they’re making less now and working a lot harder than they were then. That’s why you’re seeing more people not going to medical school and not going into the medical field, because they’re looking at what’s happening and they say ‘why should I spend four years in college, four years in medical school, and three to five years in residency or more and then come out and not get paid much for it?’ You spend all that time in school you expect to at least get a decent living.”

“I hear all these stories in the news about people getting turned down for medical care because they didn’t have insurance. That really upsets me because I’ve never ever turned anybody down or turned anybody away because they didn’t have insurance,” he said. “It really gets frustrating when you hear people talk about doctors doing that and sort of lumping everybody together. I’m sure that might happen in the bigger cities somewhere; but I think out in the rural areas most doctors are still doctors and they treat people no matter what.”

Hospitals and other healthcare providers today are faced not only with more federal regulations and reduced payments, but also government auditors who may recall payment for services provided in the past. “There’s no other industry in the country that I can think of that you can say that about,” Buchanan said. “How many industries could exist under that scenario? Not many.”

As with any change in jobs, there is a new computer system to learn. He said the “biggest thing about coming here is getting used to the computer system. The hospital here is virtually all paperless; so is the clinic. So you have to get used to doing all the stuff on the computer.”

“That’s one of the nice things about coming here,” he said. “Where I was in private practice, we were going to have to go to electronic medical records and for a doctor in private practice it was very, very expensive. It was going to be over $100,000 for me to get computers and go over to the electronic medical records. And coming here it’s already done.”

With electronic medical records, he said, the systems in a physician’s office are linked to those in the hospital.

Buchanan said he is pleased with MRMC and had high praise for Margaret West, administrator and chief executive officer.

“It’s a real nice hospital for a town this size,” he said, adding that Magnolia and the surrounding area are “very blessed to have a hospital like this.” MRMC is about half the size of the hospital where he was in Georgia. It had about 100 beds.

“I think one of the great things about it is Margaret West, the administrator,” he said. “She’s very progressive when it comes to listening to physicians. If she tells you she’ll do it, she’ll do it. If she tells you she can’t, she’ll tell you why. She does a very good job from what I’ve seen so far.”

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