By BECKY GILLETTE
When Dr. Isaac Aultman first opened a medical practice in Fondren about 29 years ago, some questioned the wisdom of opening an office in a depressed area. But it turns out that Aultman was rewarded by getting in on the beginning waves of the renewal that has made Fondren one of the most popular neighborhoods in the Jackson area.
“The renaissance of Fondren was just beginning when I moved there,” Aultman said. “It has really come along.”
Aultman, who named Physician of the Year earlier this year by the Mississippi Academy of Family Physicians, has seen major changes not just in Fondren, but in the business models for family practice during his 42-year tenure in family medicine.
“It is more stressful today because of electronic medical records and the requirement to e-prescribe instead of writing a prescription on a pad like I was used to doing,” Aultman said. “I personally never adopted electronic medical records before I retired. And there are now all sorts of quality measures you have to comply with. There have been lots of thing piled on top of patient care from when I first went into practice. Burnout is a big issue now with doctors because of that. For family practice in particular and medicine in particular, it has gotten very stressful.”
The business model for family practitioners has also evolved. Aultman said it nearly impossible for a solo practitioner to hang out a shingle now to practice medicine because of the office expenses.
“Now you have to spend so much money just to be in compliance with government and insurance requirements that it is extremely difficult to be a solo practitioner,” he said. “There are very few doctors left who are solo family practitioners or even small group family practitioners who are independent. Most doctors coming out now are employed by hospitals or other systems.”
Before his recent retirement, Aultman also saw his patient base decrease as patients aged. His practice had gotten smaller by the time he retired. He sold his office building, but didn’t find interest in someone purchasing his practice.
Aultman graduated magna cum laude from the University of Mississippi Medical Center in 1971, did a three-year residency at the John Peter Smith Hospital in Fort Worth, Texas, practiced one year in Union, and then was an instructor with the UMMC residency program for a year and a half. He did emergency medicine for one year at St. Dominic-Jackson Memorial Hospital, and then practiced in Flowood for five years, followed by practicing in Jackson for about 38 years.
Even back in 1971, students in medical school were encouraged to consider specializing.
“The professors at the university were all specialists and would always try to talk you into a specialty if you showed an ability,” Aultman said. “I had more than one who tried to talk me into to doing a specialty. I grew up in Seminary, which had a population of only about 350, and the only doctors I really knew were general practitioners. My general practitioner, Dr. Charles Tyler, delivered babies, did minor surgery, and the whole thing. He was a great person, too. I was influenced by him to want to do family medicine.”
Aultman found the most satisfying thing about family medicine was long-term relationships with patients.
“I had patients with me when I retired who were with me when I started,” he said. “That is something specialists don’t typically get to have. I really enjoyed that. Patients got to be kind of like family.”
Aultman would often talk to patients about the importance of not smoking and a healthy diet, exercise and weight control. He recommends a Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diet, which is focusing on eating more fruits and vegetables, whole grains, fish, poultry and nuts while limiting foods high in saturated fat, cholesterol and trans fats. Sodium, sweets and red meats are limited.
“I tried to set a good example,” Aultman said. “I kept my weight down and exercised regularly. I play tennis. That is my favorite hobby. Before I retired I played two or three times a week. Now I’m up to six times a week. Plus, I work out at the gym, ride a stationary bike and do weights.”
While most people wouldn’t be able to keep up with that, Aultman said studies show any amount of exercise has some benefit. The minimum should be 30 minutes three times a week.
“I would encourage my patients to do more than the minimum, but with so many patients, I was lucky to get the minimum,” he said.
While most of Mississippi has shortages of family care doctors, Aultman is encouraged by a rural scholarship program that pays the cost of medical school education for students who agree to go into primary care in smaller community in needy areas. And he said the College of Osteopathic Medicine at William Carey University in Hattiesburg is also helping train more primary care doctors to meet the demand.
Aultman’s career in medicine almost didn’t happen. He and his father were struck by lightning when Aultman was 14. His father recovered enough to give his son artificial respiration, but initially got no response. They called a doctor, and a neighbor who also gave artificial respiration and, after 40 minutes, Aultman started breathing on his own again. His revival was considered astounding, and was recounted on Paul Harvey News.
Aultman and his wife, Rachel, have three adult children: Will works in information technology for a cable company, Emily works for Blue Cross & Blue Shield of Mississippi and Daniel teaches English in Japan.