The doctor is out

PALMER — Author John McPhee’s famous description of Alaska as a “foreign country significantly populated by Americans,” always sounded just about right to David Rudolph.

Growing up in New Jersey and graduating from the University of Florida, he went to Spain to complete medical school. While there, he learned fluent Spanish and fell in love with the culture. He’d have stayed if could have gotten a job in the medical field there.

That all-at-once sense of expatriation and repatriation resonated with the young doctor when he returned to Newark when he was told by an Alaskan he met there that he ought to come out to The Last Frontier.

Rudolph had read plenty about Alaska, and jumped at the chance. But what was supposed to be a stay in Nome of one month in 1983 turned into a long and distinguished career in the Mat-Su Valley. At least the full-time version of that career came to an end this month, as after 33 years, the internal medicine specialist announced his retirement, and closed his Palmer office.

“What I thought was going to be a working vacation turned out to be something else,” Rudolph said on Wednesday, while packing up the last of his office items, his bare arms on a 13-degree day testimony to his Sourdough credentials. “I love the Valley, the surrounding mountains attracted me. When I first got here, everybody was really nice and really open. The economy was rip-roaring, so that was nice also.”

Upon arriving in Palmer, Rudolph noticed that most of the doctors in town were family practitioners who preferred to work out of their offices. That allowed Rudolph to work as much in the hospital setting as in his office across the street. He wound up being promoted to director of medicine and head of the ICU, opportunities he’s sure he wouldn’t have gotten had he stayed in New Jersey.

“I was more interested in hospital work and there were 40 beds here in the Palmer hospital. Most of the time, about 50 percent of the patients in the hospital were my patients,” said Rudolph. “I was able to be in two places almost at once. I was a really busy, 24-7 kind of guy, balancing all that work with family life, too. It was an incredibly creative and busy time of my life.”

In his letter to his patients informing them that he was retiring, Rudolph borrowed a quote from the song ‘My Way’, to express the opportunity and independence working in Alaska afforded him.

“’Regrets, I have a few, but then again, too few to mention,’” he said. “I continued to do everything I wanted to do. I have very personal relationships with all of my patients — which was marvelous. I’ve seen some get sick, get well, and some not get well. It’s been a wonderful experience.”

Many of those patients who received Rudolph’s letter had been patients of his since the 1980s. And like Rudolph, who is about to turn 65 himself, many of them now carry Medicare cards.

Knowing those patients would have a hard time finding new doctors, Rudolph sent out a clarion call around the state, and the country, looking for someone to share his practice before assuming its clientele.

But alas, no takers were found.

“There was not one doctor who have a thousand Medicare recipients to be responsible for…

There’s a lot of doctors up here not accepting Medicare patients,” Rudolph said, adding that he, too, stopped accepting Medicare patients in recent years. “Medicare does not reimburse well enough to have new Medicare patients… It did not pay to keep the lights going — the reimbursement was that low.”

A supporter of the Affordable Care Act, Rudolph said he was often the odd-man out among his fellow Mat-Su practitioners, but, he believes, government regulation has to be part of the solution to reducing the nation’s, and especially Alaska’s, out-of-control medical costs.

“I have sort of a socialist idea of medicine, personally. I think medicine has become incredibly inflated,” he said. “I looks like there’s going to be a slowing down on the ACA, which I supported. I was never really in favor with most of my Alaska colleagues, who thought that any regulations or controls would cut into the financial gains of the physicians and the hospitals, but I’ve always been in favor of certain controls. I’m not really optimistic about medicine costing less nationally or in Alaska.”

In no rush to become a snowbird, Rudolph and his wife are divesting themselves of property in the lower 48 to live year-round in Alaska where they own a home and a remote cabin Rudolph spent five years building.

Rudolph sees himself possibly getting back into medicine on a limited level, and will certainly be involved with medically related volunteerism.

Among his possible post-retirement activities are working part time with the V.A. wing at the Benteh Nuutah hospital on Knik Goose Bay road in Wasilla, or using his proficiency in Spanish to teach it as a substitute in local schools. He said he’ll undoubtedly be joining the local senior citizens center to see what contributions he can make there.

Before Rudolph makes any decisions about how to apply his skills in retirement, he and his wife are planning a trip down the Amazon River, an idea inspired by a patient who gifted him a stuffed piranha gotten from such a trip.

“I’ve seen people retire and become couch potatoes,” Rudolph said. “I don’t plan on being a potato. I’ve got a lot of things to do with volunteerism and pleasure traveling, for the most part.”