Medicine has changed a lot in the 42 years since Dr. Robert Altbaum began practicing.
Physicians know much more. They have better treatments and medications.
On the other hand, it’s much more of a business. Paperwork (on computers) has increased exponentially. There’s less time for each patient.
Another trend — “concierge” medicine — has widened the gap between those who can afford to pay for added access to doctors, and those who can’t.
Several years ago, Internal Medicine Associates of Westport — where Altbaum has spent his entire career — began talking about a concierge tier. Four partners left, to open a strictly concierge practice
“It would have made life easier, and probably more profitable,” he admits.
“But my patients had been so loyal. I wanted to continue the same way to the end.”
He accepted 100 or so concierge patients. The rest — hundreds — he treated just as he’d always done.
“Emotionally, for me, it was the right decision,” Altbaum says.
This June, one of Westport’s longest-serving physician retires. He’ll hike, snowshoe, play tennis, travel, and enjoy his wife, children and grandchildren. All live nearby.
He’ll join the Y’s Men, and — a “perpetual student” — take courses at local universities.
Yet he won’t leave medicine behind. Altbaum will teach at Norwalk Hospital, and give talks at places like the Westport Library, on subjects like hospice, advance directives, and searching the internet for diagnoses.
Medicine has been a rewarding career for Altbaum. It’s what he always wanted to do.
He graduated from the Bronx High School of Science at 16. After New York University (Phi Beta Kappa, summa cum laude) and Harvard Medical School, he did a residency in internal medicine at Massachusetts General Hospital.
His wife was a Staples High School graduate. Her mother was diagnosed with cancer. To be closer, he spent a year of ambulatory chief residency at Yale New Haven Hospital.
During his mother-in-law’s illness, Altbaum met Paul Beres and Harold Steinberg. They were looking to add an internist to their practice, established by others in the 1950s.
Altbaum joined them in June of 1978. He’s been there nearly 43 years.
“It’s gone by quickly,” the doctor says. “There have been different partners. But it’s the same shingle. The same name.”
Altbaum still works 70 hours a week. Each day, after 8 to 12 hours with patients, he spends 2 to 3 hours updating records on the computer.
He takes his laptop into the examining room too. He regrets having to look down at the screen, rather than always into his patients’ eyes.
But that same technology allows him to retrieve information quickly. It eliminates possible errors in medication. He’s come to embrace it.
Technology has also made his patients — always intelligent — much more aware of their own medical care. “They walk in well prepared with information,” Altbaum says. “That can be good or bad.”
And although he sees each patient less than before — 15 to 20 minutes, rather than 20 to 30 — he never sensed a change. “There’s still a strong bond,” he says. “They’re loyal to their doctor, and their doctor is loyal to them.”
What kept Altbaum going for over 4 decades? “I really like medicine. I like the science. I like the feeling at the end of the day that I helped people.”
His greatest worry when he began was that internal medicine would be “colds and influenza.” In fact, he says, as his patients have aged — the majority are now older than he is — their issues have grown more complex. That’s a challenge. And in that challenge, strong relationships are forged.
In the weeks since announcing his retirement, Altbaum has been heartened by his patients’ responses. “People say I’ve made a difference in their lives. That’s so rewarding,” he says. “That far outweighs the burden of the hours.
“I’m grateful that I’ve gotten a lot of intellectual and emotional reimbursement from what I’ve done.”
He always planned to retire at 70. Had he left a year ago — before COVID — he says, he probably would have come back.
“This has been very hard on our partners,” he notes. “But from a medical perspective, it’s been a very stimulating time. We learned a lot. We digested a lot of information in a short period of time.”
Much of Altbaum’s life has been focused on medicine. But he has another passion. It’s been on display for years: music.
Not just any music. Rock ‘n’ roll.
As a child, Altbaum took piano lessons. At 13, he and few friends formed a band: The Blue Shades.
“It was 3 months of acne and voice changes. We had no gigs. We were pretty bad,” he recalls.
At 18, he got a gig: accompanying youngsters at Hebrew School. When his own children were part of the Staples elite Orphenians choral group, he played piano for them.
Then, 20 years ago, he and fellow physicians Fred Kaplan, Andrew Parker and Frank Garofalo formed a band.
“It was like a Mickey Rooney movie,” Altbaum says. “We were a garage band. We actually practiced in Frank’s garage.”
Other doctors joined. They got good. They called themselves DNR (medical-ese for “Do Not Resusciate”). Their website claims that former Surgeon General Everett Koop called them “the best multispecialty rock group in Fairfield County.”
Through the years, more doctors have played with DNR. (And one attorney: bassist Fred Ury.)
The current lineup has been together about 15 years. They’ve got a devoted classic rock following. Their Levitt Pavilion show — a fundraiser for Westport’s Volunteer Emergency Medical Service — is always jammed.
COVID canceled last year’s show. But Altbaum is eager to get back on stage.
And he’ll have as much time as he needs to rehearse. (Hat tip: Amy Schafrann)