The summer 2017 issue of The Ohio Family Physician depicted the many joys in medicine. The stories published provide self-reflection on how to find happiness in practice and in personal life!
Meet Stephen Ulrich, MD. Dr. Ulrich’s story of joy by shaping students to be family physician leaders is in the following segment. Look for other happy stories in upcoming editions of the Weekly Family Medicine Update, on the OAFP website, and on the Academy’s Facebook and twitter pages.
“Doctor, I have bad news for you. I have to give the edge in the looks department to your uncle. Now, don’t get me wrong. You are a fine looking young man, but that uncle of yours is just plain handsome. But, you are younger and will be around longer so I think I will stay with you,” said the vivacious 80-year-old woman.
Stephen Ulrich, MD, was seeing this patient for her high blood pressure in his Uncle Ed’s family medicine practice. Dr. Ulrich was a little shocked and told the elderly patient that his uncle was known for his good looks. Then, he told the tale to Uncle Ed.
Uncle Ed laughed and said, “Stephen, there are patients who will always be better medicine for you than you are for them and she is one of those patients.”
This pivotal event brought tremendous joy to Dr. Ulrich. At that moment, he knew family medicine was in his future. He was happy and his heart was full. Dr. Ulrich learned then that medicine was a calling and it had an emotional, psychological, and spiritual dimension.
Dr. Ulrich is most happy when he can reminisce about his family roots and upbringing; when he is treating the New Lexington community; when his wife Terri is by his side; when he teaches and mentors students and residents (just like his Uncle Ed); and when he learns valuable lessons from his patients.
Dr. Ulrich and his nine younger siblings grew up on a farm south of Grand Chain, IL. Their grandfather was a farmer philosopher who taught them that if they chose a career that would make the world a better place, the world would be a happier place.
When Uncle Ed, a pilot, was in medical school he would often visit the farm, and even took Dr. Ulrich on his first airplane ride. Uncle Ed was very proud when Dr. Ulrich and his brother, Dennis, gained acceptance at the same time at the Southern Illinois University School of Medicine. Thirty-five years later, the Ulrich brothers, both pilots, flew separately to meet at their medical school reunion.
Experiences on the farm and Uncle Ed’s influence shaped who Dr. Ulrich is today as a family physician, husband, and father. Reminiscing about life on the farm and Uncle Ed, makes Dr. Ulrich happy. His face lights up whenever he talks about his upbringing and journey to family medicine.
“Dr. Ulrich is a compassionate physician dedicated to caring for the underserved. He and I could practice in less challenging places, but we choose to serve the rural, underprivileged New Lexington, OH, community,” said Jon Miller, a nurse practitioner serving Perry County Family Practice for 16 years.
New Lexington is a small town where everyone knows everyone. The office staff can joke with the patients because they know one another. If something happens in New Lexington, news spreads like wild fire. The rural health clinic has a high Medicaid pediatric population and a high Medicare population, with very loyal patients.
“A lot of patients come into the office talking about how long they have been coming to the practice and sharing their stories. We get upset over those patients that we become attached to when they pass away. New Lexington is a small community. Patients might call and not say their name, but I recognize their voices. They might call back 15 minutes later to give their name, but I politely say I knew it was them,” said Kristie Boring, receptionist.
“I had to tell a patient recently that I could no longer draw her blood because she is 102. We can only draw for patients up to 100. Seeing her over the years made me happy, and I’m sad I won’t be able to visit with her anymore,” said Denise McCabe, a lab medical assistant.
The people of New Lexington and Perry county are devoted to their community. Upon completion of his family medicine residency at Grant Medical Center in Columbus, OH, Dr. Ulrich and his wife, Terri, looked at several rural, underserved locations throughout the country to settle down and open a practice. They fell in love with New Lexington and its people and started Perry County Family Practice 33 years ago. Coincidence would have it that the location is on Airport Road.
Today, Dr. Ulrich and Terri, his practice manager, enjoy the rural drive together to the office on Tuesdays and Thursdays after a trip to the gym. However, Terri says Dr. Ulrich also takes the opportunity to sleep in the car those mornings. That is when he is not answering his cell phone. Terri threatens to change his personal cell phone number because he gives it out to everyone, including all of his patients.
There are two competing hospital systems in nearby cities; oftentimes, families are split down the middle with one family member preferring one system and another family member preferring the other system. This is why the practice can’t use one of the systems’ electronic health records over the other. Holding true to the Ulrich name, the practice has used the same EHR since 2003—Ulrich Medical Concepts based in Kentucky. Many people in the industry have said that the Ulrich EHR system is one of the easiest to use, though staff might not always agree with that statement.
Since the Ulrichs consider the staff to be family, they are very flexible and provide them with as many opportunities as possible. Kristie Boring’s husband has a brain injury and the Ulrichs hired him to clean the practice so that he could have employment. At the end of a crazy day, Dr. Ulrich always manages to tell each staff member “good work.”
“Patients like coming to see Dr. Ulrich because they don’t feel like a number. Once a patient was walking in and didn’t seem right. She couldn’t even tell her right from her left. Instead of taking her into an exam room, I immediately went to find Dr. Ulrich. Good thing I did because she was having a mini stroke. There was minimal damage because we acted quickly,” said one of Dr. Ulrich’s nurses.
Behind Every Successful Physician is a Smart Practice Manager
Besides the pivotal moment in Uncle Ed’s office, Dr. Ulrich has one person to thank for being a family physician—Terri. Dr. Ulrich considered child and adolescent psychology until Terri convinced him to go into family medicine. Terri completed her master’s degree in social work in June 1981; she and Dr. Ulrich opened Perry County Family Practice the next month.
Behind every successful physician is a smart practice manager, and in Dr. Ulrich’s case the practice manager is wife, Terri. Terri is the boss who makes sure that everything runs smoothly and that Dr. Ulrich is supported every step of the way.
“We have participated in some quality improvement projects and implemented some patient flow improvements. I handle payroll, human resources, and information technology. Last week the power was out and I had to go back to the office even though we have a generator (the batteries were not keeping up). Physicians can’t be gurus with any of this stuff. They don’t have the time or resources. That is where the buck stops with the practice manager,” said Terri.
Terri also provides onsite counseling and mental health services in the office. She oversees the staff and keeps Dr. Ulrich’s schedule in line. She tries her best to get Dr. Ulrich to not overcommit, but that is a difficult task.
Terri finds joy watching Dr. Ulrich care for his patients. She is not just his practice manager; she is his life manager. They do everything together.
They go to St. John Island on a regular basis to go snorkeling; Terri studies books on snorkeling and Dr. Ulrich relies on her to identify what they are seeing while underwater. Last year they had a house built for the simple reason that it was the one thing that the two of them had never done together.
There are some exceptions to the Ulrichs doing everything together. When their oldest child, Stephen, was born, Dr. Ulrich named him without telling Terri and even had it printed on the birth certificate. When Terri discovered this, Dr. Ulrich said “well, I have my junior now.”
Regardless of doing things together or apart, the Ulrichs have an “accept life and press on” attitude. This outlook has been passed down to their grown children—Stephen, Elizabeth, and Jane. After losing a grandchild and their son-in-law Craig at an early age, the Ulrichs learned to be happy despite facing adversity.
When they aren’t working in the office, at the gym, snorkeling, or trying to come up for air, the Ulrichs do a few activities separately. Dr. Ulrich enjoys aerial photography (in addition to underwater photography); it is an escape for him. Many times he is taking aerial shots from his helicopter. Dr. Ulrich recently retired from the Army National Guard. Terri cooks and sews; she made her own wedding dress.
Perhaps the thing that brings Dr. Ulrich the most joy is participating in an annual tractor pull. It reminds him of his days on the farm.
Shape Students to be Family Physician Leaders
Dr. Ulrich tells students and residents to do what they need to do to make their neighborhoods better by carrying on the tradition of family physician healers. He is shaping students and residents just like his family did.
“I had to drive an hour to get to Dr. Ulrich’s practice, but it was well worth it. Dr. Ulrich invested in more than just my professional career. He is a compassionate person who really cares about me as a person. And, I care the same way about him,” said Jessica Tucker.
Jessica matched into the Grant Family Medicine Residency in Columbus and will be an intern starting this summer. Dr. Ulrich hooded Jessica at her graduation on May 8 from the Ohio University Heritage College of Medicine, Athens, OH. That day was also the Ulrichs’ wedding anniversary. What a wonderful day to celebrate with two people she considers family!
Sara Stigler, a medical student from Cincinnati, had two weeks off and chose to work with Dr. Ulrich as part of the Army National Guard rural health experience. She wanted to step out of her urban comfort zone and work in a rural setting.
“At the end of the two weeks, I saw many similarities between the urban and rural settings—finances, transportation, resources, mistrust. I found that many preceptors, including Dr. Ulrich, have very loyal patients. Patients feel like they can approach them,” said Sara.
Sara experienced the New Lexington community and the day-to-day endeavors of the Ulrichs. She lived with Dr. Ulrich and Terri in their new house during those two weeks.
“It’s very clear that Terri is the boss. I witnessed many conversations about Dr. Ulrich not being able to locate his coffee cup and several references to having office bills to pay,” said Sara.
Dr. Ulrich tells students and residents that often patients are better medicine for them, than they are for patients, just like Uncle Ed said.
Jessica and Dr. Ulrich saw a patient, a truck driver, complaining of belly pain. After a thorough exam, Jessica discovered that the patient had an irregular heartbeat. She convinced Dr. Ulrich to do an EKG to make an accurate diagnosis. The results showed AFIB. The patient looked at Jessica and said in a curt voice that she had just cost him his job, because truck drivers can’t drive with AFIB. But, after the patient saw a cardiologist, he called back to say that he felt much better with his new medication. He thanked Jessica for saving his life and he kept his job.
From that experience, Jessica learned that she should consider the emotional and psychological side to patients when talking with them and making a diagnosis.
“Now as I live my life and see my patients age with me, I often think of that pivotal moment with Uncle Ed. Like my uncle, I have shed many tears over the years. The cost of caring is the pain we feel when we lose a dear patient,” said Dr. Ulrich.
Dr. Ulrich shares the joy of family medicine with his patients, students, and residents. Uncle Ed and the rest of his farm family encouraged him to make neighborhoods better for a happier world, and to learn from all people. Dr. Ulrich is making New Lexington better, and he hopes that his students and residents can one day make their own communities better.