Making The Rounds: What It Means to be a Doctor in Pittsburgh
In a city known for world-class care, a life dedicated to health is rewarding, challenging, and innovative at every level — from med school to the board room.
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The Primary Care Physician
Dr. Gerald Rossman
While working on a pharmacy degree at Duquesne University in the late 1970s, Gerald Rossman had a revelation: “I thought, ‘This is really interesting — I like learning about all of the medicines,’” he says today. “But I also felt like it was frustrating because I knew all of the medications but not the diagnoses [the doctors had made].”
He came home and told his wife he might want to ditch the pharmacy program and move into medicine. Well-acquainted with his fear of needles — Rossman hated going to the doctor as a kid — she laughed. “You’re crazy,” he remembers her saying. “You pass out when you get shots!”
Five years later, in 1984, he graduated from Hahnemann Medical College (now part of Drexel University) in Philadelphia.
Since then, Dr. Rossman, 59, has worked at Allegheny General Hospital, first as an intern, later as a resident, and for the past 29 years as a primary care physician. That means the soft-spoken doctor is putting in 14-to-16 hour days that start with 6 a.m. hospital rounds, followed by patient visits from 8 a.m. to 4 p.m., capped by a few hours of paperwork, dictation and administrative work. Despite the long hours, Dr. Rossman says he loves it. “Some patients have been with me almost the whole time,” he says, “and you build up really neat relationships. That’s very rewarding.”
While some patients have stayed with him for care over the course of his career, medicine itself has changed dramatically. When he started, he says, patients tended to come in only when they were sick. Today, he’s pleased that many more of them are visiting for preventative maintenance — getting cholesterol checked or talking about family histories.
Technology, too, has made extraordinary leaps in that time. “When I was first in practice, if you had your gallbladder out, you were in the hospital for 10 days,” he says. “Now, you have your gallbladder out and you go home the same day.”
What hasn’t changed, Rossman says, is the atmosphere at Allegheny General Hospital, which he says is what first attracted him during his internship interview. “From the nurses to the doctors to the support staff,” he says, “everyone is really interested in the patient. At the other places I went to, they were good people, but it wasn’t quite the same.”
Those long-lasting relationships with both patients and fellow health care providers mean he’s regularly tapped to work on new programs. In the mid-1980s, one of his fellow residents at AGH was Dr. Tony G. Farah, who today serves as chief medical officer for the Allegheny Health Network. Dr. Farah has appointed Rossman to work on various programs, including serving on a committee to develop new ways to reward primary care doctors for quality care — all of which drives his ongoing love for his work.
“This is sort of like a big, impressive community hospital,” Rossman says. “In general, we treat people more like a hospital in your local neighborhood, except we can do all of the [advanced] care that big-city hospitals can do. For me, it blends the best of both worlds.”
Dr. Raye Budway
When Raye Budway was 3 years old, her mother was sure of her daughter’s future career. She pressed the girl to tell everyone she met.
“She would say, ‘What are you going to be?’” Budway says. “And I would always say, ‘I’m going to be a doctor.’”
Now specializing in breast-cancer surgery at St. Clair Hospital in Mt. Lebanon, Dr. Budway, 53, is usually the first person patients encounter after they receive a diagnosis of breast cancer. She meets with them to talk about creating a plan of care. Those plans tend to involve three options, all of which affect each other — surgery, chemotherapy and radiation.
Budway works through different options: If a patient starts with surgery, how might that influence the type of chemotherapy and radiation used later? Can drugs be used to shrink the tumor? How might that choice affect surgery and the potential need for radiation?
“Helping a woman negotiate these muddy waters is what we do best,” Budway says.
Budway honed her approach while working as a surgeon and teaching in the residency program at Western Pennsylvania Hospital. At the time, general surgeons handled breast surgeries; those procedures could make up 30-40 percent of their caseload. (Now the work is done by specialists.) Budway found her load of these surgeries was increasing; the speciality came to her, as female patients sought out Budway and the handful of other women surgeons in the hospital.
“They liked us because we didn’t have the paternalistic, ‘This is what you’re going to do [approach].’ We had the maternalistic ‘This is what you can do [approach],’” Budway says.
A Brookline native, Budway wanted to return to the city after attending medical school at Drexel University in Philadelphia. She did her residency at West Penn. Pittsburgh was the right place for Budway to learn from the best; in pioneering work across town at the University of Pittsburgh, renowned Dr. Bernard Fisher had been discovering the efficacy of the lumpectomy (removing only cancerous or abnormal material from the breast) versus a full mastectomy (removing one or both breasts). When Budway went to national medical meetings, those in attendance were talking about studies being done in Pittsburgh.
Despite being one of the few female surgeon residents, Budway was relieved to find she didn’t encounter a drop of chauvinism from her peers.
“I was treated as just another doctor, not as a woman surgeon,” she says.
After her residency, Budway didn’t want to leave Pittsburgh, and she didn’t have to. She was offered a year-long critical care fellowship at UPMC, where much of her work involved
learning about liver transplants; she saw the sickest of the sick.
“It was an unbelievable amount of education in a very condensed period of time. When you see that many sick people in a year, it’s amazing how much you can learn,” Budway says.
The following year, West Penn offered her a job. Budway practiced there for 16 years until officials at St. Clair Hospital recruited her. They wanted her, they said, because they sought to bring the quality of city medical care to the suburban South Hills. They started wooing her in 2009; in 2011, she joined the hospital.
In the future, Budway says she wants to use lessons learned in pursuit of her undergraduate degree in engineering to think about the process of patients’ experiences in hospitals. She’s previously involved committees and created projects in her own intensive-care unit to monitor quality of patient care, but now she’s thinking about how to improve quality of care in major surgery, endoscopy and even outpatient procedures.
“I want this process to help the individual patient,” she says.