Dr. Irwin receives Lifetime Achievement Award for 50 years in medicine
News from Providence St. Joseph’s Medical Center
POLSON — In 1972, Dr. Steve Irwin graduated from Indiana University Medical School in Indianapolis. Many things have changed in these past fifty years, but one thing that has clearly remained the same is Dr. Irwin’s steadfast love of practicing medicine.
Having had remarkable foresight, Dr. Irwin purchased land outside of Polson in 1971 while still in medical school, knowing that eventually he would settle on the shores of Flathead Lake. In 1972, Dr. Irwin started his career in medicine in a small clinic in Roachdale Indiana. The clinic was built by Sears and Roebuck and gifted to the city of Roachdale, but sat empty for eight years until Dr Irwin graduated from medical school and set up his first practice there.
After spending ten years practicing in Roachdale, Dr. Irwin packed up his belongings, moved to Polson in 1983, and set up shop in the Grandview Clinic with three other physicians. At the time Dr. Irwin was an employee of the Western Montana Clinic, and he spent the next seventeen years seeing outpatients in the Grandview Building and inpatients in what we now refer to as the 1960’s building of St. Joe’s. Then, in the year 2000, the new hospital opened and Dr. Irwin, along with five other physicians transitioned from Grandview to the new St. Joseph Medical Center. The medical staff of St. Joseph at the time consisted of three family practice physicians, a general medicine physician, a pediatrician, and an obstetrician (our own Dr. Bagnell).
This was a really interesting time, according to Dr. Irwin, who commented that when he started practicing in Polson the physicians spent one-in-six weeks as the on-call emergency department physician. He also spent one day a week at the clinic in Hot Springs, and often covered the Emergency Department at the old hospital in St. Ignatius to help make ends meet.
When asked if he thought medicine was better or worse now, Dr. Irwin commented “It’s both better and worse. Medicine is better in terms of technology. Our diagnostic capability today is remarkable and rapid. However, I think that we have somewhat lost our relationships with our patients. We can’t or don’t spend as much time talking to our patients as we used to. The technology has, in many cases, made the care we provide less personal.”
When Dr. Irwin started practicing in Polson, he said there was no Ultrasound, no Mammography, no CT, and no MRI. Dr. Irwin remarked that in his early days in Polson they could not even perform the most basic tests such as PSA’s and hemoglobin A1C’s. Dr. Irwin looked back fondly on the first MRI technology he used while still in Indiana, and recalled that the brand of MRI was English Musical Instruments or EMI. EMI was, in large part, supported financially by the Beatles. So, not only did the Beatles transform music, but they also helped to transform medicine.
When discussing some of the foremost changes in medicine, besides the major technological advances that we often think of, Dr. Irwin brought up some of the less thought-of changes that made a significant impact on his practice. “I thought the introduction of fiberoptics was revolutionary, from GI work to minimally invasive surgery, the introduction of fiberoptics allowed us to do so much more that we could previously. Another remarkable change happened with pharmaceuticals. We used to have very limited options (for example there were only three blood pressure medicines, where we now have dozens). Targeted pharmacotherapeutics were game changers.” Dr. Irwin smiled and added that when he first started practicing medicine there were just two types of insulin. “We would give everyone beef insulin, and if they were allergic to that we gave them pork insulin.”
Another major change that Dr. Irwin commented on was the amount of regulation that has been introduced into the practice of healthcare. “When I started there was certainly no HIPAA or EMTALA or Stark” he remarked.
Dr. Irwin went on to say “I also think the use of plastics had a major impact on medicine. While I understand the concerns about the environmental waste plastic creates, the ease of use for things like syringes and IV bottles was a remarkable change.” With a smile he recalled, “We had a sterilizer in the office that we used to clean our glass syringes and reusable needled by paid for a service to come in and re-sharpen our used scalpels.”
Dr. Irwin reflected that he thought one of the most significant changes in medicine was the fact that practitioners used to rely a lot more on physical diagnosis and thorough medical examinations. “We used to use our eyes and our hands a lot more that we do today. I’m not saying it was necessarily better, but it was such a powerful way to build a relationship and establish a connection with your patients. It was just a different way or achieving the same goal.”
When asked about the Electronic Medical Records (EMR) versus paper charting, Dr. Irwin was quick to remark that while he appreciates the intent of the EMR, his thought was that it decreased practitioners’ ability to connect with the patient since now the providers must divide time between the computer and the patient. “I used to see upwards of 35 patients per day when I used a paper chart, with the introduction of the EMR 12-15 was my limit”
Dr. Irwin stated the advice he would give to a new physician, “I would tell the next generation of physicians to pause and reflect on the privilege bestowed upon them through the practice of medicine. We are all so busy these days that I think it is easy to forget the true gift that we have received. We are so fortunate to get to be doctors and take care of patients”. Dr. Irwin went on to say that looking back on his career he wouldn’t do anything differently, but he did say “if I was going into medicine today, I might be a dermatologist!”
As we began to wrap up our conversation, Dr. Irwin commented on how medicine has changed from a scope-of-practice perspective. “When I started practicing, we did everything, and I feel so fortunate to have been able to do so many different things,” he said. “I had a great practice with both adults and pediatrics, I performed surgery, I delivered five hundred babies, I’ve worked in the emergency department, and I’ve worked in nursing homes. I even worked in prison medicine for 25 years. What an awesome 50 years I have had!” He went on, “When I first started, I can remember sitting down with my nurse and office manager and billing manager (all the same person, my wife Jan), and discussing raising the price of an office visit from $6 to $8. I used to charge $300 per OB patient. That $300 included all prenatal and postnatal care and the delivery. Things have changed so much, but I still feel so blessed when I look back on my life as a doc.”
Dr. Irwin credits his first cousin for his interest in becoming a physician. “He was an old-fashioned doctor, but he was also a remarkably talented businessman. In fact, he had such a strong business acumen that when he stopped practicing medicine, he went on to become the dean of the Indiana University Medical School.”
At the surprise party put together by his coworkers last Friday, Dr. Irwin was presented with the Lifetime Achievement Award for his 50 years in medicine.
“I am still practicing today because I truly love what I do,” Dr. Irwin stated. “But I am also still practicing because I want to honor the sacrifice that so many people made to get me to where I am today. My parents and the instructors in college and during medical school went to great lengths to mold me into a physician. I keep practicing to honor the legacy of those that helped me along the way.”