Doctor still keeps it ‘old school’ in modern world

From article in the Gainesville Sun, Gainesville FL

Dr. David Eckel has been described as the doctor in the Norman Rockwell painting.

His emergency care clinic at 6121 NW First Place behind The Oaks Mall is indeed a bit like stepping back in time: Patients’ files are lined up in alphabetical order and color-coded like books in a library. There is only one piece of paperwork to fill out, and it’s about as minimalist as modern medicine gets: you write your name and address, date of birth and your employer.

There are a few exam rooms, designed according to function: the “boo boo” room is where people come in with lacerations that need to be patched up. There is an x-ray room, one with an EKG machine, and a “breathing” room with a nebulizer for asthma patients. But there are no CT scans, and Eckel’s stethoscope hangs on a wall like a well-worn tie. He extends a firm handshake and wears running shoes and black scrubs.

He gets the coffee pot going every morning at 7:30, Monday through Saturday, and then sees patients, oftentimes non-stop.

“When it comes to patients, he doesn’t sit still,” said office manager Tina Johnson.

Eckel, 61, has seen a bit of everything in more than 30 years of practicing medicine, from kids with strep throat to construction workers who have nailed themselves to their projects.

“You just never know what’s coming through that door. You have to be flexible enough to go from a newborn to an 85-year-old,” he said, adding that he thrives on the variety.

“I much prefer to see different people with different problems. I don’t want to tinker with a person’s diabetes,” he said, explaining why he specialized in emergency medicine instead of primary care.

Eckel is also careful to distinguish his clinic from an ER. “There’s a whole sub-population of people who need acute care but not emergency medicine. If there’s one thing this kind of medicine is based on, it’s the convenience.”

Prices for Eckel’s services are tacked on a wall in the waiting room, and Johnson said they’re the cheapest in town: you can get a strep test or a sling for $25. People without insurance aren’t turned away. Sometimes promissory notes are worked out, said Johnson, since Eckel’s focus is on treating all patients needing care who walk through the door.

“Where you get the most information out of a patient is by looking at him and talking to him,” Eckel said, adding that in medicine, “how to do a physical exam is a dying art,” as doctors increasingly rely on radiological scans.

Eckel trained in an old-school world: a transplant from the Northeast, he grew up in Massachusetts and studied at Vermont’s Middlebury College before transferring to Florida State University to study marine biology. A fellow student got him interested in medicine so he decided to give it a try. He went to medical school at the University of Florida.

“When I was a third-year medical student and we had to decide what we were going to be when we grew up, I told the dean that I wanted to do emergency medicine and he said, ‘What’s that?’” he recalled.

Since then, Eckel said, television shows such as “St. Elsewhere” and “ER” have made the specialty stand out in the public eye, also helping to give the field a certain respectability within the medical professions. Eckel started out working in the ER of Alachua County General Hospital before opening his own practice in 1982, and six years later, the clinic right behind Oaks Mall that he still runs today.

“Of all the jobs to have in the world, having one where I can actually make a difference in someone’s life in 10 minutes is pretty unique,” he said.

Eckel recalls one woman in her mid-30s who came to him after being misdiagnosed with hemorrhoids. It turned out she had rectal carcinoma.

“If she wouldn’t have stumbled in here, it might have been too late,” he said.

When patient Patti Fabiani discovered a lump in her breast that turned out to be cancer, Eckel was the first doctor she consulted and has been her anchor throughout the illness, she said.

“He made time for me immediately. He agreed that I was in trouble. He helped me through getting to doctors … in two days I went from seeing him to having an ultrasound, then having a lumpectomy, then having him discuss things with my surgeon and radiologist,” said Fabiani. “It was just an amazing thing to have someone be so steady and kind at the same time.”

According to Raymond Bergeron, professor of medicinal chemistry at the University of Florida, “If (Eckel) feels he can’t solve a problem, he always knows exactly who you should see in town.”

Whenever Dr. Eckel has to send patients to emergency rooms, he calls ahead so patients don’t have to wait. At his own clinic, patients at most wait 30-40 minutes on an extremely busy day. Otherwise, he sees a steady stream of patients.

“A lot of our business is word of mouth. Our only advertisment is the phone book,” said Johnson, the office manager.

Eckel also sees generations of families, and he does a lot of routine physicals for city workers in Gainesville and surrounding towns. Although he isn’t a primary care doctor by definition, he has cared for scores of families and thinks that medicine should be redesigned — similar to the food pyramid — whereby primary care physicians would be the base at the bottom, and specialists like neurosurgeons at the top.

Instead, medicine has become super specialized at the same time that medical information, often unfiltered and incorrect, is increasingly accessible to patients through the Internet, Eckel said. This means that patients are at a loss. “You have to disabuse them of what they think might be wrong with them,” he said.

For Eckel, it doesn’t matter if those patients are walk-ins or a long-standing patients turned family friends.

“If Dave were back in 1945, he’d probably be the doc speaking to the little child in the Norman Rockwell painting. That’s how he is with people,” said Bergeron, who has been going to Eckel about as long as Eckel has been in practice.

“I think Gainesville’s lucky to have him.”