George Boinis MD

Internal Medicine
1958 - 1998

THEN AND NOW:
FROM LIMITED TREATMENT OPTIONS TO A VAST ARRAY

In March of 1958, I was an intern at the old Garfield Hospital so by default, I became a member of the first medical resident class at MedStar Washington Hospital Center when Garfield's operations transferred over. A mere month later, our first child, Susan Elizabeth, was born here, further assuring that 1958 - and my introduction to MedStar Washington Hospital Center - would forever remain in my mind.

MedStar Washington Hospital Center was a revelation - a great, modern building, with private and semi-private rooms where Garfield and the other old hospitals all had wards. That took some getting used to! I don't know if we were aware of it then, but all of medicine was on the cusp of going through a dramatic change. At the time, specialists and sub-specialists were pretty rare and general practitioners did almost everything - from caring for patients with infectious diseases like TB and spotted fever to delivering babies.

This was also before the advent of all the changes in medical financing, like Medicaid, reimbursement rates and so on. My first year in private practice I made $11,000 from fee-for-service - I thought I was a millionaire! But because there were so few "safety nets" for poor patients who couldn't afford care, the Hospital Center also operated a clinic. I remember volunteering there half a day, every week, to work for free. A lot of us did.

Then as now, the Hospital Center cared for the most complex cases. But by today's standards, the weapons in medicine's arsenal in 1958 were quite limited. We didn't yet know about cholesterol and lipids, and didn't have any effective drugs to treat high blood pressure. All we had was insulin, penicillin, streptomycin, sulfonamides, digitalis, Pitocin, Thorazine, phenobarbital - that was about it. Compare that to today's PDR - it's at least three inches thick!