The Island’s first pediatrician has announced his retirement. Dr. Michael Goldfein of Vineyard Pediatrics, one of the few remaining private practices on the Vineyard, will retire on June 1 after 38 years on the Vineyard.
His practice will be taken over by the Martha’s Vineyard Hospital, which has hired Dr. Sonya Stevens, a Sudbury-based pediatrician, to take on his patients.
In a letter sent to patients and parents, Dr. Goldfein said he originally intended to continue on a part-time basis but could not reach an agreement with the hospital. But during an interview this week with the Gazette, the physician said, simply, it was time.
“I think I would rather end the practice while I’m still at the top of my game rather than when I’m starting to fail,” Dr. Goldfein, 75, said. More family time is also a priority. Dr. Goldfein’s children live off-Island, and he plans to spend more time visiting them.
Despite a career in medicine that spanned more than four decades, Dr. Goldfein did not always plan to be a physician. Raised in Brooklyn, Dr. Goldfein attended the City University of New York, and initially planned to be an astrophysicist. But after a difficult bout with advanced calculus he switched his major to biology and chemistry.
“I thought biologist or chemist, and that just kind of led to medicine,” he said. Dr. Goldfein attended medical school at the State University of New York’s Upstate Medical Center in Syracuse. After residencies at Case Western and Massachusetts General, he was drafted into the Army and worked as a pediatrician in Nuremburg, Germany, for three years.
After the Army, Dr. Goldfein returned to Boston, where he stayed busy with a part-time private practice and part-time employment at several area hospitals. While working in the pediatrics unit at McLean Hospital, a psychiatric hospital in Boston, he met Gretchen Jacobs, whose husband Michael was an internist on the Vineyard with the late Russell Hoxsie.
“They invited me to come down here and do some evaluations for some of the school children who were having a lot of problems in school,” Dr. Goldfein said. “So I started to come down on a periodic basis and started to do some work.” The general practitioners began to ask if Dr. Goldfein could meet with their young patients, too.
“It became very apparent to me that this was a population that could use some pediatric care,” he said. “My wife and I thought we would come down and try it out for a year or two, and here we are, 38 years later.”
Many doctors operate within a support network of fellow specialists, and can rely on collective knowledge to help make decisions in their practice. But that didn’t exist when Dr. Goldfein first arrived here. He was the first pediatrician the Island ever had.
“I think, frankly, my experience in the military, if it weren’t for that experience I don’t think I would have been able to do this,” he said. At the Nuremberg base, self-sufficiency was a must for pediatricians, he said.
“It forced me to become very self-reliant, and that ability really, I think, helped me do my work here pretty much on my own where I didn’t have other pediatricians to ask for help.” He stayed in touch with his Boston contacts, sending patients to the city if they had special concerns or needs.
It took time to build a practice from scratch. Many patients stayed with their general practitioners, and for a couple of years Dr. Goldfein split time working on the Vineyard and in Falmouth so he could make ends meet. But the early years had their own distinct appeal.
“It was very exciting for me, because I was uncovering a lot of issues, a lot of problems in the patients I was seeing, and I really felt like I was doing good work here,” he said. One patient came in who was four years old and yet hadn’t grown at all since he was 18 months. He was hypothyroid, but the problem hadn’t been recognized by other physicians. Dr. Goldfein prescribed treatment, and “We managed to start him growing again.”
Dr. Goldfein now helps the newest generation of physicians learn more about the needs of small-town communities. For more than 15 years, he has directed the Practice of Medicine in a Rural Environment course at Harvard Medical School, which brings students to the Vineyard to rotate through the hospital.
“It’s very rewarding,” he said. “The medical students at Harvard, their only exposure to medical care happens at the major medical centers. This is a very different exposure, and I think they benefit from that. The faculty benefit from having them here, and the patients benefit from having them here.”
Pediatrics is far different now from when Dr. Goldfein first started. In many ways, he said, it is unrecognizable. There are more regulations from both the government and insurance companies to keep up with. One of Dr. Goldfein’s nurses spends a whole day at the office just doing insurance referrals. And being in private practice is a challenge for any physician. Dr. Goldfein rents his office space from the hospital and covers his own health and malpractice insurance.
“It’s a financial hit, but at the same time there’s something about being my own boss that’s very appealing to me,” he said.
In many ways, though, the field has seen considerable improvement. Technological advances in imagining and better understanding of genetics make for better diagnostics. And one of the biggest advances has been in the decrease of vaccine-preventable illnesses. During his tenure, Dr. Goldfein has seen the disappearance of haemophilus influenzae meningitis in infants and young children. Though children can and do still get meningitis, that particular strain is all but eliminated. Only those who are not immunized get the illness, Dr. Goldfein said.
“In the past, before we had that vaccine, I would see at least a couple of children every winter with haemophilus influenzae meningitis, and now it’s gone,” he said.
Dr. Goldfein has about 2,500 active patients, a number he says is typical of pediatric practices. But perhaps not typical of pediatric practices is the sport of fencing, which over the years Dr. Goldfein has introduced to many children and parents on the Island. In college, Dr. Goldfein fenced competitively at the national level, but in order to attend medical school he had to turn down a spot on the U.S. national team in the Maccabiah Games, an international competition for Jewish athletes. Dr. Goldfein continued fencing while stationed in Germany, and on the Island he has for years held twice a week fencing classes at the high school.
“I’m not retiring from that,” he said.
“I think the most rewarding thing, or one of the most, is my being able to see a whole generation of Island children grow up and become parents in their own right,” he added. “And there’s a fair number of children in my practice now whose parents used to be patients of mine.” He has not yet seen grandchildren of former patients, though.
“Not yet,” he said. “I guess I won’t.”
But Dr. Goldfein will now have the chance to spend more time with his own grandchildren. There are seven.
“Soon to be eight,” he said.
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