An Emergency Medicine Pioneer
Finds His Inner Entrepreneur

If you ever find yourself in a medical emergency, Dr. Hellstern is the type of person you want nearby.

A few years ago, Dr. Hellstern was on a photo safari in Botswana with his wife and three adult daughters. The Hellstern family was flying in a small plane, when the pilot got word that another small aircraft had crashed nearby.

The Hellstern’s pilot flew over to the crash site. They found that the troubled plane—which had lost its only engine—had flipped over on its end during the emergency landing. The passengers of the crashed plane were injured, but Dr. Hellstern, an emergency-medicine physician, and his wife, Cindy, an ER nurse, treated them. All of the passengers survived.

One of the First in His Specialty

Little did the crash victims know that the physician who came to their rescue is a pioneer in the field of emergency medicine.

For almost 30 years, Dr. Hellstern has been a trailblazer in his field. His passion for emergency medicine started during a stint in the Navy during the Vietnam War.

While in the Navy, Dr. Hellstern served as a general medical officer stationed in Puerto Rico and also completed one year of surgical residency at the National Naval Medical Center in Bethesda, MD. He had planned on becoming an orthopedic surgeon, but his Navy experience changed him. “There were many medical lessons learned from Vietnam, particularly in the area of trauma—and those lessons were being integrated into U.S. healthcare,” Dr. Hellstern says. “I liked the variety of the medical challenges in emergency medicine and it was exciting to be a part of creating the new specialty.”

After leaving the Navy, Dr. Hellstern became chairman of the ER at Methodist Hospital in Dallas in 1976. There, he instituted the Careflight program. “I’d had a fair amount of medevac experience in Puerto Rico and at Bethesda, and I realized that a helicopter program would be an opportunity to reach beyond geography.” The program was the first of its kind in Dallas.

In 1979, the American Board of Medical Specialties recognized emergency medicine as the nation's 23rd medical specialty. Dr. Hellstern was one of the first physicians to take and pass the emergency medicine board exam. He then spent six years as an American Board of Emergency Medicine board examiner.

From the Emergency Room to Entrepreneur

“I realized early on that being an emergency-medicine physician is a young person's specialty,” says Dr. Hellstern. "The typical schedule for an emergency-medicine physician was eighteen 12-hour shifts per month, which was a killer schedule," he says. “Then we were rotating nights, weekend, and holidays. So there was a high burn-out rate in the early years.”

In light of the stress of the work, Dr. Hellstern continued to develop his administrative and leadership management skills and look for entrepreneurial opportunities. In 1979, he launched PrimaCare Medical Centers, the first network of urgent care facilities in the Dallas-Fort Worth area. The network eventually grew to 17 clinics.

“Unfortunately, I think I was ahead of my time,” Dr. Hellstern says, “because when we opened PrimaCare, the insurance rule was that insurance wouldn’t pay for an acute-care visit unless you went to the emergency department.” As a result, Dr. Hellstern was in the stressful position of trying to educate patients about the facilities, while at the same time educating payers about why they should pay for urgent-care visits. “The lesson I took away from that is, ‘try not to go into a business where you have to fight two battles at once,’” he says.

The stress took its toll. Dr. Hellstern had a heart attack at 43. To reduce stress, he sold PrimaCare, and changed his focus. He started a business, the Metroplex Emergency Physicians Associates, which provided ER staffing on a contract basis to area emergency rooms. Later, he also founded the MedicalEdge Healthcare Group.

Currently, Dr. Hellstern runs his own practice management and hospital-based specialties consulting business. He’s still finding ways to help emergency departments improve their service and outcomes. Recently, he’s been helping them integrate technology that uses automated callback systems to follow up on patients once they’re released from the ER.

Still Exciting

Dr. Hellstern has seen many changes in emergency medicine in the past 35 years, including a more balanced schedule (emergency-medicine physicians now work twelve 12-hour shifts) and a higher level of respect for emergency-medicine physicians.

But even in light of the more balanced schedule, Dr. Hellstern still counsels younger emergency-medicine physicians to start thinking about a second career. “Emergency medicine is a demanding specialty, physically. If you can last into your 60s, more power to you. But you need an avocation that will take over when you can’t do the specialty anymore.”

He considers himself fortunate that he’s had a fulfilling career as an emergency-medicine physician and entrepreneur. “It’s the excitement of being able to do this that still has me jumping out of bed every morning to get at it. Everyone should be so lucky.”

To contact Dr. Hellstern, e-mail him at RAH@psrinc.net.

South by Southwest Healthcare
Panels Available via Podcast

Every spring, thousands of people flock to Austin for South by Southwest (SXSW), a series of interactive, film, and music festivals and conferences. This year, the interactive portion of the event featured panels dealing with healthcare topics.

If you weren’t able to attend the healthcare panels, most of which took place on March 13 – 16, audio podcasts will be available on the SXSW website and blog. Healthcare panels at SXSW included:

• Social Health Summit 2010: What We Learned, with panelists Reed Smith and Bryan Vartabedian
• When Swine Flew: Embracing Innovation in H1N1 Response, with panelists Ann Aikin, David Hale, Andrew Wilson, and Andre Blackman
• Sick Clicks: The Evolution of Healthcare Online, with panelists Jay Bernhardt, Ted Eytan, Jay Parkinson, and Caley Van Cleave
• Design for Awareness: Mobile Technologies and Health, with presenter Robert Fabricant

Check the SXSW website regularly for more information about the podcasts.

What You Need to Know
About Office Overhead Insurance

If you own your own medical practice, you may want to consider protecting your practice with office overhead expense (OOE) insurance. The expenses of running a medical practice—employee salaries, rent, taxes, utilities—can add up quickly if you are unable to work.

With OOE insurance, you can:

• Help protect your practice and your employees in the event you suffer a disabling injury or illness.
• Pay your actual overhead expenses, up to the benefit amount you select, if you suffer a disabling injury.
• Receive benefits with even a partial disability if it negatively affects your income.

It’s important to remember that the benefits of OOE insurance go beyond covering your practice’s expenses. For example, if you die while receiving OOE insurance benefits, your spouse or dependent children may be eligible to receive a survivor benefit.

In addition, the premium payments you make for OOE insurance may be deductible on your federal income-tax return. You should consult your tax advisor regarding your eligibility for this deduction.

To find out what other insurance coverage you may need if you own or plan to start a practice, download TMAIT’s helpful guide, entitled “A Practice of Your Own,” at http://www.tmait.org/pdf/TMAIT_lscs_APracticeOfYourOwn.pdf.

TexMed 2010

TexMed is April 30 – May 1, 2010—just a month away—at the Fort Worth Convention Center. So if you haven’t registered yet, be sure to do so soon! Registration is free for TMA members and their families.

Robert Buckman, MD, PhD, will address physicians at the general session on Friday, April 30. This world-class expert on interpersonal communication will speak about “How to Become an Effective Communicator and Still Stay Stupid.”

To see a complete schedule of events and to register, go to www.texmed2010.org.