Balancing roles as full-time associate professor at Saint Louis University in Saint Louis, Missouri, serving as medical director for the Area Health Educaiton Center (AHEC), and as medical director for corrections medicine for the Saint Louis County Department of Health, Fred Rottnek, MD, MAHCM, is a family physician on a mission. Dr. Rottnek was already involved in homeless health care when the opportunity to work with corrections came up, and he said he jumped at the chance, "knowing that my population would be similar — people without resources, in particular need of health care and a bit more time." Through practiging corrections medicine Dr. Rottnek has seen patients from 8 years old to 80-plus and provided obstetric, gynecological, dental and postoperative care, health screenings and immunization services. "It always surprises me how much preventative health care we provide," Dr. Rottnek said. "We have time with people when their lives have screeched to a halt. Many people suddently realize that the priorities they have held before may need to change, and health often ranks high for reevaluation."
Family Physician Q&As
Dr. Fred Rottnek - January 2012
Q: What led you to family medicine?
Dr. Rottnek: As I entered my fourth year of medical school, I used elective time to create a family medicine rotation. We had no family medicine department at Saint Louis University at the time. I had been leaning toward family medicine or med-peds. I had already started realizing one of my professional mottos: I don’t love medicine; I love what I can do with it. During my two family medicine rotations — one at a Federally Qualified Health Center (FQHC), one a private practice — I came to realize I was much more comfortable working with people in their own communities, whether that was ambulatory care center or a homeless shelter. Working with people in their communities, with their own concerns that they identified, was a more natural fit than “doing to” people in the more patient-passive hospital environment. The day that this hit me viscerally was a day I stayed late working with my preceptor. His schedule was packed. He knew me and my skills at the time, and he knew I had been a high school teacher prior to medical school. We did a lot of tag-teaming that day, with me reinforcing care plans with patients after he made the diagnoses and plan. Time flew by, I realized I was genuinely having fun, and I found that I already was on my path.
Q: What do you love about your work:?
Dr. Rottnek: I love that I can spend my life’s energies and enthusiasm working with people to make their own best decisions about their lives, whether this is about health in a clinical setting or about professional formation and vocation in an educational setting. Both roles have a remarkable intimacy, as a physician and as an educator, because I’m allowed into people’s lives along with all the messiness, confusion, brokenness and hope. I draw insight and strength from engaging with others at various levels and in different situations. Nothing is mundane when I look at the opportunities I have, as long as I keep this sacredness at the center. Place all this in the context of other people who want to change the world on a daily basis, while displaying some wickedly funny behavior whenever possible, and I marvel that I still draw a salary on top of it all.
Q: What is your most vivid memory from medical school?
Dr. Rottnek: Unfortunately, I was so busy, stressed, and sleep-deprived through medical school and residency that I have repressed many memories (I also completely missed the Clinton presidency). While some memories are creeping back in since I came back on campus four years ago, one of my most vivid that stuck with me is that of the repeated shouting matches that occurred in the ICU when I was a student on the trauma surgery clerkship. The trauma surgeon and the neurosurgeon would literally yell and argue about a patient’s care plan in the ICU hallway during rounds! I remember being unable to process how something could be so accepted, so routine and yet so wrong at the same time. I’m proud to be part of departments, programs and an institution today that is committed to making medical school (and patient care) more humane, effective and patient-centered.
