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reed magazine logoJune 2010

Country Doc Goes Back to Basics

Dr. Fred Matthies ’49

Alumni
Profile

Frank Wesley

One otherwise routine day in the 1960s changed everything.

An African-American family had rushed their 14-year-old girl, writhing in pain, to a California emergency room. The doctors on duty inspected her swollen abdomen, consulted their textbooks, ran the latest tests, and prepared for the difficult and dangerous operation of removing an infected gallbladder.

That’s when “country doc” Fred Matthies ’49 arrived on the scene, took one look at the girl, and told the surgeons to scrub the procedure.

To Fred, the episode represented several alarming trends in American medicine: an overemphasis on technology; an excessive reliance on tests; a “when in doubt, cut it out” philosophy to protect surgeons from lawsuits; and perhaps most of all, the gradual disappearance of primary care physicians who could evaluate cases critically from a wide base of knowledge.

“It was sort of a Rodney Dangerfield moment, because primary care docs were getting no respect, and it started in medical schools,” he says.

Fred earned his MD from the University of Chicago in 1953 and practiced medicine in rural Utah for many years. Although being a general practitioner was his passion, he felt he could have more effect by teaching the craft to others. So he joined the faculty at UCLA and taught medical students to pay their dues to general medicine before considering a specialty.

Since retiring from his professorship, Fred has taken an increasingly prominent role in the health care debate. He regularly writes letters to editors about America’s worsening primary care shortage and has published op-eds in publications ranging from the Statesman Journal to the Lund Report to Family Physicians of Oregon. Taking the issue straight to the top, he penned a widely distributed open letter to Senator Max Baucus (D-Mont.), chairman of the Finance Committee, who was influential in the recent health-reform debate. Styling himself “just a lone hell-raiser,” he avoids leadership in health care advocacy organizations. In promoting a dialogue, Fred consciously embraces the Reedie tendency to skepticism if there’s any reason to question.

“Reed teaches, ‘Don’t believe everything you hear,’” he says, “which is a valuable way to look at the world.”

When Fred hears about pharmaceutical companies making dubious claims about their drugs, he remembers legendary professor Blair Stewart [economics, 1925-49] demolishing the Hudson Motor Car’s claim to an “aerodynamic” design, even though the vehicle’s component-riddled underside would still create lots of drag. (Fred notes that the phenomenon of the dark underside recurs in marketing, medicine, and politics.) He also admires how professor Frank Hungate [biology, 1946-52] took great pains to show the importance of comparative anatomy. Fred made sure that Hungate’s big-armed binocular microscope was preserved in Reed’s Biology Museum, located in the basement of the L.E. Griffin Memorial Biology Building.

As always, Reed’s general approach to education during the ’40s stressed learning how to think. Returning GIs composed over half of the male population on campus. (Fred himself fought WWII’s “Battle of California” as an enlisted corpsman at the naval hospital at Camp Shoemaker, in the Bay Area.)

True to form, Reed’s mandatory intro physics course stressed the scientific method. “I wish more people embraced the whole notion that you develop a hypothesis and test it out,” he says. “Especially our politicians.”

Much of lawmakers’ focus is now on tort reform, but Fred doesn’t believe that is the heart of the matter (although he admits that he paid just $135 for insurance in his last year in private practice, while some specialists now pay hundreds of thousands a year). When a specialist gets a patient, a diagnosis almost always comes as part of the package, and he wonders if anyone ever gets to the root cause of a problem.

As a lover of examples, he uses close-to-home cases in point regarding the benefits of comprehensive wisdom in any field. “If you remain a generalist economist like my spouse you can do really well because you can explain economies to noneconomists,” he says.

The idea of the specialist has really been sold in our culture, he argues, and there’s no doubt that specialists are extremely important for the advancement of knowledge. But somebody still has to be around to make house calls on reality.

And the 14-year-old patient with abdominal pain? Fred was skeptical about the diagnosis of gallbladder infection because it defied the old rule he had learned in medical school—that the classic patient was “fair, fat, forty and female.” After a quick examination, Fred diagnosed edema or dropsy, a painful buildup of fluid that can be treated without removing semivital organs.

—Raymond Rendleman ’06

reed magazine logoJune 2010