Defining Moments: My Fifth Decade

My father used to quote a saying that my grandfather, Morris Wasserman, was fond of.  It had to do with sacrificing one's health in order to gain wealth, and then using that wealth to try to regain one's health.  In my fifth decade, I put that saying to the test, with the addition of trying to achieve purpose all wrapped up in the middle of it!

My fifth decade began in the summer of 1999, as I continued to "commute" between Denver and Central Florida every week.  I'd leave the house on Sunday afternoon, get on an airplane and fly to Orlando, arriving past midnight and heading to the Hilton in Altamonte Springs.  On Thursday afternoon, I'd fly back to Denver.  On Friday, I saw patients in the clinic.  My daughters were 12 and 8, and it's a wonder that they knew who I was.  I was the President and Chief Medical Officer for GeriMed of America and I was trying to prove a point about primary care geriatrics and make a difference in the world.  In many ways the world wasn't ready.  Nevertheless, our business in Central Florida had expanded from Orlando to include Daytona and Tampa, and we were profitable.  We had "full-risk" contracts with Humana and Cigna. I was constantly battling these HMOs, as well as the hospital systems and other market forces.  Primary care geriatrics was a profitable business model.

I remember once considering getting an MBA, only to realize that I'd gotten an MBA in the real world of health care business.  I had some of the best mentors.  Jim Riopelle, my boss, was one of the early pioneers in managed care and accepting risk.  Ray Delisle was our Chief Operating Officer.  In his previous role as VP of Human Resources for Samsonite, Ray knew more about HR than anyone I've ever met.  He'd also had extensive experience negotiating with unions.  And he was my friend.  Very few days pass where I don't think of one of Ray's colloquialisms.  And Jim, well, you had to really know him to love him. I miss both Jim and Ray as I write this, but they'll both always be looking over my shoulders and helping me along.  

Unfortunately, while we had been successful in Florida, our Denver operations were losing money.  In many ways, it wasn't surprising.  Our Denver clinics took care of the most frail patients and there was no such thing as "risk adjustment."  We actually were profitable when it came to specialist costs, but we had still lost nearly a million dollars due to excessive hospital costs.  As President of the company, I had no choice but to shut down our Denver operations.  In the winter of 2000, I was driving home from the office and my colleague, Don Murphy, called me.  He had decided to take over his clinic and turn it into a fee-for-service private practice.  Was I interested?  I was still President of GeriMed and all of my business was about to be in Florida.  Did I really want to continue commuting to Florida every week?  I was intrigued.  And, like every major decision in my life, I immediately knew the answer.  By the time I got home I told my wife that I was going to resign and go into private practice with Don.  On January 1st, 2001, Senior Care of Colorado was born.

I need to back up to some personal stuff first.  I had herniated my L5-S1 in 1998 and had really gotten off track from my marathon running and triathlon training.  In fact, I'd gained almost 20 lbs.  My dad underwent a Bypass and aneurysm repair in May and August of 2000, an I remember thinking, I need to focus on my health.  It was time to get back in shape and reset my ironman goal that I had postponed.  My new goal for to do an ironman when I turned 50.  First, I had to build up and get back in shape.  It took me a couple of years, but I did my first half marathon and first triathlon of the new millennium in 2003.  

My fifth decade was consumed by work and training.  Owning a business is a 24/7 commitment.  In 2016 Springer published my book, "The Business of Geriatrics," which tells a lot about my fifth decade.  There's so much.  Starting a business with a partner, taking on a second partner, divorcing the second partner, going $1.5 million in debt, figuring it out, hiring a CEO, firing a CEO, hiring my old CFO from GeriMed despite the fact that we had never gotten along, and now he's a lifelong friend, fighting with my business partner, battling the marketplace, being investigated by the OIG for most of the decade, it just doesn't end.  Missing my kids growing up.

I hired a coach in 2005 (and after 16 years he's still my coach!).  My half marathon times tell the story:

2003 (Denver) 2:00:37

2004 (Denver) 1:50:10

2005 (Denver) 1:39:33

2006 (Surf City) 1:37:14

2006 (Denver) 1:43:15

2007 (Surf City) 1:32:25 (PR)

2007 (Denver) 1:43:38

2009 (Surf City) 1:33:54

So do my half ironman times:

2004 (CA) 6:08:04

2005 (CA) 5:49:56

2005 (CO) 5:29:05

2006 (CO) 5:18:39

2006 (CO)-Harvest Moon 5:24:34

2007 (CA) 5:13:07

2007 (CO)-Harvest Moon 5:34:22

2007 (CO) 5430 5:07:24

2008 Halfmax Nationals 5:43

2009 (CA) 5:19:36

2009 (Eagleman) 5:02:44 (PR)

Of note, the 2008 Halfmax Nationals qualified me for the Long Course Triathlon World Championships in Perth, Australia in 2009, but that's my next decade, so it will have to wait.  I also ran my fastest 5K ever, and my only 5K under 20 minutes on my 49th birthday in 2008.  As I got close to turning fifty, my ironman dream was in the making, but my life was also careening in terms of work:life balance.  That would ultimately define my sixth decade.