Richmond family physician Dr. Andrew Deitsch has spent decades caring for patients in the same community where he grew up — and where his father practiced before him. In this episode of the Western Wayne News podcast, he reflects with Kate on the power of long-term relationships in medicine, the joys and challenges of small-town practice, and how true healing begins with listening. Enjoy!
Transcript
Andrew Deitsch: I’m Dr. Andrew Deitsch, a family physician with Reid Health.
Kate Jetmore: From Civic Spark Media and the Western Wayne News in Wayne County, Indiana, I’m Kate Jetmore. As a native of Richmond, Indiana, I’m excited to be sitting down with some of our neighbors and listening to the stories that define our community.
My guest today is Dr. Andrew Deitsch, a family physician with Reid Health in Richmond, Indiana. A member of the Catholic community, he and his wife, Lis, have raised four children and are enjoying the empty nest. Andy enjoys cycling, reading, and his German Shepherd, and he cheers for Notre Dame football and the Cincinnati Reds.
Welcome, Andy. Thanks so much for joining me today.
Andrew Deitsch: Thank you for having me.
Kate Jetmore: Well, I do know a bit about you since you and I attended a high school together, although it’s been a few years. But I’m looking forward to catching up and learning more about you.
So let’s begin with your history in the area. When did your family come to settle in Wayne County?
Andrew Deitsch: We came to Richmond when I was about two. My dad had a practice. He’s a retired family physician, and he had a practice in the Upper Peninsula of Michigan.
I was actually born when he was a resident in Cincinnati, and then he moved up there. And after a year, my mother told him it was either the Upper Peninsula or her.
And so they moved south and settled in Richmond. So I’ve been here since I was two.
Kate Jetmore: Oh, wow. So practically your whole life, I think it’s fair to say.
Andrew Deitsch: Yeah.
Kate Jetmore: And where are your parents’ roots from? Are they from this area?
Andrew Deitsch: They, my dad grew up in Cincinnati, and my mom right across the river in Northern Kentucky. Fort Thomas, Kentucky.
Kate Jetmore: Okay. So why Richmond?
Andrew Deitsch: Part of it, I think, was it was close enough that they could care for their parents as they aged.
And part of it, they tell me that my older sister, Sarah, who’s two or three years older than me, really got along with one of the, one of the partners that interviewed Dad for that practice when they were here. So kind of a random reason to settle somewhere.
But yeah, that’s the story I’m told.
Kate Jetmore: Well yes and no, cause I mean, part of your, part of your question is about your parents’ parents. Part of your question is about your parents’ children. So it really sort of comes down to family, doesn’t it?
Andrew Deitsch: Yeah. In a lot of ways. And in retrospect, I’m glad they settled where they did. I mean, Richmond has treated our family really, really nicely over the years.
Kate Jetmore: Yeah. Well, you and your wife, Lis, have obviously decided to stay in the community. You’ve raised your four children in the community. What’s kept you here?
Andrew Deitsch: Well, I think, you know, when I was a resident, Lis and I got married in the middle of medical school and then together decided to go up to South Bend for my family practice residency. And, you know, coming to the end of those three years, we would have been perfectly happy to stay in South Bend, South Bend is a wonderful community. But I knew I had a practice waiting for me here if I wanted to come back and join my dad.
And her family’s from here as well. At the time, our two families actually lived about a third of a mile away from each other on Henley Road.
And so we decided coming back, while it was going to be a little mixed, I remember saying to each other, you know, if we move back, we’re going to have a front row seat for our parents’ aging process. And that’s not always going to be wonderful. But the pro and the con, I mean, having a practice waiting for you in a community that you both know, you know, Lis had been very active in [Richmond] Civic Theatre and, you know, community is an important thing. And so we decided to move back, and we’re really glad that we did.
You know, I end up talking to patients fairly frequently about Wayne County and Richmond as a community. For me, it kind of boils down to this. I think if you are married, it’s a great place to be. If you’re single, it can be a little bit hard. Finding a spouse in Richmond can be a little difficult, I think.
But once you’re married, I mean, you’ve got great access to Cincinnati, Indianapolis, Dayton, you know, if you want to go see a show or, you know, that kind of thing.
But you’ve also got a small-town feel. And that is really important.
You know, I remember when my kids were little, and we would go to Meijer or go to Walmart or something like that. And four or five people would stop me along the way through the aisles and say, hey, can you take a look at this rash or hey, you know, we started that medicine.
And we would get out to the parking lot after the visit, and my kids would say, geez, Dad, you know everybody. And obviously, I don’t, but to me, that is one of the neatest things about Richmond and Wayne County as a community, is that we know each other, by and large, and we have a shared experience.
Kate Jetmore: Yeah, yeah, that’s really powerful. Well, let’s turn to medicine. You did mention that your dad’s also a doctor, and that he had his practice in Richmond.
I’d love to know, you know, other than the obvious, how you decided to go into medicine, and how that process unfolded.
Andrew Deitsch: Yeah, you know, it’s kind of almost an embarrassing question, because I’m not sure I really remember when I, when I made that decision.
I know when I left for college, I did not want to be a doctor. You know, I was in that phase of life where it’s time to rebel against your parents, not join them. And so that wasn’t really, you know, on my bingo card. But I ended up, I graduated from Notre Dame with a Theology degree, but along the way realized, yeah, number one, this theology thing is pretty intense and, you know, I’m not going to go to the Middle East and learn foreign languages to really be good at it.
And so I took my pre-med classes on the side, you know, I took Physics and Bio and, and the whole nine yards. And so by the time I was done with undergrad, I knew that I was going to go to med school.
But I don’t really have a moment. You know, I guess the nice thing is that growing up. HIPAA wasn’t a thing yet, and so patient privacy wasn’t quite as foremost in our minds as it is now. So me and my two sisters would compete with each other to see who could go on rounds with dad this weekend. And so I absolutely remember sitting on the end of patients’ beds, you know, when I was 8, 10, 12 years old, while he was, you know, practicing medicine. And so certainly that had a big effect on it. It was just in a stealthy way that I didn’t really recognize, I suppose, when I was 18 and leaving for college.
Kate Jetmore: Yeah, yeah. What was it that drew you to wanting to make rounds with your dad? What was it that you liked about that?
Andrew Deitsch: There were lots of things that I liked. I liked the interaction with the others, you know, with the other physicians in the doctors’ lounge. I liked, you know, the nurses were always very kind to me on the floor.
The patients, and I find this to this day, you know, if I have a medical student following me or if I have a resident that is working with me that day, patients love to explain themselves to that extra person. They really like, I think they perceive it as extra, this is going to sound bad, but extra attention or that they like to know they’re teaching, number one, and they like a chance to tell their story. We all like a chance to tell our story. I guess that’s why I’m on your podcast today.
Kate Jetmore: Yeah, for sure.
Andrew Deitsch: But yeah, and so it was, it was really neat to be exposed to these people who took the time to not necessarily teach me, right? I was too young for that, but just to open themselves. And, you know, I think that to a large degree, that is a lot of what family medicine is.
You know, I remember on my way through, my dad said to me, he says, you know, he said, if it’s the pure science that interests you and excites you, family medicine might not be your calling. You know, your fourth ear infection of the day isn’t medically thrilling. Now, sometimes we do have things that are fascinating, you know, as far as pure medicine goes. But he said, the way you know you want to be a family doc is if it’s the people that interest you. And he always told me, he says, you know, I consider medicine as just the excuse to get people in the door.
He said, if I didn’t know the medicine, they wouldn’t come talk to me, he said, but the value is in the conversation and the relationship and, you know, something that you build over decades. And now decades into it, I agree completely. I mean, that is, you know, I’ll always go through my schedule for the day and I can think, oh, at one o’clock, so-and-so is coming in. That’ll be a great time to catch up. And it really is nurturing for my soul and I hope for theirs.
Kate Jetmore: Yeah, well, it brings us back to the word you sort of came to in the first question about community. You know, it really sort of is a very important piece of that fabric that you were talking about.
And, you know, given what you’ve just shared and given how we change, you know, from the time we’re an undergraduate to, in your case, a med student, a resident, now many years into your career, I’m curious how your practice and your approach to providing care have changed over the years. Can you trace that a bit?
Andrew Deitsch: Yeah. Well, you know, I think, you know, in family medicine, your practice tends to age with you a little bit. You know, when you’re brand new and you’re young and bushy-tailed, you tend to have a very young practice. You know, you’ve got newborns, you’ve got young married folks, you know, things like that. And then, as you, and, you’ve got older folks, too, but as you age, your practice tends to age with you.
And so, you know, the newborns that I had 25 years ago are now having babies. And the people that were middle-aged 25 years ago are now senior citizens and have entirely different concerns, which is at the same time fantastic and can be a challenge.
You know, I remember, and I’m kind of reading into it a little bit, you’d have to ask my dad for the pure answer, but I suspect towards the end of his career, it was difficult for him because these people that he had come to know over the last 40 years were dying.
And, you know, you can imagine how hard it is if twice a week, every week, somebody that you’ve known for 40 years dies. And so towards the end of a family medicine career, I think that gets harder and harder.
You know, I’d like to think I’m better at it than I was at the beginning. I remember when I first came, Dad and I shared, we were in practice together for about 12 years. And so when I got to town, several, many of his patients kind of thought, well, the older model’s getting ready to retire. We’re going to jump ship and go with the young guy. You know, while we have the chance. And I would have several patients say to me, oh, you just listen to me so much more closely than it felt like your dad did at the end.
And I said, yeah, but that’s just because I have to. I said, I don’t know you, you know, and I really have to pay attention and listen to pick up all the things that he just knows.
Kate Jetmore: Right.
Andrew Deitsch: Right? I mean, he’s walked with you for 30 years. He knows all of this. And if I don’t perk my ears up and spend a little bit of extra time, I’m going to miss it.
Kate Jetmore: Right. You’re still learning.
Andrew Deitsch: And so it was kind of a, you know, and I remember talking about it with him and, you know, he took it a little bit personally sometimes I think when a patient would switch. And he realized the dynamic that I was having to, you know, pay very close attention while sometimes he already knew the answer before they said it.
Kate Jetmore: Sure. Sure. Well, let’s talk a little bit more about, I mean, I’m actually fascinated with everything you’re sharing, the whole sort of your story and the personal side of medicine, but I’d also like to talk about how you approach medicine given how healthcare is structured in the United States, at least at the moment.
So I’d like to know if you tend to compare notes with other providers in other parts of the country or even internationally, and whether there are challenges and opportunities in health care that are specific to Richmond or to Wayne County that you’ve observed.
Andrew Deitsch: Yeah, health care in this country, I don’t think anybody would claim that it’s anything but broken. Our health care system has so many parts of it that don’t serve the patient.
Man, insurance coverage in particular, it is infuriating to patients and to providers alike that insurance companies get to decide what treatments they have access to or don’t.
You know, the real hot-button issue right now, it’s a class of medicines, the GLP-1 agonists, Zepbound and Mounjaro and Wegovy and Ozempic, these weight loss injections that really show a lot of promise for a lot of people for a lot of reasons. But they’re very restricted insurance-wise because they’re expensive. And insurance companies don’t want to pay for them. And so they put up lots of barriers.
And patients verbalize their frustration. Why are these companies that we pay premiums to able to just say, no, because we say so? Oh, it’s so frustrating.
As far as comparing notes, I think, you know… Physicians kind of stay current, believe it or not, and this will strike most people as being the most boring idea in the world. There are practice-specific journals. You know, I have two or three family medicine journals that I read and work with every month to stay current.
And within the Wayne County community, I think we’re really blessed with physicians across the specialties that are very willing to have conversations about different patients or different topics. You know, if I run into something that I’m not super comfortable with, I can call anybody in any specialty and say, hey, do you have three minutes, you know, can you talk me through this? And vice versa. So that’s a real resource.
And I suspect every community is like that. But certainly in Wayne County, we’re blessed with that. And I think, again, part of it is the smallness, right? I mean, if I’m in Indianapolis or Cincinnati, I’ve got three or four competing hospitals and, you know, different practice groups that are competing with each other. In Richmond, that’s just not the case. I mean, we’re all kind of rowing in the same boat.
Kate Jetmore: Yeah, yeah. That’s interesting.
Andrew Deitsch: And that’s a real strength. As far as challenges that people, kind of unique challenges that people face here, you know, I think our deeply ingrained health habits aren’t great in the Midwest.
You know, you visit Colorado or, you know, places like that, and people will come back and they’ll say, my gosh, everybody was so fit, you know, and they were all on their way to hike or swim. And, you know, we have plenty of people who are very fit here, but I don’t think that’s a cultural norm in the Midwest.
And, you know, obviously you have much more of an international view than I would, but I also suspect, you know, the European countries and first world countries around the world are much more health conscious, I think, than the United States. So, you know, the inherent health problems that come along with that, you know, I just told a patient this morning that a lot of what we do in medicine is we try to make up for the damaging decisions we make about our own lives. You know, I spend a lot of time trying to fix tobacco-related illness or obesity-related illness, you know, all kinds of stuff like that. And I think that in the Midwest, we face those challenges.
Kate Jetmore: Yeah, yeah. Well, it’s interesting that you should bring up Europe, and I wasn’t actually going to speak to this, but since you brought it up, you know, in a place where universal health care is the system, one thing that is so interesting is that because the government is picking up the tab, there is a huge effort to prevent.
So there is so much information, so many classes, so many workshops, there’s this huge ongoing campaign for how to be healthy and how to stay healthy. And the reason is because it’s cheaper.
Andrew Deitsch: Yes. Yeah. And, you know, in America, we have what we call a fee-for-service model, which is, you know, health systems get paid when you access them. You know, if you have a bronchitis, there is a charge to come in and be treated for that. And there are all kinds of problems with that.
You know now, thankfully, in the Reid system, my reimbursement has nothing to do with what I order or what medicines I use. And that is such a blessing, because I can say to the patient, I am able to care about nothing but your health. And if you need a chest X-ray, I can explain to you why you need it, and you can be comfortable that when I go home today, my pay doesn’t change at all, whether we order that test or whether it doesn’t.
But you never want to have market forces or financial concerns pushing care. And man, if we could figure out, I’d be a big fan of the European model. And my paycheck would probably take a hit with that, but that doesn’t make any difference.
You know, it’s interesting, my son is midway through his Master’s program for hospital administration, and so he has this view towards medicine that is different than mine. And he’s wrestling with the ethical dilemmas of… How should this look versus how does it look? And who are the interest holders and the stakeholders that make it stay the way it is? Insurance companies and for-profit health systems and pharmaceutical companies and all kinds of things that result in this system that is frustrating. And I’m sure in European countries, they have frustrations too. Just different than ours, probably.
Kate Jetmore: For sure, yeah. How do you handle time, Andy, when it comes to, you know… There’s no denying that you have a limited amount of time with each of your patients. So how do you kind of find that sweet spot and strike that balance between, you know, being present, listening, giving the time that’s warranted, but also getting into the next exam room before you fall too far behind?
Andrew Deitsch: Yeah, that’s a real thing. You know, I try to, before my day, actually the day before, I go through my next day’s schedule and write down all of the previous problems that we’ve dealt with. You know, hypertension, high cholesterol, diabetes, joint pain, you know, all that kind of stuff.
I write down all of the labs that they are either up-to-date on or need, where they are with their mammogram, where they are with their immunizations, all that kind of thing.
So I have kind of an outline when I go into the room.
I purposely leave computers out of the room. I know that makes me a bit of a dinosaur. But to me, having my face in a computer really harms connection. And so I write on paper what I want to do, you know, if I need to change this medicine or do that exam, and then I hand it to my nursing staff. And I’m telling you what, my nursing staff is absolutely the backbone of how we can move because they do all of the work behind the scenes. They put the orders in, they call the specialist’s office and say, hey, can we get this person in? This is really important. They do a lot of the heavy lifting, and it allows me to be the person who is relating to that patient.
And, you know, I think you can develop a significant, meaningful interaction that doesn’t have to be long, right? You know, I think if you’re… If you’re skilled at it, and my hope is that my patients feel this way, that even if it’s a 5-minute interaction or a 10-minute interaction, you can come away from that thinking, he completely heard what I meant, he understood it, we talked together about what solutions might fit, and then he made sure I understood it before I left. And we also had time to talk about my new grandson, and I got to show him pictures on my phone, and, you know, and those are really meaningful.
Kate Jetmore: Yeah. Andy, have you read Abraham Verghese, any of his books?
Andrew Deitsch: I have. They’re very good.
Kate Jetmore: Well, hearing you talk, I feel like I’m sort of listening to his TED Talk. In his TED Talk, he says something about the most powerful instrument that a doctor has, that a physician has, and it’s the hand. It’s touch.
Andrew Deitsch: Yeah. You know, I always kind of balk at telehealth and things like that. I mean, when forced, you can do it, but it always kind of cracks me up that when you see an advertisement for telehealth, you see a doctor wearing a stethoscope, which they’re obviously not going to use.
Kate Jetmore: That’s true.
Andrew Deitsch: The number of diagnoses that I think you can adequately treat without laying hands on a patient is incredibly small. I mean, even rashes, right? You’d think, oh, you can look at that rash and tell what it is. The vast majority of providers would say to you, I truly understand a rash when I can feel it, when I can touch it. That’s when I know.
And so telehealth, I think, is fraught with peril. And don’t even get me started on AI. I think AI to an old-time physician like me, AI just seems like a terrible idea.
Kate Jetmore: Well, I’d really, I’d love to talk about you in the sense that, you know, we’re talking about what your patients need and what your patients are seeking when they come to you and when they call your practice.
But, you know, given that you are walking with people in some of their, some of the most difficult moments of their lives and doing that, you know, day after day after day and not all patients, you know, you also have wellness checks and, you know, hopeful new parents. But what about, you know, many, many days that are filled with difficult moments? How do you take care of yourself, and how do you maintain your momentum?
Andrew Deitsch: Yeah, well, I think you give voice to part of the solution. And that’s sort of why I really love family medicine, because you have that variety.
You know, every time I’m kind of like, oh, gosh, how many more 85-year-old dizzy diarrhea patients can I see, you get a beautiful newborn, or you get a sassy teenager who’s in for their sports physical. Or you know, if you have too many sassy teenagers, you get to say, oh my gosh, I get to relax with this 85-year-old who is such a pleasure to be with. So that variety. I always sort of feel bad for oncologists. I think that would have to be a really challenging practice, just by virtue of dealing with so much cancer and the difficulties that attach to that.
But, you know, like any job, I think it’s important to be able to turn it off sometimes. You know, I don’t think it’s a mark of not caring if you can go home and turn it off and say, yes, that is an important, meaningful thing in that person’s life, and I’m there for it.
But I’m also going to go to the show with my wife and recharge so that, you know, so that I can still be helpful.
Kate Jetmore: And is that something that you were taught at some point in your training or by your dad, or is it something that you have learned over the years?
Andrew Deitsch: You know, that’s a great question. And there were probably times in medical school and residency that, you know, people said, hey, be aware of this, burnout is an issue. And I don’t remember those times specifically, but I can’t imagine that wouldn’t have been shared either on a formal level or just from the wisdom of other doctors who have gone before you.
Kate Jetmore: Right, right.
Andrew Deitsch: And, yeah, you know, it’s a big advantage, I think, to have a father who has done it before and, like all of us, has done it well sometimes and done it not well at other times.
I remember when I was a kid, my mother saying to me, hey, your dad lost, I think it was a young person to asthma, he had a patient die, and it’s going to be kind of challenging for the next few months. I don’t remember anything other than that short conversation. I don’t remember how he struggled or whether he showed me that struggle or not, but I remember that.
And there have been, you know, I could pick out two or three or four patients over the years that really left a mark, whether because you question the care you provided, whether you did it right or not, or just the power of the situation. And like all things in life, you know, I have some patients that resonate deeply with me and others who are perfectly kind and nice, and we have a good working relationship, but we don’t really meet on that deeper level, and that’s okay, too.
Kate Jetmore: Right.
Andrew Deitsch: But yeah, it is. You do feel like you’re navigating it a little bit, keeping in mind your own mental health. But I mean, that doesn’t just apply to me or this job. I think people in any job need to keep an eye towards their mental health.
Kate Jetmore: Yeah, for sure.
Andrew Deitsch: Each job has challenges and benefits to it.
Kate Jetmore: Yeah. Well, Andy, I want to thank you so much for taking the time to talk to me today. I loved catching up with you, learning more about you, and I want to wish you and your family all the best.
Andrew Deitsch: Well, I appreciate it, Kate. Thank you very much.