Robert Rubino discusses his passion for gynecology, his advice to medical students, and his thoughts on the current state of health insurance in America.

Question: What drew you to gynecology?

Robert Rubino: You know, essentially, it’s kind of the nexus of medicine.  It’s where all the disciplines kind of meet.  There’s some internal medicine, there’s surgery, endocrinology, a little bit of pediatrics and some psychiatry, you know, so it’s kind of the area where if you like everything in medicine, it’s a natural discipline for a lot of folks then.

Question: What advice would you offer to medical students?

Robert Rubino: Well, it’s probably similar to what everybody told you along the way; you really have to have almost like a magnetism for the specialty or, you know, for medicine.  So if you don’t feel like an undertow bringing you there, then you probably shouldn’t pursue it.  But if you do feel that undertow, you eventually have to give into it so you might as well do it sooner rather than later.  After, you know, five years in business, the undertow is still there.

Question: What are the challenges and rewards of private medical practice?

Robert Rubino: Well, I think balance and perspective is a daily challenge so you have to kind of remember why you did it and make sure you’re still happy doing the actual work, which for me, that’s easy, But you also, you know, you have to pay attention to the things that nobody wants to tell you about when you’re in training which is, you know, the business of medicine.  It’s kind of our duty to really learn that, not only for our patients but for ourselves and our families that we support and I think always looking to keep it interesting.  And for me, I’ve gone through all the clinical disciplines that interest me and I, you know, kind of grow into the next one.  Electronic medical records was something that was a big part of my life for the last five years, converting my practice from the old paper chart to the digital records and now we’re all paperless.  And that’s still an ongoing challenge, but I like that a lot.  And then, you know, the new technologies that arrive, to investigate them, find out if they’re a flash in the pan or if they’re really something legitimate for the future and that’s always interesting.

Question: How does the current insurance environment affect your practice?

Robert Rubino:  Well, I think after you come to grips with it, you shrug it off and say well, I’ll succeed and whatever I have to do to succeed, you know, I’ll adapt.  And I think that philosophy serves anybody well.  In our particular private practice, we do work out of a teaching hospital so we do teach residents and that keeps it interesting, but always adjusting to whatever, whether it’s insurance companies or new developments, you just have to kind of adapt and always pay attention to your core discipline of taking care of the patient and at the end of the day, paying attention to what you need to do to survive, which as long as you’re willing to work, you can do it.

Question: Do you welcome the concept of universal health care?

Robert Rubino: It depends on what somebody’s intent is, universal healthcare.  I think government taking over healthcare, I just imagine going into Motor Vehicle and my experience there, and that’s kind of a simple task; medicine is too complex I think for one person to take care of it.  I think our system here is not as bad as everybody says and, you know, I’m a member of it.  And while it’s not perfect, I still think it breeds the best innovation in medicine.  And still I think around the world, people look to this country for the innovation in medicine.  And I think a universal system, while it sounds great ‘cause no matter what it is, we’ll have like one fix for everything, it just doesn’t work in medicine.  So I think we can’t fix it, we have to just adapt to it and let it almost naturally run its course and see what we come with.  But right now, the system is not as terrible as everybody thinks, but I think it could be continually improved.

Question: What improvements could be made?

Robert Rubino:  Well, I think letting the consumer really drive the marketplace.  So some people will choose now not to have healthcare because they’re banking on their health somewhat the same way maybe a twenty-one-year old won’t buy life insurance because they’re banking on the fact that they’ll be around for ten or twenty years.  I think over time, letting the consumer spend their healthcare dollar I think would be in the long run cheaper than paying up front for insurance because to a certain extent, they’re just paying forward for their healthcare, it’s not insurance because they know the event of going to the doctor’s gonna happen.  A lot of times insurance is paying for something that might not happen.  Well, going to the doctor is going to happen for preventative care.  So I think giving folks the option of paying as they go to the doctor and then maybe to put some money aside in a tax-free account to grow over time where they’ll be rewarded for staying healthy and maybe having some kind of safety net for
getting admitted to the hospital where your costs really take off.  I think at the level of the office, we keep things inexpensive because it’s preventative care a lot of the times where the interventions don’t call into play all the services of other professionals.

Recorded on: 04/29/2008