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Longest Practicing Community Pediatrician Shares How ‘Caring for Generations’ Has Changed
Edward Cahill, M.D., came from a family of architects and engineers – he didn’t set out to become a doctor. But an aptitude test and a high school counselor led him to try medicine and eventually focus on pediatrics.
After graduating from medical school in 1970, he entered the Air Force and practiced pediatrics for two years. “Serving in the Air Force was great training,” he says. “In medical school, patients would not return for their follow-up appointments, and there was no ability to track them down or get them to come back. The Air Force gave me the experience of follow-up care, reinforcing the concept of continuity of care, something that I would need in private practice.”
Dr. Cahill pictured at Loveland Pass in Colorado.
Following his service, Cahill completed a fellowship in child psychiatry at The Johns Hopkins Hospital where he was introduced to his first partner, Allan Leffler, M.D., a Howard County pediatrician. “Dr. Leffler was incredibly bright; he was a member of the medical honor society and had done research,” says Dr. Cahill. “But, he decided he didn’t want to be a bench scientist. He wanted to be a family pediatrician, just like the old-time docs.” While completing his fellowship, Dr. Cahill began working weekends with Dr. Leffler’s practice, operating out of the basement of Dr. Leffler’s home. They entered into a full-time partnership and moved to new offices on Route 40 in Ellicott City. The practice expanded, added new physicians and moved to Chevrolet Drive in Ellicott City. Dr. Leffler died tragically in an accident in 2007, but Dr. Cahill still practices, carrying on the legacy of superior pediatric care that the duo started years before.
An Ever-evolving Practice of Medicine
Just as the offices and the county have changed during the past 40 years, so has the practice of pediatric medicine. Dr. Cahill recalls several significant changes, such as when the hospital hired hospital-based physicians. Neonatologists began providing 24-hour coverage in 1990 in the Labor and Delivery Unit and Special Care Nursery (the predecessor to the Lundy Family Neonatal Intensive Care Unit). Pediatric coverage for emergency and in-patient care began when the HCGH Children’s Center opened in 1997. Prior to this, pediatricians were on call around the clock, and often traveled to distant hospitals to care for their patients—not easy for physicians trying to run a practice. These changes also raised the level of care. “Before, regular [adult] emergency physicians weren’t ideal for treating children, and community-based physicians could be rusty in acute emergency care,” Dr. Cahill says. Now, with specially trained pediatricians in the hospital emergency department, pediatricians in private practice can concentrate mostly on office-based care, although many still visit the hospital to perform initial physicals on healthy newborns.
The Era of Managed Care
When managed care emerged, it brought major change to pediatricians who previously had operated on a fee-for-service basis. At the time, most patient insurance only covered hospitalizations.
Dr. Cahill believes that broader preventive coverage offered through managed care plans brought mostly positive changes. “The good news was that patients could afford immunizations and physicals,” Dr. Cahill states. “Physicians didn’t have to worry that patients couldn’t afford the treatment they needed. It improved follow-up care because the price tag wasn’t too bad for the patient. The downside to managed care was that it rained patients down on us, which made us busy and things like hospital rounds and extra training or education fell by the wayside.”
Dr. Cahill also notes changes in medicine, including the vaccine for bacterial meningitis. “Before the vaccine, we would have to catch this dangerous condition early, diagnose it correctly and administer immediate treatment to preserve the patient’s intelligence and life,” he recalls. “Now we see very little bacterial meningitis because of the vaccine.”
Looking to the Future
Today, Dr. Cahill’s practice, Ellicott City Pediatric Associates, has four full-time and two part-time physicians, allowing him to finally slow down. “I don’t have to work weekends and evenings anymore, but I’m not ready to retire; retirement is oversold.” In his newly found spare time, Dr. Cahill enjoys riding his bike. As a member of the Baltimore Cycling Club, he has participated in tours through the Rockies, and last year, at age 70, he racked up more than 7,500 miles.
Drs. Leffler and Cahill’s practice, Ellicott City Pediatric Associates, has cared for generations of families. Joan Jeffries started bringing her children to the practice in 1972. Now her children bring their children. “As a parent, I had so much respect for them as doctors,” says Jeffries. “They kept open lines of communication, and they had great insight into whole families. They built up trust that lasted for generations.”