ORAL HISTORY PROJECT

Edward J. Saltzman, MD

Interviewed by Edward Zissman, MD

June 8, 2013

Palm City, Florida

This interview was supported by a donation from Pediatric Associates, South Florida

2013 American Academy of Pediatrics Elk Grove Village, IL

Edward J. Saltzman, MD Interviewed by Edward Zissman, MD

Preface i About the Interviewer ii Interview of Edward J. Saltzman, MD 1 Index of Interview 53 Curriculum Vita, Edward J. Saltzman, MD 55

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PREFACE Oral history has its roots in the sharing of stories which has occurred throughout the centuries. It is a primary source of historical data, gathering information from living individuals via recorded interviews. Outstanding pediatricians and other leaders in child health care are being interviewed as part of the Oral History Project at the Pediatric History Center of the American Academy of Pediatrics. Under the direction of the Historical Archives Advisory Committee, its purpose is to record and preserve the recollections of those who have made important contributions to the advancement of the health care of children through the collection of spoken memories and personal narrations. This volume is the written record of one oral history interview. The reader is reminded that this is a verbatim transcript of spoken rather than written prose. It is intended to supplement other available sources of information about the individuals, organizations, institutions, and events that are discussed. The use of face-to-face interviews provides a unique opportunity to capture a firsthand, eyewitness account of events in an interactive session. Its importance lies less in the recitation of facts, names, and dates than in the interpretation of these by the speaker. Historical Archives Advisory Committee, 2012/2013 Jeffrey P. Baker, MD, FAAP, Chair Lawrence M. Gartner, MD, FAAP Jacqueline A. Noonan, MD, FAAP Howard A. Pearson, MD, FAAP Tonse N. K. Raju, MD, FAAP Stanford T. Shulman, MD, FAAP James E. Strain, MD, FAAP

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ABOUT THE INTERVIEWER

Edward Zissman, MD Edward Neal Zissman is a graduate of Temple University and Hahnemann Medical College [now Drexel College of Medicine]. After an internship at Sinai Hospital of Baltimore, MD, he completed is pediatric residency at Boston Naval Hospital and Boston Floating Hospital [Tufts New England Medical Center]. Following two years service as Chief of Pediatrics at the Orlando Naval Hospital, he cofounded Altamonte Pediatric Associates a thirty nine year old private pediatric practice which currently employs six Board Certified pediatricians and six Pediatric certified nurse practitioners in three Central Florida office locations. He is Assistant Professor of Pediatrics at the University of Central Florida College of Medicine. Dr. Zissman served in all of the Florida Chapter AAP officer positions, and chaired the FCAAP third party payer and private practice committees for many years. He was a member of the initial AAP CPT trainers network as the Florida trainer and was a regular lecturer on the SOAPM circuit. He served on the SOAPM Executive Committee and the AAP Committee on Child Health Finance and was District X Vice Chair. He was encouraged in all of these activities by Eddie J. Saltzman, MD, FAAP, SOAPM founder.

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Interview of Dr. Edward J. Saltzman DR. ZISSMAN: This is an interview with Dr. Edward J. Saltzman conducted by Dr. Edward Zissman on Saturday, June 8 [2013] in Palm City, Florida. Eddie is the founder of Pediatric Associates, the largest pediatric group in the United States, and the founder of the AAP Section on Administration and Practice Management, SOAPM. Eddie’s been my mentor and a long-time friend. How are you doing today, Eddie? What are you currently working on, or are you just taking it easy? DR. SALTZMAN: Well, I’m doing OK. I’m taking it easy. This is a busy community with a lot of wonderful people, and I’m a golfer, and I’m a reader. And I’m loving life. And things are OK. DR. ZISSMAN: I’m not sure I know much about your family, wife and children. DR. SALTZMAN: OK. Well, I have 2 children. I lost 2 children to an illness, but I have 2 children and 4 grandchildren, all doing well, all behaving. Two of them are in school, one out of college and one too young to go to college, just nine years old. I lost my first wife, Joan—we were married over 40 years—to lymphoma back in 2005. And I remarried to a lovely decent human being, Joyce. And things are working out well. DR. ZISSMAN: Good, good. Tell me a little about where you were born and your parents, your siblings, your family life. DR. SALTZMAN: OK. I was born in Philadelphia, Pennsylvania in 1926. Grew up in a very mixed neighborhood. I can tell you very quickly a little anecdote. I remember coming home one day, and my mother said, “What did you do?” And I said, “I spent the afternoon, I had a great time. Jackie Reinhart and I went out with sticks, and we were looking for Jews to beat up.” So my mother was horrified obviously. And she said, “Well, do you know what you were doing?” I said, “No. I don’t even know what Jews are, but—what are they?” I think I was five years old at the time. Needless to say, within a year, we moved to a Jewish neighborhood, and I went through the normal childhood of knowing what I was and what my background was.

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My mother was born in New Jersey, the daughter of the superintendent of schools and a farmer, in Carmel, New Jersey, which is a little suburb of Bridgeton. She became head of nurses at a hospital in Philadelphia, where she met my father, who had recently graduated medical school, and they started a life together. My father was born in Lithuania, was ordained as a rabbi at 14, came here at 16, taught Hebrew school and gave sermons on the weekend to pay for his college, 2 years at Temple University. Then he was accepted at Jefferson, and he graduated Jefferson Medical College in 1922. Even though he was ordained, he was almost agnostic. They would send him the sermons to preach, and it had to be exactly that way, whether he believed it or not; and a lot of times, he didn’t believe in some of the things they were saying. He had a very tough time. So when he became a doctor, I think life was different for him. He did family practice and ear, nose, and throat. He was a specialist in ear, nose, and throat and taught at Temple University School of Medicine for about 40 or 50 years. He wrote the first book on hearing in this country [Saltzman, Maurice. Clinical Audiology. New York: Grune & Stratton, 1949]. Hearing aids were unknown. Hearing was interesting; you lost your hearing while you were old. That happens. Well, a lot of things have changed obviously. He wrote the first book and half of the book was physics, and he never had a physics course in his life. The famous guy in ear, nose, and throat, I remember, was a guy named [Julius] Lempert in New York City, and he used to go to New York City and consult with him, and then he’d come to Philadelphia. My father was a very well-respected otolaryngologist; very honest, very moral. We didn’t break laws. We didn’t think the wrong way. You didn’t look down on somebody unless you were picking them up. There was no such thing as talking down to a maid. We did have a maid. Rosie got $7 a week. But we were always taught to be respectful. I have a sister, an older sister (Peggy Bedell), who is a psychologist, and she was head psychologist at Payne Whitney [Psychiatric Clinic] in New York. My brother is a year and three-quarters younger. He was professor of medicine at Duke [University School of Medicine] and was the United States authority on hyperbaric medicine. When the submarine went down in the 1960s off of Key West, he was there to help them with the hyperbaric chambers and things like that. I think Duke was one of the first medical schools to have that and they used it purely for medical and scientific purposes, not to lose weight or to enlarge your breasts or things like that. He recently retired, about 3 years ago. He was a recognized authority in

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pulmonology, a good guy and a lovely human being. That’s my sister and my brother. We lost a little sister in 1941 with rheumatic fever. In those days, there were no antibiotics, and I guess she developed myocarditis or pericarditis, and we lost her. At that time, interestingly enough, I said, “I’m going to be a pediatrician. I’m going to be a children’s doctor.” And you know, when we grew up, you were either a doctor or a lawyer or a businessman, if you were lucky to survive, but the world was different. There were no computers, and there was no Internet; there were no cell phones. So my father was a doctor, and I had the opportunity of learning all my life. Medicine is a wonderful profession, and it’s an honor to be a doctor. My father never sent bills because if they couldn’t pay, they couldn’t pay, and we did fine. He supported us, and we lived well, and all of us went to college. You wouldn’t think of not going to college. I entered college early. I didn’t finish my senior year of high school. When I was finishing my first half of the 12th grade at West Philly [Philadelphia] High [School], I was a good student, B-plus student, As, Bs. My sister was all As. My brother was all As. When I’d get in a class the teacher would say, “You can’t be Peggy’s brother.” I had that most of my life, but I wanted to play ball. I was more interested in playing ball than going to school. But we still studied because that was the ethic. You studied with the radio on, whether it was Jack Armstrong or some other radio program, Batman or the Green Hornet. You listened; there was no television. I entered LaSalle College when I would have been starting the last half of my senior year. In the fall of 1943 I entered college; I was not quite 16. After 3 years of college, in the fall of 1945, I entered Jefferson. So I never graduated high school. I never graduated college. I graduated in 1949 at the aged of 22 1/2. Interestingly enough, I took my internship at Jefferson Medical College Hospital [Thomas Jefferson University Hospital]. My father said, “You’ve got to go to a medical school hospital for an internship because then you’ll get the residency you wanted.” At that time, there were only 2 major children’s hospitals in the country that I knew of: Boston Children’s [Children’s Hospital Boston] and Philadelphia Children’s [Children’s Hospital of Philadelphia]. And I remember when it was time to go to medical school, and I told my dad, “I think I’d like to go to medical school in Boston, where I could ski in the winter in New England and things like that.”

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“You’re going to Jefferson. You will go to Jefferson.” “Yes, Dad.” I went to Jefferson. And there was no anger. Things were different then. It wasn’t that we didn’t talk back to our parents. When I went to bed at the Truman-Dewey election, I was having my milk and chocolate cake about 11 o’clock at night, and my father said, “Well, it will be interesting in the election.” I said, “It’s not going to be interesting. Dewey will beat Truman easily.” And my father said, “Don’t be so sure. Truman’s got a nice manner about him.” I said, “Oh, Dad. You don’t know what you’re talking about.” That was the extent of “you don’t know what you’re talking about” when we talked back to our parents. And I went to bed, and of course the next morning, Truman was president. Anyway, getting back to medical school-- DR. ZISSMAN: Tell us about medical school and then internship. DR. SALTZMAN: Internship was at Jefferson. And I wanted to go to Children’s Hospital because “You’re staying in Philadelphia.” I had a wonderful, wonderful residency. When I was an intern, if they needed to “inject poison” and they couldn’t find the appropriate person, they found an intern and “injected poison.” At that time, it was a tyrannical internship. You didn’t breathe. When I went over to Children’s Hospital, I remember Dr. [Joseph] Stokes [Jr.] was physician in chief. Joseph Stokes was world-class. Where did you train? DR. ZISSMAN: I trained at Hahnemann [Medical College]. DR. SALTZMAN: So you know Philadelphia. DR. ZISSMAN: I did a rotation at Philadelphia General Hospital, and I trained with Dr. [C. Everett] Koop for 6 or 8 weeks at Children’s [Hospital of Philadelphia], the old Children’s. DR. SALTZMAN: Koop was a very beloved friend of mine, and I’ll tell you about him later. Anyway, the first or second day of rounds, Dr. Stokes said, “Well, what was the blood count on this patient?” And I said, “I’m awfully sorry. We didn’t get a blood count.” He said, “Oh, I thought I asked you to get a blood count.” Well, if I were an intern, I’d be face up in the Delaware River. And his response was, “Well, maybe it wasn’t clear. Why don’t you get a blood count and give me a call when you get the result?” And I almost

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fainted with the niceness of the people at Children's Hospital. Family, warm, kind, loving. Made us work hard every other night and every other weekend. I would go home every other night to sleep, but very good training. Chick Koop and I got to be very friendly. He was there about 3 or 4 years when I got there. He was already chief of pediatric surgery and a lovely decent guy. He was extremely religious. He’d come out of the operating room, and the parents would say, “Well, tell me about how things went.” He said, “They went fine. Let’s all hold hands.” And he would be holding hands and saying a prayer, not forcing it on them, but saying a prayer and thanking God in a nondenominational way and telling them about the success of the surgery or whatever the issue was. As you know, Chick was very anti-abortion. But when he got appointed to be [US] Surgeon General, I was in Florida. Somebody who knew him said to me, “My God. He’s going to be a horror.” I said, “No, he’s not. He’s not going to inflict his basic beliefs on the country.” And that was exactly his creed. Anyway, we’ll talk about Chick later. He was just a nice guy. They all were. When I left Children’s Hospital, I finished my residency and it was career time. Although I wasn’t obligated to go into service after residency, there was a doctor draft and I could have been drafted. I enlisted anyway. Many of my friends or older recent graduates got into practice and then went in the service, and their lives were disrupted. So I said to my parents, “I’m going to enlist and do my 2 years and then go out into practice.” DR. ZISSMAN: How was that received by your family? DR. SALTZMAN: My family was very upset because my father said, “You could go to Korea.” I said, “They wouldn’t send a pediatrician to Korea.” But I went down to Washington and I had to talk my way into enlisting because I really just didn’t want to go into practice. I had a lot of offers from the Philadelphia Children’s. Dr. Stokes asked me to stay at Philadelphia in his office full-time, and I had other offers from other people in big practices there. I was going to practice in Philadelphia, no question about it. It was not even worth discussing. And of course my family was there. Lo and behold, they sent me to basic training. I finished my residency June 30, and on July 1, I got on the train to San Antonio, Texas for 6 weeks of basic training. We worked very hard, and I liked it. As part of my training at Children’s we learned how to do exchange transfusions, which in those

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days were very new. I remember when I was in basic training; they were going to do an exchange at Brooke Army Medical Center. And they had great people there. But somebody said I was from Philadelphia Children’s and would I help out. And I said, “Oh, sure.” So at 2 o’clock in the morning, they came to get me, and I helped out, and everything went well. But the interesting thing is at 2 o’clock in the morning, there was no ice on the road and it wasn’t cold. I don’t know what hit me on the head, but I said, “Boy, Florida. There’s a new medical school in Florida, and just maybe...” Well, for the first time in my life when I was in the service, I wasn’t on call every other night. I did medical officer of the day, and I was on call. I can tell you about that, but I had a chance to think about my future. And I was sent to Fort Dix in New Jersey. I had orders to Korea, and I was going on orders to FECOM, Far East Command. And Dr. Stokes found out about it and said he wanted me near Philadelphia. I would come into Children’s Hospital once a week while I was at Fort Dix, and it was a miracle. It was wonderful. We were doing polio vaccine. At the time, the Salk vaccine was in investigative issues, and we were drawing bloods and coordinating it around the country and stuff like that. “Is it going to work? Isn’t it going to work?” And the antibodies. They needed hands, you know. Then they sent me to Camp Kilmer, which is in New Jersey. During that time, I had a chance to think and pause because college and medical school and everything was ‘bing, bing, bing’ the next day. I thought I’d like to check out Florida. My parents were surprised and didn’t think I would last down there. Dr. Stokes, when I talked to him about it, said, “Oh, you’re not going to last down there because Florida medicine -- ehh.” So a pediatric practice with 2 doctors found out about me, and they invited me down there to interview. I went down there, and they said, “Well, you have a good record, and we have a busy practice, and we have a lot of hotel patients. You’ll make all the house calls in the hotels for 2 or 3 years, and eventually, we’ll introduce you to our office. We’ll introduce you to the office in 2 or 3 years. But you’ll do nothing but house calls for the first few years, and we won’t be burdened.” Well, when I heard that, I said, “Uh-uh. This is not for me.” I heard they had a new hospital [Memorial Hospital] in Hollywood. I went up there and talked to the administrator, Joseph McAloon, a fine gentleman. He said, “We could use a pediatrician, a young pediatrician in town.” There

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were 2 other pediatricians in town who were much older and hadn’t trained in the new technologies. I looked at Fort Lauderdale, and that didn’t appeal to me. Bal Harbour, which was a suburb of Miami Beach, didn’t appeal to me. I opened up an office in Hollywood. Let me see. Memorial Hospital was a wonderful hospital. There was no pediatric unit there then. It was brand-new. When it came to moving to Florida, I went to Dr. Stokes and the people -- Koop, and John Hope, the pediatric radiologist. He was a very close friend of mine after a while. And [Alfred M.] Bongiovanni, all these guys. I said, “I need some letters because I want to get hooked up in the medical school, and I’m moving down in July.” I was still at Camp Kilmer. And they said, “We won’t; sorry. No letters of recommendation.” Well, you know, needless to say, for 15 seconds, I was in shock. And they said, “Well, we don’t do that sort of thing around here. We call these people.” And of course they called, and they spoke to Bob [Robert] Lawson, who was the chairman of pediatrics at the University of Miami School of Medicine. That led to another interesting story. I took my written [board examination] in January, and you take your orals 2 years later. Dr. Stokes said, “Well, if you’re going to take your orals, and you’re going to be practice down there, and you’re going to be coming back here because you’re not going to like Florida, you ought to take your orals soon and not have to wait 2 years.” So thanks to Dr. Stokes, I took my writtens in January and my orals in April or May, 3 months later– and I didn’t have to knock myself out and study, it was a miracle. I had my uniform on and as I entered the area, they greeted me with, “Captain Edward Saltzman.” He said, “Do they call you Eddie?” I said, “Yes.” He said, “I can’t examine you.” Well, I broke out in a sweat. He said, “Joe Stokes called me about you. It’s not fair to these other people.” He said, “We’ll get somebody else to examine you.” So they got me Ralph Platou, who was chairman at New Orleans at the time, a tough guy, didn’t know me from a tree. And boy, did he put me through it. Anyway I passed my Boards, moved to Hollywood, Florida and opened an office—waiting room, 2 examining and a doctor’s office. I got hooked up with the medical school right away. And what happened was there were 2 other pediatricians in town, who were very busy, but they weren’t trained in the latest techniques. They were giving antibiotics and penicillin shots to everybody. When we trained at Philadelphia, you didn’t give antibiotics unless there was an indication and we were very religious about it. I started out, practicing this way and the mother says, “I want a shot of penicillin, and I’ll find somebody that will give it to me.” And then I

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almost would say it, but that was her choice. I lost a lot of patients. But the medical school referred me patients from Fort Lauderdale to Bal Harbour and North Miami Beach. I had lots of patients for very early in my practice. The young doctors in town would send me their families. After a while, taking care of their families, the obstetricians would come to me and say, “We can’t send you too many babies because we’ve been sending to these 2 other people, and it wouldn’t be right.” I was busy, and I didn’t know enough to say anything, yet they began sending me their children for medical care. And I still didn’t say anything. After a while, I got their newborns after they went home because the other pediatricians rarely answered their phone at night. So, of course, the practice blossomed because of the university and because it was 24/7. And 24/7 in those days, was 24/7 with house calls, and there was no beeper. There were no cell phones, but there was no beeper. So whenever you did anything, if you went to a home, you used their phone right way. And you said, “Service, are you looking for me?” And then you saw the child. When I was at Kilmer, I was medical officer of the day, and Joe [Senator Joseph R.] McCarthy was having a hearing, the McCarthy hearings, and the subject was General [Ralph W.] Zwicker, who was a wonderful general at Kilmer with a great record. They had us go there to make sure the general didn’t get ill or anything like that. And so I had to let the court know and the base know the phone number where they could reach me in case. Whenever I went to a movie, I had to let them know where I was or what the phone number was at the movie because again there were no beepers. When [President Dwight D.] Eisenhower’s son [David] would travel from Washington north to New York, if he got into my area of New Jersey and had an automobile accident, I would be on call; but I never got a call. Eisenhower’s son grew up to be a superstar, and I never met him. But that’s the way we lived in those days. And it was fine. We didn’t know any better, and it was fine. DR. ZISSMAN: Did you have a family when you were doing 24/7? DR. SALTZMAN: I had a family. I had a little boy. When I was in the service, you didn’t work 24/7; you rotated call. Only when I started practice, 24/7 was really 24/7. You also were responsible in the hospital for all patients, private and non-private pediatric patients. You rotated. If an IV came out, you had to go back and start it up again. Or you had to do the cut-

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down before surgery. The radiologists at the time, I would go look at my children’s films. They showed me an expiration film with pneumonia. I had trained with Philadelphia with John Hope, who taught us the differences in a chest x-ray with a decent inspiration and expiration. With a poor inspiration you would always see something that wasn’t necessarily true; i.e., an enlarged heart or areas that could be construed on the film as pneumonia. Once the patient took a proper inspiration, the heart would appear normal and the pneumonia infiltrates would disappear if they weren’t present to begin with. I said, “Did you get an inspiration film?” He said, “No. This was enough. There’s enough congestion.” So we got an inspiration film, and of course the pneumonia disappeared, and the enlarged heart disappeared. That was what it was like in the early days. I knew John in Philadelphia. And of course when John came down to Jackson Memorial Hospital to give a lecture, and there are 250 people in the room, he said, “How do you do, everybody?” And he looked up and said, “Where’s Eddie?” I mean, that was John. And Bongi did the same thing where he would come down to the lectures. It was really a loving family. Children’s Hospital is a Quaker institution, and boy, they lived by their principles. Wonderful place. Anyway, back into practice. I got very busy, and 24/7 meant no life. I had 2 people, one, the funeral director, and one, somebody else, with Rh-negative blood, and I had enlisted them in case I had to do an exchange transfusion. I hadn’t done any, but I just wanted to be prepared. In those days, you got fresh donors to come in and give blood. Well, we had a lady that came to see me who was Rh negative and had a stillborn, a fetal -- erythroblastotic baby that died, and she was pregnant again. She heard I was in town; somebody at the medical school told her. She asked if I would be willing to accept her as a patient. So the other pediatricians in town told Joe McAloon, the hospital administrator, that exchange transfusions were dangerous and were not indicated. Now, I hadn’t decided; I didn’t even know whether the baby was Coombs positive or not. I just wanted to have my guns loaded -- my ducks lined up. And they went to McAloon and said, “Exchange transfusions are dangerous. He shouldn’t do it. The hospital is going to be liable. It’s the county hospital.” Dah, dah, dah, dah. So McAloon said, “You can’t do it.” I said, “Mr. McAloon, would you do me a favor? The doctor in Boston is so-and-so who does exchange transfusions. If this lady is Coombs positive the bilirubin is approaching 16 or 17, because 20 was the magic number in those days. His name is Dr. [Louis K.] Diamond. I don’t

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know him, but you can talk to him. He will tell you the indications for an exchange transfusion, and these 2 guys don’t know what they’re talking about. I trained in Philadelphia, but call Dr. Diamond because I don’t know him. The lady I trained with was in Philadelphia.” But he called Dr. Diamond, and he gave him the history. And Dr. Diamond said, “Well, I don’t know anything about this young doctor. He said he trained in Philadelphia. Let me call Dr. [Neva M.] Abelson in Philadelphia at Children’s, and I’ll get back to you.” So in a couple hours, he called McAloon, and he says, “Listen.” He said, “I spoke to Dr. Abelson. Just leave this guy alone. Let him do anything he wants. These other guys are insane.” And it turned out that the lady did have Coombs positive baby, and I didn’t want to wait and wait for high bilirubin, and I did an exchange and then waited. And the bilirubin started to rise again. I did a second exchange, and the baby did fine. And that’s what practice was like early in my career. We had no Isolettes, and I went to Mr. McAloon. I said, “You know, we have preemies. We ought to have Isolettes.” Now, Isolettes were developed in Philadelphia with a doctor named [Charles] Chapple; lovely man. In 1955, after I finished my army training, I started practice. I talked to Mr. McAloon about getting Isolettes for Memorial Hospital in Hollywood, Florida, and the other pediatricians in town, never having seen an Isolette, said we don’t need them. McAloon said to me, “I’m not calling Philadelphia again. We’re getting Isolettes.” Eventually we got a small children’s ward, because in those days, we took care of everything. Meningitis, contagious diseases that required hospital care,pre and post-operative care was also my responsibility. We were very involved and we had a lot of sick kids. When a patient was diagnosed with polio, we were also responsible for all of their care. And polio, of course, until the early or middle 1960s was a terror and a fright, especially in a warm climate. Be that as it may, I was in practice about 6 months, and I said, “I’ve got to find somebody to cover me.” Solo practice and the on-call responsibility was exhausting. DR. ZISSMAN: And you haven’t even mentioned C-section attendance. DR. SALTZMAN: Oh, yes. All C-sections. The other pediatricians didn’t attend them because they weren’t trained to intubate. I told the obstetricians, if they had a C-section, I would be there. It was very difficult to leave your house at night or during office hours to stop what you were

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doing, and go to the hospital to attend the cesarean section. But you know, I was the pediatrician, and I did it. But then I realized that I needed another pediatrician in the office. The practice was getting too big. Somebody told me about this very nice young Navy pediatrician at Key West that was getting out in January of 1957. And name was Arnold [“Bud”] Tanis. Bud came up, and I met him, and I met Maxine, and we hit it off very well. He joined the practice in January 1957. He was an employee for one year and then a full partner. I didn’t know anything about anything. In fact, when I first started practice, the accountant came to me. He said, “This is what the accountant does, taxes, works with your staff, etc., etc. And it’s going to cost you $50 a month.” “$50 a month?” He said, “Pray you can pay me $2,000 a month and $3,000 a month.” And he taught me the ropes, and I learned from him. Ira Lieberman. Tough guy, but I learned from him. DR. ZISSMAN: So this is what Bud said. Bud said, “Towards the end of my first year with Eddie, he stated to me that at the end of first year, he wanted me to become a full partner.” I said, “You can’t.” He said, “Why not? It’s my practice.” I said, “No one I knew of has done anything like that.” He said, “Then it will be a first.” And it was. He said he liked me, and I liked him. We shared the same feeling about the practice, so it was done. DR. SALTZMAN: True. He was like a brother. I didn’t have second thoughts. And I didn’t want to have second thoughts when I wasn’t on call. But there was a problem with Bud. When he took a vacation or wasn’t on call or had a day off, “I hated him.” And I said to Bud, “You know, we’ve got to get a third doctor. We’re busy. We’re going to get busier. And we do good practice.” I mean, we did our own spinal taps. We went to the hospital to do the spinal taps. We brought in a third doctor, Robert Pittell, who was trained at Tufts [Medical Center] and Boston Children’s. Lovely, lovely guy. Grew up in Buffalo, went to [University of] Buffalo Medical School. Bud went to [University of] Chicago. I liked the idea because we were from different places and knew people from all over the country. That was one of our techniques when we expanded the practice. We looked for people in the early years from different parts of the country and different training areas. Let me go back. When Bob Pittell joined the practice, life was more bearable because you still had every other night to sleep when somebody was on vacation or visited their kids in camp or looked at schools or whatever.

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DR. ZISSMAN: See, this is what Bob said. Bob said, “In 1961, I completed my military service, passed pediatric board, and wished to join a pediatric practice in south Florida. I placed an ad in the Broward County Medical Journal and received a lovely response from Ed Saltzman inviting me to come to Hollywood, Florida, and meet with him and his partner, Bud Tanis. Our meeting was favorable for both sides, and I was thrilled to be invited to join their practice. Locally, we became known as the STP Group. Over the next 7 years, 2 more physicians were added, and we became Pediatric Associates. Growth continues to this time. I found Eddie and Bud to be wonderful teachers for me. Office practice in suburbia was very different from that in the Navy clinic or hospital setting. I truly learned a lot from them.” DR. SALTZMAN: Well, Bob is a dear friend and a lovely human being. But when the 3 of us got together, we still made a lot of house calls, and it was at that time we decided this is silly. If we have to make a house call at night, you make a house call at night. But on weekends, why don’t we open up the office? We had Saturday morning office. Why don’t we open the office at 5 o’clock, and if somebody wasn’t sick at one o’clock in the afternoon on Saturday, meet them at the office at five o’clock. We saw 5 or 6 children at the office in the time, and we wouldn’t get home at midnight. We would get home at 7 o’clock for dinner. That was so successful, after a month or 2, we decided to open up office on Sunday. So we had Sunday hours. We brought in a lab technician. We brought in a nurse and a front office person to answer the phone. After we finished rounds, newborn nursery, and sick children, we got to the office at 8:00 or 8:30 in those days on a Sunday. Patients started coming in at 9 o’clock. We’d be home at 12:00 or 12:30, come back to the office at 5 o’clock for an hour or 2 and rarely left the house after 9 o’clock. Once in a while we made a 10 o’clock house call, but not like what it was. And people got much better care. It was less expensive for them and they were very appreciative of the quality that we gave. None of the other doctors in town did that. Of course when an obstetrician’s kid was sick on a Sunday, they could whip right in and not wait, and they became more and more appreciative. Our practice kept growing and growing and growing. And doctors from other areas, Fort Lauderdale, brought their kids to us, and North Miami. We had a huge North Miami practice for the same reason. We made house calls in North Miami when we had to, but when we started to open up the office, it changed everything.

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Then we decided we ought to have a real laboratory in the office, and we hired only certified laboratory technicians. We wanted to have an x-ray unit in our office to do x-rays of extremities and chests only and then have a radiologist look at them as a check because we were not expert enough. But we could see a Colles’ fracture or a fractured rib or pneumonia right offhand and get treatment started, do what we had to do. We did our own spinal taps in the office. Now, one of the problems when you had a child with a stiff neck or a bulging fontanel is you sent them over to the hospital. By the time you got to the hospital and by the time they got the spinal tap tray ready, 3 or 4 hours would go by. And that was sort of unconscionable. Whereas in the office, we had our own spinal tap trays, sterile. Everything was sterile. We did the tap. We took out 3 tubes of spinal fluid. One tube was for a cell count. Other tubes were not touched but sent to the hospital with the patient for the hospital laboratory to do the cultures and chemistries. If the cell count came back positive, that child was sent immediately to hospital, put on the antibiotics at the time, which were broad spectrum. The hospital did the culture and the chemistries and another cell count and the Gram stain; everything that had to be done. The patient was treated within a half an hour because the emergency room was called, and by the time they got there, everything was ready. We felt very good about the quality of care they were getting. Every once in a while, a child would come in with a high fever, and we would have to do a blood culture. We’d do a blood culture in the office. But that was really rare. If they were sick enough to need a blood culture, they would go to the hospital. DR. ZISSMAN: Nobody else was doing that around the country. DR. SALTZMAN: Nobody, nobody. Nobody in south Florida was doing it. And it was interesting. You know, if a child that’s a 10-month-old baby with 104 fever who on exam was alert, playful and made good eye contact, with an otherwise normal physical examination was sent down the hall in the office to the laboratory, we got a white count in 30 seconds. If the count came back 6,000 we could breathe a little easier, it was probably a virus. If it was 35,000, you did a spinal tap and a blood culture; if you didn’t find anything else, and the patient invariably had something seriously wrong. Then they did the smear and everything else. But we did have a modern, well-equipped, carefully supervised laboratory. It was very nice. It was also very nice when you had this sick child, we sent the child to the laboratory. The technician would come in the room. While you’re waiting 2 or 3 minutes, you could look at somebody who had a red ear. And our creed at the time,

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and our nurses were carefully trained, is that kindness is a language everybody understands. We had a sign in the office, “Kindness is a language everybody understands.” I still have the sign in my office bedroom here, which was in my consultation room, that “Life is not a drug deficiency disease,” which I would show to patients when I didn’t want to give them an antibiotic. “Well, Dr. So-and-so always gave me a shot of penicillin, etc.” To demonstrate part of that kindness bit to the staff, a mother would call up and say, “My child has an earache or a stomachache.” We didn’t say, “We can fit you in at 4:30,” or “We can’t see you.” The nurse or the phone receptionist said, “Come right over.” We always found time for sick children as a “work-in.” During the time, if she said, “Listen. By the way, I’m having a problem with Jimmy at school.” “We’ll talk about that at another appointment; let’s reschedule it. Right now, let’s take care of this.” “Oh, thank you so much for working him in for this incident. This is more important.” And this is how we treat patients almost like customers, responding to their need. In our office, when they said “God bless you,” we took it as an occupational word. We didn’t take it as a religious expression. Doctors are not deities and that is very important for pediatricians to learn in their early life. DR. ZISSMAN: Yes. It’s so much -- so much of what you’ve just talked about is lost on all the new pediatricians now, and we’ve taken spinal kits out of our office since we’ve had the Hib vaccine. DR. SALTZMAN: Right. Different world. DR. ZISSMAN: Different world. Different world. DR. SALTZMAN: And in our day -- DR. ZISSMAN: You did it all. DR. SALTZMAN: We did it all. And we got a lot of gratitude and a lot of respect. We felt good about it, but we also felt good when the newer vaccines were available and we stopped seeing many of the major illnesses. DR. ZISSMAN: So you were still in one office? DR. SALTZMAN: Still in one office.

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DR. ZISSMAN: And it’s the 3 of you? DR. SALTZMAN: Three of us. One of the problems was that the 3 of us were very busy, and we all took a day off a week. We worked 4 days in office practice, and weekends, we rotated Saturday mornings. Two of the 3 were in on Saturday morning, and then the third one was off the entire weekend. And we rotated. We eventually added Dr. [Philip A.] Levine and Dr. [Jed J.] Jacobson. I knew them because they were both residents at Jackson Memorial Hospital, but Phil trained partly at Ohio State [University]. Jed trained up in Rochester [New York]. At that time, I was getting involved in the [American] Academy [of Pediatrics] a little bit which was starting to use up my time. I said to Bud and Bob, “We ought to add Phil Levine to the practice. He has just started a practice in Hollywood. He’s alone. And before he gets too busy, let’s bring him into our practice.” Well, Phil was not too receptive to joining the practice. He liked the idea of being in practice alone. I talked to Jed. I said, “Jed, I’d like you to join us,” and made him a very nice offer. He said, “I am very flattered and I’d like to, but I sort of committed to Phil, and that’s why he wasn’t anxious to join you.” So I went to Phil, and I said, “Phil, we’ll take both you and Jed. This is the deal.” And they were both partners very quickly and we had room for them in the office. We were in the first office at the time. The second office was a small office, but we were in the process of negotiating for a larger office, which we got. Then we had 6 consultation rooms and 3 waiting rooms and suites, and we had 4 doctors in the office with 6 consultation rooms. Everybody had their own consultation room. Phil and Jed joined us and they were both superstars. Jed’s a lovely man. Phil was a lovely man, may he rest in peace. They both developed doctor relationships and practices very quickly. And Bud and Bob said, “Are you crazy, taking 2 guys at once? What, are you nuts?” But they were the kind of easy-going partners that said, “If you really think so, do it.” Never a peep. The 2 of them joined our practice at once and they were wonderful. DR. ZISSMAN: So Jed said, “I returned to south Florida from South Vietnam in the spring of 1967. I have the unique distinction of having taken the written board examination in Saigon. I grew up in this area and was looking for a place to practice. I took a third year of residency as chief resident at Jackson, mainly to buy time and scope out the pediatric landscape. I had the good fortune of meeting Phil Levin, who was completing his second year and planning to go into practice in Hollywood a few months later. I liked Hollywood and Phil. Phil opened his

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solo practice and began to grow. In the fall, I went to visit him, and he offered to bring me aboard the following July when I was finished at Jackson. I told him I appreciated the offer and would most likely accept. At the same time, there 7 or 8 pediatricians in Hollywood: Saltzman, Tanis, and Pittell, a 2-man group and 3 or 4 solo practices. STP was clearly the top of the list. The practice was very busy, growing, academic and modern, and most importantly, was a partnership of 3 very bright and friendly guys. They made me an offer. I thought about it for a few days and told Eddie that as tempted as I was to accept it, I had implied to Phil I would join him and thought I had that obligation. Two days later, Phil called me to say that STP had offered a merger of his practice and me, and asked my opinion. It didn’t take long to make that decision. The deal was done within a few days, and while we eventually drew up papers, it might as well have been done with a handshake because we never looked back. Phil closed his office. We all moved to 2740 Hollywood Boulevard, and our 5-man group was the largest pediatric practice in south Florida at the time and continued to grow.” DR. SALTZMAN: Jed is a lovely man. Quality guy. He was the most academic of all of my partners in the beginning. When I thought I saw a child with Kawasaki disease, he was the first one I’d ask, “What do you think?” He’d say, “You know what? Rash, throat,” you know, etc., etc., etc. DR. ZISSMAN: Well, he says that, you know, “Each of the founding doctors brought something unique to the practice in terms of instinct, style, skills, personalities and ideas. Most importantly, great chemistry. All early decisions were made by consensus and unanimity. We discussed things late into the night until everybody was convinced we were making the right decision. We always didn’t -- obviously didn’t agree, but everything was on the table. Everyone’s views were valued. That experience engendered the bonds that are strong today as they were over 40-plus years ago.” DR. SALTZMAN: Nice. Yes. DR. ZISSMAN: Plus saying some nice things about you personally. DR. SALTZMAN: Oh, that’s nice. Everything was -- in those days was a mere handshake. And we took in a sixth doctor, Dr. [Robert] Schultz. DR. ZISSMAN: And Bob, I knew during my internship, and I guess he’s the only one who left your practice.

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DR. SALTZMAN: Bob Schultz preferred solo practice to group practice and though he did well with us he left after about 18 months and opened up his own practice. There was no rancor; it was a mutual decision. DR. ZISSMAN: He trained me in in Baltimore. He was the diabetes specialist. DR. SALTZMAN: Right. DR. ZISSMAN: So then you grew past Bob. DR. SALTZMAN: Yes. But he was with us for about a year, a little over a year. And then we brought in Bill [William E.] Bruno [Jr.] from Jackson. Bill’s a lovely guy. He was our sixth partner after Bob left. Let me tell you a story about Bob Schultz. Bob Schultz got a contract for $3,000 a month to start way back. That was the going contract then. He came to us 4 or 5 months later and said, “I hate to say this, but I’m having trouble making ends meet.” I said to him, “I will talk it over with the group and discuss your problem.” We had an ethic in those days with the 5 of us having solidarity in our partner relationships. If I said to Bob, “Oh, no. You need more money,” and he didn’t get it, I was the good guy and all the other guys were bad. So in any of our discussions with anybody, we never allowed that kind of ego to erupt. Nobody was a good guy. You always said, “Well, we’ll talk it over.” Not “I agree.” No commitment. Talked it over with the group. And they said, “Well, he has trouble making ends meet. That’s ridiculous. I don’t understand it.” But we raised his salary, and we changed everything around. I looked at his mortgage, and he was made whole and very grateful. He was very appreciative. There was no discussion. Even though he had a written contract. He said, “I’ll honor the contract, but I just want you to know I’m having a tough time.” Anyway, that’s just a side issue. We did what we felt was the proper thing. Then we brought in William E. Bruno, who I knew as a resident at the University of Miami. Lovely, decent person—he was now our number 6. Bill frankly told me one day while still a resident that we should bring a Gentile into the practice, a great idea and Bill was an asset from day number 1. DR. ZISSMAN: So Bill said, “There’s some Eddieisms. Sport coat or suit for bar mitzvah but no socks. I was the first Gentile in the practice, so he told me

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how to snack before the event because you don’t eat till ten o’clock. Always have a tongue blade in your lab coat pocket. That way, you can use it to get some of the cake or desserts brought to the office. Office practice is at 8:00 am, but you’d better be there by 7:45. He predicted many years ago that pediatricians would no longer take care of their hospitalized patients. His thinking about practice and how medicine was going to progress was very much in advance of his time. Treat the patient with respect and dignity. Without them, there’d be no practice for you to come to. Eddie was always someone I respected and looked up to. His patients loved him. I wanted to be the doctor he was, and therefore, my patients would respect me also. He’s definitely my mentor, and he made me the pediatrician that I am. I listened and watched him practice, asked him about practice issues, asked his advice about living as a doctor, how to juggle practice and family life. I followed his advice and lived a professional and family life that I’m proud of. I was very lucky to have Ed Saltzman as my partner, and by being with him in practice, I became the father, the doctor and husband I was then and am today. God bless him, and thanks to the AAP for recognizing what a wonderful asset he has been to them and to all families and children he treated over his years.” I was involved when you went to bat for Bill with the Academy because I’m sure you took a lot of grief for that, and I took some grief for that Academy because there were people in the Academy in Florida who said if you can’t pass it, you shouldn’t get it. But I think out of respect for you and those who knew Bill, they gave him that Academy fellowship. DR. SALTZMAN: Besides the reception area, our office consisted of 3 waiting rooms—called parks (North Park, Central Park, South Park) because they were decorated with artificial trees and Astroturf. Attached to the each park were 6 examining rooms and 2 consultation rooms. Bill was in South Park with me and we worked together. He would come to me and say, “What do you think of this? How do you handle this? How do I do this?” Etc., etc. I showed him where the bathrooms were, so to speak, in his early years. Bill was a very good doctor and patients loved him. Bill had one problem—difficulty with a written examination (necessary for Board certification), although he was very well accomplished intellectually. I asked the psychologists at the University of Miami to tell me about people that can’t take exams and they gave me an education about people who can be very bright, very skilled; they just can’t take tests. We obviously wanted Bill to have AAP membership, for office policy mandated Board certification and AAP membership. I personally ached for

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him because we wanted Bill to be a partner. We went to the AAP and explained the examination situation, and people like you, Ed Zissman, were extremely kind and understanding and we were very grateful when Bill was made a member of the AAP. DR. ZISSMAN: OK. So after Bill... DR. SALTZMAN: Well, back to the practice -- what happened was that the homes in the Emerald Hills section of Hollywood were beginning to cost $150,000, and young people could buy a new home in Pembroke Pines, which was 15 minutes away, for $40,000 and this became a growing suburb of Hollywood. You could also buy a home in Plantation, a suburb, for $40,000. Young families were moving to Plantation and Pembroke Pines, so we decided to open up satellite offices. We still had one call system, and we rotated through the satellite offices. As we added doctors, the first satellite office was Plantation, and we added Peter [J.] Shulman. Peter’s brother was an obstetrician in Plantation. DR. ZISSMAN: Good move. DR. SALTZMAN: It was a good move, but I’m just trying to think of what happened. Someone said something to the brother about coming in with a group like this and would he be mistreated. Anyway, the brother said, “Well, you know, I talked to Eddie. He seemed like a nice guy. We shook hands.” And Peter joined our practice. When they built a new hospital, Plantation General Hospital, we joined the staff and rotated through the new Plantation office until Peter came aboard. When Peter got started, he worked in our office for about a month to see the way we did things, our routines, and our charts. He took over that office, and we covered him when he was not in the office. DR. ZISSMAN: Vacations. DR. SALTZMAN: A day a week and weekends and nights. Peter lived in Hollywood but went to Plantation. That was so successful, because these were young families, and we had taken care of the doctors from Plantation. They knew us. We opened up the Pembroke office with the same philosophy. So we had those 3 offices for a long time and eventually we expanded to many, many, many more offices. Gary Lieberman came in, and then Jack

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Cohen came into the practice. Good doctors–decent people. Again, nice to patients, open at staff meetings, with no hidden agendas. When they had a personal problem, it was our personal problem. When they had a family problem, it was our problem. If they had a money problem or a bad decision, it was our problem. There was really no greed by anybody in the practice. There were a couple of us that were the big producers. When you have 8 or 9 people, you have 2 or 3 huge producers and then the middle, and then you have people that aren’t big producers, but they add other things to the practice. They add discussion. They add intellect. They add perception. It worked for us. It didn’t really hurt our incomes if they weren’t producing as much. Practice profit was shared equally among the partners. And so there was no incentive at that time. DR. ZISSMAN: Nobody was on productivity. Everybody shared. DR. SALTZMAN: At that time. DR. ZISSMAN: Back then. DR. SALTZMAN: Later on, it went to productivity. I was starting to look to retire because productivity made me very unhappy at that time. Things were changing in the practice. Productivity came in, and doctors were ordering too much lab work, for example. But we soon adjusted the rules and we did not allow lab work included in productivity data. DR. ZISSMAN: No. Not at all. DR. SALTZMAN: We quickly stopped that sort of thing. Incentive needs to be proper. DR. ZISSMAN: Well, of course that’s a critical time when you go from the group of 7. Back then, when they said everything was done on a handshake to when you get too big to operate that way. DR. SALTZMAN: Yes. But still, when we were a group of 7, I was doing the office management. I said, “Look. I can’t do this anymore. We have to hire an office manager, pay her $75 or whatever it was an hour so we could make 2, 3, 4 hundred dollars an hour.” And it worked out great. That is how we eventually hired people. We hired people to give us advice. The accountant

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came to us and said, “Look; we’ve got to change your handling of your accounts or your billing system.” And we did have a billing system. Of course people had insurance. Once in a while, we sent somebody to a collection agency, i.e., a family that made us angry, maybe once a year, that sort of thing. But we did what the accountants told us to do. We weren’t, “We know everything because we’re doctors.” We had good office managers. We learned from them, and they learned from us. The practice thrived and continued to grow and needed full time office management. Phil Levine, one of the partners, became full time office manager and Peter Schulman later succeeded Phil and today still serves in that capacity and is a superb management executive. DR. ZISSMAN: Right. So how did it work when you were doing all the management and having to see the patients and being the higher producer? DR. SALTZMAN: Because I’d come in at night or I’d come in on weekends or I’d do the lunch hour. I would work with the front office. We had one girl in the front office that was the office manager, but she was not the manager, if you know what I mean. She was the leader of the front office. I would delegate responsibilities and discussions with her. I learned one thing in my early years. The Japanese had a philosophy, a Kaizen philosophy. How can we improve? And they would develop their cars. I learned that they would tell you, “We have the best car in the world. How can we improve it?” And I would go to the staff or the staff meetings, and I would start out saying, “You guys are great. I need you. There’s no question about it. But let’s see how we can improve things. Make it better for you and better for the practice.” And that’s when I would say to them, “You’ve got to be in at 7:45 to start 8 o’clock hours, not at 5 after 8:00.” Anything was always prefaced by how great you are. The office girls quickly learned that when a patient was unhappy, they would come back to me and say, “I just want you to know that Mrs. Jones is very unhappy. She needs to talk to you about something that came up last night or on a bill or something like that.” Mrs. Jones would walk in, and I would say, “Good morning. Are you doing your hair differently?” Or, “Gee, you look well.” Whatever I said defused her, and then she would talk to me and unload. More often than not, the patients’ parents were right. But if you defuse her, you find out. If she’s angry, then you don’t find out. All you do is get hatred. And that’s another philosophy that the office quickly learned that, you know, Ed, as second nature, but we had to learn this all growing up.

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DR. ZISSMAN: Yes. I think we all learned, and I think it’s still a problem that pediatric practices are facing now with those of us who are pediatric practice managers being recognized for that talent and being compensated for it either with money or with time. And so it sounds like as long as you were at that practice, you never really got that time -- DR. SALTZMAN: In the beginning, I got time, an extra week a year. But when my Academy involvement became more demanding of my time I did my Academy work on personal vacation time and weekends. Our practice vacation time was more than adequate. We had 6 weeks a year vacation plus another thing we instituted, which I started and I insisted on. Everybody had to take a course a year. If you took that course, you got $1,000 and an extra week vacation. It had to be a course. It couldn’t be going to an Academy meeting and listening for an hour and then walking around San Francisco. You had to be at a formal CME course, somewhere in the country, and get a certificate, and you got $1,000 plus an extra week off. So we got 7 weeks off a year because everybody took the course. And that kept us up academically, we felt. DR. ZISSMAN: Did they have to report back to the rest of the group about what they learned? DR. SALTZMAN: Yes, absolutely. Eventually, they said, “Well, we took a course in antibiotics. It was this and that.” But we already knew that. It wasn’t a lecture series when they came back after a while. But they did learn and they did bring things to the office and to the practice. And it was a good thing. DR. ZISSMAN: And you listened. DR. SALTZMAN: And we listened. Yes. DR. ZISSMAN: So one of your partners said that you made the comment that we should consider third-party payers to be partners, not adversaries. How did you come to that conclusion, and did it work out well for you? DR. SALTZMAN: OK. In the very early 1970s, American Health Care Plans invited us to join their health plan. They had capitation and we knew nothing about capitation; we had never heard of it. We would be paid $8 a month per patient whether we saw them or not.

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DR. ZISSMAN: Nobody did. DR. SALTZMAN: I didn’t know anything about that kind of insurance. But I said to the group, “Why not? Why not? Let’s learn from it.” And we did learn the pros and cons of capitation but ultimately we did very well with that plan. They respected us. Other plans came in. When we had a problem with managed care, we went to them, to the medical directors, and said to them, “Look; this is how we run our office. This is what we do.” And every time, they acquiesced and realized we ran a different kind of practice. We didn’t put their patients in hospitals that didn’t have to go in a hospital. If we did a spinal tap on a child that was negative, that child was sent home, was treated symptomatically, etc. This saved them money. DR. ZISSMAN: It saved them money. DR. SALTZMAN: It saved them lots of money. And they realized it very quickly. When Medicaid came out, nobody took Medicaid. They paid us $6 an office visit, but our regular price was $9 and $10. And I said to the group, “We are a charitable office. We’re doing well. We’re all of the Jewish faith.” I didn’t want a reputation that money was the only thing that was important to us. And I felt very strongly about it. And they agreed. We had a large Medicaid practice, but 3 years later, Medicaid of Florida sent us a letter saying that they are concerned about Medicaid. They pay us $50, $60, $70,000 a year. And the closest office was a $1,000 or $800 a year, and that we must be doing something wrong. I called the guy that was head of children’s services, who I knew through Gerold Schiebler, who was my beloved friend and wonderful to me -- that’s another story. I said to him, “We’re not doing anything wrong. We see a lot of Medicaid patients because nobody else will take them. You can come in. Our books are open to you. You can come in today or tomorrow so we don’t have time to doctor them. You can work with my accountant. You can see where the bills were generated and what we did. And I give you notice that we will quit seeing Medicaid 3 months from now because I’m really offended by the suspicions of somebody.” I said, “Send somebody.” So they sent 3 people down the next week, and they spent a couple weeks in the office. And about 3 weeks later, a letter of apology. The head of Medicaid came down to renegotiate our fees, and we got increased payments. And we stayed with them. But that’s a true story. Most of the other pediatric practices just did not want to see Medicaid patients at that time. We did a spinal tap on a Medicaid patient

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and the child didn’t go in a hospital. We’d bill them $25 for the spinal tap actually saving Medicaid money. That’s my Medicaid story. DR. ZISSMAN: Yes. We were audited also. DR. SALTZMAN: Yes. But they were angry because they were paying us so much money at that time, and we worked them in. It didn’t matter. And whether they were black or orange, it didn’t matter to the practice. We had celebrities in our practice. We had movie stars in our practice because the Fountainbleau [Hotel] and the Diplomat [Hotel] had people like that, and we took care of the people that owned the Diplomat. Their kids were our patients. So when somebody got sick, they were in our office. DR. ZISSMAN: But you didn’t have a separate waiting room for Medicaid patients. You didn’t have separate hours. They were treated as patients. DR. SALTZMAN: They came in like everybody else. We were seeing chickenpox in those days, and we took care of black patients. I made house calls in what we called, in those days, “Colored Town” at night, and lovely people. And when Mrs. So-and-so would call up and say, “He’s got a fever, and he’s got a couple spots on his chest and his back -- and the funny thing. He’s itching.” I’d say, “Come on in. Let me take a look at him, but come in the back door.” And she would come in the back door. And one of the early ones said, “You know, I didn’t think you were like that. We love you, but I didn’t think you were like that.” I said, “Like what?” She said, “Making us come in the back door.” I started to laugh. I said, “He’s got chickenpox. He’s got a contagious disease. If you were a white, Anglo Saxon, I would tell you to come in the back door.” Then they understood, though I understood their sensitivity. In fact, I invited one of the guys I trained with, before my first Christmas in Florida, George Ward from Philadelphia, to come down to Florida with his family and spend a week with us. He said, “I can’t be on the street there after 5 o'clock where you live.” “What? Are you kidding me?” I said, “Of course you can be on the street.” Well, he couldn’t, and I didn’t know it. But that was in those days. Be that as it may, everybody came in the same waiting room. We always had extra examining rooms available. If somebody came in and the nurse spotted he’s got a contagious disease, she’d whip him in a room before the chart came back. Or if somebody was holding his wrist, she’d grab me out of a room and say, “This boy could have a

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fractured wrist.” I’d walk out in the waiting room or I’d walk in another empty consultation room, go get him x-rayed and go back and see the patient I was seeing. Our flow allowed us to do that and our nurses were so great. We trained them and they trained us; worked both ways. We were able to practice that way, which was all novel to a pediatric society at that time. DR. ZISSMAN: A lot of us learned from you because that’s what we did too. So you talked about capitation; you lived through many of the different payment iterations. Maybe you can reflect on some of them. You started out with fee-for-service. No third-party payers for anything. DR. SALTZMAN: Right. Then eventually we got insurance. DR. ZISSMAN: Just for hospitals and -- DR. SALTZMAN: Professional courtesy for doctors -- DR. ZISSMAN: Dentists? DR. SALTZMAN: Dentists. DR. ZISSMAN: Rabbis, pastors. DR. SALTZMAN: Right. Complete professional courtesy. And when a nurse or a doctor would bring in the insurance check from Blue Cross or Blue Shield, we would write them a check for the proceeds. We took no money. Well, eventually that all changed, and as you know, with the system today in place where insurance payments are accepted. DR. ZISSMAN: But first, we had just no insurance for anything. DR. SALTZMAN: Right. DR. ZISSMAN: Then you had insurance only for inpatient stuff. DR. SALTZMAN: Right. DR. ZISSMAN: And nobody covered outpatient . DR. SALTZMAN: Some of them did, in the beginning, a little bit.

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DR. ZISSMAN: Or vaccines or any of that kind of stuff. DR. SALTZMAN: And then eventually, it -- DR. ZISSMAN: And then everything was bundled, right? I mean, when a kid came in to see you for the one year checkup, it was one fee, right? DR. SALTZMAN: Right. DR. ZISSMAN: Covered everything. Do you remember what it was back then when you started? DR. SALTZMAN: Well, $5 was a visit. $3 was a urine; $2 was a hemoglobin. And the TB test was free. And a vision and hearing was $5. Whatever. But it was a number. DR. ZISSMAN: So you didn’t do things separately because when we first started, everything was, like, a one-year checkup and was the same. DR. SALTZMAN: Yes. We did them separate. But with the insurance companies, just everything changed. DR. ZISSMAN: Yes. DR. SALTZMAN: And as it changed, we worked with it. We took more and more insurance plans. We were more and more fee-for-service insurance plans. In my later years in practice, in 1986, on my day off, I became medical director of Prudential of South Florida. They came to me and said, “We need a medical director. We have 100,000 patients in south Florida, most of which are Eastern Air Lines., but we don’t know what we’re doing with the doctors, and we need somebody. You have a big reputation and the medical school said, ‘Go see Eddie.’ If you’ll work with us, maybe you can do a half a day a week. We’re starting out, and we’ll see.” I did a half a day a week in order to learn that side of the medical reimbursement system. I took cell phone with me when I went away or when I was at home on weekends. They could call me in the office during the week. After I was there a month, I said, “I need a specialist as an advisor in every specialty because if an adult has a patient with chest pain, I can’t judge how he’s

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treating him. I need somebody to call on the telephone and say does this make sense? And this person ought to be compensated.” I had a whole list of people, mostly they were my buddies from Hollywood or Fort Lauderdale, but I did call up. I would say, “Listen. I’ve got this doctor in south Miami who did this and this and this.” “That’s ridiculous.” I mean, they would do a pelvic, and they would charge for inserting the speculum and then for this or that. They would -- DR. ZISSMAN: Pad the bill. DR. SALTZMAN: -- pad the bill. And Prudential very quickly said, “This doesn’t make sense.” I would call the doctor and say, “You can’t do that,” etc., etc., etc. But I learned a lot about managed care working with Prudential for 4 years. DR. ZISSMAN: Without telling me the number, did they pay you reasonably? DR. SALTZMAN: They paid me $35,000 a year for that Friday morning. DR. ZISSMAN: That was reasonable back then. You saved them much more than that. DR. SALTZMAN: After a year or a year and a half, they came to me and said, “You know, we’re having a problem with your compensation. You’re not getting enough.” And I think they gave me $50,000 or $55,000 a year, which was mine to keep because I was doing it on my day off, and my partners understood it. And I got permission from the partners before I accepted the job. DR. ZISSMAN: Sure. DR. SALTZMAN: You don’t do anything hidden. In 1971, we moved into new offices. The big realtor called Hollywood Inc. in the suburb of Emerald Hills had a big square block, and they were going to open it up to businesses. I had been somewhere where they had medical offices with central parking and I went to the owner of Hollywood, Inc., and I said, “Why don’t you make it a medical square with offices on the perimeter and central parking available to all of the offices.” And that’s how Emerald Hills Medical Square started. We bought a parcel of the land and built the building.

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DR. ZISSMAN: You bought it yourself? DR. SALTZMAN: I bought the land myself. We built our office on that land. Later when the medical square was almost completely sold out I was offered another parcel of land and after consulting with the partners I bought the last parcel available. DR. ZISSMAN: Smart. DR. SALTZMAN: A Hollywood dentist did the same thing and we combined the property—to be used as rental property over the years. DR. ZISSMAN: You get income. DR. SALTZMAN: Decent income. Now, there’s the SurgiCenter for Memorial Hospital on that property. DR. ZISSMAN: So you started with capitation. How did you make it work with part capitation and part fee-for-service? DR. SALTZMAN: Fee-for-service was fee-for-service. The capitation was only for the people that had capitation. DR. ZISSMAN: But it’s -- DR. SALTZMAN: Your first years of practice, you did newborn care for a $100 a year. You saw them once a month, and you gave them all their shots and their yearly exam for $100 a year. That lasted about 6 or 7 years. And eventually with the more shots and polio vaccine and everything else, it couldn’t be done. So we went to straight fee-for-service. But fee-for-service patients were fee-for-service, and -- DR. ZISSMAN: But for some practices, it’s difficult because the capitation patients cost you money when they come in. The fee-for-service patients make you money when they come in. So there might be a differential on how you answer the phone. DR. SALTZMAN: No differential. Absolutely no differential. We never answered the phone. We hired people, which was also unusual at that time. We trained the staff to communicate with patients and respond to their

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needs. Most of the time we did not need to return the call, which saved us valuable time, but the nurses would say, “Would you feel better if you spoke to your doctor?” If the answer was yes, we returned those calls personally. Capitation patients, we also worked in. We didn’t lose money on capitation. We never felt that we lost money on capitation. We got paid separately for appropriate lab work. DR. ZISSMAN: You carved something out. DR. SALTZMAN: Yes. We didn’t see them that often. If somebody had an earache, we had them come back in 2 weeks. They didn’t need to come back 5 days in a row for injections of penicillin. We were different at that time. Oral medication was the treatment of choice. We had a lot of patients that left us because they went back to the other doctor so they’d get their shot of penicillin every day. Once I made a house call, on another pediatrician’s patient (he was out of town and I was covering for him). And it was a 9- or 10-month-old baby with a 104 fever, alert, playful, good eye contact. Had a fever for two days. Eating. No vomiting. So I said to myself, Well, I think this is roseola. I said that to myself. I said to the parent, “I think it’s a virus. I want you to give him aspirin” -- in those days, it was aspirin -- “and lukewarm tub bath, and I want you to call me back at 5 o’clock tonight, let me know what’s happening. And if need be, I’ll see him tomorrow.” So the next day, her doctor came back into the town and was called to see the patient because the child still had a fever. The mother said, “I wanted Dr Saltzman to give him medicine but he wouldn’t do it. That is why I’ve asked you to see my child today again.” When the doctor visited, he noticed that the child had a swelling in the jaw, parotid swelling. So he called me, and though he wasn’t that friendly, he did ask me to come over and see the child with him. So I came over to the house and I said, “Mumps.” And he said to her, “Do you see why he said it was a virus yesterday and didn’t give him penicillin and why he did you a favor?” I was stunned by the other pediatrician’s support, but appreciative. DR. ZISSMAN: Nice mensch guy. DR. SALTZMAN: Yes. It was nice. Even though at the beginning, exchange transfusions were this issue. Very nice DR. ZISSMAN: So getting back to the different payment schedules and things, do you have any comments about the SCHIP [State Children’s Health

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Insurance Program] program? How about HMOs [Health Maintenance Organization] in general? DR. SALTZMAN: I think HMOs changed the practice of medicine for the better. I think they made doctors more conscious of how they acted and there was more quality care. I think that they had a third party looking at what they did, and they weren’t Godlike because there was somebody else in the equation. Doctors paid more attention to availability, coverage, following protocols, appropriate consultations, etc. When I started practice, doctors weren’t always responsible when on call; they didn’t answer the phone at night. I remember when I was in practice maybe 6 months and seeing a child on a private floor who had pneumonia or something. And the nurse came and said would I do her a favor. There’s an adult patient with diabetes in the next room. “Aren’t these blood sugars a little high?” This was on a Sunday, and the patient was in since Wednesday. The doctor hadn’t been in since Wednesday to see her. Well, that wouldn’t happen with a malpractice specter over people. Doctors are much more careful. I had no problem with that. DR. ZISSMAN: How about PPOs [Preferred Provider Organization] or IPAs [Independent Practice Association]? DR. SALTZMAN: Same thing. If that’s what the patient chooses, we would try to get patients to do PPOs because we felt that the HMOs didn’t give them choice of doctor and choice of hospital. And in my early years, before the PPOs and the managed care, I would send people to Koop in Philadelphia. You have to understand that the northerners thought, and still do, that Florida has below average medicine, as you know. Now, one of the things about Florida medicine after the 1950s was you didn’t get on any hospital staff unless you had proper credentials. The rules were strict because they were all the hospitals were new and needed to establish credibility immediately. And the standard of care was superb, but the northerners didn’t know that. So when I, in my early years, saw a child with distended abdomen and their Miami Beach pediatrician kept wanting to give him enemas, and they came up to see me because somebody at the medical school said they needed another opinion. I sent them to the only radiologist in our town, in private practice, who had trained at Columbia and knew how to do a barium enema for Hirschsprung’s [disease] with a narrow segment, and didn’t race it through and say he’s just constipated. I told him this patient needed an operation, and because we had no pediatric surgeon in

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south Florida, I referred the family to Boston or Philadelphia. They could see Dr. [Orvar] Swenson in Boston, who I didn’t know, or Dr. Koop at Philadelphia, who I did know. They went back to their Miami Beach pediatrician, and they said, “He’s crazy. Just needs laxatives.” And the child was not gaining weight and was very sick. Not sick-sick, but sick. And I said to them, “I’ll tell you what I’ll do. You work for the post office. You have good insurance. I’ll pay your airplane fare,” which to Philadelphia was $60. “You will see Dr. Koop, who I know personally. Or, if you prefer, I’ll pay your fare to Boston to see Dr. Swenson.” They went to see Koop, and he pointed out to them what they needed, and he performed surgery. And then Koop called me back and said, “Should I charge them? What are they?” That’s the kind of person Koop was. He accepted no fee when appropriate. I sent other people to Koop or to Gene [Eugene B.] Spitz, neurosurgeon. We didn’t have a pediatric neurosurgeon at Jackson in those days. They would call me and I would say to them, “This guy owns the world. Send him any kind of bill you want.” They would see anybody for me because we didn’t have subspecialists at University of Miami at the time. Once we got the subspecialists, no problem. I sent them all to the University. When discussing managed care, I would say to the patient, “You’re better off with a PPO because you have a choice of doctors or hospitals if you have to leave the area.” DR. ZISSMAN: Did you guys ever have to join an IPA or you were big enough that you didn’t need to join with the other pediatricians? DR. SALTZMAN: We never joined in my day. I don’t know about the present time; Peter could answer you, but we didn’t join at that time. DR. ZISSMAN: OK. And any comment about this new ACA [Affordable Care Act] business? DR. SALTZMAN: When Medicare came in in the early 1960s, my parents were in their late 60s. They thought it was a wonderful thing. I looked at my parents, who could afford care, had insurance. It wasn’t a problem. But what a wonderful thing Medicare was. We were told by organized medicine that Medicare would be the ruination of medicine. Hospitals would be closing; doctors would quit the practice in great numbers. People would not want to attend medical school. The Broward County Medical Association assessed each doctor in a practice $100 to fight Medicare.

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DR. ZISSMAN: To fight Medicare. DR. SALTZMAN: This was in the 1960s. There were 3 of us at that time. So I called the head of the Broward County Medical Association. You had to be in the BCMA in order to have hospital privileges in Broward County. But I said to them, “I’ll donate the $300 to any charity, any religion, your religion, anything that makes you happy, but I will not be a part of fighting Medicare because I believe in it.” And he said to me, “I’ll talk it over with the board.” The board 3 weeks later said, “You have to pay the $300. That’s the way it is for everybody. Take it or leave it. A hundred dollars a doctor or you’re not going to be in the BCMA.” So I paid it. I see nothing wrong with the ACA. Some preexisting clauses were in with Clinton, but not for everyone. DR. ZISSMAN: Yes. I think this Affordable Care Act, I think, the issue is we couldn’t get a public option and pharmaceutical industry was not supportive. DR. SALTZMAN: Yes. DR. ZISSMAN: There’s the 2 pieces that need to come into the Affordable Care Act next, I think. DR. SALTZMAN: I think that’s got to work out. But I think it’s constructive. The other thing is that the opponents to this have no alternative. They haven’t come up with any plan. See, now if they could come up with a plan, I would look at that and compare. DR. ZISSMAN: OK. So we’re getting started again with Ed Saltzman. This is still Saturday, June 8, and we’ve just taken a little pause, and we’re starting up again. DR. SALTZMAN: One of the things I didn’t tell you about my partners, I was very fortunate with partners. We didn’t have anybody that had a social problem, a personality problem. We all had different personalities, but nothing that would embarrass anybody. We had guys that were very charitable, involved in philanthropic organizations, and they felt that that was important. They felt that [Jewish] Federation was as important as the Academy was to me. Not that I wasn’t for Federation. But they felt, and I agreed, that time spent coaching little league was important. They were all

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good and decent people. There was no partner that was an alcoholic. There was no partner that was a womanizer. There was no partner that did anything that ever made me for a particle of a second worry about dishonesty. Even when I was solo, we would make house calls and many times receive cash, and at the end of the day I would have $200 or $300 in my pocket. I would bring it back the next day and give it to the business front office. I did want to keep out of jail, you know. I didn’t want to be blackmailed. There was never that kind of a problem. And I was very fortunate so that I had peace of mind when it came to the practice. DR. ZISSMAN: I think you have to give yourself credit for picking the right partners too. DR. SALTZMAN: I was lucky. DR. ZISSMAN: A lot of good choices are luck. Maybe not so much luck. DR. SALTZMAN: When I retired, just as an aside, Chick Koop called me. He said, “I hear you’re retired.” I said, “Yes.” He said, “How would you like Washington, DC—6 months a year?” Because Chick knew me from meetings and conferences and from growing up and stuff like that with him in pediatrics. I preferred to remain in south Florida but I was very appreciative of his kindness, thoughtfulness, and friendship. DR. ZISSMAN: Sure. DR. SALTZMAN: That’s the kind of people these people were. DR. ZISSMAN: Have you seen the book about him? DR. SALTZMAN: Yes. DR. ZISSMAN: I have a copy of it. DR. SALTZMAN: When Bongi [Bongiovanni] was offered the chairmanship at the University of Florida, he called me and said, “I’ve been offered a job at the University of Florida, but I want to talk to you about it.” So I said, “Well, come on down here and spend a few days in the sun, and we’ll talk.”

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So he came down and spent 3 or 4 days with me and then drove up to Gainesville. And I told the people in Gainesville that he’s a sensational, wonderful person. So Bongi called me from Philadelphia later. He says, “You know, I always wanted to be chairman at Philadelphia. That’s my dream.” He said, “And I don’t think an Italian Catholic in these days is going to do well in Gainesville.” So he turned down the job. And a couple years later, he got the job at Children’s in Philadelphia. DR. ZISSMAN: When you’re talking about Philadelphia and your years there, one of the things I did to prepare for today was read Lew [Lewis A.] Barness’ oral history. You can go online at the Academy and read it because he talks about those same years of PGH and Children’s. DR. SALTZMAN: Lew Barness was one of my mentors, and Lew was in Tampa. DR. ZISSMAN: Right. DR. SALTZMAN: I would go over there. When I would be invited to the University of South Florida School of Medicine to lecture, and he was in a different area, he would always make sure to call me, and say, “Let’s have dinner when you’re finished talking.” I said, “I can’t. I have a scheduled dinner with my hosts.” He said, “Well, then I’m coming to you.” And if I were still talking till 5 o’clock, he’d show up at 4:30 and be there till 5:00. So we were very good friends. Outstanding, outstanding human being. DR. ZISSMAN: Yes. I did some of my training at Philadelphia General Hospital with Sumner Ziegra, my pediatric teacher from Hahnemann there at the Philadelphia General. Later I spent 6 or 8 weeks with Dr. Koop as a student. DR. SALTZMAN: Wasn’t he a joy? DR. ZISSMAN: He was wonderful. DR. ZISSMAN: I didn’t know that person. One day after observing Dr Koop repairing a hernia, he asked me to write the orders, and I said, “Dr. Koop, I’m just a medical student. I don’t know what you’re talking about.” I said, “What are you supposed to write?” He said, “Feed when awake.” DR. SALTZMAN: And one other thing --

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DR. ZISSMAN: Sure. DR. SALTZMAN: I used to play tennis. I was very involved with tennis. DR. ZISSMAN: I remember. DR. SALTZMAN: Linesmen at tournaments and television. I loved to play tennis; lived it. I would always get tennis balls and tennis rackets as gifts. Why? Because the father would come in to see me. This is pre-Roe v. Wade. And he would say, “My daughter is pregnant. She’s a month pregnant, 2 months pregnant, and I don’t know what to do about it. And her life is ruined. Nobody does abortions. Do you know a doctor that would do an abortion?” I didn’t know whether these people had a wire on or not because you would go to jail as a doctor in those days if you said, “Oh, well, Dr. Smith down the street is a good doctor, and he’ll do it for you on the side.” I said, “I don’t know anybody that does abortions.” This was my standard line. “But if you stay at the Hilton in San Juan, Puerto Rico, or you” -- I forget the hotel in Mexico City. “Ask the concierge the best restaurant in town and talk to him.” They would be referred to the gynecologist at the medical school and come back 3 days or 4 days later with much gratitude and even gifts. That’s the kind of thing you did. I learned to empathize in those days. DR. ZISSMAN: Now you can get thrown in jail as a pediatrician if you ask if they had a gun. DR. SALTZMAN: If we just asked a patient, “Do you have a gun in your home?” to emphasize the concern if your child plays in a house that has a firearm (not locked away) and that signifies a tragic accident waiting to happen. Just last month there were 2 fatalities in the United States with young children in that scenario. Our governor wants to charge the physician with a felony for just making that inquiry. Is that not bizarre? DR. ZISSMAN: It’s bizarre. It’s bizarre. So you know, I want to get back to the clinical stuff, but let’s talk a little bit about your AAP [American Academy of Pediatrics] involvement. I understand you started off by chairing the Committee on Practice and Ambulatory Medicine, COPAM. Was that your first AAP involvement?

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DR. SALTZMAN: I would go to the Academy meetings because you were taught you had to keep up. And I didn’t want to embarrass myself in front of the residents at Jackson. I’d go to Jackson a day a week. Well, that was my Fridays until I became medical director at Pru [Prudential]. So I’d go to the meetings, and I’d meet all these different people. And somehow, Gerry Schiebler came down. Somebody told him about our office and he came down and wanted to see our office. I showed him the office. We had 5 of us at the time. This is in the late 1960s. I showed him the way we practiced and the charts and the phone, the whole bit. And he said, “Would you come up to Gainesville and talk to residents about it?” He said, “We’ll pay your transportation and all that.” I said, “Well, I have to think about it.” He said, “And I would like you to give a talk at one of the Academy meetings, to pediatricians.” So I went to the Academy meeting first and talked about pediatricians who are unhappy, and the reason that they’re unhappy is they don’t sleep at night, and it’s their fault. They don’t make enough money, and it’s their fault. They don’t have to cheat to make money. I had an audience of about 150 pediatricians. This was the first talk in the early 1970s and it evolved because of Bob [Robert] Grayson, who was a pediatrician in Bal Harbour, extremely supportive, a solo practitioner. He knew what I was talking about and he was very active in the Academy. I wasn’t. Eventually it went into talks about starting in pediatric practice twice a year, where I’d bring other people and we would talk about different things important for starting a pediatric practice. And that’s been a tradition for all these years. DR. ZISSMAN: All right. So here’s a letter from Bob Grayson to me, dated December 24 of 1971, saying, “Sorry we didn’t invite you. For some reason you didn’t get on the list.” And it talks about Eddie Saltzman, and it gives me the Committee on Practice and Ambulatory Medicine. It’s from 1977, Bob Grayson. And this is where the letter from Tom Robb came with a set of your slides and -- DR. SALTZMAN: Well, that’s how the committee started. Provisional committee, then a committee, then a section with [Charles “Buzzy”] Vanchiere. Vanchiere came to me. He said, “We ought to have a section on practice.” I said, “Don’t you think the committee does enough?” He said, “Well, you could reach more people that way, and you could have more power.” He was so right. And Buzzy used to go to my talks. He would invite me down later to Baton Rouge; I got to be very friendly with Buzzy. And we started the Section on Administration and Practice Management.

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DR. ZISSMAN: But when did you decide that you were smart enough and expert enough that you could teach others? How did that come to you? DR. SALTZMAN: I’ll tell you. It came to me because we were very successful, and I would go down to Jackson Memorial Hospital every week, and all I heard were the pediatricians were unhappy and bitching. And they didn’t have time for this, and they didn’t have time for that. And I had another partner. Then I had 2 partners, and I had 3 partners. Five partners. When we asked a resident to join our practice, they received more money and perks than many of the established pediatricians in practice. Another aside, when I was in practice for 6 months, a nurse came to me. “Could you lend me $300?” I said, “Of course. What’s the problem?” She said, “I need my uterus out, and I don’t have insurance, and the hospital is $20 a day. And the doctor charges $150 for the operation, and I have to pay in advance. So that’s why I need the money. And eventually I’ll pay the hospital and everything like that.” So I went to my accountant. I said, “Let me ask you a question. Nobody in my office has insurance. It’s terrible.” So he checked out Blue Cross/Blue Shield. It was $60 a person. I decided to make hospital insurance available to all of the office staff, not just the partners. I really did it for me, for I realized that I would be responsible for my staff, i.e., paying their hospital bills when necessary. They were part of the family. This way they were protected and I was protected. We were the first ones in our town to do this. Later, when I spoke to pediatricians about why they were unhappy and what can be done about it, the premise was that pediatricians must be able to accommodate people; work in sick patients immediately, be available 24/7, have extended hours, add physicians to practice when necessary for coverage, etc. Most of which pediatricians knew nothing about at that time. DR. ZISSMAN: Simple to you. DR. SALTZMAN: Right, right. And then when Gerry Schiebler got me into teaching nationally and other people started asking me for guidance in starting a practice and preparing residents for an interview—dress, questions to ask that are appropriate, where to obtain further information about the prospective practice (i.e., further information about hospital administrative personnel, pharmacists, key physicians in the town, etc.) I would describe my first Florida interview and told them that the doctors told

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me that I would only make hotel calls. Maybe in a few years I’d be good enough to walk into the practice. I was stunned and certainly not interested. Now, 3 months after I opened my own office in Hollywood, FL, the Miami Beach doctor had a coronary and his partner came to Hollywood 2 months later and said, “I’ll buy out your office. I’ll start you out at $25,000 a year.” (My first offer making hotel calls was $10,000.) This is 3 months later. I said, “I’m not interested.” I was using this example to explain to the residents how life is a big circle. What goes around comes around. In my early AAP experience, Bob Grayson was very much involved in bringing people together with practice management issues. We had different people from all over the country. Tom Robb was the Academy coordinator. He was the Jose Lopez at that time. DR. ZISSMAN: So you became a practice guru by doing it, but how did you have the audacity or chutzpah to decide you’re going to carry the whole Academy of Pediatrics on your shoulders and bring them into the -- DR. SALTZMAN: What happened was people would say, “You’re crazy.” They’d say, “We’re only interested in treating meningitis. We’re not interested in money. I don’t mind working every night.” And I’d get angry and I’d say, “But your wife minds it.” “Well, that’s her problem.” But I really felt that they were very unhappy and didn’t want to express their true feelings. Many of them would come back to me privately and say, “You know what? Can we come down and visit you?” We had more people that came down from those talks. I would get all kinds of Christmas gifts. Bottles of wine. People I didn’t even know. They would say, “We did this, and it’s changed my life,” or it’s done this. People fought, fought everything. I remember going to Hilton Head one year as part of an AAP 3 day CME course. I explained that I was the last one on the program on Saturday, but if they would be patient and stick around for the third day and my Saturday talk“I guarantee you I will pay for your trip to Hilton Head and your tuition and your Christmas gift to your wife.” So Saturday comes. And this is a time when bank interest rates were 12 to 14%. Sure enough, almost at the end of the meeting, someone said, “Hey, you’re going to pay for my trip.” “Yes.” Another hand went up. I said, “Oh, yes. Now I’m going to pay for your trip.” Doctors generally paid their bills immediately upon receipt and they needed to change that habit and learn how to bank all of their office income daily, accruing the high interest income and leaving the money in the bank as long as possible. That was foreign to them. We suggested that you

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pay your staff twice a month and all other bills once a month on a specific day. The cash accrued really would generate good income. They learned this and were very appreciative. DR. ZISSMAN: Yes. When I got involved with the CPT trainers, we weren’t allowed to talk about money. We only could talk about codes. We were very, very unhappy about that until we brought the Academy further along. What challenges did you face in bringing your message to the Academy and other people? DR. SALTZMAN: Well, again, they felt that I really had no right to talk about it. I felt that I did. I said, “I know pediatricians are unhappy.” I said, “How many people in this room are making $50,000 a year?” Not a lot of hands went up. And I said, “We’re making $90,000 a year. And I have appropriate time off and family time.” Then when I talked about going to the hospital, I said, “Look. I do my spinal taps in the office when possible instead of wasting time traveling to an emergency room and waiting to be accommodated.” And we also were paid appropriately for this procedure. At that time we were paid $100 to do the tap in the office, plus the office visit, by the insurance companies. I said, “And it certainly benefits the patient when they are not wasting valuable time.” I never was interested in being chapter chairman for Florida, even though Gerry Schiebler kept saying to me, “You’re going to be chapter chairman.” I said, “I’m not interested because I’m talking about practice techniques that are controversial, and people are constantly fighting with me. ” I was alternate chapter chairman and I did get into the gig about recertification. One day at a chapter chairman’s meeting of the district, I said, “Look. We’ve got to recertify voluntarily.” It was voluntary at the time. I said, “Airplane pilots certify. We have to add credibility to our patients, and managed care is coming in in a big way. Businesses need to monitor their expense carefully and medical care is one of their major problems. Eventually insurance companies will deal with only board certified pediatricians or re-certified pediatricians. Eventually the business world will validate pediatricians’ medical practices and billing practices only with these credentials when they put their panels together. Believe me it is going to happen.” Everybody promised to recertify, every chapter chairman and alternate. I took the first exams for recertification and I recertified. When I came back to the next chapter chairman’s meeting and found out

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that of the 14 of us or 16 of us, whoever were in the room, only one other person recertified. This made me very unhappy and disappointed and pretty much ended my interest in being a chapter chairman. I was so hurt by that, what I thought was a real rebuke. I remember saying to my wife, “They are wrong. Eventually they are going to have to recertify and they don’t know it.” Later on, the American Board [of Pediatrics] invited me to speak to them about recertification, how best to do it for a practitioner and so on. And I said, “Well, you have to make it success-oriented and the exam has to be fair enough. You can’t ask them for the formula for cholesterol. Jim [James A.] Stockman III, said, “How about a system where if we ask a question and 75% get it wrong, we throw it out.” I said, “That’s more than fair and would get pediatricians’ attention.” So I would go and talk to these people about recertification. I’d say, “Let me tell you something. When they do the test, they’re going to eliminate questions that answered incorrectly by a huge majority, deeming them unfair.” And when they heard it from me, they thought I was the genie even though it wasn’t my idea. Whenever I would go around the country, if I went to Orlando or anywhere, I would meet all those guys smarter than me. You learn from them, and you bring back stuff. Dan [Daniel W.] Shea, a member of the Committee on Practice Management, was one of my closest friends, and helped coordinate the writing of the first manual, Management of Pediatric Practice, which we have. Now we have 2 editions. Lenny [Leonard A.] Kutnik was the editor of the second one. Before the first manual got off the ground, Bob Grayson came to me and said, “The Board [of Directors] can’t raise money for your manual.” He said, “That’s a problem because you really have to write the manual.” So I went to Wyeth [Pharmaceuticals] at the meeting, and I talked to Bill Flanagan. Bill Flanagan got on the phone to Philadelphia, and an hour later, he came to me. He says, “You have $400,000.” The Academy got a grant of $400,000, but Wyeth must be able to hand it personally to the pediatrician in his office. They can mail it to people who aren’t in practice. Bob Grayson went back to the afternoon session and said, “We have the funding.” That’s how the first manual got off the ground. It was successful and the second manual came along. They were well received. DR. ZISSMAN: So you started SOAPM. You started the professional section, this, that and the other. Here are lists of people, and I have no idea some of the role they played. So maybe you can tell me or pass.

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DR. SALTZMAN: At the top of the list is Bob Grayson, where I have this note in 1971. I guess the note was trying to see what I would do in the state chapter. Maybe it was 1977. It’s hard to read his writing. Eternal gratitude to Bob Grayson. Very supportive; very understanding. When I would come to a river, he would open the river for me so I could walk across it. That’s the best way to say it because he was high up in the Academy board. He was very well-respected. Super doctor, lovely guy, lovely family. DR. ZISSMAN: So he opened the doors for you? DR. SALTZMAN: He opened a lot of doors for me. He would tell these people who didn’t know who I was that I was credible, that I was honest. We were a quality practice, did not pad bills, or do unnecessary procedures, etc. We just had a much lower hospitalization rate for a doctor than the other doctors in our town because we treated at home. DR. ZISSMAN: And that was a question of how you could explain that to the other insurance companies and stuff that you were actually saving them money. DR. SALTZMAN: And when we had a problem with insurance companies that weren’t fair to us, we would go to them, and they would look over some things and agree, and we’d get better money. The only stipulation was we couldn’t tell anybody. But we got very well paid by the insurance -- not well paid, but it was more than fair. DR. ZISSMAN: And I think there were other pediatricians here in south Florida that were very jealous of that because you were the big gorilla who could. DR. SALTZMAN: We never badmouthed another pediatrician. DR. ZISSMAN: Absolutely. DR. SALTZMAN: We always tried to help the other local pediatricians. For example, we always had lots of vaccines on hand, buying them directly from the manufacturer. We even had special thermometers in our refrigerators long before it was the usual practice. The kind of thermometers that were 24 hour thermometers. In the early days, when there was a hurricane, we took our vaccine supply to Memorial Hospital and put them in their big generated-protected refrigerators. Many a time, the other doctors in town ran out of vaccine, and we would give them ours until they could replace it,

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but we didn’t have any problem with it. We were happy to help them out when they had a problem. DR. ZISSMAN: Now Buzzy Vanchiere. DR. SALTZMAN: What can I say? Buzzy was a good doctor, an excellent doctor -- I don’t mean good rhetorically. He practiced in Baton Rouge with a group. He was always at the ‘starting in practice’ talks and the ‘entering practice’ presentations and my CME programs at the Academy. DR. ZISSMAN: You were doing them all. DR. SALTZMAN: Yes. He came to me and said, “You know, you’ve got to change the Committee to a Section. The Section would add more doctors because the Committee has only certain doctors, whereas a Section could take 300, 500, and they could all be a part of a meeting and discussion.” I said, “You know, Buzzy, I never thought of that.” And again, what I said to you, I always learned from people. DR. ZISSMAN: Because you’re modest enough to listen. DR. SALTZMAN: But they were smarter than I am or as smart. And Buzzy said this to me and he was right. I said, “You know what? You’re right. Let’s try to have a section.” And we worked on it, and we had a section. DR. ZISSMAN: This is one of Buzzy’s things. Buzzy was always big with these charts. This was his medical encounter, what happens in the doctor’s office. Buzzy’s family was at the luncheon last year and we handed that out because unfortunately, you know, SOAPM is over 1,000 members now. What you started is over 1,000 members now. And people don’t know who Eddie Saltzman is. They don’t know who Buzzy Vanchiere is. So that was one of the things that really worked. We put this on every table so everybody could see what what Buzzy did. And there was another one he had, which talked about how you get paid and how you go to this company and that; just one of his charts had a million boxes on it. His family was there and so that was really very nice. DR. SALTZMAN: One of the nice things was when Buzzy invited me to Baton Rouge, I didn’t realize there was a medical school in Baton Rouge. I said, “Well, you know, how about the New Orleans pediatricians?” He said, “They’re going to come to Baton Rouge.” I said, “No, no, no, no. Really.”

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He said, “They’ll come. Wait.” And the whole stack of them came to Baton Rouge. Buzzy was well-respected. DR. ZISSMAN: I think he got a lot of your credit because we lost him so early. You were still doing it, and he was gone. DR. SALTZMAN: Good for him. God love him. DR. ZISSMAN: A. D. Jacobson. DR. SALTZMAN: A. D. came to me in San Francisco in 1978. DR. ZISSMAN: He says 1974, but you’re close. DR. SALTZMAN: And he said to me, “I’m an accountant, turned medical school student, turned pediatrician. I love what you’re saying. I can’t thank you enough. Can we keep in touch? Can I visit your practice?” We got to know each other and eventually became very good friends. He invited me down there to Phoenix a few times. DR. ZISSMAN: He said that you asked him to be involved and how much he respected you. And he said that he thought it was the fall of 1992 or 1991, that he got a call from Eddie. He’d like me to join him at the annual meeting in San Francisco, to set up the Provisional Section. He thinks there were 7 or 8 people there. Don [Donald P.] Barich, Anne Francis, Mark Reuben, Buzzy Vanchiere. He doesn’t list the others, though I have them listed in other places. A.D. has good things to say about you, and he became the Section chair after you, right? DR. SALTZMAN: Oh, yes. And a very decent, lovely man. I had patients that I would refer to him and they loved him and loved his practice. When my best friend moved to Scottsdale, a suburb of Phoenix, A.D. cared for his family professionally and personally. His wife, Donna, is also a wonderful person. I had another close friend, James Frey, at the Barrow [Neurological Institute]. Incidentally, James Frey was also very friendly with A.D. DR. ZISSMAN: Don Barich?

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DR. SALTZMAN: Don was in Cleveland, in practice, and I brought him into the Section Executive Board. A lovely, bright guy, very direct and a real asset. Don and I frequently would go together to different medical schools and training programs around the country giving an “entering practice” talk. Don was always on the twice a year AAP “entering practice” panel as a featured speaker. We would go to talk to the residents; it would be a residents’ day with us. For example, we would go to Georgia, and they would collect residents from all over the state and bring them to the one school. This happened many times, in different states. One time, I think it was in Georgia, the department chairman said, “I can’t have dinner with you guys tonight.” It was just Don and I. “But I have a reservation for you at my private dinner club. It’s the best food in the area, and you’ll love the experience.” He said. “You need a jacket and a tie.” I said, “No problem.” I went to Don, and he said, “Shit. I don’t have a jacket.” He said, “I don’t have a tie. We don’t wear ties to come talk to residents. You don’t need that.” I said, “Don. Let me tell you something. You never travel without a jacket or a tie. You never know.” And we found a jacket for him and a tie, and we went, but since then, he’s always had a jacket and a tie. He’s a very good speaker and very direct. Many times, he would disagree with me, and he would say something at a presentation. For example, he would say, “Now, I know Eddie disagrees.” And I would get up and say, “Yes. I do disagree, and let me tell you why. But it’s OK because sometimes there’s more than one way of doing something in practice. If you learn only one thing from us today, it’s that whatever you do, you think about it, and you weigh it. And if it doesn’t work, you try it another way. But think about what you do. And here’s a classic example of where we’re disagreeing and do things completely differently, but they are both correct. It’s not just my way.” Don is an outstanding teacher as well as a super pediatrician. DR. ZISSMAN: Yes. He said he started his practice management as a member of COPAM and then Dan Shea -- you and Dan began working together in 1981. You were looking for somebody who knew about technology, and you got him because he could even learn to type, he said. It was 25 years ago. He talks about this is in his [Charles “Buzzy”] Vanchiere Award acceptance speech. “By then, Eddie and I had been talking to residents and some other young pediatricians about some of the issues they face, but there needed to be some way to connect with the larger membership. Being close friends, I’d been in the military, so I

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should have learned there never volunteer. I left that meeting as program chair of the then Provisional Section that functioned” -- and he continued in that role as the program chair until Mark Reuben took over. Actually, one of the guys answered that you always did say you have to make sure and bring a jacket and tie with you. OK. DR. SALTZMAN: But you never know. DR. ZISSMAN: Alan Kohrt. DR. SALTZMAN: Alan Kohrt started out as a generalist pediatrician in the Harrisburg, Pennsylvania area, eventually Children’s Hospital full-time. Now he’s in Tennessee. DR. ZISSMAN: Yes. He had moved to Georgia, I think, and then Tennessee. DR. SALTZMAN: Atlanta and then Tennessee. An outstanding, decent, quality human being. Soft. Remarried a lovely woman. Lois is his wife. And very successful. He had a heart attack last year, but he did fine. And he’s still in Tennessee. DR. ZISSMAN: Bob [Robert] Perelman, they said was at that first meeting from the Academy? Bob Perelman, who is the director of the Department of Education at the Academy now. DR. SALTZMAN: Yes. Well, he came later. DR. ZISSMAN: Mark Reuben came along, as well as Anne Francis. DR. SALTZMAN: Yes. Mark and Anne were quality people. Anne Francis, I got very close to. Anne Francis practiced in Rochester, New York, and by the time I got to know her, I had already written a chapter in Bob [Robert A.] Hoekelman’s second and third editions. He had invited me to write a chapter on pediatric practice. Lisa McInerney, on the faculty at University of Rochester Medical School, also on the faculty of many of the AAP CME courses with me, also became a close friend. Thus I had a strong Rochester, New York connection. When we moved to Harbour Ridge after retirement, a gentleman walked up to me one day and said, “You’re Eddie Saltzman.” He said, “I’m so-and-so. I’m an internist in Rochester. I told them that I

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was going to buy a place in Florida, and they said they knew a pediatrician in Florida who they loved.” Really a small world; the circle goes around. DR. ZISSMAN: So what is your trademark that Anne Francis wanted me to get a picture of you with? DR. SALTZMAN: God, I forgot it. Oh, the glasses. Yes. DR. ZISSMAN: Anne says to give you her best, and she wants a picture for this with your red glasses. DR. SALTZMAN: That’s right. DR. ZISSMAN: That was your trademark. DR. SALTZMAN: I wore red glasses, and wanted them to remember. That’s right. Then those people could come up and say, if they didn’t remember my name, “Are you yutz with the red glasses who said,” etc., etc. DR. ZISSMAN: I have to take some pictures, so you might want to put the glasses on. DR. SALTZMAN: But yes. Anne was very supportive, and I was supportive of her because she was a star. DR. ZISSMAN: OK. So we already talked about Dan Shea and Jerry [Jerald] Zarin. DR. SALTZMAN: Jerry Zarin, a fine pediatrician. Quiet. Didn’t do a lot of talking, but when he talked, he had something to say. You know, when we had the original COPAM, and we would vote on issues, and there were 9 of us sitting around the table, if there was an 8-to-1 vote or a 7-to-2 vote, it was OK. But if it was a 5-to-4 vote or a 6-to-3 vote, we tabled it. Because we didn’t want too many people in the room unhappy and feeling that maybe they had something to say that we weren’t getting. You know, they’re not dopes. And if 3 people feel that strongly it must be important. I mean, I don’t know how you can do a Supreme Court decision 5 and 4, but that’s a different issue, and a whole different philosophy. But be that as it may, Jerry Zarin was very helpful.

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DR. ZISSMAN: He’s done these beautiful newsletters. DR. SALTZMAN: He’s very good. DR. ZISSMAN: We had some of the old ones. And then I’m sure you’ve seen the new ones now -- DR. SALTZMAN: Yes. DR. ZISSMAN: -- that are very well-received and being all sent out electronically now. You’re mentioned in here over and over and over, even though you’re modest and modest and modest. You’re mentioned in almost every one of the Vanchiere Award acceptance speeches. I was lucky enough to have been the president of Florida chapter when you were nominated for the Vanchiere Award, because, you know, each chapter has to approve any nominee. DR. SALTZMAN: I didn’t know that. Interesting. DR. ZISSMAN: So I was lucky to be able to approve that and we have our minutes there of that. DR. SALTZMAN: The [Clifford G.] Grulee Award was the thing that astounded me. I don’t know whether you know the Grulee Award. DR. ZISSMAN: I know what it is. I don’t know that much . DR. SALTZMAN: It’s an award given to somebody that’s not an elected official at the Academy or has no official position at the Academy that has made a national impact. That’s the thing. I really never thought they had any feeling for it other than the few people in the Academy that were very supportive. I was absolutely stunned at that award. DR. ZISSMAN: Well, you certainly fit the criteria. You worked with Roger Suchyta? DR. SALTZMAN: Roger and I were originally on COPAM, because Roger was in practice. DR. ZISSMAN: Right. In Salt Lake City.

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DR. SALTZMAN: Yes. And then he gave it up. He was one of the early people. A very talented guy who had something to say. But again, he didn’t have any idea of practice. Yet he had good things to say, and we all learned from each other. DR. ZISSMAN: Lisa Honigfeld? DR. SALTZMAN: Lisa Honigfeld was the Academy staff person. She was very bright, very supportive, helped us with all the meetings and all the arrangements, put me in my place when I said something I shouldn’t have. I’m not a caustic person. I don’t fight with people, but when she said, “You’ve got to do it a different way. Let me show you why,” she was always right. I haven’t seen her in years, but I still have her phone number. She’s married, and she lives in, I think, Rhode Island. I’m not sure. And Sam Flint was in his early years at the Academy. He grew as I grew. He was another super talent that always had something to say to me and would take me aside and say, “Let me tell you, this is the way you’ve got to do it.” And Lisa would say, “I’ve been telling him that.” In the early 2000s, I stopped being active in the Academy because I had mentored so many people, and I always felt that if I were in the room and somebody would say how much is 2 and 2, they would look at me, not the person that was chairing the meeting. I felt I didn’t belong. DR. ZISSMAN: Well, you didn’t want to take over. That’s your nature. DR. SALTZMAN: That’s human nature. Yes. DR. ZISSMAN: So a couple more Academy things. I’m showing you the book Practice Management Consultant: A Compendium of the Articles from Practice Management Online. Everybody says that Anne Francis was the godmother of Practice Management Online, but if she was the godmother, you were certainly one of the -- DR. SALTZMAN: She’s the godmother. She’s the founder of it. DR. ZISSMAN: But couldn’t have done it without you. DR. SALTZMAN: I wasn’t involved then.

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DR. ZISSMAN: Well, but it was the outgrowth. So that we now have a whole place online. DR. SALTZMAN: But Anne Francis is a super talent. DR. ZISSMAN: Yes. DR. SALTZMAN: I see Hershel Lessin here. DR. ZISSMAN: Right. DR. SALTZMAN: Bright guy. Good. Bill [William] Zurhellen. [Norman] Chip Harbaugh. Errol Alden was always very supportive. In Florida, they had a District 3 meeting in Florida one winter, and they gave me an award. They had a private dinner or something like that for the award. And Errol came to that, flew down. I said, “It’s Errol.” Nice guy. People at the Academy are very nice to me. I never saw this. I got an email yesterday. Emeritus members -- you know, they raised the dues from $75 a year to $200 for emeritus members. DR. ZISSMAN: I didn’t know that. I’m senior, but I’m not emeritus yet. DR. SALTZMAN: So it came out about 6 months ago. So I sent in a check for $200 because at least I can be an emeritus member. DR. ZISSMAN: Right. DR. SALTZMAN: Apparently there’s a big hue and cry, and I got an email yesterday from Tom [Thomas K.] McInerny, saying that for anybody over 80, it’s free, and you’ll get a subscription to Pediatrics and the Red Book, and you’ll be invited to be a member of the Section for Senior Members. I wrote Tom back. I knew Tom from the Academy and he is also one of the Rochester, New York gang. I said, “Let me suggest something. I think that’s wonderful, but I think what’s as important is you offer a huge discount to the emeritus members to come to the meetings so they still stay in touch with the Academy and support the Academy and the younger pediatricians. I understand the Academy is having a lot of problems with the younger pediatricians paying the dues and that.” For example, in my practice, if you were a member of the Academy, we’d pay your dues. You do that in your

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practice too, but you know, if a guy said, “Well, you don’t have to be a member. Big deal.” I just felt that they ought to get more senior members in the audiences. DR. ZISSMAN: Absolutely. Absolutely. The same thing, I have an AAP.org email. And when I was done being an officer, they wanted to say, “Well, you don’t have that email anymore.” And I said, “That’s dumb. You want more of us to have more emails and everything, to keep the contact.” So this is the NCE [National Conference and Exhibition] meeting brochure. I don’t know if you’ve seen this yet. DR. SALTZMAN: The new one? DR. ZISSMAN: Yes. So this is to pay for your attendance, which you don’t have to do, as an honored guest, to the Section on Administration and Practice Management, Edward J. Saltzman Luncheon. DR. SALTZMAN: Yes. That is very nice. I didn’t see that. DR. ZISSMAN: Well, it’s up there. And you know, that’s just the place where you pay, but it’s nice that they’re honoring you as the Edward J. Saltzman Luncheon where the Vanchiere Award is given, instead of it just being the Vanchiere luncheon. DR. SALTZMAN: I never saw this. DR. ZISSMAN: This is the just the book that’s coming out for the next meeting. DR. SALTZMAN: Isn’t that nice? DR. ZISSMAN: Yes. And we also just realized that this is the 20th anniversary of the section. DR. SALTZMAN: Wow. DR. ZISSMAN: So this luncheon is going to be a big deal besides introducing you and besides there’s going to be a whole commemoration of the section.

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DR. SALTZMAN: Do I have to give a talk other than just thank you? DR. ZISSMAN: No. DR. SALTZMAN: OK. I can. When they introduce me, I can say thank you. You know, there’s enough talking at a luncheon. You’re going to make it stale. That’s fine with me. Where’s the luncheon going to be? Do you know? DR. ZISSMAN: It’ll be at the convention center. DR. SALTZMAN: They’ll send me a badge, and they’ll do all that. DR. ZISSMAN: Yes. They’ll do all that. It’s going to be very nice. And it’s going to be the 20th anniversary. Do you think children are better off today than they were when you started off 55 years ago? DR. SALTZMAN: Yes and no. I think they’re better off medically. I think that pediatric practice has evolved into more growth and development than caring for acute illness. I think acute illness is not serious. I don’t mean not serious, but it’s not -- DR. ZISSMAN: Life-threatening anymore. DR. SALTZMAN: That is thanks to immunizations and better public health and better awareness. The tragedy is that kids that don’t get medical care. Even though it’s available to them, they don’t take it for various social and monetary reasons. I think that the lack of 2 parents in a family is a major problem because I think kids only learn at the dinner table. They learn minor stuff in school, minor stuff in church or temple. They learn minor stuff on the playground. But they learn at the dinner table every night. That’s the basis of their life. At the dinner table; not on vacation. I think families should take vacations. I think you should go to your kid’s Little League games, you know. I think you go to their recitals. I think you go, whatever you do. But they don’t learn except at the dinner table. I feel very strongly about that. Now do we need mothers working as well as fathers? Yes. But there ought to be some way to get that parenting at the dinner table, if there are 2 parents.

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DR. ZISSMAN: So how would you like the pediatricians of Florida and of this country to think about Eddie Saltzman? What is your legacy? DR. SALTZMAN: I never thought about it. And I just think he was a good guy and was fair and honest. And you know, maybe he showed people that you can learn from everybody around you and that there’s always somebody smarter than you. And yet you share what you learn because it comes back to you in many ways. And it does.

END OF AUDIO FILE

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Index

A

Abelson, Neva M., 10 Affordable Care Act, 31, 32 Alden, Errol, 49 American Academy of Pediatrics, 1, 15, 18, 19, 22,

32, 34, 35, 36, 38, 39, 40, 41, 42, 44, 45, 47, 48, 49 American Academy of Pediatrics, Committee on

Practice and Ambulatory Medicine, 35, 36, 44, 46, 47

American Academy of Pediatrics, Section on Administration and Practice Management, 1, 36, 40, 42, 50

American Board of Pediatrics, 18, 40 American Health Care Plans, 22

B

Barich, Donald P., 43, 44 Barness, Lewis, 34 Bedell, Peggy, 2, 3 Bongiovanni, Alfred M., 7, 9, 33, 34 Brooke Army Medical Center, 6 Broward County Medical Association, 31, 32 Bruno, William E Jr., 17, 18, 19

C

Camp Kilmer, 6, 7, 8 Chapple, Charles, 10 Children's Hospital Boston, 3, 11 Children's Hospital of Philadelphia, 3, 4, 5, 6, 9, 34 Clifford G. Grulee Award, 47 Cohen, Jack, 3, 19

D

Diamond, Louis K., 9, 10

E

Edward J. Saltzman Luncheon, 50 Emerald Hills Medical Square, 27 Emerald Hills, Florida, 19, 27 exchange transfusions, 5, 9, 29

F

Flanagan, Bill, 40 Flint, Sam, 48 Fort Dix, 6 Francis, Anne, 43, 45, 46, 48, 49 Frey, James, 43

G

Grayson, Robert, 36, 38, 40, 41

H

Harbaugh, Norman Chip, 49 Health Maintenance Organizations, 30 Hoekelman, Robert A., 45 Hollywood Inc., 27 Honigfeld, Lisa, 48 Hope, John, 7, 9

I

Independent Practice Association, 31

J

Jackson Memorial Hospital, 9, 15, 36, 37 Jacobson, A.D., 43 Jacobson, Donna, 43 Jacobson, Jed J., 15, 16 Jefferson Medical College, 2, 3, 4

K

Kohrt, Alan, 45 Kohrt, Lois, 45 Koop, C. Everett, 4, 5, 7, 30, 31, 33, 34 Korea, 5, 6 Kutnik, Leonard A., 40

L

LaSalle College, 3 Lawson, Robert, 7 Lempert, Julius, 2 Lessin, Hershel, 49 Levine, Philip A., 15, 16, 21 Lieberman, Gary, 19 Lieberman, Ira, 11 Lopez, Jose, 38

M

Management of Pediatric Practice, 40 McAloon, Joseph, 6, 9, 10 McCarthy, Senator Joseph R., 8 McInerney, Lisa, 45 McInerny, Thomas K., 49 Medicaid, 23, 24 Medicare, 31, 32 Memorial Hospital, Hollywood Florida, 6, 7

P

Pediatric Associates, 1, 12 Perelman, Robert, 45 Philadelphia, Pennsylvania, 1, 2, 3, 4, 5, 6, 7, 10, 24,

30, 31, 34

54

Pittell, Robert, 11, 12, 15, 16 Plantation General Hospital, 19 Platou, Ralph, 7 polio, 6, 10, 28 Practice Management Consultant: A Compendium

of the Articles from Practice Management Online, 48

Preferred Provider Organizations, 30, 31 Prudential of South Florida, 26, 36

R

recertification, 39, 40 Reinhart, Jackie, 1 Reuben, Mark, 43, 45 Robb, Tom, 36, 38

S

Salk vaccine, 6 Saltzman, Joan, 1 Saltzman, Joyce, 1 Saltzman, Maurice, 2 Schiebler, Gerold, 23, 36, 37, 39 Schultz, Robert, 16, 17 Shea, Daniel W., 40, 44, 46 Shulman, Peter J., 19, 21, 31 Spitz, Eugene B., 31 Stockman, James A. III, 40 Stokes, Joseph Jr., 4, 5, 6, 7 Suchyta, Roger, 47 Swenson, Orvar, 31

T

Tanis, Arnold "Bud", 11, 12, 15, 16 Tanis, Maxine, 11 Temple University, 2 Thomas Jefferson Memorial Hospital, 4 Thomas Jefferson University Hospital, 3

V

Vanchiere Award, 47 Vanchiere, Charles "Buzzy", 36, 42, 43, 44, 50

W

Ward, George, 24 Wyeth Pharmaceuticals, 40

Z

Zarin, Jerald, 46 Ziegra, Sumner, 34 Zurhellen, William, 49 Zwicker, General Ralph W., 8

55

Edward J. Saltzman, MD FAAP

Birth December 9, 1926, Philadelphia, PA

Married Joan 1966-2005 (deceased) Joyce 2007 Two children – Joel, Robert

Educational Background LaSalle College - Philadelphia, PA, 1943-1945 MD, Jefferson Medical College, 1949

Hospital Training Following Graduation Rotating Intern – Jefferson Medical College Hospital, July 1949-February 1951 Resident, Pediatrics – Children’s Hospital of Philadelphia, 1951-1953 Assistant Chief Resident, July 1952-July 1953

U.S. Government Captain U.S. Army Medical Corps, July 1953-July 1955

Private Practice Pediatrics Hollywood, FL – Solo then group with multiple offices Founder: Pediatric Associates, 1955-1991

Medical Staff Memorial Hospital, Hollywood, FL Pediatrician 1955-1991 Chief Medical Staff 1966-1967 Jackson Memorial Hospital, Miami FL, 1957-1994

Faculty University of Miami School of Medicine Department of Pediatrics, 1957-1994 Clinical Professor of Pediatrics, 1982-1994

Pediatric Certification Board Certified, American Board of Pediatrics, 1955 Voluntary Re-certification, American Board of Pediatrics, 1980

56

American Academy of Pediatrics Fellow 1955 Chair & Member: Committee on Practice and Ambulatory Medicine, 1979-1984 Section on Administration and Practice Management, 1984-1988 Council on Pediatric Practice, 1988-1991 Awards Cllifford Grulee Award, 1996 Vanchiere Award, 2001 Publications Management of Pediatric Practice, 3rd Ed, Editor, 1986 Management of Pediatric Practice, 2nd Ed, Co-Editor Author, Chapter, Hoeckelman Primary Pediatric Care, 2nd Ed, 1991 Author Chapter, Hoeckelman, Primary Pediatric Care, 3rd Ed, 1997 Editor, Pediatric Resident, Dowden Publication, 1991-1992 Pediatric Management, Dowden Publication, 1992-1994

Other Medical Director, Consultant Prudential Health Care System, South FL, 1986-1990 Program Chair, Speaker AAP “Starting in Practice” Annual and Spring Meetings, 1980-2002 Multiple AAP CME Programs Multiple US Residency Programs, Medical Association Programs Children’s Hospitals, Pediatric Residency Progams, TV-Radio Commentary

Membership American Academy of Pediatrics American Medical Association Florida Pediatric Society Florida Medical Association Broward County (FL) Medical Association