August 15, 2013
Dr. Richard “Bunky” Bernstein has retired from the Charlotte Family Health Center, but the art of medicine he practiced will live on there
One day in the 1970s, Dr. Richard “Bunky” Bernstein stood along Charlotte’s Town Beach as his son participated in swimming lessons. As he watched, three people told him in passing that a doctor in town was retiring, each of them unaware that Bunky was a doctor himself.
Soon after this series of random encounters, Bunky—his father gave him the nickname—would move to Charlotte and take over for the doctor and later begin the Charlotte Community Health Center where he has worked for nearly 40 years and from which he retired last week.
This is why Bunky says he didn’t quite choose Charlotte as much as it chose him. When he started the Health Center with a few physician assistants in 1975, he wasn’t sure where the venture was going to lead or even if he would stay permanently. He’d wait and see.
The Health Center is in a white house near an old red barn surrounded by a field of wildflowers along Ferry Road. The inside is a mix of wooden-floor charm and modern equipment, a combination of the old and the new that is in so many ways like Charlotte itself.
The operation within the building has “grown and evolved” since the 70s, and not just into an important part of the Charlotte community, but into a health care facility that is an extension of Bunky’s compassionate, candid bedside manner.
Bunky grew up in Maryland and went to Kenyon College, graduating in 1968. He went to medical school at Case Western Reserve in Cleveland and traveled to UVM for his medical residency in 1972. From there he practiced at the Stowe Clinic and the Community Health Center in Burlington.
At the Health Center, Bunky began to develop a philosophy of medicine that puts a premium on helping patients become less apprehensive about the health care process. It was an approach that grew out of the counterculture movement, he said, a period where a feeling of new barriers breaking down filtered into the medical field, with the goal of making medicine more accessible.
“I think fear itself motivates people to come here,” he said. “Yet, physicians often magnify fear by not acknowledging it up front.”
He offers the example of a mammogram in which a spot is discovered, which leads to another mammogram a few weeks later, followed by a biopsy a few weeks after that. Each appointment, and the subsequent wait, serves to ratchet up the patient’s fear and apprehension. Even if the spot is found to be negative, the process becomes something like the condition itself.
“Imagination is the source of a lot of stress,” Bunky said.
His goal, then, is to demystify the process.
“Right from the beginning it’s about trying to explain things in a way that people can understand,” he said. “It takes out the mystery, takes out the fear.”
At the Health Center, Bunky liked to keep the day’s schedule open enough to be able to talk to his patients about their health care needs. He’s tried to maintain a business that hasn’t had to schedule six patients an hour to get by. He admits finances for such a small clinic have always been an issue, but the number of patients there has grown every year, in large part because he’s seen patients, their children and even their grandchildren.
All of this makes Bunky and the Charlotte Family Health Center an outlier in the world of small, independent health care practices. He cites Hinesburg Family Health, which was recently absorbed by Fletcher Allen Health Care after two of its physicians moved out of state. Students graduating from medical school leave with huge debt and look toward larger hospitals that can pay more than independent practices.
But as a clinical preceptor on UVM’s family practice faculty, Bunky has tried to impart his small-town-doctor philosophy to third-year medical students who spend up to five weeks with the staff of the Health Center for a class called “Teaching in Vermont.” It’s not something he actively imparts; rather, it’s something he demonstrates by modeling. Most students pick up on it, he said.
It’s an approach that will continue as his colleagues Andrea Regan, Gordon Geig and Nurse Practitioner Jennifer Allaire take over his patients.
Without hesitation, Bunky said he will miss the people—his patients and colleagues. the center. In a letter to his patients, he wrote, “The hardest part of leaving, of course, is that I will miss the associations I have developed—some extending back decades, some with children and grandchildren of my early patients. I’ll miss knowing how it all turns out.”
Bunky is going to approach retirement in the same way he approached starting the Health Center.
Though he intends to sail the Intercoastal Waterway to winter in the Bahamas, he isn’t sure what the future holds. He’ll wait and see.
“I feel like I’m entering a new phase of life,” he said. “I’m opening myself to new experiences.”
He’ll continue to make furniture and do carpentry, he said. He’s a problem solver at heart, and he likes to work with his hands. That’s what drove him into medicine, after all, and he’s not going to leave it behind. Bunky wants to study the concept of human will to find out how doctors can help patients use it to improve their health. It’s an idea that lends itself to his interest in the art of medicine, something he’s well versed in.
“In essence, the practice of medicine is the communication between two people—one a good listener and the other sharing his or her deepest concerns and fears,” Bunky wrote in his letter to patients. “The art of medicine, as I have come to understand it, is the ability to truly hear these concerns and to address them in a way that promotes overall well-being.”