Dr. Julie Donohue has to spend a considerable amount of time fighting insurance companies. Disputes over billing and reimbursements can rob her of time that she prefers to spend with her obstetrics and gynecology patients.
She relished a recent chance to get away from the insurance-related paperwork.
Donohue, 44, who has been in practice 14 years, accompanied a team of local physicians on a trip to Grenada last month to train doctors and treat patients on the Caribbean island. The nine-day mission also helped her reconnect with the passion that galvanized her medical career.
"I was in a place in my life where I wanted to remember why I went to medical school, and I also wanted to do something in a Third World country to help people," Donohue said.
The Martha E. Johnson Foundation's surgical assistance program was the prescription she needed. The foundation, established 17 years ago, is devoted to advancing medical care in poor countries.
Donohue was the first gynecologist to visit Grenada with the foundation.
She treated patients who were more ill than those she typically sees in her Lockport practice. She performed 12 surgeries, including the island's first endometrial ablation and its first tubal ligation, at St. Georges General Hospital in St. Georges.
As she worked, four of the hospital's OB/GYN doctors observed and assisted.
"The people of Grenada have this gentle grace and were very appreciative, and it makes it a joy to take care of them," Donohue said. "It's sometimes hard to feel that way as an American physician, where we live in fear of lawsuits and have to fight with insurance companies. It was nice to experience a simpler system."
For the past 13 years, the Johnson Foundation's work has been solely in Grenada. Doctors from around Western New York have volunteered their time, and medical equipment companies and hospitals have donated supplies for the foundation's missions.
"The goal is to introduce procedures through training and hopefully get them the equipment, so they'll start doing these procedures themselves," said Dr. Eric Johnson, the general surgeon who started the foundation after a visit to the island.
"The foundation has been working in Grenada because there's a need there that's not been addressed by other organizations," Johnson said.
Over the years, doctors have introduced many medical procedures to their Grenadian counterparts, and helped provide safer and more effective care to patients. Last year Dr. Joseph Buran, an Amherst orthopedist, accompanied Johnson and did the island's first uncemented total hip replacement surgery, allowing a woman to walk normally for the first time since a 1980 accident. Buran returned to the island last month and performed open-knee surgery, also a first on the island.
Because the island's medical community lacks laparoscopes, minor surgeries require large incisions, which lengthen hospital stays and increase pain. But with the equipment available during the recent trip, Donohue's surgeries were quicker and less invasive, and patients were out of the hospital after a day.
"It just makes you realize how fortunate we are to have everything we need in this country when you practice medicine," Donohue said. "As an American physician, I feel privileged to be so well-trained here and have so many tools to make diagnosis."
But Donohue also was impressed by how doctors make do with the little they have.
"The other really interesting thing is how much they do with so little," she said. "They reuse a lot of equipment that legally we couldn't use here. But they don't have a higher infection rate than we do."
Donohue is keeping in contact with the doctors she trained and receiving patient updates via the Internet. She plans to return to the island do more procedures and training.
"Every American physician I've ever spoken to who took the time to travel to a Third World country raves about the experience," she said. "It's great for getting perspective on health care and getting back to the roots of why you went into medicine.
"And Dr. Johnson's Grenada project is a very doable project. Grenada is a place where one doctor can make a difference. I love the idea of feeling one woman can make a difference. And I feel like I've done that."