My Kind of Medicine: Real Lives of Practicing Internists: Kevin Egly, MD.
As a boy, Dr. Kevin Egly learned how a skilled physician can make a positive impact on people’s lives. It was the 1970s and Kevin’s grandfather had been battling heart failure for years before finally agreeing to have open heart surgery. In those days, what doctors were able to do for heart patients was limited. His physicians gave him a prognosis of 10 years following the surgery, but he lived for 18 years instead. Experiencing the wonder of modern medicine at an early age instilled in Dr. Egly a conviction that great things actually could happen, especially if you were a doctor. “I thought it would be pretty cool if I could do something like that,” he says. Today, the 37-year-old internist from Illinois is doing just that. He is driven by a strong faith in himself and his peers. “Physicians are committed to the health of their patients,” he says, “and we will always do what is right, regardless of the obstacles.”
Drs. Kevin and Angela Egly with Adam (6 years old), Matthew (4 years old), and Christopher (1 year old)
As he became older, Dr. Egly’s wish to become a doctor was made more probable by an innate interest in the sciences. He had a natural proclivity for biology and chemistry. As time went on and more of his abilities emerged, his dream became more of a reality. In high school he breezed through science courses, acing exams and even winning an award or two along the way. At the University of Illinois, he was so adept at anatomy that he taught fellow pre-med students as a teacher’s assistant. In medical school, he organized mock practical exams for his fellow medical students.
His talents did not go unnoticed. While on rotation at the Loyola University Medical Center, Dr. Egly, then a senior resident, was called on by his attending to see a patient who had been examined but had yet to be diagnosed. Upon further examination of the woman, he noticed some physical examination findings that seemed to indicate a problem with the patient’s cranial nerves and further diagnostic tests were ordered. When the results came back, Dr. Egly was able to make the correct diagnosis: an early case of bacterial meningitis, which can result in brain damage or death if left untreated. “After that my supervisor said to me, ‘You are a doctor’s doctor.’ I didn’t really know what it meant, but it meant something to me that he said it.” As it turned out, he was a natural for the field of internal medicine. One of the often cited reasons for choosing internal medicine is the ability to diagnose complex medical conditions.
A Cool Head
Dr. Egly is full of real-life stories like that of the patient with meningitis. He recites them in a casual matter-of-fact tone, as if he were telling you about what he was planning on having for dinner. There is not much that really throws him. On one occasion, while working at Valley West Community Hospital in Sandwich, Illinois, he saw a patient who had come from the ER with an odd combination of presenting symptoms: a swollen face (from being hit) and a hypothermic temperature of 94 degrees. For no apparent reason, the woman began to slip into respiratory failure and had to be intubated. Things were not looking good. Then Dr. Egly got an idea. “We were having trouble clearing her oral secretions,” he said, “which led me to suspect that she had an early pneumonia compounded by an undiagnosed low functioning thyroid. Once I discovered this we were able to give her the correct treatment. The condition was corrected, she was rehabilitated and everything turned out fine, but only because we anticipated the thyroid dysfunction. If left untreated this condition carries an 80% chance of mortality.”
On yet another occasion, he diagnosed his twin brother, over the phone with a protein breakdown in the muscles (rhabdomyolysis) based on only two complaints: pain in the arms and urine “the color of Coca-cola.” Dr. Egly advised his brother, who was training heavily for a marathon, to go to the ER. Instead, his brother chose to visit a clinic and was given a different and much less serious diagnosis by a physician. Later on in the day his condition had not improved, at which point he did heed his brother’s advice and went to an ER. When Dr. Egly arrived the next day after flying out overnight to see him, his brother was in intensive care, undergoing treatment for rhabdomyolysis. “That was the most memorable diagnosis I’ve made, and it was over the phone,” he recalls.
Architect of His Own Destiny
Dr. Egly’s steady-as-you-go demeanor and unique aptitude would have made him a great surgeon, something he considered pursuing before he discovered internal medicine. “I just assumed that I would go into surgery since I was so good at anatomy, but my hands shook when I drank coffee. The surgeons didn’t like that,” he recalls. Once he got a glimpse of what being an internist would be like, he was hooked. “As a resident, I remember at the end of each rotation saying to myself, ‘Wow, I’d like to do that.’ I realized that I wanted to do all of it; I liked it all. With internal medicine, you can do it all.”
During his training, Dr. Egly saw something else that he liked a lot: Angela—a pretty blond with a sharp mind and green eyes who was a fellow medical student one year ahead of him in the program. Not one to be intimidated, he summoned his trademark confidence and asked her out. They began dating and ten years later they have three sons, ages six, four and one, and work side-by-side at a private practice they created together. He says setting up your own practice is not easy, but that running his own office means calling the shots, which is well worth the effort. “We designed our clinic to be very efficient,” he says. “We conduct patient care the way we think it should be done—one hour with every new patient and a half hour to 40 minutes with every follow up. The official name for such a practice is Ideal Micro Practice, or IMP for short. It requires efficiency in office procedure and coordinating patient care. We use an electronic medical record (EMR) system from eMDs and an online resource called www.Howsyourhealth.org. Running my own business means I’m the master of my own life. I enjoyed my days working for hospitals and a large specialty group, but having my own practice gives me a great quality of life.”
True to form, Dr. Egly is optimistic and undaunted about his future. “We need to take the next step in creating efficiencies that will help us make the transition to patient-centered coordinated care,” he says. “That means developing an electronic disease management program. If you can manage your checkbook online there’s no reason why we can’t come up with a way or a tool to manage your healthcare online. We haven’t developed that tool yet, but at some point we will. Or I’ll do it myself.”
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