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In honor of ACP's Centennial, My Kind of Medicine: IM
Family is a new series of physician profiles featuring
multi-generational internists. The stories will appear in several
issues throughout 2015 to showcase how a tradition of caring and a
passion for internal medicine are passed from one generation to the
ACP Master: Warren C. Lovinger, MD, MACP
Current Occupation: Internist, Nevada Internal
Medicine, Nevada, MO
Residency: Barnes Hospital, University of
Washington, St. Louis, MO
Medical School: Johns Hopkins University,
School of Medicine, Baltimore, MD
ACP Member: Sarah Lovinger Florio, MD
Current Occupation: General Internist, St.
Luke's Medical Group, Lee Summit, MO
Residency: University of South Carolina,
Medical School: University of Missouri,
ACP Medical Student Member: Daniel W.
Current Occupation: Fourth-year medical
student, University of Missouri-Columbia, Columbia, MO
Medical School: University of
Missouri-Columbia, Columbia, MO
Dr. Warren Lovinger
From a young age, Warren Lovinger, MD, MACP was used to being
surrounded by adults. His father was the president of Central
Missouri State University, and Dr. Lovinger grew up in the
president's house in the middle of an "enriched academic
environment." Growing up he thought that he would enter academia to
teach. However, while playing football in high school, Dr. Lovinger
suffered an injury that caused his left arm to be paralyzed for
nine months. He had an interest in science and communications
during high school, but Dr. Lovinger's injury was the first time
that he was exposed to the medical community and that's when his
interest in medicine was sparked.
He began to see medicine as a combination of people and
communications skills, and science and intuitive thinking. After
completing medical school at the Johns Hopkins School of Medicine
in 1977, Dr. Lovinger completed an internal medicine residency at
Barnes Hospital at Washington University in St. Louis. Dr. Lovinger
applied to the Missouri State Medical Association, and heard back
from 55 places. He and his then soon-to-be wife, now wife, Marilyn
identified 11 communities they wanted to visit. They developed a
rating system that included criteria such as quality of the medical
community, schools, churches, community services, and general
quality of life. Their goal was to move where they could stay for
the rest of their lives. In the end, they decided on Nevada, MO,
pronounced with a long "A." Nevada is in the western part of
Missouri, south of Kansas City and north of Joplin, and has a
population of about 10,000. Dr. Lovinger and his wife lived in the
same house in Nevada for 27 years, while they were raising their
four children. They recently built a bigger home, which they share
with their Labrador retriever, Sammy. In the lower level of their
new home are four suites, one for each of their children, so that
they have no excuse not to come visit with the grandchildren.
After moving to Nevada, Dr. Lovinger joined an existing primary
care practice where he worked for two and a half years. He says
that he learned a lot of practical skills during that time, since
he went into private practice after having worked in academic
settings. After those two and a half years, Dr. Lovinger opened his
own private practice, where he has practiced for the past 33 years.
"I haven't regretted it for a minute. This is a fantastic community
in which to live, raise and family, and practice medicine," he
He describes his practice as a "classic diversified general
internal medicine practice." Dr. Lovinger is in the office four and
a half days each week. He works with his wife Marilyn, who is the
office manager, and a registered nurse Verna Jaross. In addition to
his private practice, Dr. Lovinger took care of patients at Nevada
Regional Medical Center for 35 years. In late 2014, Nevada Regional
Medical Center created a hospitalist program. Now, every morning
Dr. Lovinger makes a point to visit his patients who are still in
the hospital, so that he keeps direct communication with them.
While at Nevada Regional Medical Center, he reads EKGs, Holter
monitors, echocardiograms, and does stress tests for the hospital.
Dr. Lovinger is also the medical consultant at Heartland Hospital,
a child and adolescent psychiatric hospital in Nevada, and the lead
physician at Cottey College, a junior college in Nevada. He also
has a large nursing home practice, which he says is fairly common
for physicians in rural communities. On the first day of each
month, Dr. Lovinger visits the nursing home, where he has an
average of 60 patients. He gets a lot of calls in this role. "You
have to be a little bit dependable in that realm," Dr. Lovinger
says, having never missed a monthly visit in 36 years.
A self-proclaimed "people person," Dr. Lovinger says that he
enjoys getting to know his patients while talking about everything
from literature to farming. He and his staff consider their
patients as friends, and look forward to seeing them each day at
Not only is Dr. Lovinger very involved in medicine in his
community of Nevada, he also is involved with organized medicine,
such as ACP. During the 2011 Internal Medicine meeting in San
Diego, CA, Dr. Lovinger became an ACP Master (MACP). Only about 15
living physicians in Missouri are Masters of the College, and Dr.
Lovinger feels honored to be a part of the select group since he is
a non-academic physician in a rural community. Dr. Lovinger served
as a transitional governor of the Missouri chapter during the
ACP-American Society of Internal Medicine (ASIM) merger from
1998-2000. He encourages physicians, including his children, to be
involved with organized medicine because it helps create
intellectual and personal connections within the medical community,
and promote the medical profession. From 2017-2018, he will serve
as the president of the Missouri State Medical Association.
Dr. Lovinger also believes in community involvement and served
on the Nevada School Board for 18 years, was on the board of the
chamber of commerce, was president of the Nevada Rotary Club, and
is an elder of the First Presbyterian Church of Nevada. He was the
cofounder of the Nevada YMCA. In 1987, he was named Citizen of the
Year for Nevada, MO.
He has passed on his passion for medicine and serving his
patients to his children. Dr. Lovinger urges medical students to
have a long term plan that addresses important issues such as
preferred field of medicine, preferred practice format, and desired
lifestyle. Dr. Lovinger has experienced what today's medical
students face since three of his children have pursued the medical
profession, and reminds medical students to have a long-range plan
in mind by performing well but also understanding what is going on
in the medical industry.
Dr. Sarah Lovinger Florio
Sarah Lovinger Florio, MD is the first-born child of Dr. Warren
Lovinger and his wife Marilyn. In first grade, she wrote a book
about her dad being a doctor and said that she wanted to become a
doctor like him. Dr. Florio does not remember ever considering any
other career path. She says that her father was a role model for
her when she was a child, and is still a role model for her today
because he loves what he does. "When you have a positive role
model, it influences your decisions," Dr. Florio says.
Growing up in Nevada, MO, Dr. Florio remembers her father
receiving calls to address issues related to his job as a physician
in a small town, and she found it interesting to see her dad's role
in the community. Her interest in science was present from a young
age when she found her passion for participating in science fairs
in middle school, where she embarked on a two-year project about
the effects of antioxidants on planaria regeneration, which went on
to the regional science fair. Now when her patients ask about
different antioxidants, Dr. Florio often refers to the science
fairs that she participated in as a child when explaining things in
an understandable way.
While in medical school at the University of Missouri School of
Medicine in Columbia, MO, Dr. Florio knew that she would go into
internal medicine or family medicine, and that she would work in a
primary care setting. She had an interest in obstetrics and family
medicine, but in the end she chose internal medicine because she
knew the specialty would afford her a lot of career options.
Today, she is a general internist at St. Luke's Medical Group in
Lee Summit, MO. Dr. Florio enjoys interacting with her patients and
getting to be a part of her patient's personal lives and families.
Most of the patients she sees have chronic medical conditions like
diabetes, hypertension and hyperthyroidism, and because she is
familiar working with a variety of conditions, she does not have to
refer everything to subspecialists. Dr. Florio makes it a priority
to spend three to five minutes at the beginning of each visit
talking with her patients about their lives. "I get to spend time
getting to know them, and I love it. They're my friends and I care
about them," she says.
In addition to the four days each week that she works at the
primary care practice, Dr. Florio works some hours in the emergency
room, and in nursing homes and hospital settings, and is the
hospice medical director. "It's exceptionally rewarding," she says.
Dr. Florio cautions medical students to not make a decision about
what specialty or work environment they will pursue based on how
much money they will earn in the future, and to choose the
specialty based on passion. She also encourages medical students to
consider primary care internal medicine, and to keep in mind the
extra things that they may want to do in life such as having a
Dr. Florio's ACP membership is valuable to her work because it
has allowed her to develop relationships with physicians outside of
her geographic location and specialty, adding that there is a great
mix of young and old physicians to learn from. The College also
helps Dr. Florio set goals for herself as a physician, and allows
her to take advantage of the educational resources that ACP offers
to its members.
Understanding her patients' lives in more depth than their
medical conditions is one of the reasons that Dr. Florio says she
is a good internist, but she says that, like all doctors, she faces
challenges. Maintaining a work-life balance is one of her biggest
challenges as a physician. She makes eating dinner with her husband
Andrew, a Presbyterian minister, and their 2-year-old son, A.J. a
priority. "There is so much to do in medicine that you could
literally work for 24 hours per day because there is such a need,"
Dan Lovinger, the youngest child of Dr. Warren Lovinger and his
wife Marilyn, and brother of Dr. Sarah Lovinger Florio, is a
fourth-year medical student at the University of Missouri-Columbia
School of Medicine. As an integrated resident , he will be starting
his internal medicine residency at the University of Missouri after
he graduates in May 2016. Integrated residents spend two-four
months of their M-4 year with the Department of Internal Medicine
and Department of Child Health acting as an extern. An extern is a
medical student who acts as an intern accepting all the duties of
Like his sister, Dan remembers always wanting to become a
doctor. He doesn't remember considering any other career because he
grew up in a family of doctors and his father loved his job so
much. When Dan graduated from high school, his first grade teacher
presented him with a framed picture that he drew in first grade.
The picture said "when I grow up I'm going to be a doctor like my
Even though he knew that he wanted to be a doctor, Dan entered
medical school with an open mind. As he worked his way through the
various clerkships, Dan found that he really connected with the
internal medicine faculty at the University of Missouri-Columbia
and liked the way that the internal medicine doctors practiced
medicine, cared for patients, and treated students and fellow
staff. Dan plans to keep his options open as he enters residency,
but says that he will likely go into private practice internal
As a child, he saw the time commitment that his father made to
the medical profession, especially as a doctor in a small town. Dan
says that he observed his father's dedication to medicine as he
took calls from patients day and night, and went into the office
early and left late. "The doctors who choose that path are happy to
do it, but it's not always an easy lifestyle," Dan says.
Dan grew up with his three older siblings in Nevada, MO, and was
a three-sport athlete, participating in football, basketball and
track during his high school years. He is an Eagle Scout, and
enjoys outdoor activities including farming and fishing. He says
that his family made an effort to travel around the U.S. as a
family, and by the time he graduated from high school he had been
to all 50 states.
As a fourth-year medical student, Dan works with physicians at
the University of Missouri, sees patients and is learning how to
make a diagnosis and how to treat all different illnesses. Each
year his responsibility increases, and next year as an intern he
will have even more responsibility. His schedule changes each month
as he does a different clerkship. "I'm in learning mode," he
He advises fellow medical students to read a lot and work hard,
but to never lose sight of what their goal is, which is to become a
physician who provides great patient-centered care. He says that he
is always reminding himself of the end goal because early in
medical school sometimes students are so focused on studying and
test scores that they forget their end goal. Organized medicine
through membership of ACP is something that Dan relies on to
connect with physicians and mentors from around the country, and as
a way to meet doctors who already practice in the specialty and
environment that he hopes to be in one day.
Forming relationships with patients is by far my favorite part,"
Dan says. He calls himself a "people person," and says that a good
doctor is someone who works with patients to develop a relationship
and build trust so the patients will open up and work with
physicians. "I always want to work with patients, and not against
them," he says.
He says that the time commitment is likely to be his biggest
challenge as a physician, in addition to keeping up with all of the
paperwork and charting that is part of the profession.
Dan was just married on October 24 to his fiancée,
Mariette, a speech pathologist at a local school. They have a
chocolate Labrador puppy named Scout. In his free time, he enjoys
helping his cousin on his cattle farm, traveling, sports, and
completing home improvement projects at his condo in Columbia,
November 2015 Issue of IMpact
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