In 1966, after two years of living and working in Libya, my wife and I, with two young children and a Siamese cat, returned to the United States. We decided to pause for an extended holiday in Europe and, at the factory outside of Stuttgart, Germany we picked up our pre-ordered Mercedes 200. It required manufacturer’s servicing after a few hundred miles of driving. That was done in Koblenz, Germany. I suspect I still have the bill somewhere. It routinely indicated what was done and the associated costs. But, in addition, it included a photograph of the mechanic who serviced the vehicle and his qualifications. I have no idea whether this is, or once was, usual in Europe; here the servicing mechanic remains anonymous.

You always remember life’s firsts. My first haircut was given by Jimmy, whose barber shop was on 115th Street, just off Liberty Avenue. Dr. Schnabele was the doctor who delivered me at home. We were then in the depths of the Great Depression. At that time, doctors routinely made home visits. As a child, I believed that all doctors drove Cadillacs with MD license plates. Office visits were more usual. You arrived at the doctor’s office during his visiting hours and waited to be seen. Of course, things change.

Soon after arriving in Allentown, we found our family doctor and have been seeing him ever since. We know him and he knows us. We have confidence in the care he provides. But, he no longer has an independent practice. As with many other doctors both here and nationally, he is now a salaried employee of a hospital. In the Lehigh Valley, we have both the Lehigh Valley Health Network, which is now a part of Jefferson Health, and St. Luke’s University Health Network. Independent practices still exist, but most doctors now seem to be associated with one or the other of the mentioned hospital networks. Our family physician is a member of the LVHN.

For a doctor, there are many advantages to becoming a member of a hospital network. Salaried employees, which doctors become, enjoy income certainty. And, an important addition, all the non-medical administrative details of an independent practice are now assumed by the administrative staff of the hospital network. The hospital’s assumption of those tedious details allows the doctor to focus on his or her medical responsibilities.

What about the patients, such as my wife and me? What about you and your family? We see our family doctor twice a year for a scheduled checkup. We have some lab work done prior to our scheduled visit. If, however, I’m feeling sick and call my doctor’s office, I am told that my family doctor will not be able to see me for another two weeks or so, if I’m lucky, or two months or more, if I’m not. I was once told that about 80% of the ailments that prompt us to see a doctor are things that we’ll get over without any treatment. I don’t know if those statistics hold up to examination, but, at least they may be comforting when you are told that your family doctor is not available for another several weeks or months.

If I really feel the need to see a doctor, LVHN has convenient Express Care centers that I can visit. Of course, I don’t know the physician or health care worker that I’ll be seeing, nor does he or she know me. But, I can feel reasonably confident the person I see has the appropriate qualifications.

Maybe you now see why I started with my Mercedes servicing story. On that visit, I was informed as to the mechanic who serviced my car and his qualifications. That’s not what you get in the Lehigh Valley or elsewhere when you take your car in for an oil change or new transmission at your dealership’s service center. You can assume that the mechanic who works on your car is qualified, but there is no personal relationship.

Health care now seems to work on what I call the car dealers model. You bring your car or yourself in for inspection and servicing. You’re assured the mechanic or health care professional who is providing the service is knowledgeable and competent, but that’s it. The family doctor with whom you had a personal relationship and who knew you by name rather than date of birth is vanishing. I feel the loss because I knew something different. My grandchildren will not miss what they never had.

This is a contributed opinion column. George Heitmann is professor emeritus of management science at Penn State (University Park) and professor emeritus of economics at Muhlenberg College. The views expressed in this piece are those of its individual author, and should not be interpreted as reflecting the views of this publication. Do you have a perspective to share? Learn more about how we handle guest opinion submissions at themorningcall.com/opinions.

https://www.mcall.com/2025/10/02/opinion-medical-care-in-the-new-age-of-technology/