Knox physician finds military life a good fit
April 30, 2010
- Dr. Stephen November enlisted at 53
- Disenchanted with private medical practice, November enjoys the benefits of military medical practice
- Also a practicing orthodox Jew, November finds maintaining his orthodoxy not too difficult
- Family appreciates understanding identities as Americans, Jews, and citizens
FORT KNOX, Ky. -- While the age limit on active duty Army Soldiers has been expanded, few are allowed to enlist after age 42.
However, Stephen November is living proof that there are exceptions to every rule.
Lt. Col. Stephen November-Fort Knox's new chief of ob/gyn at Ireland Army Community Hospital-was commissioned in the Army at the age of 53. Physicians in uniform, of course, seem perennially to be in short supply, so joining at age 53 would have been easy.
The recruiter also dangled a sweet-assignment carrot at the November family, which had four grown children and little reason not to bite.
Their first duty assignment was to Vicenza, Italy. While there, November was the chief of a free-standing birthing center, the only one of its kind in the military.
But joining at an age when most civilian medical careers are peaking seemed an odd choice.
November explained the decision that he and his wife, Nancy, made.
At a large university's medical center in the eastern U.S., November worked at a hospital where more than 8,000 babies are born each year. The practice became more and more driven by profit motives, and he was urged to see more patients by spending less time with each. There were more conferences about coding and how to get the most visits from a particular diagnosis.
"I wasn't comfortable with it," November said. "I was thoroughly disgusted. We were told not to give any results on the telephone, but to make the patients come in for a visit."
He was even told that the telephone was his worst enemy; phone calls were not billable.
November began talking with an Army recruiter.
"I had good feelings about the military; I felt I should have been in the military," he said.
November had childhood friends who died in Vietnam, then the 9/11 disaster worsened his feelings of guilt.
"I thought trying to provide good care to the Families of those who were putting their lives on the line was an honorable approach," he explained.
"Our lives totally changed when Stephen decided to leave private practice and join the military at the age of 53," Nancy November said. "We both feel military Families are very special and we love the dedicated people we have met since he joined."
A lifelong fitness buff, November was accustomed to swimming for exercise, so the military height and weight standards were not an issue for him.
"Now I run almost daily, which is a plus," he said.
After five years in the military, November has a unique perspective on medicine.
"There are pros and cons to both sides of the practice," he said. "In the military, I can spend the appropriate time with each patient, and I don't have to worry if they can pay for a test. It's nice; you can do what you need to do. There's no calling insurance companies and begging them to do a test the patient needs, regardless of their coverage-no authorizations to extract.
"You have more impact on how things are done in the military practice. MDs have more input on the administrative side, like standards of care. Most civilian doctors are excluded from that process," he said.
Business issues aside, November said he prefers military medicine.
"If I had it to do over, I probably would have joined the Army sooner. In the Army, we all have the same goals, the same mission," he said. "There are so many other concerns in civilian practice-the insurance, the business, the liabilities. In the Army, those are not a constraint."
Medicine aside, a military career presents other challenges for the Novembers.
They are observant Orthodox Jews, so strict dietary rules, meeting with those of similar faith, and the restrictions of religious holidays might seem problematic to a military career, but the couple said they've been pleasantly surprised.
"It was amazing to find truly kosher frozen poultry at the commissary the very first day we shopped in Vicenza," said Nancy. "That hasn't been true at every post since."
However, if they cannot find a given item at the commissary, it's usually available somewhere in the surrounding community.
In addition, November said the restrictions about surgery, deliveries, and blood are superseded by the principle of saving life.
"It's sort of like a dispensation for Catholics," he explained.
November is easily distinguished from his physician colleagues in the military because he normally wears his kippah (also known as a yarmulke) with his uniform, which Army standards allow.
"Occasionally, I get funny looks, but (the hospital staff) gets used to it," he said. "I think the military population-in general-is more tolerant of others and friendlier. The patients are much more appreciative of the time you spend with them."
Nancy added a surprising result of the military lifestyle.
"It has made us better understand who we are as Americans, Jews, and people working for an amazing cause," she said. "We always cringed every time there was a terror attack in Israel ... but if it upsets us as Jews, it was still in another part of the world, and we felt safe here. Now terrorism is a global problem and there is no real protection except with our military. We can't do enough for our military family."