As part of an ongoing series, Providence profiles Anthony (Tony) Ohotto, M.D., geriatrics, hospice and palliative medicine physician, Providence ElderPlace
Hospice medical director; Navajo reservation physician in Arizona; Sun Health/St. Joseph Geriatrics fellowship; family medicine residency in St. Paul, Minn.; medical degree, University of Minnesota. Also, cardboard box maker, hospital CNA, paper boy
How has our understanding of geriatric care changed over the years?
I continue to be stunned by iatrogenic problems I see in our elders. It is all well intended, but we cause so much harm with our pills and procedures and tests and hospitals. It is, sadly, our cultural norm.
If there has been a change in my own understanding, it has been incremental and thus hard to notice. I think there are very few true watershed discoveries in medicine in general, and in geriatrics in particular. Geriatrics is about doing the little things carefully and correctly and gently.
Why did you choose this specialty?
When I got to the reservation the medical director asked me if I wanted a field clinic assignment or to take responsibility for the few nursing homes in our area. It was all quite random, but I chose the nursing home assignment and discovered I liked it.
I took care of some amazing people: Navajo code talkers; politicians and policymakers for Navajo Nation; little grandmas who would give anything to be back out living in their hogan in the canyon.
What’s the most important thing your older patients have taught you?
The old bromide, “Getting old is not for sissies,” seems to be quite true. I sometimes feel old now in my 40s. My patients have said to me, “Oh, to be in my 40s again.” One really needs to take care to enjoy the moment, because as the years slip by, things become increasingly difficult.
What’s different about practicing medicine on a Navajo reservation?
It rains more here. Otherwise, I don’t think there is any real difference. People are people. You try to respect patients for their idiosyncrasies, and you try to do the best job possible with a cheerful attitude. Most people respond.
What medical mystery do you wish could be solved?
Addictions. Our culture bears a considerable morbidity caused by its addictions: tobacco, overeating, drugs, etc. If we had a medical way to help control these issues, we could do a lot of good.
I once heard a Navajo medicine man give a bit of a sermon. He referenced the use of wine in the Christian tradition and the use of tobacco in native religious traditions. Then he asked rhetorically if it is any wonder we suffer so greatly when we abuse these substances which are supposed to be sacred.
If you weren’t a doctor, what would you be?
I would be a farmer. Both my parents left small family farms as young adults to move to the big city. If I had been raised there, I can’t imagine ever leaving. Difficult, dirt, outdoors. Sounds like a nice life to me.
Do you still make house calls by bicycle?
Much has been made of my bicycle-powered house calls. The real story is that we are doing house calls at all. It is such a good way to deliver medical care to frail elders. Sadly, it is rarely done. The reasons are multiple and complex.
Do you have any hidden talents?
Morel hunting from a mountain bike might be my most surprising talent. Showing off might be my most hidden.
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