In 1979, when Dr. Peter Milstein first started as a cardiologist at Lawrence + Memorial Hospital, some days were so slow that he used to go home and refinish furniture as a side job to help pay the bills.
“It was so much slower back then, and we were dirt poor,” he says, smiling and marveling at how the last 33 years have advanced his life and transformed his favorite community hospital.
“In those days,” Dr. Milstein explains, “if you had cancer you went elsewhere, if you had a bad heart, you went elsewhere, if you had renal failure, you went elsewhere. Today, there is such a wide array of sub-specialties. There’s such depth of services, and that’s the strength of our hospital. You don’t have to go elsewhere.”
The changes in heart care are what Dr. Milstein knows best because he’s lived it since “the early days.”
“We didn’t even have a portable X-Ray,” he recalls. “We used to put a pacemaker in and turn it on and just advance it blindly waiting to see if it would capture the heart. It was just crazy primitive stuff that makes us think today, What in the world were we doing!?”
Dr. Milstein understands the significance of those early days because he has helped transform the cardiology programs that today make L+M a leader in community heart care. He was an integral player, for example, in the establishment of L+M’s emergency PCI program for heart attack victims.
PCI stands for Percutaneous Coronary Intervention, and L+M is the only hospital in all of eastern Connecticut that has the life-saving service, where doctors insert an image-guided catheter into a patient’s arteries, find the blood clot that is causing the heart attack, clear that clot, then insert a balloon device and stent to keep the artery open.
“Helping bring emergency angioplasty to L+M is one of the highlights of my career,” Dr. Milstein says. “And I really respect Bruce Cummings, L+M’s CEO, because although he’s a businessman, he has always said, ‘Do we need it medically? And, if so, let’s go ahead and do it.’ He realizes we’re not selling widgets. With healthcare, sometimes, for the good of the community, you’ve got to do it.”
Dr. Milstein’s latest hospital initiative aims to reduce the high rate of hospital readmissions for patients with congestive heart failure, the most common and expensive diagnosis for inpatients, he says.
The program to prevent readmissions includes education, visiting nurse supervision of patients in their homes and a doctor’s follow-up within five days after the patient’s hospital stay.
“If we can catch heart failure early enough, we can adjust medications and help prevent people from being readmitted to the hospital,” Milstein says. “It’s self awareness. We have to teach people the warning signs. If your weight goes up two pounds quickly, that’s not fat, that’s fluid. You call your doctor. If you can’t lay down because you’re short of breath, that’s heart failure. If your ankles are getting swollen and puffy – that’s heart failure kicking in.”
Dr. Milstein grew up in Portland, ME. He went to the University of Vermont for his undergraduate studies and then to Tufts for Medical School. He did his internship and residency for internal medicine at Georgetown University and then returned to Tufts for a fellowship in cardiology.
Dr. Milstein arrived at L+M in 1979 after a former cardiology fellow, Wallace C. Andrias, then the new chief of cardiology at L+M, recommended that both Milstein and another fellow, Dr. Brian Ehrlich, come down and join the practice in New London. The practice grew over the years and, most recently, Eastern Connecticut Cardiology Group joined the Lawrence + Memorial Physicians Association.
A life-changing event for Dr. Milstein occurred several years ago when, while riding his bicycle home from L+M to his house in Mystic (a commute he made each day) he was struck and badly injured by a car.
“I’m still recovering,” he says. “That accident had a lot to do with some of my philosophical changes. If you have a life-threatening event like that, and you survive, you look at life differently.”
It’s one of the reasons Dr. Milstein sees the big picture at L+M, focusing attention on programs and services that help improve the lives of many patients, now and in years to come.
“I’m at a nice place in life now where I can look at the bigger picture and say, OK, the hospital needs this. The community needs this. This would be fun to do. This would be useful to do,” he says.
After a long career in a changing field, “I still think that being a being a doctor is the most fabulous thing,” he says. “I’d do it again in a second. Medicine suited me perfectly because, every time you open that door and go in to see a patient, you smile, they smile, and you have immediate gratification.
“Every time you meet with a patient,” he says, “you have a chance to be successful. I need continuous reinforcement. I need to do some good and feel like I’ve done some good and medicine is just perfect for that. I enjoy the patients here more than anything else.”
To learn more about Dr. Milstein, click here.