This podcast features an interview with Dr. (& General) David Hamlar, MD, DDS, FACS.
In this episode, we are going to chat about the unusual path many physicians take, how the profession has changed, and what physicians can do outside of the exam and operating rooms to impact the world.
That’s why I decided to invite Brigadier General David D. Hamlar.
Brigadier General David D. Hamlar is Assistant Adjutant General – Air, Minnesota National Guard.
Besides his wonderful service to our country, he is also a physician, performing craniofacial/skull base surgery and as a professor at the University of Minnesota.
He’s had an amazing journey- serving our country both as a physician and as an officer, but it wasn’t an easy path.
This interview reveals the following:
– How General Hamlar traded for time, instead of money (and how you can too!) and how he built his first clinic
– Why he changed from dentistry to a physician and an ENT specialist (Hint: It’s not just because he loves learning!)
– Who is a GREAT candidate for government debt reduction programs and who is NOT. Also, get to know the steep penalty if you don’t serve your time!
– The biggest, life-changing advice that he gives regularly to residents
TRANSCRIPTION
(Note: I outsource transcription efforts, please forgive in advance any grammatical errors. I just simply don’t have time to review it all)
David: My name is David Denniston, welcome to the latest episode of the Freedom Formula for Physicians Podcast. Well, today we’re going to chat about the unusual path that many physicians take. How the profession has changed, and what physicians can do outside of the exam and operating rooms to impact the world? Well, I have the distinct pleasure of hosting our guest today, Brigadier General David D. Hamlar. He is the Assistant Adjunct General of Air and of Minnesota National Guard. And besides his wonderful service to our country, he’s also a physician, performing Cranial Facial Skull based surgery. And as a professor at the University of Minnesota. And he’s had an amazing journey serving both our country as a physician, and as an officer. But it has not been an easy path. He graduated from Tufts University, in Boston, with a Bachelor’s Degree in Science, Biology. And then attended the Howard University College of Dentistry. As a National Health Service Core Scholarship Recipient. Gaining a commission as the equivalent as rank of Lieutenant. And here he was practicing dentistry in Ohio. He ended up changing careers in and entering medical school, at the Ohio State University, Ohio State University in 1985. While completing his studies in three years, he spent his fourth year as a basic research scientist. And this lead to a one year of Post Graduate Training in General Surgery. And four years in Otawantronology. (mispronouncing that one?) And finally, a Fellowship he had in Facial Plastics Reconstructive Surgery. Where he went to Minnesota in 1994, where he attended the U of M here. And finally, was a practicing physician. Well, welcome General.
Dr. Hamlar: Thanks Dave, glad to be here.
David: Well, tell us about yourself? You’ve had this incredible path. And I know quite a few physicians who started careers. Moving from one thing to another, but I never met someone who’s had this military service like you have. So, tell us about your journey, and this transition and the process from Dental to military service, to addition.
Dr. Hamlar: Well, something, a to alibi’s is? One is instead of ordering guys EMT. That’s most at the moment. But a, I’ve never been good at it. And the other is I’m a slow learner, it takes a long time to get to a point where you want to be. But growing-up I had a father who, #1. An advocate for education, and also in that for his children that one of them had to maybe have the benefits he didn’t have. And more of those pathways to get there with a good education. So, education very highly evolved within our household. So, I never had a problem with that. In fact, I probably had more fun than I should have along the way. So, growing-up I was privileged to have great parents who knew the difference in right and wrong and knew what they wanted. Believe me, they were task masters. You know, one of the things that, we didn’t have any flippage in our studies or what we told to do. To me that felt a good thing because a hero will get you. So starting out I had to prove of not only having good parents, but having good people around me. If anyone was going to make it in life, I was, and there was no excuses about that. All my givings and I agree that they were the reasons for that, for our success.
Now the other end of that is, I don’t mind hard work. I don’t think I’ve ever been the brightest guy in any of my classes, or anything like that? But, the one thing I will say is, that many of these class advisors and mentors I’ve been around is? I have out worked them, when I’ve been blessed to have that badge of limitless energy, I accede in gold in that.
David: And so you went to dentistry school, and why did you end up changing? What prompted that change in dentistry?
Dr. Hamlar: Well, my dad was a dentist and I grew-up totally informed in working in the dental office of doing odd jobs and actually I think our child labor laws that were being scuttled, but? Fine, I grew-up around dentistry, I loved it. I loved working around using my hands. I repaired cars later on in life. Not a whole lot of woodworking, but pretty good at that to, loved working with my hands. And dentistry is all about a vocation of working with your hands. Obviously bring the medical/dental side out of it. Making decisions and I was pretty good at that. But having that background, dental school was the next step I saw it as an opportunity to practice with my dad. I dare say that was one of the reasons for going after it.
David: Wow, and then can you end up making a career pitch at the same time here? Serving in the military, tell us about that? When, what inspired you, what motivated you to serve your country, and the community. Tell us a little bit about how your service very has changed you?
Dr. Hamlar: Well, you know, the order, that changed in 1972. They cut the draft out at the end. And I was a 1H. So, a 1H means, that, “You’re going to go at some point!!” In terms that from the accessibility to the city a lot of the folks that came to that base later settled into the city. And they were physicians, dentist, and so Columbus wound up having a base that provided a ready-made work force to, such as we have in the American community right there. And believe it or not those little guys who came last had a political history came at the end. So, from the military stand point, having a father who was in the military. To having spent a year in that. It was getting a bit natural to gravitate towards something that would benefit yourself and everyone. Now, I didn’t jump into the military after the draft died right away. It wasn’t until like, dental school. I had to heap on a way of paying for dental school, I joined the service. Now you can do that several ways, And either go to a military school and provide rotation. And I’ll tell you about that. Or they can pay you and then they obligate yourself. And then after besides the duty clause, and National Service Corp. National Service Corp. is part of Private Corp. Service. Private Corp. Service is, sometimes you see it, a litho-graph, or some old guy? And it’s stunning because they keep some old guy who does tele-graph Service, and sure enough. Their duty is to provide signatures of owness of what you say, the state side in garrison support. For all the folks who can’t, who are no longer here. Without also to, they also provide an add to seaman who come into port for the mid-American population. And they do it for those who just can’t. And don’t have the means to support themselves. They join that in about 3 years later I opened my plan up and I served it state side originally. I was going to be a indigent care area. In L.A. the money got taken away from me. And then I had to write a grant. And I wrote a grant to service a small community of Southern Ohio called, “Chillacoffrin.” So, that’s where I built my first clinic. And it was funded by the federal government.
And it provided care for all those in that area that didn’t have didn’t already have access to care. And that was during school, that was during and after dental school. And then this kept going and I changed careers after I changed careers that sort of thing. I was sitting up in dental school. There was a commonality between medical and dental school. That school is the school a lot the same way. The first two years are basic time, because you learn basic the same. So, I’m sitting up in Hepology, a big lecture hall, 400 people. And I’d asked a question about ligature in the mitosis? And the guy looked at me, and said, “Are you mental, or are you medical?” I said, “Dental.” And he said, “You don’t need this, you can go.” But those kinds of challenges, spur me on. And, long story short, I went back to medical school.
David: Wow, wow, wow. So, I know that the NASC still has a number of scholarships that are available. That physicians can take advantage of when they are coming into or going out of residency. And I think one of the biggest issues, meaning, that students face? This huge burden of debt, and I see many residents that have over $300,000.00 of debt. That is a nice sized ouch right there. And I’ve heard that service to our military and our country will capture these kinds of programs like NASC, can be a way to eliminate or reduce the debt. Can you tell us more, you eluded to earlier? How military service to works with this? So, you said it could be on the front end, or the back end?
Dr. Hamlar: Yeah. I was in dental school in Washington, in DC, and there is no better place to find out who the movers and shakers are? Yeah, I got to a cocktail that provides that service. So, you have these regular uniform services: Air Force, Army, Navy, Mariners, we use navy personnel for their medical service. You can wrap the mariners up from there. And all of them have hospitals that are here state side that have teaching two programs at a time to them. Not all of them have medical schools. The teaching programs, they do the residency. Now, the one hospital that still has a teaching program is, UMHU, that’s Uniformed Military Hospitals, and it’s actually in Bethesda, Maryland. And so the old Walter Reed was on George Avenue. Now part of Bethesda Medical. And actually walks up into there Sir Walter knew Reed, and half expect. But, anyway, you can apply to those schools, get in, and they pay for your entire education. And now your obligated, in some cases a year to two and a half years that you receive service. And also actually a year per year. You can’t beat that entire debt. Now, less obligation, now you rather owe time, or owe money? Now, again, I don’t mind working hard, I don’t mind being a late bloomer, late learner. I was the way I considered for me to go. Now, you can take out loans instead. And I think I’m at the University of Minnesota and I looked at the average debt there? Of a guy coming out, with thousands of dollars $60 to $200 thousand. Now, you can defer that, you know, through loan companies and everything else. But, eventually you have to pay. Now, what’s the benefit of military? I think it’s just what you said, you get to serve your country. In fact, I’m an advocate of service to this country in some capacity once you reach the age of 18. But that’s neither here nor there? The fact is, that I think you learn a lot by becoming part of the fabric of this country. And there’s no better way to do it than enlisting through the military. Now, with me? I guess the reason I chose that Self-Service Corp. is that the person I ran into. That a gentleman told me the benefits of service. You receive all of your tuition paid, and a monthly stipend. But that allows you to sleep, and eat and be a normal person while struggling through school. The back issue to that is, you owe the time and when I was coming out? I had dreams of being in California.
Both got dashed because of money was limited, this was 1981. And with limited funds, I think L.A. county had to withdraw funding for the clinic I was going to. Instead of paying, and get this? If you don’t serve your time back up after receiving the funds. You pay close to 7 times the amount that you owe.
David: (Whistling)
Dr. Hamlar: So, if they catch you withdrawing, and you can afford it. I’m sure like, they are going to take out from a life-long loan to pay that. But anyway, I had the option of working in some other areas, to build, and furnish a facility again. So, I was able to get through it for a year or so? 1981to 1983 I was a Lieutenant. And that was in the Public Health Service, that we met and Health Corp. Service did. After that, surprisingly I got out, and I ran into an Air Force guy. One of these guys who were going into the Air Force base, in Columbus Ohio. And he had all these aircraft in his lead, indeed. And a retired Colonel, from the Air Force, and who was in the National Guard. I had no idea what the National Guard was? Not so sure I was going into that? Sure of the National Guard and not some thirty years later, I’ve loved every bit of it.
David: So, if you’re talking to a person that’s looking into being a medical student, and they’re considering these options? What kind of person do you think would be good for military service, and the back end of it? And what kind of a person would not be good for that kind of commitment?
Dr. Hamlar: Well, you know, It’s like, I am on the admissions committee here at the University of Minnesota. And if you’re going to be a physician? And one goal is to make money. Or one of the goals is to be respected in the community? If both of these goals, you’re not going to make it. I think service to the community is one thing that you have to want to do! Particularly the military, you can go in and say, you want to achieve a certain rank? Which is what you want to do. But since you want to go fight in wars, or whatever? You want to fly aircraft, you want to pilot a sub, those kinds of things. But unless you want to really serve your country? You’re not going to be satisfied. Because there’s always going to be road blocks. And some of these are harsh, in fact, you see it every day. Boot camp, you know, the days without rest. Being deployed somewhere you don’t want be. The being separated from your family. Those things catch up to you. So if you really don’t want to do those things? Then, and you don’t have the love of your country, and that willing to serve, then you’re not going to be successful. So, that has to be your inner matrix. Something quality deep within that you want to do. Because, you know, there’s other ways to make money now days. And probably a lot easier than spending those. I think I spent 14 years after dentistry, re-training going through all the self-fellowships and everything. And started a profit. That’s 14 years of your life. Until I actually started what I was doing. So those are the kind of folks that do well. And accepting a serious obligation.
David: So it sounds like someone, that has that dedication, a love for people. And is full driven by those things.
Dr. Hamlar: Exactly, exactly, that’s true.
David: I mean, if you love money and that’s what youre going for? Than the more power to ya.
Dr. Hamlar: And I just don’t think it’s the driving force that helped me along. And I met a lot of others who have gone that way. And it’s not the driving force that’s what keeps you up at 3:00a.m. in the morning, studying? Of a clip cycle that you’re not going to understand 15 years later. Because you have to do it from memory. Somethings that you have to endure.
David: Hum, great advice. Well, besides all this work that you do? How you and I met? With a Lions Club Meeting here in Bloomington about a month or two ago. I was surprised you were involved, because I haven’t met many docs, that are involved with Lions Club or this sort of service organizations. So, tell us about that? How did you find the time? What lead you be involved in Lion’s Club and other service organizations?
Dr. Hamlar: Well, Lion’s Club has been very beneficial to the University. Specifically, with ophthalmology which is one core above us here, and about 17 right now. And in our department, the study of Ophthalmology both Lion’s has provided, obviously visual aids and the Lion’s Eye Bank. And to us, it’s all been about feelings, Lion’s is a great supporter of ours. In terms of feeling for those who can’t hear, providing hearing aids. And of late, providing the implicus for infant hearing and screenings in both the hospital and clinic settings. Those things provide just wonderful benefits to that, that population. To not be able to see, and not be able to hear. Now, the way I got involved is, when I was early on here, I was with the Lion’s audiogram, audio group here. And it’s just an amazing group of guys. And they come from all over the state. To see the benefits of all the dollars they’ve given to the University of Minnesota. And we have plaques, we have photos, of murals, we have everything here. We can help, and to share respect for the Lion’s and the benefits they provide. Now, at the same time, we have provided the option of joining Lion’s. I’ve been members of other Public Service organizations, and I believe in that. No matter what kind of time, I can’t put a lot of time in. But, I do give monetary support or something? And that’s a big deal, and that’s how I got involved. Because we, the Lion’s Ambassador’s club right here. Within the University’s, typically right here in the Ophthalmology Department.
David: And I think a physician denounce 40-50 years ago, they weren’t having to see patients every 10-15 minutes. It wasn’t the machine, in the hospital setting that it is today. It seems like, at the time, being involved in service organizations like Lion’s, Rotary. That was requirement, if you were a service provider, like a physician and for other small businesses. So, you all talk about, why do you think, docs aren’t involved today? What would you say to other physicians who are listening today?
Dr. Hamlar: Well, you know, medicine has become corporate, you know, the fact that less productions. You used to go into medicine as an entrepreneur. And I remember growing-up, you had doc’s office. Both physicians and dentists around the surrounding community. It’s hard to find that anymore. Because, number one, the cost of setting up an office is very expensive. And then the settings in the office, you have the mal-practice insurance. All the things that are incombant upon a businessman. And what happens is, administrators come in and in the job of arranging the day to day practice. And it allows physicians that care for patients. Now at the same time, production numbers. And we joke around now, at the universe and everything else is cost. Literally I feel like I can be an employee, because I have little say in what I can do now.
So, with that, meaning to do something. Or you know, you get your hands in that, in those conversations then you don’t have time to be competing.
David: Here’s my personal prediction that I see coming? It seems the hospitals and the major practices have been gobbling, gobbling up. As we get into the scenario, where we’re talking about Medicare reimbursements? This pressure, from the, “Affordable Care Act.” Although, they are not philanthropic on some patients? I personally for see some entrepreneur coming back. Whereas if you are an entrepreneur, you have far more pay possibility than you do as a doc in a hospital. And I think, being involved in these things, in service organizations. You can connect with the community as well. A great way for people to find patients, if they are the entrepreneur in the future. Where you don’t have to be part of a surgical center, or you have some of these other revenue possibilities, besides just being in practice.
Dr. Hamlar: And that’s true, I have friends and have seen some of my friends who are a real entrepreneur and he opened up a surgical center. Now, I would love for him to keep practicing and seeing patients. But, you know, you can’t expect the password or try and settle back and making money now. I would like, now, If you do, or if you are successful than you want to use your skills in other ways. Now at the same time, it’s funny you say that? When I was in Chulacoffee, and opened up a practice for indigent patients? There were people, who simply were, the paying clientele in that same city. Now, they were happy in their paying clientele. They never crossed into, or saw the benefits, of keeping indigent patients of the Medicaid population. You know, I went into that entire population. And by doing good work, word got around. So, I was starting to see all people in that community. Something my dad told me a long time ago. He said, “Everybody that’s on welfare, isn’t always going to be on welfare.” And that is true today as it is at that time. Welfare is helping a hand up. And so, once they succeed in re-establishing themselves. There are patients that I knew, that were in that predicament. They came back and were the same customers than the family did. So, you know, that’s how entrepreneur spirit in sort of a different way. But, you know, seeing the people in the community, again in somewhat service related. Because now people taking opportunity even to see certain places, populations, and driven by advertisement to success.
David: Very interesting. What I want you to, turn the gears a little bit on you? And we’re just wrapping it up here in the next few minutes. Now imagine, you’re sitting across from a table. You’re talking to a resident they’re finishing up their residency. What advice would you give them?
Dr. Hamlar: I actually do have the other residencies, we actually have four residents, who graduated each within a year. And for my money obviously with efficient academic men. Because we need more researchers out there, we need more discovery. You need the people who will recruit in four years, five years inspire, consider it their obligation. Learn it to touch everybody, who comes into the field. So that’s my thing, that, I actually push an academic bend through it. Now, you gotta face here, your families not enough families now. You got to take your wishes and desires. You have to be private thoughts. But the goal of it is, do what you love. Because if you do it for what you love. I do it to, you won’t work a day in your life. Feel that way, you don’t, after 23 years in practice, and in the military, I love what I do.
So, that’s my first thing. If you do it, you do what you love, you will be successful. You’ll have success at both ends, mind and body played out for others.
Fortunately now, especially with the ACA coming on. Now there’s more primary care docs. On especially we need primary care docs. And right now, we need, especially in rural Minnesota. There are tons of ways of community that are getting together to fund primary care physicians to be in their community. So we see that every day in the medical schools. And we see different ways of financing that, that can happen. And be state money, county money, it can be a lone city’s money? Military is still an option, especially now the Service Corp. So, when people sitting down and a process of, are you willing to? Even if that’s, you may not like being in there okay. You may not want to do those things? It is something you can do to use as a template at the time. For two at a time, to see that you got your footing. I remember when I was a fellow here, one of our co-fellows, he going up the ladder. So it wasn’t a santa up there, it was barely a care fare, and they needed a EMT doc. And the needed an EMT Doc. Badly and we have need for it bad, the reimbursement goes up. So, he got a very healthy contract to go there. Now is he chasing dollars? No, he’s actually funding further. So he’s actually funding other docs. But the thing is, when I sit down and talk with residences. Okay, you’re going to have a burden put on you. Try to find a way to do something you love to do, that’s not putting a strain on your family. Because remember, if you look in medicine, not the monetary reimbursement. You look at the divorce rates of docs. It goes up a little bit once you get out of school. Because you mom, has been supporting you now. For one reason or another, it’s all unraveling. So, that’s something you have to be, you have to think of yourself and your family. So, the biggest thing is, if you’re career driven? Look for a way to take advantage of your strengths. If you’re not career driven? You’re just going to have a nice walk. There are places in between cities. There are places across the country you can find that will make you a nice profit. Find the place you want, and not be, the mission that you’re trying to push further.
David: A-huh, absolutely. I just want to thank you so much for being with us today. Actually, thank you, thank you, for your service. If you got more questions, about your background? And some of the things you learned along the way. And the questions about military service. What would be the best way to get in contact with you?
Dr. Hamlar: Well, obviously you can Google anybody now days? But I am asking you at the university. And I’m probably, I’ll check out Emails a lot of the time. So, you can Email me, and I give out my Emails, at the university
Hamla001@umn.edu. So Hamla is my name just drop the “R” and go zero, zero, one.
David: Well wonderful, thank you again for joining us General Hamlar. Reports speaking with you, checking in at some point? If you want a position or want to tell your story? Grappling with tough issues and want to get on a soapbox for a few minutes? I’d enjoy sharing your story. Next Freedom Formula Physicians Podcast. Be sure to contact me at on my website – www.daviddenniston.com/physicians and doctorfreedompodcast.com. For the Freedom Formula Physicians Podcast, I’m David Denniston, thanks so much for joining us. Make sure to subscribe and check-in again. Thank you have a good day.
