A Special Practice

by Jacqueline E. Burrell

For an instant, they look like three business executives joking with each before a meeting. Laughter fills the air and the mood is easy.

Then the pagers beep. The intercom buzzes.

The real world of Harry Oken, Gary Milles and Jerry Seals interrupts. They are longtime doctors in Howard County who’ve been in practice together since 1987.

But their medical practice, which is unique in many ways, extends beyond their own patient lists.

Though he shrugs off his role, Dr. Gary Milles is founder of a free clinic for many in the community who cannot afford medical care. Called the Health Alliance for Patients in Need, various physicians, nurses and other medical professionals volunteer their services. They juggle their schedules and coordinate time to care for patients who otherwise might not receive care.

Dr. Harry Oken is very involved in educating the community about skin cancer. Brochures about how to spot changes in moles and other skin cancer information can be found at your neighborhood pool, the library and other public locations. Oken is co-director of the Howard County Skin Cancer Awareness Project. He is also involved in the research and treatment of Lyme disease.

And Dr. Jerry Seals is well known for his work with infectious diseases, in particular with county residents stricken with AIDS or who are HIV positive. Seals is working on a National Institutes of Health approved series of clinical trials using five protocols in the treatment of HIV. He is also active in the "Howard County - A United Vision" project.

This is in addition to their regular practice.

All three are general internists. Milles has a specialty in geriatrics; Oken’s specialty is in cardiovascular conditions; and Seals’ is in infectious diseases.

Back in the late 1980s, when the three opted to go into private practice, the challenge was how to provide quality care and still be able to pay the bills.

Health management organizations, or HMOs, work well in theory to prevent illness, notes Oken. But the reality often translates into something else. Some capitated insurance plans, where a fee is paid per person per month, result in overbookings, or worse, operate on a bet that patients won’t even call.

"That’s not the way we wanted to operate," said Oken. "We decided to take our time and treat the total patient. Someone may come in with a bad back, but the real cause of the pain may be stress elsewhere, in some other part of their life."

The trio linked up with insurance companies they felt would put the patient first.

They also decided to base the business side of their practice on the philosophy: What goes around, comes around.

These guys even make house calls.

As a result, they’ve built up a loyal following, in some cases treating more than one generation of a family.

Putting in 12 and 13-hour days, Oken, Milles and Seals decided to add another partner. In 1996 they sold a minority share of the business to Johns Hopkins.

"It is the first of its kind," said Oken, where a major teaching hospital and university has partnered with a primary care practice. The result has provided access to consultants and brought economies of scale to bear that have allowed the medical practice to grow.

Offices in the Ellicott City condo office park have been expanded.

And a year after Johns Hopkins came on board, a 5,000-square-foot office in Columbia opened called Johns Hopkins at Cedar Lane.

It is here where Seals conducts his AIDS work. It is here where Milles has formed a geriatrics network as well as his volunteer free clinic. And it is here that Johns Hopkins faculty members--pediatric sub specialists, cardiologists, psychiatrists and other medical experts--can be called for consultations.

The Howard County Chamber of Commerce recently honored these three doctors, calling them Howard Heroes.