By Dr. Anthony Policastro

Most people know that I had a career in Air Force medicine. However, most of them do not know why I chose to do so. In addition, people do not know that I decided to be a pediatrician in the second grade after a visit to my pediatrician. I never changed my mind.

I joined the Air Force at the end of my second year of medical school. It was during the draft years and the Vietnam War. Serving my country was a no brainer. It was what everyone my age did. The exceptions were those trying to find an excuse to be declared 4-F.

The program that I signed up with guaranteed that I would enter the Air Force as a pediatrician after I completed my pediatric residency. It was kind of coincidental that the draft ended three months into my pediatric residency. I would have never been drafted but I did not care. I wanted to serve.

My first Air Force assignment was at Dover AFB from 1975-1976. One of the things that people do not often realize is that sick children can sometimes get even sicker after seeing the doctor. They may have a pneumonia that will have increased breathing issues. They might have asthma that will worsen. They might have an infection for which oral antibiotics are not sufficient.

There were three options when seeing patients who were that ill. One was to admit them to the hospital to make sure that they didn’t get worse. That would be a lot of unnecessary admissions. A second was to send them home with instructions to come back if things got worse. That put the burden on the parents.

The third was to send them home with instructions to come back and be checked the following day. That put the burden on the physician. However, it meant an additional office visit. The question was who would pay for that visit.

In private practice, the physician could see the patient but someone would have to pay for that visit. It might be the insurance company. It might be the parent. It might be that the doctor didn’t charge. But in a way that was still payment for the visit.

Air Force dependent children had care covered by the military. The payment was in doctor salaries not visits. Thus, if I wanted to see a patient back the next day, there would not be an issue of paying for it on anyone’s part. That was the way I wanted to practice pediatrics. So I stayed in the Air Force because it allowed the type of Pediatric practice that I desired.

Several years later I got called into the Commanding General’s office at Andrews AFB. He told me that he thought I should consider looking at becoming an Air Force Hospital Commanding Officer. My response was that I liked practicing clinical Pediatrics.

I still remember his answer. He told me that if all the good clinicians felt that way, we would be having the non-clinical doctors running the hospitals. My first Commanding Officer was a medical researcher so I knew what he was talking about.

That led me to spending the last 9 of my 20-year Air Force career commanding two different Air Force Hospitals. It allowed an impact on patient care that extended far beyond the Pediatric Clinic.

I still continued my Pediatric practice three half days a week during those nine years. Thus, when I formally retired, I was able to get a position at Nemours Seaford Pediatric Clinic. At first it was part time while I was the Medical Director at Nanticoke Hospital. However, when I retired from that role, I went back to being a full time pediatrician.

I had not strayed from the path that I decided upon when I was in the second grade.