In nearly a half century of practicing medicine, Dr. Robert Cuthbertson has seen a lot of changes.
"I got in at the end of one era, and then we started another era," the 73-year-old family practitioner said.
"When I started practice we only had penicillin and Terramycin. No one ever touched the heart -- that was forbidden.
"They didn't do coronary artery bypasses and all that. They didn't have any oral diuretics. They had to use injectable mercury, which is unheard of now."
One procedure that dramatically delineates the progress medicine has made in the last half century is cataract surgery.
"A person had to go into the hospital and spend three days with his head in sandbags so it wouldn't move, because they took out the lens and put these big thick lenses on and so forth," Cuthbertson said. "The last patient I had down in Phoenix who had a cataract was an older lady about 80. She had her cataract done in the morning and went shopping in the afternoon."
Cuthbertson was born and raised in Phoenix, and wanted to be a doctor ever since he was in "grammar" school.
"I didn't go into medicine for the money," he said. "I went into medicine because I wanted to be a doctor. We had a family doctor who was a pretty nice guy.
"I knew if I did a good job, the money would come -- and it did. But it's been shrinking."
Cuthbertson went to Phoenix College, then to the University of California - Berkeley, and then to medical school at the University of Southern California.
On his first day at USC, all new medical students were taken to the draft board and given physicals.
"They said, ‘You're drafted,' but they gave us deferments."
Upon earning his medical degree Cuthbertson spent three years in the U.S. Navy as a flight surgeon.
"It was a great experience," he said. "I had a wonderful time. I learned to fly, then became involved in gliders."
After his discharge in 1954, Cuthbertson opened a practice in the Valley. Back then, an office call was $5, house calls (which Cuthbertson used his motorcycle to get to) were $7. Hospital visits were $7. A baby delivery was $75.
While prices are astronomically higher today, doctors see less of it.
"Reimbursement by Medicare, HMOs and PPOs is so poor," Cuthbertson said. "Even though I (continued to see) a lot of people, I wasn't making any money. HMOs determine who you can see and what you can do and Medicare in a way does too."
Cuthbertson decided to move his practice to the Rim country in 1993, after driving to Payson to discuss the move with his good friend, Dr. Ray Hatch.
"I drove up in my Lincoln and he said, ‘Doc, this is a pickup town.' I walked out of the hospital and there in front they had the doctors' names and that's where they all parked their pickups."
Fortunately Cuthbertson also had a pickup, and when he moved to Payson he left the Lincoln at home. He set up his practice on Main Street.
"I thought I could work part time and slow down a bit, but after 18 months I had 2,000 patients," he said.
In 2001, Cuthbertson moved his practice to Pine, but still was busier than he wanted to be. "Seventy-five percent of my patients followed me," he said.
Finally in October of 2001, Cuthbertson called it quits. In two weeks he was so bored he became a "locum tenens" doctor, living in a motor home and providing medical care in communities that needed a substitute doctor for a month or two to fill in for a doctor who was ill or one who hadn't arrived yet.
He spent time in northern California near Yosemite, then worked on three Arizona Indian reservations.
"I enjoyed working with the Indians," he said. "They're a very interesting people and they have a very good health care system.
"It's socialized medicine. It doesn't cost them a dime."
Cuthbertson recently returned to the Rim country and will soon be working part time with Dr. Mark Mouritsen at Primary Care Specialists. While health care is expensive today, he believes the level of care and the services available in the Rim country are exceptional for a community of this size.
"We're very fortunate here in Payson to have an excellent hospital and the good doctors we have," he said.
Cuthbertson praises the advances that technology has brought, but sometimes yearns for the days when practicing medicine was simpler.
"Today, there is so much going on -- so many new things. Every month there's a new medicine out.
"You have to read journals and attend seminars and listen to tapes just to keep current."
And while he believes Payson has some outstanding specialists, Cuthbertson emphasizes the important role that family practices still play.
"The primary interest is still on the patient in family practices," he said. "Sometimes specialists are more interested in the disease."
Cuthbertson has found that the bond that develops over time between a family practitioner and a patient provides invaluable insights into his or her medical care and treatment.
"After you've known patients for a long time, you can read them like a book," he said. "You develop an intuitive awareness of what's happening with your patients -- a communication develops that is non-verbal."
The most important trait a doctor can have is kindness, Cuthbertson believes. The best medicine for his patients is to be happy.
"You live longer if you're happy, and we've got an awful lot of unhappy people in the world," he said. "We live in very stressful times."
How much longer before Cuthbertson finally hangs up his stethoscope?
"The practice of medicine is still a challenge for me," he said. "I'll keep going as long as I can."