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Healthcare Professionals / Progress Notes / In the Spotlight / Dr. Thomas Gates isn’t retiring -- but he is moving to Malawi

Dr. Thomas Gates isn’t retiring -- but he is moving to Malawi

Dr. Thomas Gates will leave LG Health after 20 years to serve as medical director of a community hospital in Malawi.

Dr. Thomas Gates wants to put a rumor to rest: He’s not retiring.

It’s true that Dr. Gates will leave Lancaster General Health Sept. 1, after 20 years with Downtown Family Medicine and Lancaster General Hospital’s Family Medicine Residency Program.

But he’s not done practicing or teaching medicine just yet.

Dr. Gates and his wife Liz will move to the impoverished African country of Malawi, where he will work for the nonprofit NGO Partners in Health as medical director of a community hospital with one other physician.

“Medically, Malawi is a different world,” he said. “The No. 1 cause of mortality in children is malaria, and No. 2 is HIV. In terms of per capita income, it is near the bottom of the list, so predominantly we see diseases of poverty.”

Before he came to LG Health, Dr. Gates worked in a hospital in rural Kenya for three years. He’s taken several short trips to Kenya since, and he always hoped to live in Africa again one day.

“I’m in a position in my life where I have the freedom to do something else. Our kids are grown, and our parents have all died.  I’ve been thinking about how to spend the last few years of my career,” he said. “This opportunity to return to Africa has been the nudge that pulled me away from LGH.”

After graduating from Williams College and Harvard University Medical School, Dr. Gates completed his residency and internship at the University of Utah, where he met his future LGH colleague, Dr. Stephen Ratcliffe.

Dr. Gates practiced for eight years in Lancaster, New Hampshire, then moved to Kenya, where interactions with visiting medical students sparked his interest in teaching. Tenacious recruiting by Dr. Nik Zervanos brought him here to Lancaster.

Dr. Gates, who recently received the LGH Medical Staff’s Henry Wentz Award for career achievement, as well as the Faculty Teacher of the Year Award from the 2015 graduating class, said training primary-care physicians is more important than ever. Currently about 8 percent of medical school graduates pursue a career in family medicine, far fewer than needed.

“LGH graduates are highly sought after, and salaries are going up,” he said. “But many graduating medical students owe several hundred thousand dollars. Understandably, they gravitate toward higher-paying specialties.”

Duty-hour limitations have made residency a bit more humane than a generation ago, Dr. Gates said, but today’s residents also accumulate less hands-on clinical experience. The growing number of women entering family medicine – locally at least – has been an impetus to improve work-life balance, he said.

“It’s good for us to think about whether it’s possible to have a family life and be a family physician,” he said. “I think we’d all like to think that it’s possible.”

At Downtown Family Medicine, Dr. and Mrs. Gates started the Reach Out and Read Program, where physicians encourage reading by giving free books to young children at well-child checks. The program has since expanded to other LG Health sites.

“We’re serving a population that hungers for books,” he said. “These kids are at a disadvantage from the beginning. We see it as an antipoverty program, something that lays the foundation for school achievement.”

Dr. Gates also chairs LG Health’s Bioethics Committee, which provides education, shapes policy and offers consultations when there is a conflict or question about the direction of a patient’s care.

“Over the years, the opportunity to consult on difficult cases has been very challenging,” he said. “Most ethics issues involve failure in communication between the medical team and patients’ families, and to the extent I have been able to help, it has been gratifying.”

In Malawi, Dr. Gates will care for patients and train local physicians in family medicine. The Gateses will live about 800 miles from their son Matt, who works in agriculture and development in Rwanda.

“It’s been very emotional saying goodbye to my patients, including many I’ve seen for 20 years,” said Dr. Gates, who plans to return to Lancaster in a couple of years. “It’s made me realize the deep connection patients have with their doctor.”

  • Click here to read Dr. Gates’ article on cancer screening, which appeared in the November 2014 issue of American Family Physician.


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