Gary E. Applebaum, MD

Executive Director of Seasons Hospice & Palliative Care of Maryland

“I find that it's all too easy to forget the daily challenges that both patients and providers face in our system unless you're there and part of it," explains Dr. Applebaum. "And, just as important, seeing patients is something I need to do—for myself."

At Johns Hopkins, where Dr. Applebaum did his residency in internal medicine after graduating from the University of Pennsylvania School of Medicine, faculty in the cardiology department urged him to follow up with a fellowship in that arguably more glamorous field. He chose geriatrics instead, he says, for three reasons.

First, there was the appeal of what Dr. Applebaum describes as geriatrics' intense humanism.

"Medicine is both a science and an art, but I think geriatrics is one field that really pushes the art," explains Dr. Applebaum, who lives in Owings Mills, Maryland with his wife, Julie, and their two adult sons. "You have to know the science, but the art—the personal engagement with your patient—that's the key. In geriatrics, your patients have the most complicated medical problems, and you can't just go by the book. You have to educate them and help them make decisions about their options. And to do that, you have to form a bond with them. There's the humanity. That's the magical part for me."

Second was geriatrics' emphasis on comprehensive care. And finally, there were the demographics. Even 20 years ago, demographers were raising alarms about the coming Age Boom and warning that the nation needed to prepare. To Applebaum, the son of an accountant who'd always been attracted to business, it was clear that success in geriatrics required both expertise in medicine and the ways of the marketplace. He was hooked.

So, in 1989, when Erickson Retirement Communities, now one of the largest developers of continuing care retirement communities in the US, offered him a job as a staff physician and medical director, he accepted without hesitation.

It was Dr. Applebaum's first job and he was Erickson's first staff physician and medical director—in charge of care at Erickson's first community, outside Baltimore, home to 400 older adults. By 1994, he was the Chief Medical Officer there. Ultimately he was responsible for 14 communities, in 8 states, housing 17,000 seniors, and with a full-time medical staff of more than 70 providers.

"It's extremely satisfying that at Erickson, we proved that if seniors lived in a socially supportive, active environment, with quality onsite medical care, the outcomes would be superior and the costs would be dramatically reduced," thanks to lower morbidity and hospitalization rates, Dr. Applebaum explains.

Dr. Applebaum and Erickson worked together after he decided to make a bid for Maryland's open Third District seat in September 2005. They emphasized the importance of providing a supportive environment that offered social engagement, physical activity, nutritious meals, and comprehensive primary and preventive care. This, Dr. Applebaum's geriatrics residency had convinced him, would pay off both clinically and financially. And it did.

Erickson's results, in fact, ultimately led the Centers for Medicare and Medicaid to approve a three-year Medicare Advantage demonstration project, launched in January 2006, which paid the corporation a monthly capitation for each resident who enrolled in its program, EricksonAdvantage. Under the terms of the project, Erickson paid for all care, including hospitalization. "When people are healthier, overall costs lower," adds Dr. Applebaum. "Our biggest problem with medical care in this country is that we don't get results. We're spending enough money, but we can get a lot more out of the money we spend," he said.

Although Dr. Applebaum lost the election by fewer than 1,100 votes, he said, "It was an honor to participate in the electoral process. The skills and contacts I made will serve me well as I continue to work to improve healthcare for all Americans."

 In 2009, Dr. Applebaum returned to his roots as a clinician and began doing house calls with Seasons Hospice & Palliative Care of Maryland for their roughly 350 home based hospice patients. “I always found it enormously gratifying helping patients and families deal with end of life decision making.  If done well, the patients get the care they want—which is not always what their providers think they need. And when families feel that their loved ones got the best care despite a difficult situation, they end up with good memories, not guilt. It’s an important part of the continuum of care that is often overlooked.”

After several months of providing clinical care and medical direction at Seasons Hospice & Palliative Care, Dr. Applebaum was asked to assume the role of Executive Director. He agreed, as long as he could still see patients a few hours a week. "For one thing, I find that it's all too easy to forget the daily challenges that both patients and providers face in our system unless you're there and part of it," explains Dr. Applebaum. "And, just as important, seeing patients is something I need to do -- for myself."

In his role as Executive Director, Dr. Applebaum manages a staff of around 200. Seasons is a privately held national company with 14 operations in 10 states. “I am focused on my own site in Maryland,” says Dr. Applebaum, “but I can’t help but participate in the national growth of Seasons because of my passion to make sure that more Americans receive the valuable services hospice can provide. Hospice is woefully underutilized and I hope to be able to use my communication and marketing skills to change that.”

 “I’ve been blessed to find a second career in both clinical medicine and management.”  When asked if he’d ever run for office again, he didn’t duck the question but adroitly responded, “Never say never—but as long as I can stay very busy impacting care and growing a business, I think I’ll be content—for now!”