Dr. Pamela Letts has a reputation for talking tough to patients.
One patient recently stopped by and told her he didn’t like her or what she told him at first, but he had changed his mind.
“I have learned to respect you and to really understand that you care about your patients,” he said.
Letts told him: “Then, I have accomplished my goal.”
Letts, 69, owner of the Centre Shops Family Practice and Urgent Care, will retire May 5.
She doesn’t consider her practice a financial success; it currently runs at a deficit of approximately $30,000 a year.
Instead, Letts considers her practice a success in terms of her patients. She averaged 1,700 patients annually and has treated at least 10,000 patients on the Key. She believes she succeeded in bringing her superior diagnostic skills, in spending extra time with her patients when necessary and in her focus on patients instead of the bottom line.
Weldon Frost, one of those longtime patients, stopped by the Longboat Observer office Tuesday on his way to Letts’ office to get one last bit of advice about his health before the practice closes and explained why he values her as a physician.
“She listens,” Frost said. “That’s the No. 1 thing that has kept me coming back.”
Letts has spoken about her impending retirement for at least four years. She has told the community about the difficulties of providing medical services year-round on the Key, given its seasonal nature. She hoped to recruit another family practice physician, possibly one who could receive support from a nonprofit foundation.
The tipping point that led Letts to retire this year was the looming Health Insurance Portability Accountability Act (HIPAA)-set deadline of October 2015 for converting to the ICD-10 diagnostic code — a change that increases the number of codes from 16,000 to 90,000, at a cost of between $56,000 to $83,000 for a solo practitioner.
“I decided to retire because I did not want to go bankrupt during my last year of business,” Letts said.
But she thinks about her patients when she describes why she is sad about retirement.
“I say multiply that sadness by 1,700 patients, and that’s what I feel,” she said. “I enjoy the patients I see and I will miss them dearly.”
A Staten Island, N.Y., native, Letts knew she wanted to become a doctor from the time she was 5 because of two events that occurred that year:
The first was a traumatic tonsillectomy she underwent. Hospital staff wouldn’t let her see her parents or hold her stuffed toy horse. She decided there had to be a better way to do things and that she would find it.
The second occurred when her father, Bill, had a major heart attack in his late 30s. She saw him in the ICU hooked up to machines and recognized the power of medicine. He survived, thanks in part to good medical care, and went on to live into his 80s.
Letts graduated from Bucknell University, in Lewisburg, Pa., with a bachelor’s degree in biology, and then, from the University of Toronto, in Ontario, Canada, for her master’s degree in cell biology. She opted to stay at the University of Toronto for medical school because earning an M.D. in Canada is significantly cheaper than in the U.S.
Letts earned her M.D. in 1979 and practiced in Canada until 1995, also serving as assistant professor of medicine at the University of Toronto from 1982 to 1995. She moved to Sarasota in 1995 to be closer to her parents and began her six-and-a-half years at the former Bay Isles Medical Group on Longboat Key in 1996.
(Letts can legally practice and prescribe medication in both countries and considers her knowledge of both the U.S. and Canadian health care systems an asset for her patients.)
Later, in 2003, she opened the Centre Shops Family Practice and Urgent Care.
She experienced many seasonal struggles familiar to Key businesses beginning in 2004, when the Holiday Inn closed. Business took another hit in 2010, following the BP oil spill. That was the first year Letts saw her income drop from the previous year.
But the hurdles went beyond declines in tourism.
In 2011, her practice was one of 11 businesses that were victims of a payroll company embezzlement scheme. Letts’ practice lost a quarter’s payroll. The owner of the company was sentenced to 12 years in prison, and victims received no compensation, according to Letts.
She also lost a significant source of revenue when pharmacy chains began offering flu shot voucher programs.
Letts has concerns about the impact of not having a primary care physician. She frequently sees elderly patients who seldom drive off the Key and who might try to self-treat or self-diagnose if they have to visit a physician on the mainland.
She believes firefighter/paramedics and EMTs, along with local ERs, will feel the impact.
Still, Letts looks forward to the opportunity to pursue other opportunities in retirement. She wants to travel more and possibly live in France for a summer, volunteer to hug babies at Sarasota Memorial Hospital and pursue her love of choral music (she is a member of Key Chorale).
She is considering teaching a hypnosis for pain management seminar at a Clearwater-area birthing center and might also do shift work. She wants her longtime patients to know they can still reach her at [email protected] or on her cellphone.
While Letts worries about the impact of her retirement, she also believes it could serve as an impetus. She continues to discuss possibilities for other physicians to take over the practice. She also believes the Longboat Key Foundation, which has expressed willingness to help a future practice with startup costs, is doing valuable work.
“I think people will realize that medical care was really a necessary service, and hopefully, they will think that it was a valuable service and see a need to get people out here and pay them properly,” Letts said.
Dr. Pamela Letts’ longtime patient Richard Mittenthal recently wrote this poem in honor of her retirement.
A mystery: How “Letts” Became “I’d rather not…” or did she
By Richard Mittenthal
Doctor Letts has spoken —
The message is ambiguous,
Her name itself, “let’s…let us”,
Suggests the plural, positive community.
Yet her pending retirement
Was announced in the Longboat Observer
On April 1, April Fool’s Day
When the printed word is
No more than a practical joke,
So I ask, on behalf of other grateful
Patients, “Stay the course.”
Your ministrations will be missed.
Continue to diagnose our ills,
Bandage our wounds, recommend specialists
Your choices have proved exceptional.
Allow us to express our gratitude
And admiration for your work.
Contact Robin Hartill at [email protected]