Dr. Julia Cosma turned from surgery to primary care after deciding she wanted to spend more time with patients. She now runs her own practice in Clearwater.
Clearwater’s Dr. Julia Cosma doesn’t just like her job, but considers it a privilege to go to work every day.
Cosma is a family physician practicing in her hometown and living in the house where she grew up. Getting there, however, wasn’t as easy.
You might say she was born into the medical world. Her father is a psychiatrist, Dr. Guillermo Cosma. It was because of him that Cosma realized she wanted to become a doctor. When she was 9 years old, her father was stricken with leukemia and the family spent many nights in Miami where he received specialized treatment for his cancer.
She decided she wanted to become a heart surgeon because she was fascinated with the work of South African doctor Christian Barnard, the man who performed the world’s first heart transplant. But by the time she grew up and was ready to go to medical school, she had changed her mind.
“By then I wanted to become a plastic surgeon,” she said. “I wanted to help little kids and fix their faces and the like.”
But it was not to be.
“I went to medical school at the University of Miami, and I liked surgery but it didn’t like me,” she said. “It is very much a man’s world. When I would get my evaluations they would all negatively state that I spent too much time with my patients.”
Something else kept her from becoming a surgeon.
“Managed health care dictated that surgeons did the operating and internists did the diagnosing,” she said. “I loved diagnosing. Surgeons in a way have become technicians. I diagnose and tell the surgeon what to take out and he takes it out.”
Being a woman in a surgical environment also had its challenges.
“Everything you see on TV is true. There is plenty of sexual innuendo all the time,” she said. “I wasn’t cut out to do it.”
With that realization, Cosma moved into primary care. After spending time working in Miami and San Antonio, Texas, she spent two and a half years working in Montgomery Hospital in Norristown, Pa.
“It was a good transition for me moving from surgery to primary care because that hospital allowed me to do everything,” she said. “I moonlighted in surgery and did all sorts of other work there.”
After that it was back home. In 1998, Cosma came back to Clearwater and worked for a time at the Diagnostic Clinic.
Ten years ago, she opened her own practice. She admits it was a scary prospect.
“I know how to practice medicine,” she said. “I know how to take care of patients, but running a business is completely different.”
It all comes down to money.
“I once discovered one of my receptionists would allow patients to leave without paying because they said they forgot their checkbook. Do you think Publix would let you walk out without paying because you forgot your checkbook?”
Like it or not she says she has to pay the bills.
Cosma does have a concern about people’s overall health in this day and age.
“What good is the best, most effective pill in the world if people can’t afford to pay for it?” she questioned.
She recalled seeing some of her patients in line at the food bank when she dropped by one day to make a donation.
“It was then I realized that we really don’t know our patients as well as we should,” she said. “They don’t tell you in the examining room that they have to get food from the food bank. The biggest challenge right now is expenses. People are neglecting their health because of finances, and it is then things get out of control.”
Cosma admits situations like that often get her down.
“I have my moments when I get frustrated. I think everybody does,” she said. “I don’t know what else to do. I’m pretty good at what I do, but sometimes on a down day or frustrating day I wonder why I’m doing this.
“But then a patient will come in and thank me for saving their life or a family member’s life, and I realize that’s why I get out of bed every day.”
Cosma said the majority of her patients are women, but she does see plenty of men. She believes her success as a family physician is the same thing that plagued her during her surgical studies.
“I believe females listen more than men do,” she said. “I see fewer patients than a male doctor does because I spend more time with each patient. But I know when I get a call from an emergency room about one of my patients I know all about that person. I try to remember my patients as people.”
At 45 years old and single what does the future hold for Dr. Julia Cosma? She said she intends to keep going in what has become a comfortable environment, sharing an office with her dad, who recently celebrated a 50th wedding anniversary with her mom.
“Once in a while I have to take a vacation to re-charge my batteries, but in fact it is a privilege to have people allow me to care for them. I have treated three generations of the same family, so it is special that they still want to see me,” she said.
She admits it is hard work.
“Sometimes you give and give and give, then realize you have nothing left to give,” she said. “But you get up the next day and do it all over again.”
She said she’ll know when it is time to quit.
“I cry whenever one of my patients dies,” she said. “When I stop crying, I’ll know it is time to hang up my shingle.”