Providing compassionate care as a family medicine physician-turned-radiologist

Iowa and DMU are fortunate that when Dr. Elmer Groben, a physician serving troops in Europe during World War II, asked his buddies for a good place to practice, many advised he head to the Midwest, Iowa in particular. After the war, he and his wife, Martha, got on a train from Buffalo, NY, to Columbus Junction, IA, a town of approximately 1,200 people.

R. Paul Groben, D.O.'75
R. Paul Groben, D.O.’75

โ€œGrowing up, some people in town called me by the nickname โ€˜Doc,โ€™โ€ says the Grobensโ€™ son, R. Paul Groben, D.O.โ€™75, the 2021 College of Osteopathic Medicine Alumnus of the Year. โ€œI guess it was because I was the offspring of my dad, but I was kind of tickled by that.โ€

The familyโ€™s fortuitous decision to move to Iowa eventually gave DMUโ€™s College of Osteopathic Medicine (COM) a loyal alumnus and gave hundreds of Iowans better care thanks to Grobenโ€™s expertise as a radiologist and his caring bedside manner. In recent years, itโ€™s also provided the state with award-winning wines (more on that later). For Groben, however, his DMU education sparks gratitude.

โ€œIโ€™m so thankful the University opened a door for me, and Iโ€™ll never forget that,โ€ he says. โ€œThere are 100 other physicians who could receive this award, and Iโ€™d like to recognize them for all the work they do.โ€

While Groben was applying for medical school, his girlfriend-now-wife, Jean, introduced him to her family doctor, Joseph Baker, D.O.โ€™50. A DMU faculty emeritus and longtime member of the DMU Board of Trustees (now deceased), he encouraged Groben to consider osteopathic medicine. He interviewed at the College of Osteopathic Medicine and Surgery, now DMU, at its dilapidated building on Sixth Avenue in downtown Des Moines, which he calls a โ€œscary experience.โ€ He enrolled nonetheless, joining the second class to attend COMSโ€™s new campus on Grand Avenue in a former Catholic girlsโ€™ school.

The osteopathic program at the time was three years; classes were taught in the chapel and the โ€œPit.โ€ After a grinding first year of basic sciences, Groben found lectures by legendary faculty and osteopathic physicians like Norman Rose, Roger Senty, Robert Kreamer and others to be uplifting.

โ€œThey were so full of life and so in love with their practices. They put the fire in me,โ€ Groben says. โ€œThat was the first time Iโ€™d had an opportunity to learn in detail from an osteopathic physician. I knew I was on the right course.โ€

After a three-month externship in family practice in Charles City, IA, and an internship in Columbus, OH, he returned to Charles City to enter family practice.

โ€œI had a wonderful practice and became very busy,โ€ he says. โ€œI loved opportunities to interact one-on-one with patients. Thatโ€™s the advantage of practicing in a small community. Most of the patients I knew as friends or at least I knew their names and something about them, so they werenโ€™t strangers. I enjoyed taking care of people I knew.โ€

After five years, however, he says his โ€œgood fortune at being busyโ€ began working against him.

โ€œIt seemed like my night on call came too often. This was before the day of emergency room physicians, and I was gone a lot,โ€ he recalls. โ€œI missed my three kidsโ€™ birthdays and got the typical burnout.โ€

Then another fortuitous event occurred: The tests he could perform at the time and symptomatic treatment he provided werenโ€™t helping a patient who had chronic abdominal pain. Groben heard about a new test being performed at a health center in Mason City, IA, a CT scan, so he sent the patient there. The results were eye-opening.

โ€œI remember looking at these images, seeing the report and just really having a good understanding of what this person had going,โ€ he says. โ€œI decided radiology was for me.โ€

Pursuing that goal wasnโ€™t easy. Groben moved his young family to Dayton, OH, where he enrolled in a three-year radiology residency program and enduring the switch from being a โ€œfull-fledged physician to a resident, which is a step above being a flunky.โ€ He completed the program and practiced for a while at a satellite hospital of the University of Wisconsin before returning to Iowa, joining Skiff Medical Center in Newton. He was a radiologist there for nearly 30 years.

โ€œI got to practice with a great group of physicians and great staff in a community where I knew the patients,โ€ he says. โ€œIโ€™m proud of what we did.โ€

When he joined Skiff, he also got to lead the creation of a new radiology department, select its equipment and assemble a group of โ€œtechs who were savvy, well trained and compassionate.โ€ Skiffโ€™s investment in the department made it a โ€œshow siteโ€ for other hospitals, he says.

โ€œThey would come to little Newton and look at our equipment,โ€ he says. โ€œOur motto was, weโ€™re certainly not the biggest radiology department, but weโ€™re going to give our patients the best care. We tried to treat our patients how we would like to be treated.โ€

Grobenโ€™s interactions with patients and colleagues was shaped in part by his years of family practice. โ€œI knew what the family docs or the specialists were looking for; I understood that,โ€ he says. โ€œI loved the opportunity when a patient would ask me, โ€˜Well, Dr. Groben, whatโ€™d you see?โ€™ And Iโ€™d say, โ€˜Would you like to come to my office and weโ€™ll go over it?โ€™โ€

He didnโ€™t shy away from discussing his analyses when they were worrisome, says Paul Ruggle, M.D., a family medicine physician at Newton Clinic PC who is affiliated with Skiff and was a colleague of Grobenโ€™s for more than 20 years.

โ€œCountless times he would leave his office and come to one of the radiology suites, talk to the patient and make sure he had enough background information to give us the most specific diagnosis or differential diagnosis,โ€ Ruggle says. โ€œHe was especially thoughtful and tender when he was the one in position to tell a patient that they had a finding that could be a potential problem.โ€

Groben enjoyed sharing his radiological expertise and enthusiasm with medical students, including from DMU, who rotated at Skiff. โ€œRadiology offered such an incredible detailed look at all the different organ systems. Knowing the pathology that affects those systems, I was able to arrive at a diagnosis,โ€ he says. โ€œIt was a delight to me to have these students see at CT scan or mammography or see how I did a biopsy for the first time.โ€

When he decided to retire but knew it might be a difficult transition from full-time practice, he entered a fellowship program at the Andrew Weil Center for Integrative Medicine at the University of Arizona. โ€œI wanted to learn other modalities in how to care for oneself,โ€ he says. โ€œIt opened my eyes to a whole different means of how we could personally become healthier without the need to ingest all kinds of prescription medicines.โ€

The Grobens practice a healthy lifestyle, but they didnโ€™t need to worry that โ€œretirementโ€ would be sedentary. In the early 2000s, their son Mason got into viticulture and enology after observing his parents growing and talking about grapes on their small farm near Newton. He persuaded them to use the grapes to make wine. The idea led to what they jokingly call a โ€œhobby gone astrayโ€ and their opening, in 2003, of Jasper Winery.

Five years later, they moved the winery from Newton to a new facility near Des Moinesโ€™ Water Works Park. It has since become a popular venue for DMU alumni events as well as weddings, reunions and weekly outdoor summer concerts that draw thousands of people.

โ€œItโ€™s not a cash cow, but the community has received it well,โ€ Groben says.

With Mason now running the winery, Paul and Jean enjoy helping out and spending time with family, including son Luke Groben, D.O.โ€™06, a cardiologist at the Iowa Clinic PC in West Des Moines; daughter Carly Groben Ross, a research administrator at the Nanovaccine Institute at Iowa State University; and their three grandchildren.

โ€œI feel extremely blessed. Des Moines University gave me a real opportunity, and I got to practice the way I wanted to,โ€ Groben says. โ€œLife is good.โ€

โ€œI loved opportunities to interact one-on-one with patients. Thatโ€™s the advantage of practicing in a small community. Most of the patients I knew as friends or at least I knew their names and something about them, so they werenโ€™t strangers. I enjoyed taking care of people I knew.โ€

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