Dr. David Gilbert: Cardiologist On His Own

 

Dr. David Gilbert

On an early morning drive to one of our favorite hiking spots, we saw a large roadside billboard announcing Dr. David Gilbert’s private cardiology and vascular practice. My husband knew Dr. Gilbert, but was unaware of this new venture. Would he want to give us his story? Maybe. 

After we passed the smiling image of him again, we contacted him to ask. “Sure,” he quickly said. So we sent him the address of the website containing more than fifty prior doctors’ stories. 

A few weeks later, not having read any of the narratives (he was busy, he said), Dr. Gilbert showed up for the interview. Despite not knowing what to expect, what others had said, and what was written about them, he seemed relaxed and confident.

David said that he was born and raised in a “lower middle class” community in blue-collar Dundalk, Maryland, a planned close suburb of Baltimore. Nearly all the men (and many of the women) worked for giant Bethlehem Steel. The work could be dangerous, but it was steady. 

Worker near blast furnace at Bethlehem Steel,
Sparrows Point, 1951
(Credit: HumansAreMetal)

His Parents and the Family

Dr. Gilbert said that his parents were from “broken homes.”  His dad’s father “ran off” early, and his dad’s mother spent 14 years (yes, years) in a TB sanatorium. So his father was “passed around among family members,” and he was only 16 when he and David’s mother (then 15) were married.

They had six children, three boys and three girls. So, at one point, eight people lived in a house of about 2,000 square feet with one (that’s one, as in uno) bathroom. As his father worked in the steel mill, his mother took a job as a (stern) school crossing guard in the inner city. 

David said that his parents “were great.” His mother was “tough” but good, while his father, his “hero,” was simply “a good, good human being.” Dr. Gilbert told me that he appreciates the many invaluable lessons he picked up from the hard-working individuals of his childhood environment. There could be, he noted, profound wisdom about life without the need for a formal education.  If the family was on the poor side, he didn’t feel that at all.

As a kid, he was, in his words, “preoccupied with sports.” In football, he was one of the best players (as he quarterbacked for bad teams), but baseball was his true “passion,” and he admitted that he was a pretty good all-around ball player. As he was preparing to graduate from Dundalk High School, he didn’t know what he wanted to do, “to avoid getting into trouble.” You see, nobody at his school, including the so-called guidance counsellor, talked to him about college. You might take that route for sports, but never for pure academics. So David was slightly adrift.

Dundalk High interior (Credit: David Robert Crews)

The Navy

Since he enjoyed being challenged physically, six months after graduating, at the age of 18, he joined the Navy.  He wanted to be a special-ops, highly-trained Navy SEAL. In his (adolescent) mind, “knocking off third-world dictators wouldn’t be a bad job.”

(Credit: med.navy.mil)

He heard that one of the best ways to improve your chances of getting into the SEAL program was to start as a Navy Corpsman, where he would learn how to provide medical care for Naval and Marine personnel. The job required academic and physical skills, and he went for it. As a Corpsman, David moved around, and when he was assigned to the Great Lakes Naval Hospital in Illinois, he worked in an ICU.  It was here that he “fell in love with medicine.”  He saw firsthand that you could take somebody who was at the brink of death and return them to a good life. He wanted to be a doctor like that.

(What about his dream of being a SEAL? Well, nobody had bothered to tell David that he needed to have perfect 20/20 vision to qualify for the program; his eyesight was 20/200. Enough said.) 

So, as he fulfilled his Naval obligations around the country (sometimes moonlighting as a respiratory therapist), he took enough college courses to allow him to apply to medical school without having an undergraduate degree. (He had plenty of  credits, just not enough of the ones that York College, where he took his final courses, accepted for a degree.)

Medical School at PCOM and Early Practice

At this point, Dr. Gilbert noted, by the way, that his brother Tom, ten years older than him, and “a tremendous brother” who always tried “to do the right thing,” was an osteopathic ER physician. So when it was David’s turn to go to medical school, he followed his brother’s example and attended the Philadelphia College of Osteopathic Medicine (PCOM) on City Avenue, just off the always-busy Schuylkill Expressway. 

Mid-1990s campus overhaul of PCOM (Credit: PCOM)

Because of his years in the Navy, he entered medical school at 28. As an older, motivated student, he was “incredibly dedicated” to his studies. He had an “overwhelming fear of failure,” but he did well and graduated in 1998 at 32. Dave then did a three-year medical residency at Memorial Osteopathic Hospital in York. 

While in training, he wanted to specialize in cardiology, but by 35, he was “out of gas” and (in his words) “tired of being poor.” So he put aside his lofty ambition and joined a group private practice in York, Internal Medicine Consultants. The practice was busy, and he did inpatient and outpatient work for seven years. During this time, he met his wife, Tiffany (more on her later).

Time for a Heart and Vascular Fellowship

And by age 42, Dr. Gilbert was reenergized enough to look for a cardiology fellowship. By then, he had developed a special interest in peripheral vascular work.  He had taken care of amputees whose legs might have been salvaged with skilled intervention that was not readily available in York. He wanted to change that.

He was offered a position at the Deborah Heart and Lung Center in New Jersey. He was aware that they focused on peripheral vascular disease as well as heart disease, and he liked that, as he could bring back something of value to the region, should he stay. For more than three years, he commuted more than two hours each way daily in order to be with his family. He felt that being an older “non-traditional student“ was a benefit.  (Deborah was founded in 1922 as a small TB sanatorium to allow patients--regardless of their ability to pay--to get away from New York City for the healing fresh air of New Jersey.)

Philanthropist Dora Moness Shapiro founded Deborah in 1922
(Credit: Deborah Heart and Lung Center)

Dr. Gilbert spent about a third of his clinical time doing peripheral vascular work. His world-renowned mentors in this area included Richard Kovach, M.D., and Jon George, M.D., both of whom, according to Dr. Gilbert, are “tremendous critical thinkers.”

Time for a bit on peripheral vascular medicine, impaired circulation in the legs:  

Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis. Modifiable risk factors, including cigarette smoking, dyslipidemia, diabetes, poor diet quality, obesity, and physical inactivity, (and these), along with underlying genetic factors contribute to lower extremity atherosclerosis. Patients with PAD often have coexistent coronary or cerebrovascular (disease), and (an) increased likelihood of major adverse cardiovascular events, including myocardial infarction, stroke, and cardiovascular death,” (Bonaca, p. 1868).

And:

While LDL-lowering statins are not for everybody, there is underuse of statin therapy in patients with PAD. These medicines have “demonstrated a strong, intensity-dependent effect on amputation and mortality.. (and) cardiologists, primary care physicians, insurers, and other care providers need to do a better job in helping both our colleagues and our patients understand the importance of these medications in preserving both life and limb,” (Aday, p. 1449).

Back to the story:

Dr. Gilbert and his wife considered going south after he would complete his training in the Mid-Atlantic, but as he was a bit into his fourth year at Deborah (the year of interventional work), he received an unexpected call from the small Hanover Hospital, thirty miles west of York. They wanted to develop a cardiac program.

Developing a Cardiac Program

Staying in the area where his wife’s parents lived would foster close extended-family ties, and this appealed to Dr. Gilbert and Tiffany. So he accepted the challenge to build something for the community. Since this was not to be an interventional program, David chose not to finish his fourth year at Deborah. 

Dr. Bridenbaugh

In 2011, about 12-18 months into the new Hanover venture, things were going well, and the administrators changed their minds; they now wanted to offer full interventional services. Obliging, Dr. Gilbert returned to New Jersey to finish the fourth year of his fellowship.  And in 2013 or 2014 (David couldn’t recall the exact date), having racked up lots of miles commuting while listening to cardiology tapes, Dr. Gilbert and local cardiologists Dr. Larry Freer and Dr. Alan Bridenbaugh joined to provide their patients with some of the latest technical advances in heart and vascular care. Acutely ill patients no longer had to wait to be transferred to a large medical center to receive life-saving and heart-muscle preserving stents.

The interventional program quickly became successful, and they expanded from three physicians and a nurse practitioner to a professional staff of 21. They went from doing 100 cases a year to 1600 yearly, all while trying, in David’s words, “to do everything with an ethical and moral perspective.” The aim was to do things “for the right reason and in the right way,” and “not just to do cases and make money.”  

In 2016, Dr. Gilbert, having lost two young patients to acute pulmonary embolism (PE), added another type of procedure to what he had to offer: he learned to remove the deadly, thick blood clots from the lungs that were severly compromised by PE. And, turning to the usual source of the clots, a deep vein thrombosis (DVT) in the legs, he learned to pull them out to prevent the troublesome late complications (swelling, pain, tiredness, and skin changes leading to poorly-healing sores, or ulcers) that were not avoided with use of anticoagulants alone (the standard approach).

When UPMC/Pinnacle took over the Hanover Hospital and Memorial Hospital in York as the Pittsburgh-based health system expanded into the York area, Dr. Gilbert became the Medical Director for both cardiac programs. He was busy. But, after a while, he became, he said, “disenchanted with corporate medicine.”  While he had a lot of responsibility, he had virtually “no say” (when it came to institutional decisions). 

UPMC Memorial (Credit: jeffreytotaro 2019)

Disallusioned 

He was asked to do things (such as to recruit a heart surgeon), but was not invited to the meetings where the final decisions were made (e.g., there would be no surgery). He tried, but could never meet with anybody at all. He saw that the (Pittsburgh) people in charge didn’t understand the nature of the small community they had stepped into. In time, it was too much for Dr. Gilbert to accept. He was paid handsomely, but money was not enough to ease his conscience. He was 58 and could just walk away from medicine altogether, but “it didn’t feel right” to do that. 

(Confirming his suspicions about the administrators and their relationship to the practicing physicians, they made no effort at all to retain him after he told them he was bowing out. You see, he was just “a replaceable cog” in a vast impersonal machine.

A scene from Modern Times (1936) (Credit: Roy Export SAS)

So David decided to do the nearly unthinkable in the current climate and start a private practice. He knew how things worked, and he had built a full program before, but this would be his own, and he could adhere to his strong ideals of being, as he said, “a devout Christian.”

He chose to practice medicine in such a way that he would have peace of mind. He realized that he would have a substantial cut in  income at first, but Dr. Gilbert said that he doesn’t lose sleep over money or anything.” He said that money itself is meaningless to him (as long as he doesn’t repeat the time in his twenties when his electricity was shut off).

Return to Private Practice

But building a modern (and viable) medical practice while being hemmed in on all sides by corporate healthcare giants with loads of cash would be a real challenge. After serving the York and Hanover areas for years, people knew of him and his work, but he was aware that word of mouth alone wouldn’t assure success. He had to create a reliable referral base. 

Dr. Green

As he provided the advanced heart and vascular services, he would not be alone. Dr. Gilbert has brought on a respected podiatrist (as peripheral vascular problems usually show up in the feet first), an older but energetic and wise general surgeon, John Green, D.O., to do wound care (as poorly-vascularized tissues heal very slowly), and a seasoned nurse practitioner (filling the somewhat surprising need for additional primary care services).  Dave tried to convince a graduating resident to join him, but the wary resident chose the system instead, the seemingly safer option.

This brings us to a special integral part of his team, his wife Tiffany, who runs the practice. She has a doctorate in Natural Medicine, focusing on traditional herbal and nutritional remedies, manual therapies, and homeopathy. She follows a holistic (i.e., a mind-body-spirit) approach. Dr. David Gilbert, trained in osteopathic as well as allopathic medicine, also believes strongly in the importance of caring for the whole patient, not just their individual parts.  

He said that in his practice, his “security is rooted in doing the right thing.” And he said that  he needs to know that he did what he could, and that he “made a measurable difference in the world.” As noted, Dr. Gilbert was disillusioned as he saw up close that the prime motive of corporate medicine appeared to be financial profit, so the decision to break away from that model wasn’t totally unexpected. 

Moral Injury

It has been claimed that physicians leave medicine altogether, or change jobs (looking for something less stressful), because they are “burned out.”  It is said that they are mentally and emotionally exhausted by the workload and that they need to learn how to cope better, that they are just not strong enough, not resilient enough. It has been suggested that the stressed-out doctors should do yoga, or meditate, or splash on some lavender oil to cope better. Maybe what is needed is a Chief Wellness Officer. But brief research told me something else. 

The real problem, according to psychiatrist Wendy Dean and others (writing in 2019, before the Covid-19 pandemic), is that our healthcare system creates moral injury. Accordingly, she notes: 

Moral injury occurs when we perpetrate, bear witness to, or fail to prevent an act that transgresses our deeply held moral beliefs. In the health care context, that deeply held moral belief is the oath each of us took when embarking on our paths as health care providers: Put the needs of patients first. That oath is the lynchpin of our working lives and our guiding principle when searching for the right course of action. But as clinicians, we are increasingly forced to consider the demands of other stakeholders— the electronic medical record (EMR), the insurers, the hospital, the health care system, even our own financial security—before the needs of our patients. Every time we are forced to make a decision that contravenes our patients’ best interests, we feel a sting of moral injustice. Over time, these repetitive insults amass into moral injury. (Dean, p. 400) 

As Dr. Gilbert, I believe, sensed that creeping moral injury, he did something about it. He bemoans the current general societal “lack of empathy for our fellow human beings.”  And he believes strongly that there is “not as much compassion as there used to be.” (Recall that empathy is feeling what others feel, and compassion is that, plus taking action to relieve their suffering.) He reminds his three sons to think of others before they think of themselves, and that they are the least important people in the room. David has “complete disdain for selfishness.”

Back to Family

When he’s not doing for others, how does he spend his free time?  He doesn’t play golf, or fiddle with cars, or play video games, or whatever. He simply said he “hangs out with family.”  David and Tiffany’s first son (Carson, currently a junior at Liberty University) was adopted from Guatemala. His adoption was followed (of course!) by “natural” (fraternal) twin brothers (Grant, an ice-hockey athlete, and Tate, an aspiring actor). Dr. Gilbert revels in watching them mature. Family is very important, and he credits his capable wife for how well the boys have turned out (though I think he has had something to do with it).

And just to remind us that life is short and should be savored, when my husband and I went back to our hiking spot recently, the sign for Dr. Gilbert’s medical practice was replaced by one for a new local family-run funeral home.

References:

1. Aday, Aaron W., MD, and Everett, Brendan M., MD. "Statins in Peripheral Artery Disease: What Are We Waiting For?" Circulation. 2018;137:1447–1449.

2. Bonaca, Marc P., Hamburg, Naomi M., Creager, Mark A. "Contemporary Medical Management of Peripheral Artery Disease." Circulation Research. 2021;128:1868–1884. 

3. Dean, Wendy, MD, Talbot, MD; and Dean Austin. "Reframing Clinician Distress: Moral Injury, Not Burnout." Federal Practitioner, September 2019.

4. Trzeciak, Stephen and Mazzarelli, Anthony. Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference.Studer Group. LLC. Pensacola, Florida, 2019.  Exhaustive compendium of scientific and observational studies making a strongly reasoned argument that compassion for others always benefits the giver as well as the receiver. (But awareness of that mystery is ancient knowledge that has to be continually rediscovered.) 

By Anita Cherry 8/17/25

Ballet Class at the Downtown York JCC
(Chalk sketch by Anita, 1986)

(The first collection of these stories is available in book form:  York Doctors: Their Stories Vol. 1)