On Being Well-Trained
By
Leonard Zwelling
The first federal tax return we filed after coming to Houston was prepared by Louis Lerner, CPA in April of 1985. We had been referred to him by our financial advisor at the time. We immediately hit it off with Louis and he prepared our tax returns every year thereafter until this year when he had to retire for health reasons. He is well over 80.
Now what do we do?
I was referred to a new accountant by a close friend. The new accountant was, of course, much younger but seemed quite capable when we originally met at a get-acquainted session. We signed on.
Today was our first meeting doing real business. I presented him with the wherewithal to file our returns for 2025.
The new CPA’s office is on the 20th floor of a tower on Allen Parkway. There is tight security to get in and one of those elevators where you press the floor you want outside the doors and the computer tells you which car is yours among six. Once you get in the car, it is destined for only your floor. Even when I get to the accountant’s office, there was tight security to get in the door, but I made it. I was placed in a small conference room right in front of the receptionist’s desk.
Since I had a moment before my meeting with my new CPA was to start, I carefully laid out all of the packets of data I had put together so that he could file our tax returns. There was a stack for income that contained all the statements from employers, banks, and investment houses. There were the specific tax related documents that denoted what was not taxable (charitable contributions from our IRA required minimal distributions). The documents for my two companies, although this was more about expenses than income so were small piles. Finally, there were the itemized deductions for which we probably don’t qualify as the minimum deduction is better for us and has been for years.
As the CPA went through the documents, he seemed to be a little surprised that I had summarized every pile with a cover page behind which were the required documentation forms.
“Lots of people don’t do this.”
“I know, but I have been well-trained by Lou Lerner. As I understand it, you charge me by the hour, so the more I do to save you time, the less I have to pay.”
And that’s the sermon for today. There is no substitute for being well-trained and that training can come from anywhere.
For most of us, our first real training came from our parents. As far as I can see, the only guard rails we are born with are the ones in our genes that determine our potentials and our limits. After that, how we behave is largely determined by how we are trained by our parents.
When we get to school, the training extends to our teachers as well as to our classmates. The real damage of Covid may have been the reduction in social interaction among school children forced to learn in front of a computer.
But perhaps, the most critical training for a future professional is on-the-job training. I don’t know how that’s done for attorneys, but I do know how it’s done for physicians and how it’s done now vs. how it was done for me is a subject of great concern for us old people aka frequent patients.
There is no doubt that the tools at the beck and call of today’s physicians put the tools we used when I was in training to shame. As an intern, I had no CT scanners, no MRIs, and no genetic testing. There were many times when all I had was a history, a physical exam, some early lab data, and the help of someone who had been through the training that I was undergoing. What I worry about is that the current group of young doctors overly rely on technology and, because of limits to the amount of hours they work, they have little understanding of the natural history of common conditions like diabetic ketoacidosis.
Human disease does not obey the clock. It’s different in every patient, so the more patients you see and the more diseases you treat—from start to finish, the more competent you are likely to be. In the end, the basis for a competent physician is his or her training. There is no substitute for good training.
Just as my training by my accountant of long standing prepared me well to work with my new accountant, my training at Duke and the NCI made it possible for me to become a competent (I was never great) board-certified internist and medical oncologist. It was also the training by my lab mentor Kurt Kohn that served me well when establishing my own research program and my MBA which was the basis for becoming an administrator.
There is no substitute for being well-trained for any job. So, answer me this. How do you train people to be good leaders and why are we doing such a terrible job of this in American politics and academic medicine?
Perhaps the first order of business is to train those who choose our leaders. That’s surely true in Texas politics and its university systems.
In American politics including Texas, that would mean everyone who votes. That’s what education about the origins of our nation and its true history, even the ugly parts like slavery, is supposed to do. Trying to expunge the parts you don’t like, as President Trump is doing, is harmful to the training of our future voters.
Judging from who is in Congress and the White House, I would conclude there’s a lot of training to be done of those choosing our leaders. We are doing a poor job.
