Dermatalogist Dr. Irving Milberg is 97, practicing out of his home compound near the old Granit Resort between Accord and Kerhonkson. He's accomplished, astute, and full of the sort of vast experience that translates into deep knowledge of his field, general healthcare issues, and the myriad ways in which our world has shifted over his lifetime.

"They tell me that when I was a kid I would bring clothes to anyone I knew who got a cold, I was always looking to help others feel better," this gentle man says softly, the sound of the waterfalls his home and office perches over sounding in the background. "I grew up in Brooklyn, born in Williamsburg and raised in Flatbush. My father had come over at the age of 18 from Romania, my mother at 6 from what has been Russian at times, Polish at other times, depending on the most recent war."

Dr. Milberg attended Erasmus Hall High School, went on to Johns Hopkins University and then got his medical degree from the State University of New York Downstate Medical Center College of Medicine in 1943, after which he interned at SUNY Health Science Center at Brooklyn before joining the war effort and practicing medicine for the first time in England on the eve of D-Day. He decided to specialize in dermatology after he developed a rash on his hand during his sophomore year in med school.

"Everyone said I should use starch and water to cure it and I asked why. They didn't know," he said. "I went to one of my teachers and asked if I could have a lab to work within and he gave me one and I started to explore how colloids have a big effect on skin, especially in terms of inflammation. And it turned out to be a perfect specialty for me, involving lots of surgery, lots of psychology, and a constant chance for me to use my brains."

After the war Dr. Milberg and his wife moved to Fort Dix in New Jersey, after which he set up a practice in Brooklyn and eventually moved to Manhattan, where he kept offices on East 78th Street for decades. He kept his practice in the city until 1994, after which he started working full time for Beth Israel Hospital until eventually moving full time, and reopening his private practice, at the Ulster County compound he started putting together on a waterfall in the early 1960s.

"I've got four kids, five grandchildren and three great grand kids," he said with a big smile. "I pioneered the conjunction of dermatology and psychology after going back to get a degree in the latter... Over the years I headed all the leading associations in my field."

How has medicine shifted over his 72 years of practice?

"Few people had insurance when I started, and for years afterwards. People paid what they could. Your practice was based on the good relationship doctors had with their patients," Dr. Milberg replied. "If the guy was poor you didn't charge him. Each patient was a person you got to know, and the same principals applied to doctors' and patients' relationships with hospitals. Now every decision involves what seems to be thousands of people." In his own specialty, dermatology, Dr. Milberg said he's noticed a shift away from old afflictions, such as tumors and venereal diseases, to food additions, and the effects of chemicals and pollution on the skin. Cancers have grown more complex, but also more treatable.

We asked the nonagenarian dermatologist how he'd summarize his views on medicine today. What words of advice, and concern, did he have?

"Of all the civilized nations we have the worst system there is. The fact that medicine got to be a business saddens me to no end," he said. "I think the Affordable Care Act is a good step in the right direction but it saddens me that we can't muster the political will to do what's really needed and move on to universal healthcare."

What has he learned, personally, over the decades he's been practicing?

"I've learned a lot about people; I've learned a lot about myself," he answered. "And I finally left Beth Israel when this person I took to calling 'the Armani lady' started reprimanding all the veteran doctors for spending too much time with their patients, saying we should max that relationship out at 15 minutes... I started seeing more and more instances where computers were diagnosing, and not diagnosing correctly."

Will he retire anytime soon?

Dr. Milberg smiled, looked out at the forest surrounding his office as a car pulled up. His next patients in a day full of them.

"As long as my eyes are working, my hands are working, and my brain is working, why should I retire? he replied. "I just can't see waiting around. What I know, what I do, still has value."