edited: Wednesday, August 22, 2007
By Lady Soliloque
Rated "G" by the Author.
Posted: Wednesday, August 22, 2007
Become a Fan
Where have the Family Doctors gone? An essay on the loss of the original patient advocate.
Doctor in Internal Medicine, general practice, aka Family Doctor.
Cares about patients, willing to stand up to Insurance companies for patient rights, willing to learn patient history, does not rely on nurse ‘cheat sheets’. Ability to listen and work with patient for total care, coordinate with specialists (if needed), and take over any and all prescriptions for a safe medical treatment.
Once upon a time, this job description was filled in every county, every city, every town across America. Families could rely on their doctor for total care, and these doctors were able to provide them with truly personalized care, treating the person, and not the disease. They retained a ‘common sense’ approach, personally knowing the patient they could easily take life and history factors into account when treating them.
In this age of ‘Medical Miracles’ and ‘High Tech Care’ where are these doctors? Sure, there are still ‘General Practices’ and ‘Family Doctors’ listed in the phone book, but this is an illusion. In these offices you are treated by a ‘group’ of doctors, nurse practitioners, and nurse assistants. Even though you may have a single doctor listed on your insurance card as your ‘PCP’ (primary care physician), this too is an illusion. If you are lucky to make your appointments in advance you may be able to work yourself into seeing this PCP once or twice a year; although if you get sick, you are at the mercy of the roulette wheel – that is IF you are able to even see a Doctor. More often than not, you can only see the Nurse Practitioner.
Remember when you could call the doctor and speak with them on the phone? Once you make it through the automated system, the receptionist politely tells you that Doctors are not allowed to speak to patients over the phone due to some insurance regulation and they will direct you straight to the nurse’s line to leave your message. Hopefully, this is not an emergency and you can wait for the nurse to call you back eventually, otherwise pack up to go to the Emergency Room.
Speaking of hospitals, there was once a time when your Family Doctor would be the one to take care of you if you happened to need to go. You would call and tell your Family Doctor what was happening, and they would meet you there. Really! I’m not kidding. Ask your grandparents, or your parents if they are old enough to remember. It wasn’t that long ago.
Where did they go?
Some might say they were choked out by the invention of the HMO. Insurance Companies have taken the power away from the Doctors and forced them to beg office workers with little or no medical training for permission to treat their patients. They make Doctors abide by endless rules and regulations, time constraints, and limit their ability for diagnosis forcing them to rely on underpaid Nurses and ‘Cheat Sheets’ for diagnostic purposes.
Another possible reason for the disappearance of the true Family Doctor is the rise of the ‘Specialist’. In the last two decades these Doctors who have tailored their practice by limiting their expertise into one specific field have transformed the medical community. Even with the many benefits provided by such expertise, expertise that was once available by a referral from your person physician, much is lost when there is no one there to interpret and apply this knowledge to the entire health and history of the patient.
Money plays a large part in the decimation of the Family Doctor. Incredibly high malpractice insurance costs coupled with the cost of owning and running a personalized medical office have made it almost impossible for anyone in the Health Care Industry to stand on their own. Make no mistake, it is a Health Care Industry, a business. The bottom line is that like any other business or corporation, our health care system is based on profit. On this simplest level Doctors who specialize their practice make more money than general practitioners.
In Search Of.
With the loss of this most important base in our health care system, we have become a nation of people floundering from one physician to the next, visiting specialist after specialist and surfing the Internet in search for answers. The Family Doctor was the primary patient advocate, coordinating the care received by Specialists, interpreting test results, and providing medical care for the entire whole body health of the patient.
Stepping into the 21st century we need our Family Doctors more than ever. Every day new breakthroughs are made, new diseases discovered, genetics unraveled, and mysteries are solved. Even with all of the miracles of modern medicine, we need those physicians who remember that even though we are all human, every person is different and in this we need personalized care. As we are more than the sum of our parts, we are more than the notes on a nurse’s cheat sheet, we are a whole file.
I am still searching for my Family Doctor, and I know I am not alone.