This is a finalist in the 2015 STFM Blog Competition.
This article was inspired by a personal encounter I had after a 16-hour work day on labor and delivery. As I was leaving the hospital and making me way out of the College of Medicine, one of the hematology oncology attendings joined me on my way to the parking lot. He asked me what program I was in, and I proudly said family and community medicine. He responded with how impressed he is by the field of family medicine. I smiled back and asked why. He responded that being a specialist for more than 30 years he is extremely well versed in the literature regarding the diagnosis, prognosis, and latest treatments available within his field. He recalled that he spent many years reading material specific to his specialty, that at times he becomes uncertain of himself when a patient comes in for a follow up, and they ask him for advice regarding their groin pain, erectile dysfunction, or is incidentally found to have a low vitamin D level. He is the expert on peripheral smears, new and innovative treatments of leukemias and lymphomas, but he still has moments of uncertainty, and this was very enlightening and reassuring.
In residency, we look at attending physicians as fountains of knowledge and think to ourselves, will we ever be this well-versed in the medical literature? To add yet another layer of complexity is the image of the specialist. As a family medicine resident, there is a great deal we know and little that intimidates us, but there is still that uncertainty of whether we are up to date with the latest diagnostic modalities and treatments. This brings forth a great deal of distress and from anecdotal evidence, I know that we are always reading and asking ourselves whether our patient is getting the standard of care or whether they would be better served with a specialist.
When I got to my car and began driving home, I started thinking. We spend years in medical school learning the pathophysiology of almost every organ system in the body. Then as we go through our training we desire to become highly specialized and, at no fault of our own, begin unlearning what we spent all those earlier years reading, memorizing, and drilling into our minds. I know I don’t speak for everyone, but the specialty I have chosen is one that is congruent with what I always assumed a physician to be. I guess in my mind I have fixated images from the 1950s and 1960s where the community had one doctor, and that is who everyone sought out when they needed help. I always wanted to be that doctor. I wanted to be able to take in any patient complaint and create a plan of action toward recovery and reassurance. The family doctor’s role ranges from listening to the patient, performing the necessary diagnostic tests, prescribing appropriate treatments, following up as needed, providing social support, treating other family members, and referring if necessary.
In most instances, when a patient has a complaint, the family practitioner is the first person the patient encounters. We are the army that stands at the frontlines of medicine. It is definitely overwhelming at times, but I am on my way to becoming the doctor that can have an answer for my patient when they walk through the door. This can range from simply listening to what they need to say, alleviating their pain, treating their nausea, checking them annually for their preventative health care, or giving them the specialized care they need.
I love what I do, and my hope is that many more begin to realize how important family medicine is to patients, populations, and to the medical community as a whole. Margaret Chen, general director of the World Health Organization, said it best when she declared, “Primary care is our best hope for the future. Family doctors are our rising stars for the future.”