This is a finalist in the 2016 STFM Student Blog Competition.
It was the end of a rather long fall afternoon at the family medicine clinic where I worked as a scribe. Our last patient of the day, a cheerful, spunky, bubbly woman 80 years young had come in with her family—three sons, a daughter, and two younger sisters. She had been diagnosed with end stage lung cancer, and they had come in to discuss her goals of care and options moving forward. I had the honor and privilege to be privy to their conversation. As I sat there, typing up notes on their open, honest discourse with shaking hands, I filled with emotions. Their love and optimism to make the best out of the time that was left in as dignified a manner possible touched me deeply. During that visit and subsequent appointments, the whole family had welcomed me into their health care team, quite literally embracing me and encouraging me to learn about what it means to heal once they learned about my dream of becoming a physician.
“I don’t want to know how much longer I have,” our patient had said, “I feel good, I just want to spend time with the grandkids, watch hockey, and have a good time.” I remember that she had laughed about her funeral arrangements and how everyone in the family knew that she had dry cleaned and hung up her desired dress to be buried in, a bright red number that showed off her figure and loyal support of her favorite sports team. My doctor had later told me that this woman had been her patient since she had started practicing almost 20 years ago and that two of her sons and their families came to the same practice. I remember her subsequent visits where she was still just as cheerful, her clothing pristine and her hair always perfectly coifed.
This was just one of hundreds of experiences I had over my year as a scribe where patients trusted me and accepted me into their health care team. They provided me scaffolding for what quality patient care meant. The mother of four who brought in all her children to her baby’s checkups and I would try to distract her 3-year old daughter with coloring pages. The couple married for over 40 years who always came in together, arguing and commenting about the other’s health. The father who expressed concerns about his son’s depression after his granddaughter had passed away in an accident—all three generations had been patients at the clinic.
I want to challenge that while we will see many amazing changes as we progress further into the 21st century, the fundamentals of the field of family medicine will be preserved.
Ten years from now, family medicine will remain at the forefront of primary care.
The next decade may bring a technology revolution where the power of big data is brought into physicians’ hands through cell phone apps, and telemedicine increases access for all. Simultaneously, I predict that we will see the reclamation of the patient’s story: the narrative that tells us who we are treating and what is important to their quality of life when helping them navigate through their treatment plans.
The beauty of family medicine is in its name. While we might see innovation in the architecture of clinics, bringing together interprofessional teams in round-table offices working together seamlessly to take care of the whole patient, this change will be centered around maintaining the integrity of the patient-provider relationship. Family medicine. Even the name describes a relationship.
I think back now on my experience with the lady in red almost 2 years later, as a second-year student in medical school. I wonder how this patient’s story read. I wonder whether she was happy in the last moments of her life and whether the care she received helped her achieve her goals at the end of her life. I wish I could somehow convey to her how important she was to the trajectory of my life.
I hope that 10 years from now, I can be practicing medicine just like my mentor, the family medicine doctor—medicine that focused on healing, on listening, and on the knowledge that relationships and family are fundamental to the art of medicine. I hope to be helping my patients gain the skills to navigate the health care system and be empowered to communicate and pursue their health care goals. I hope to see beautiful births, dignified dying, and everything in between—something that is unique to family medicine alone.