HEALTHCARE

When I was a kid, you had a doctor; a family doctor. He was yours for your life or for as long as he practiced. People were not so mobile as they are now. We walked to see the doctor. He worked out of a house in the neighborhood. I'm not sure that specialists even existed.

My doctor would have delivered me had I been born in town; he did deliver my sisters. He cared for me continually even after I was married...until he retired. He stitched my lip in his office after hours when I badly lacerated it when I was five or six. He treated me at home when I had scarlet fever as a youngster. He wrapped my ankle (in lieu of a cast) at Jewish hospital when I got bursitis while on a pass in the Army. When I went to him complaining of being tired when I was about thirty, he told me I probably drank too much beer and sent me on my way. When they told me I had elevated blood pressure at an insurance physical, he checked and told me I was fine. I never saw a specialist until after he retired.

I'm convinced this is the desired relationship every family should have. The sad reality is that there are way too few family physicians. This genre of family doctor is going extinct. It pays too much to be a specialist in relation to family medicine. The old system is dead.

It fits our modern sensibility that a specialist would do a better job than a generalist. I think it's a false perception. Nothing can replace the long term knowledge of a patient a family doctor gains or the trust that a patient develops in this relationship. Of course, you wouldn't want your family doctor to perform brain surgery on you if you needed it. But surely we can reduce trips to specialists, unnecessary procedures, excess medication and improve general health with family physicians.

But, you cannot find a family doctor in much of our country. So, what are we to do? We can't force medical students to go into family medicine. It's natural to want a large payoff for a large investment. We certainly wouldn't want a family doctor with less education. Do we want the government to take over our health care system and force future doctors into slots or necessary specialties? I think not. Do we want the government to set up large clinics where family doctors can oversee and serve along side paramedics? Could a valuable relationship be established in this environment?

Family doctors will become more prevalent when the desire and resultant need for them exists...when people are willing to pay the price. That won't happen until people are convinced of their value. A campaign to educate our citizens about the value of family medical care from birth to death would be money well spent. A campaign to convince health insurers would make things happen more quickly.
:o)