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Inside the world of family medicine: a patient’s eye-opening account

Today’s health care system is in a state of drastic flux. Gone are the days of private practice family doctors, the “Marcus Welby, MDs,” who stood ever-ready to heal the sick and comfort the disillusioned. They were the sole decision-makers in the care of their patients and had the welfare of their patients at the forefront. Now, the corporate blanket has fallen upon the field of medicine, oftentimes blurring the true objectives of this noble profession.

Many of you, upon receiving your medical degree, recited an oath that outlined the tenets of the practice of medicine. One such oath is “The Oath of Maimonides,” which I find very relevant in today’s world.

The Oath of Maimonides

The eternal providence has appointed me to watch over the life and health of Thy creatures. May the love for my art actuate me at all times; may neither avarice nor miserliness nor a thirst for glory or a great reputation engage my mind; for the enemies of truth and philanthropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.

May I never see in the patient anything but a fellow creature in pain.

Grant me the strength, time, and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense, and the spirit of man can extend indefinitely to enrich itself daily with new requirements.

Today he can discover his errors of yesterday, and tomorrow he can obtain a new light on what he thinks himself sure of today. Oh, God, Thou hast appointed me to watch over the life and death of Thy creatures; here am I ready for my vocation, and now I turn unto my calling.

Some might say this is a collection of nice-sounding words that have no relevance in today’s world. I beg to differ… if there was ever a time in our history that we needed to have these words ring true, it is now. So much of what goes on in the world pits one side against another, the haves against the have-nots. Sadly, this happens in health care when the cost of being healthy is more than some can bear. These unfortunate individuals fall through the cracks of our society and are forgotten. Are you ready to meet the challenges that await you? Hang on for the ride of your life!

As a patient, I would like to share what I consider to be the traits of an “excellent” family medicine physician:

You realize that you are the patient’s primary point of contact for all health-related issues; you are the “gatekeeper” for the health system. You are there to help the patient navigate the often confusing tangles of medical information that often place undue stress and anxiety on the patient. Therefore, you should make an effort to explain things in a manner a patient will understand and in a manner that is not condescending. Remember, we patients did not attend medical school.

You are compassionate in your interactions with your patients. The word compassion is derived from the Latin word “compassionem,” meaning “to suffer with.” Try to imagine what it must be like to be in your patient’s shoes… how a particular diagnosis affects the entirety of a patient’s life and that of his/her loved ones. For example, to be told that you have cancer is a moment in time that shakes one to the bone.

When discussing medical facts with the patient, you are seated so that you are on the same level as your patient. You should not be in a standing position towering over your patient, which implies a position of power over the patient that can be intimidating to some. You are looking at your patient, not the computer screen, when discussing pertinent medical information. In other words, give your patient the feeling that you are entirely present with him/her during the office visit.

You allow the opportunity for your patient to ask relevant questions about their health. As a teacher, I always told my students that no question was ever a “dumb” question. It is an opportunity for you, as a physician, to determine where more information/instruction is needed. By doing this, the patient is more likely to follow the proper course of action. Be proactive along these lines and never assume that your patient completely understands the intricacies of the situation simply because they are remaining silent. It may be that they are silent simply because they cannot put into words what they are feeling inside.

You are a family doctor who remembers his patients, addressing them by name and with a smile on your face when you enter the exam room. Remember, together the two of us form a very important team.

You are an advocate for your patient, always willing to explore the best course of action to enhance the patient’s level of health. You have the moral courage or willingness to stand up for your patient despite any barriers that may lie before you.

You are a source of encouragement for your patient during stressful times. It may well be that the patient has no one else “who is standing in his corner.” A positive word of encouragement can make all the difference in helping your patient reach his/her health goals.

Lastly, I saved probably the most important trait until now: As a family medicine doctor, you listen to your patient. You allow the patient to tell his “story,” i.e., what is taking place in his life that is potentially impacting his health. You get to know your patient, the things that bring joy to him, the things that may bring hardship. This “listening process” may very well allow you to hone in on very relevant information that will lead you to an accurate diagnosis, instead of prescribing time-consuming and possibly irrelevant tests and procedures.

As I said at the beginning, taking on the role of a family medicine doctor is not for the “faint of heart.” It requires commitment, dedication, compassion, and a true desire to improve the well-being of another. In today’s corporate system of health care, many demands and obstacles are laid before you. You must be willing “to talk the talk” but also just as important, “to walk the walk.” We, as patients, are depending upon you … our very lives rest in the balance. I wish you all Godspeed!

Michele Luckenbaugh is a patient advocate.

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