I have a BHAG (Big Hairy Audacious Goal).
I want people to hear
“family medicine” and know that it refers to a medical specialty
dedicated to providing relationship-based, patient-centered health care.
I
want people to know that family docs take care of a lot of complicated,
challenging diseases – and not usually in isolation. Our patients have
high blood pressure, complications from type 2 diabetes, congestive
heart failure, depression, chronic kidney disease, emphysema, anxiety,
asthma, and coronary artery disease, to name a few; treating each of
those conditions individually is nothing like treating them in relation
to each other.
I want people
to know that I trained for three years to become an expert in my
specialty. During my family medicine residency, I learned about
providing preventive care. I learned how to treat a multitude of acute
problems – colds, fractures, lacerations, rashes, etc. I learned how to
deliver babies, resuscitate victims of cardiac arrest, and drop a
central line into a coding patient. I can take off your moles, skin
tags, and warts. I can remove your ingrown toenail and treat your acne.
I can obtain your pap smear, discuss your birth control options, and
treat your STDs.
I want people to know that I can care for your
kid and your grandparent. I routinely counsel teens about sex, drugs,
and rock ‘n’ roll. I am comfortable in offices, hospitals, maternity
wards, newborn nurseries, intensive care units, nursing homes, and even
patients’ homes.
I want people to know that family medicine
residents learn about using the best medical evidence and the latest
medical technology to guide decision-making conversations with patients.
They can intelligently sift through the tremendous reams of medical
studies that are published daily to pull out the information most
relevant to their patients.
I want people to know that those
residents learn how to work within a healthcare team. Nurses, medical
assistants, pharmacists, care managers, social workers, administrative
staff – it takes all of us to provide outstanding care. These
incredibly important people are my hands, eyes, and ears into the
thousands of little tasks that must get done every day in the office and
at the hospital.
I want people to know that no medical specialty
is as devoted to medical education as family medicine. The Society of
Teachers of Family Medicine holds an annual meeting devoted solely to
medical student education. We are one of only a handful of medical
specialties with an entire fellowship (post-residency training) devoted
to faculty development – training the next generation of academic family
medicine teachers, researchers, and leaders.
Lastly, I want
people to know that family docs do everything that they do in the
context of our patients’ belief systems, families, and communities. Our
specialty is the only one that mandates dozens of hours of educational
time during residency about the doctor-patient relationship. How to
help folks quit smoking/over-eating/whatever, how to tell someone that
the biopsy did show cancer, how to mediate family disagreements about
end-of-life wishes – this behavioral instruction is just as important to
a family medicine resident as the pathophysiology, treatment, and
prevention of disease.*
If you’re not a family doc, I bet you
didn’t know all of those things. And the blame for that truth lies
squarely with us as family docs. Frankly, other specialties have been
better than us at promoting themselves. You all likely know what a
dermatologist or a cardiologist is, even if you’re not working in the
medical field. Family docs can learn a lot from how other specialties
have advanced the interests of their patients by advancing their
specialty’s cause; it’s something we have failed to recognize the
importance of until now.
Because of that failure, family medicine
is not understood – and thus not valued – by the public, by politicians,
by health plan administrators, and by too many of the other people who
make decisions about health care in this country.
We need to show them what family medicine is all about.
My
BHAG is to share family medicine with the people who don’t know about
us yet. I hope that this blog does that in some small way; certainly,
many of the family medicine bloggers and tweeters out there are doing it
in a bigger way.
But, I don’t think that’s enough. We need more.
We need an #FMRevolution. I have to believe that there’s something
even bigger, hairier, and more audacious that we could do. I wish that I
knew just what that that big, hairy, audacious thing was. Fortunately,
though, I am but one of many.
It will take all of us to get the chorus of family medicine to echo across our nation.
Jennifer Middleton is a family physician who blogs at The Singing Pen of Doctor Jen
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