Primary Care

Welcome to my general store.

I provide good old-fashioned grade-A Primary Care.

Primary Care

Primary care is “the initial medical care given by a general health care provider, especially a family physician, internist, or pediatrician, usually as part of regular, nonemergency care.”

Primary Care doctors are the generalists, I’d call them the giants of medicine. Primary care doctors set the tone for healthcare delivery and create a medical home for a patient.

What is a Medical Home?

A medical home is more than the walls of a clinical practice. 

“The medical home, also known as the patient-centered medical home, is a team-based healthcare delivery model led by a healthcare provider to provide medical care to patients to obtain maximal health outcomes.”

“A medical home should be the following:

  • Accessible
  • Family-centered
  • Continuous
  • Comprehensive
  • Coordinated
  • Compassionate
  • Culturally Effective”

The spirit of primary care says, “I am your home base there’s nothing you can’t bring here.”

The spirit of family medicine says, “To everyone, of all ages and stages of life with any ailment, you are welcome.”

Family medical perspective

Family medicine contains the pathway in medicine with limitless possibilities and roots itself in person-to-person contact. I was attracted to focusing on the person first rather than on a particular body system or a disease. I chose to be a family doctor because was interested in, “I know you well, and you know me well, let’s see what healing can come of it.” That perspective lives strongest in primary care and in family medicine. 

The vastness of the generalist’s field cultivates humility. Specialists can develop a sense they know all that is known in their field. This carries the risk of complacency and missing out on the realization that knowing all that is known is far from knowing all. Generalists don’t get lured into such a trap. The limitlessness keeps us humble, which when you think about it, is the absolute right way to be in front of the mysteries of health and illness. Being in awe is being open. Being open is the primary position for learning.

Choosing Family Medicine

Imagine the 19-year-old has made the decision to go to medical school and applies himself to get into a program. Choosing to go to medical school is a big choice for a young person, but it feels like an extension of college for the first two years. Then you enter the hospital in the third year and all of a sudden you face this major decision at the end of that year: what life in medicine do you want? What specialty will you choose? Careers in medicine vary vastly.

I went against the grain at Georgetown University Medical School to choose Family Medicine. It wasn’t a primary care type of medical school. Cardiology, Neurosurgery, and Orthopedics were the common choices and would pay off student loans reliably fast.  

There is nothing wrong with these other specialties, it just wasn’t what I wanted.

“Why would you want to do family medicine? It’s basically glorified nursing,” said a professor at my school, an orthopedic surgeon.

Glorified nursing?… Let me digest that, sir.

“Nurses dispense comfort, compassion, and caring without even a prescription.” 

— Val Saintsbury

“A nurse is one who opens the eyes of a newborn and gently closes the eyes of a dying man. It is indeed a high blessing to be the first and last to witness the beginning and end of life.”

— Unknown

Glorified nursing… count me in!

Partnership

Do you want to know one of my favorite things about being a primary care doctor? We never have to say: “There’s nothing more I can do for you.” We don’t know that phrase…

Upon reflection, I sense it’s short for, “There’s nothing more this paradigm can do for you; no standard pharmaceutical options apply.” The dreadful underlying assumption here is that doctors are pharmaceutical medication experts, not health experts.

Primary care doctors aren’t wedded to the medical paradigm. Our allegiance is to the patient. Period. We have replaced that phrase with:

“There may be no pharmaceutical options in the standard paradigm, but we have lots we can do. Let’s get creative and come up with your path forward.”

On Course

We should remember a couple of things: (1) the patient is the point, and (2) primary care is the difference maker. A medical system with a strong primary care basis will have better health outcomes and will have cost savings. This is a well-documented and accepted fact in healthcare. This is true whether we are talking about a personal health team or the country’s medical system.

The problem is the US has significantly under-invested in primary care. Primary care is not prioritized or incentivized, so a shortage of primary care physicians has developed. A system with weak primary care is like a ship without its captain.

With no captain how can the ship remain on course?

I often wonder if our knowledge of physiology, anatomy, and pathology is serving a mutant clone of medicine created to support industry interests. The mandate is to connect to the essential elements of medicine: the timeless parts of the vocation that nourish both the patient and the doctor.

Conclusion

For a healthcare system to function well, on either the micro or macro level, I see relationship as the key element, a non-negotiable. That’s what allows for clear sailing.

That’s the primary care / family medicine / medical home perspective. That’s my perspective.