Wednesday, May 18, 2011

Family Medicine: #FamMedChat "The Dreams of the Founders" Thursday, May 19 9 PM ET

The #FamMedChat this week on Twitter will focus on "The Dreams of the Founders of Family Medicine" as reflected by Larry Bauer, MSW, MEd in his guest post May 12 on The Singing Pen of Dr Jen's blog.  

Just to add a touch of the founders voice. Here is what G. Gayle Stephen, MD and Tom Leaman, MD said after reading the piece I wrote. They gave me permission to share this.
This is a perfect summary of our best motivations and intentions as they evolved following the 'Reports of 1966'. I never felt however that these dreams were fully endorsed and assimilated by our leadership which seemed more interested in professionalizing a new specialty than in genuine reform. I do not blame anybody for this because both projects were enormous. The reform ethos lasted about five years and was subverted, in part, by three economic recessions in the 1970s and another in 1982 (when unemployment rates were higher than now. I could be a bit more specific about other parts at another occasion. My point is that the dreams were bigger than our organizations were prepared to deal with. Under the circumstances, internally and externally, we did pretty well, given the politics of many physicians. We have demonstrated that we can manage a specialty and run academic departments, but can we grasp the nettle of reform again?
G. Gayle Stephen, MD author “The Intellectual Basis of Family Medicine”
I liked your document very much, but I think that it lacks emphasis on one principle that I think is absolutely basic. That is the close, almost intimate relationship that develops between the family doctor and the patient. Attorneys shudder at the mention of actually hugging a patient; psychiatrists abhor the idea of touching a patient. Many family docs, with the patient’s permission, occasionally pray with their patient. In my practice I learned, slowly, to love some of my most disgusting (physically and morally) patients.
That relationship is truly one of the greatest therapeutic agents we have - it is most in evidence when we have nothing else to offer. It is also the source of one of the greatest joys of family practice.
Thomas L. Leaman, MD founding Chair, Department of Family and Community Medicine, Pennsylvania State University School of Medicine.

Family Medicine, the journal of the Society of Teachers of Family Medicine, recently featured the writings and career of G. Gayle Stephens, MD, one of the founders, in an article by John Geyman, MD (another founder) titled, "G. Gayle Stephens Festschrift".     G. Gayle Stephens Festschrift

John Frey, MD from the Department of Family Medicine at the University of Wisconsin wrote a letter to the editor of Family Medicine in May congratulating the journal for the Geymen article about Dr. Stephens.  In the letter he expressed a concern "about the discipline and our adherence to the values about which both Geyman and Stephens write.  Unfortunately, Stephens' comments about the moral nature of general practice and family medicine in its historical affiliation with traditions such as utopianism, community service, and a special emphasis on the poor is belied by the conduct of those of us still caring for patients."  He notes that AAFP reports in 2008 indicated that 27% of family physicians were not accepting new Medicare patients and 45%  were not accepting new Medicaid patients.

Dr. Frey asks if we as a discipline affirm Dr Stephens' assertion about the care of the public.  "I would suggest not.  We have a long way to go in holding ourselves true to what Gayle Stephens and John Geyman helped create this discipline to do or our country"    

We will invite comments from persons who participate on #FamMedChat about these items and how they relate to where Family Medicine was intended to be, where we are and where we are going via their response to stimulus questions from the moderator (@apjonas) for this chat.  Everyone on Twitter with an opinion is welcome to voice it (in 140 characters or less).  We should have fun with this discussion as we quest for the type of health care that everyone needs and the access dreamed of by the founders of Family Medicine.

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