Sunday, April 15, 2012

Family Medicine Activist: Keep Your Spouse and Family Doctor

Friday AM.  The sun is shining.  I'm seeing a couple together.  We're finished with relating about the three major problems of the designated patient and reviewing goals for the near future when the spouse verbally nudges the designated patient.  "Well, aren't you going to tell him?"

I knew there was something else at that moment.  It was important and possibly sensitive.  She really cared about him and kept nudging until we identified the problem and developed a treatment strategy.  It was a common problem that Family Physicians treat every day.  Somehow, he had a sub-specialty visit about the problem that had him very worried and preparing for an expensive procedure.  I sometimes get surprised at some of the expense generated in response to common problems noticed by people who "went in the wrong door." They were pleased and relieved to find it was such a simple, everyday problem, treatable with a short term prescription and a follow-up visit.

Medical care is getting complicated by electronic upgrades to our usual way of doing practice and business.  Much of it is necessary while much of it is peppered with "phony quality initiatives".  Watch out while we doctors and hospitals get "widgetized" to maximize the "suckables" for perfect billing.  Sometimes, you may need diagnostic or therapeutic interventions that are very expensive.  Other times, you may be in the wrong place for the degree of difficulty of your problem and have needless expense with no quality benefit.

Keep a relationship with your Family Physician to help you to prevent or treat conditions and diseases as you glide down a path of losing 1% of the function of your major organs each year starting at age 30.  If sub-specialty consultation is needed, your Family Physician will help you to select a physician who is aligned with your needs.  They will also advise you of what to expect and of the limits of their skills and the skills of the consultant.  This helps you to enter "the right" door and optimize health care expenditures while maintaining reasonable quality of your health (depending on random events, your health heritage, and/or your personal habits).

Sometimes it helps to have your spouse along when things are getting complicated, complex or worrisome.  You may be pleased to be reminded of your good judgement in selecting them as your spouse.

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