Tuesday, April 2, 2013

Family Medicine Activist: What is Family Medicine?

HAWMC 2013 Day 2

So I'm a Family Physician in the private practice of Family Medicine.  What is Family Medicine?

"Family medicine is the medical specialty which provides continuing, comprehensive health care for the individual and family. It is a specialty in breadth that integrates the biological, clinical and behavioral sciences. The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity." (1986) (2010 COD) From the American Academy of Family Physicians

It sounds fairly broad and deep, and it is.  It has to be to respond to your needs.  Notice that it includes integration of biological, clinical and behavioral sciences.  The behavioral part is very important because it enables the Family Physician to connect with the context of your situation.  I've often said, "Context is everything."  What good is it to tell someone how to care for their elbow pain unless the doctor knows where the elbow has been and where it's going?

Your life, your story and your ongoing narrative are the focus of Family Medicine.  Your parts don't have much meaning without your life and  your whole being.  You are born, have a life, then die, then have a hereafter.  All of that matters to your Family Physician in the context of your life.

Not surprisingly, the Family Physician's context matters, too.  As the wholeness of the physician meets that of the patient, there is increased potential to relate and allow better health to happen.  Even when health is failing near the end of life, wholeness can be maintained as the dyad of patient and physician recognize the meaning of the lives lived.  A spiritual aspect of the relationship may add comfort at these times and others. The family context of the Family Medicine dyad may often provide insights about birth, health, illness, disease and death.

The biological and clinical aspects of Family Medicine include all diseases, therapies and diagnoses.  The relationship based nature of the specialty generally adds to the ability to treat and respond to medical diagnoses.  The comprehensive nature of the specialty includes coordinating care across multiple specialties and settings.  It requires collaboration and teamwork with physicians and other professionals.  It may be cumbersome and confusing at times because of the vastness of the modern health care non-system, but patients and Family Physicians can work together in context to get things done.

My life as a Family Physician has no meaning without patients.  They are the key relationships in my career. They allow me to learn about the human condition and apply that learning to shared planning and problem solving.  Their values, goals and beliefs are important aspects of our relationship and mold the decisions that we share in identifying health care and disease care strategies.

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