Thursday, April 4, 2013
Family Medicine Activist: Wholeness isn't Billable
#HAWMC Day 4
Famed scientist David Bohm was frustrated by the way science seemed to fragment or isolate subject matter. According to Peter Senge who wrote in the introduction to Bohm's book, Dialogue, "But it's efficacy hinges on its being able to fragment... It fails and may become actively dysfunctional when confronted by wholes, by the need to understand and take effective action in a highly interdependent context."
"The fundamental problem here, according to Bohm, is that the whole is too much. There is no way by which thought can hold the whole, because thought...limits and defines."
Advocating for Family Medicine is challenging at times for reasons that Dr Bohm would understand. We have a relationship-based specialty that aims for patient wholeness while having to bill for the care of patient parts. The wholeness quest wrestles with the desire to succeed financially. If we succeed financially by traditional medical billing, we are eroding our clinical success by carving up wholeness into parts. This is one of the paradoxes of Family Medicine.
Patients may feel the tension as the clinical encounter seeks to break them into parts, while overlooking issues of wholeness, which would be more healthful. We have to find ways to align the wholeness quest with a realistic business model since we believe that Family Medicine should survive.
God knows wholeness. Can we?
How can we share the wholeness quest with our patients for our mutual benefit?