Monday, April 8, 2013

Family Medicine Activist: You Matter


I remember one of my sergeants in US Army Ranger School used to say, "It's a case of mind over matter.  We don't mind and you don't matter."   Do you get that "you don't matter" feeling sometimes when you're involved in the health care system?

Sadly, people with mental illness seem to be the first to be discarded.  Hospitals are closing in-patient psychiatry units, since they are not profitable.  Emergency departments are jammed with patients since there aren't enough Family Physicians or other primary care physicians to care for them. Strangely, many hospitals are closing Family Medicine residency training programs, just when Family Physicians are in great demand, because they aren't as profitable as other specialty training.  They don't admit as many patients or send as many patients to Emergency Departments (which you may appreciate).

How does it get better?

It starts with your mirror.  Look at yourself in your mirror every day and enthusiastically say, "I love you!"  It knows that you matter.  Your mother knows that you matter.  And, your Family Physician knows that you matter.  You do matter.  Well or sick or injured, you matter.

One other way to matter in health care settings is to reaffirm your identity/ humanity.  Be more than your disease or your cholesterol.  How do you do this when your Family Physician is busy with medical activities?  Remember where I wrote that "context is everything" a few days ago?  You can firm up your physician's knowledge of the context of your life.

Physicians share information about patients by "presenting" information about them to each other when  needed.  Similar information about your context would include your age, marital status, gender, occupation, living arrangements and location, and where you are headed in your life, work, play or other narrative.  Providing elements of your context as part of the expansion of your chief complaint (reason for the visit) and  history of present illness should help your physician.  It might sound like this as your physician thinks of your situation, "This 42 year old female high school principal who lives in a home in Beavercreek with her husband is intending to start a PhD program in June and is here today for left knee pain for the last two weeks.  She is  a tennis club member and their season started two weeks ago."

Do you notice how the context of this person's situation should help the physician to personalize the diagnostic process and treatment plan?  The information enables the physician to have a broader understanding of the potential diagnoses and individual treatment strategies for this unique person.

Your Family Physician also enjoys their relationship based specialty more as they get a deeper understanding of you and other family.  People are interesting.  Body parts and numbers aren't as interesting without a person with a context.

As your Family Physician and other specialists better understand your context, they can better personalize your care.  Because...YOU MATTER!

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