Tuesday, October 1, 2013

Family Medicine: We Take Care of People

I love doing Family Medicine (FM).  The people are amazing.  Their biologic variation is phenomenal.  The opportunity for helping others to have their life is quite satisfying.  That's what I call quality.  They define it, often with our help, and together, we deliver it.  What a team.  Wow!

Secret:  Later, they all die.  Oops, we do, too.  Even if we don't smoke, or drink or swear.  Even if we had a great set of labs every year.  Even if we had our shingles shot, colonoscopy, flu shot, pneumonia shot and Adacel.  What kind of quality is it if we all die?  Who decides?

The Medical Director of Wholeness may be the one to decide.  If we die whole, that's quality.

I remember an elderly patient I was caring for who arrived at a terminal state while in the hospital with pneumonia.  He improved enough to get comfortable enough to die.  Alone.  His wife said he didn't die alone.  He was with God all along the way, and he didn't need people for his departure.  She declared that he died whole, with God.  She was pleased.

Another opportunity to redefine quality arises with the expansion of Direct Primary Care.  My mode of  practice is a hybrid of "traditional" FM and a version of DPC that I call  Direct Family Medicine (DFM).  In DFM, I have more time to work with patients to define their goals after learning about their values and dreams than many Family Physicians who are getting caught on the "medical hamster wheel".  Dream building helps to define quality goals in a personalized way.  That's the fun of  both traditional FM and DFM.  Personalized care via dreaming.  What is their dream?  How can we use our skills to better align them with it?  How do we celebrate accomplishing the dream?

Once we identify the dream, we assess motivation and belief.  Do they believe they can do it?  Much of Family Medicine is about these steps, especially helping them to know that they matter and we believe in them.  We look out for our people.

As they succeed over time,  we recognize the quality and celebrate with them.  We take care of people.  It's special.  It's Family Medicine.

Let's protect it like we do our people.  Let's adjust our business models so we can still dream for our patients and for ourselves.  Let's respect it, our patients and ourselves.  We all matter.

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