Sunday, March 1, 2015

Family Medicine: Sharing Our Humanity with Patients More than Pride in our Clinical Skills

As a Family Physician with over 180,000 patient encounters of experience, I'm still learning and appreciating patients and my specialty and uncertainty.  Yes, I appreciate uncertainty. It helps us to honor the "fog" in the human condition.  It helps us with our spiritual practices, too.

Should Family Medicine be more aggressive and prideful at our place in the health care of America?  Should we push back a bit at the system?

Many may consider pride in one's skills to be "sinful", but our specialty, possibly because of our humility- misguided or not, is indeed "complicit" in medicalizing American life, as Allen Perkins, MD, MPH notes, and, as I believe, helping to bankrupt America by co-dependence with a mis-aligned Medical Industrial Complex. 

We have moved beyond McWhinney,  who wrote and spoke of the clinical methods and skills of Family Physicians, but forgot to integrate his message in many of our teachings. We now understand in a different way that "all our patients will die". That fact dampens clinical pride a bit and enhances our relational connections with patients for the long haul.
Intense celebration of diagnostic wizardry and "high fives" for clinical acumen give way to quests for better understanding of the human condition. Patients teach us that allowing them to be human and protecting them from medical misadventures is part of our job. Another part is validating their humanity and their sufferings. The heartfelt quietness of the slow dance with the human condition is instructive.  Family Physicians Dance well, but we may dance slow.
We love the dance. BUT, it doesn't do much for the quarterly return on the investment of Wall Street or help the budget of the local hospital that may own our practice and expect us to feed it. Many questions face Family Medicine.

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