Family Medicine Activist: 31st Post in 30 Days

Wow!  The Health Activist Writers Month Challenge is over.  I 'm posting a 31st time to say thanks to WEGO Health.  The opportunity to share cyberspace with these activists is a blessing.  Thank You.  You help so many to understand so much.  Bless you.

p.s.

Family Medicine Activist: Words Matter, Too

Below is a "Wordle" aggregating many words from recent posts of mine.  It looks blurry but I see the word Friends in the middle.  I like that since friends are so important to everyone.  Patients is rather large and physician is smaller, as it should be.  Pharmacy and hospital are more prominent than I would have thought would be consistent with my writings.  It's an interesting way to reflect on one's writing.  And, a great way to finish Thirty Posts in Thirty Days.

Family Medicine Activist: Doctors Need Patients

Doctors without patients are like fish without water.  We are useless without patients.  Are they useless without us?  I would generally think not.  So we are dependent on our patients.  We need you.

Family Medicine Activist: Learning from a Dying Physician

The first patient I cared for on my first clinical rotation as a third year medical student at Ohio State was a physician.  He was dying of heart disease after several heart attacks.  Heart transplants and bypass surgery hadn't been invented yet.  He seemed to know the end was coming, but he wanted to give me some tips about being a doctor.  He told me to spend as much time as I could with my family.  "Spend time with your son" (we only had the first of three at that time).  This was powerful advice to me from a physician patient.

He let me draw blood from him and start IV's (We had no IV Team then, either).  He talked of his heart disease and clinical findings to help me with my thinking. He died on the last day of the rotation in my arms as I was holding him up to get an urgent X-Ray.  On the teaching service we didn't seem to be good at knowing when a patient was near death.  Even a physician patient.

It was literally 5 PM, the end of the last clinical day of my first rotation and no one but residents and students were around.  I felt empty as I left the hospital.  The residents and students had no process to reflect on the meaning of a patient death, not even a physician patient.

I was anxious and jittery for hours to days, I couldn't tell how long I wasn't my self.  There was no formal process to reflect on how I felt or what had happened.  The morbidity and mortality rounds to discuss this patient would be two weeks later when I was somewhere else on another clinical rotation.  Back then, this was how we learned.  Even from the death of a physician patient.

Family Medicine Activist: Tim Tebow and Primary Care Nurse Practitioners are Winners

"No one has ever played quarterback in the NFL at a high level unconventionally.  You have to stand in the pocket and throw the football at some point."...Greg Cosell of ESPN in NYT March 24, 2012 from"Passing Flaws May Negate Tebow's Physical gifts" by Mike Tanier.

"For many years, nurse practitioners have been arguing that they can do almost anything that a primary-care physician can, and that they should be allowed to practice independent of a doctor's supervision. Twenty-eight states are now considering providing that authority, and more are likely to as the primary-care shortage worsens. But it's nonsense to say that NPs are as capable as physicians or that they should be addressed as "doctor,".

NPs are good at providing routine care, especially to chronic disease patients, and we need more of them as part of care teams in medical practices. But if I have symptoms that indicate I might have a serious problem, I want to see a physician. That's not to say that a doctor might not miss my abdominal aortic aneurysm or my incipient cancer. But I'd have a better chance of being correctly diagnosed if an experienced physician responded to my symptoms."...by Ken Terry, blogger March 2010 CBS News.com


So, Tim Tebow isn't a "legitimate" quarterback, but he won several exciting, close NFL games in the waning seconds, including the exciting overtime win over the Pittsburgh Steelers with the more than 80 yard touchdown pass in the 2011 NFL Playoffs.  A dejected Ben Rothlesburger, the Steelers "legitimate" quarterback and two-time Superbowl Champion, walked off the field defeated.   Nurse Practitioners aren't seen as "legitimate" team leaders in primary care, but they are winning the day in hundreds of clinics, offices and community health centers by caring for thousands of patients.  Why are Tebow and Primary Care Nurse Practitioners winning?


TEAM
They are team players.  They share and they care.  They know their strengths and they know their weaknesses.  That just may have to suffice.


What do you think?


P.S., I've worked with several Family Nurse Practitioners and I believe they can step up and be the extra Primary Care workforce needed by America.  (They won't being playing quarterback in the NFL, though)