A rather disappointing commercial is making the rounds on the local radio stations here.
In the commercial, the voice of a mother is heard talking about how scary it was to take her young son to the Emergency Department with his first asthma attack. A deep, male voice follows, intoning that "even a single trip to the Emergency Department with a breathing problem" indicates the need for this child (and, by association, your child) to be seen by the "asthma specialists" at our local children's hospital. The commercial ends by reassuring parents that these specialists "will work with your child's pediatrician" regarding the treatment plan.
The family docs reading this post doubtless already know where I am headed.
1. A single trip to the ED with asthma does not necessarily indicate the need for consultant* management. Perhaps the family is having trouble affording this child's asthma medication. Perhaps the office didn't make room to squeeze this child into the schedule. Perhaps there's a trigger - dust, cockroaches, pollen, even a pet -that's setting this child's symptoms off. Regardless, the implication that one event should trigger automatic consultation, without discussion between the family and the child's primary doctor, is ludicrous. Family doctors and pediatricians both receive more than adequate training to treat most kids with asthma, and the care they provide is often more cost-effective. Knee-jerk consulting irresponsibly drives up cost and fragments the provision of patients' care.
2. Referring to the child's primary doctor as a "pediatrician" is a subtle tactic designed to imply that all children need a pediatrician and, by inference, further implies that family doctors are incapable of providing quality primary care to children. This kind-of language is divisive and unnecessary. The world needs us both. A more inclusive phrase such as "your child's doctor" would have been just as easy to use.
These assumptions reflect the need for Family Medicine to more aggressively market itself. Many people know what "dermatologists" and "cardiologists" and "pediatricians" are - not exactly simple, self-explanatory words. Yet these specialities have successfully branded themselves and their services to the lay public. Given all that we offer, "Family Medicine" should be an easy sell - but the vast majority of Americans do not know what our specialty is and does.
It is time for all of us family docs to proudly share who and what we are.
* I prefer the term "consultant" to "specialist" - after all, since I'm board certified in the specialty of Family Medicine, I'm a "specialist," too. (Those more radical family docs pushing for the word "partialist" to describe those physicians only focusing on one part of the body - I'm with you.)