Wednesday, April 13, 2011

Family Medicine - the antidote to the common sense blues

Reading through the responses to my post from yesterday, I realized that Steph and webhill were taking the conversation in a new direction.* I'd like to expand on their very valid points.

These kind responders shared similar stories of supposedly "abnormal" health metrics that initiated some sort of protocol, even when it didn't make an ounce of sense.  Two healthy newborns subjected to unnecessary (and costly) interventions.  Another similar experience to mine regarding "low" blood pressure.

You don't need any medical knowledge, really, to figure out that Steph's baby didn't need to go to the NICU, or that webhill's didn't need formula.  Heck, you don't need a day of medical or nursing school to know that the resident's patient from yesterday's code story was perfectly fine.

So, what is happening in nursing and medical school that strips that common sense away?  Certainly the first two years of medical school focus on learning the minutiae of how the body works - biochemistry, anatomy, etc.  All that time spent memorizing neurotransmitters and cell receptor signals then yields to being ready to respond instantly to your attending's pimping in the third and fourth years about the coagulation cascade or your patient's colonoscopy biopsy results from eight years ago.

The partialists** especially seemed to delight in these details when I was a medical student.  Frankly, it seemed then - and it seems now - that those practitioners best able to see the whole picture were - and are - the family docs.  Perhaps it's because they are the only ones truly taught to think about the patient as a whole being and not a collection of organ systems and biometrics.

Of course, we need our partialists.  They provide important and complimentary skill sets to ours.  But a family doctor should be at the center of every patient's care.

More family medicine as an antidote to the common sense blues?  It couldn't hurt.

* I genuinely appreciate every one of you readers who, at some point, has taken the time to continue the conversation by responding to one of my posts.  You all are the ones who truly keep things interesting around here.  :)
** Please see entry from 3-1-11 for more about the "partialist" label.

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