Googling "Family Medicine" - who's defining us?

After my last post, I started to wonder about my non-family-doctor readers.  What if they are part of that large majority of people who really don't know what our specialty is all about?  Where might they go to learn more about us?

Google, of course.

So, here are the top 3 Google hits for "family medicine":

#1. Home page for the American Academy of Family Physicians.  The AAFP's home page, not necessarily inappropriately, focuses on CME (continuing medical education) for members, advocacy, and public health issues.  Some clicking around eventually leads to a "about the specialty" page, which has lots more links.  Click on one of them, scroll to the bottom of the page, and you'll find

Family medicine is the medical specialty which provides continuing, comprehensive health care for the individual and family. It is a specialty in breadth that integrates the biological, clinical and behavioral sciences. The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity.  http://www.aafp.org/online/en/home/policy/policies/f/fammeddef.html

Hmmm.  Maybe a little obtuse...if you manage to even find it buried in the site.  Let's move on.

#2. Family Medicine Journal, the official journal of the Society of Teachers of Family Medicine;as an STFM member, I receive and read this journal regularly.  Much clicking around this site gives no succinct definition of family medicine.  Again, not totally unreasonable given the site's focus.

#3.  Wikipedia.  (C'mon, you knew it was coming.) 

Family physicians deliver a range of acute, chronic and preventive medical care services. In addition to diagnosing and treating illness, they also provide preventive care, including routine checkups, health-risk assessments, immunization and screening tests, and personalized counseling on maintaining a healthy lifestyle. Family physicians also manage chronic illness, often coordinating care provided by other subspecialists. Many American family physicians deliver babies and provide prenatal care.  http://en.wikipedia.org/wiki/Family_medicine 

I must admit - decently done, Wikipedia. 

The Google hits further down start focusing on "find a local family medicine doctor" and family medicine residency programs.  So, truly, those people seeking to find a succinct answer about what our specialty is will probably stop with that Wikipedia link. 

National Family Medicine organizations, as a member of all of you, I implore you to add some simple definition of Family Medicine to your home pages.  I get that promoting Family Medicine to the lay public isn't your main agenda for these sites designed for physicians.  (Though maybe it should be on the agenda somewhere.)  But these sites are at the top of the Google "hit list" for our specialty, which confers responsibility on you.  Don't make people dig through your sites to find out who we are, and don't leave the job of defining us to unsanctioned voices on Wikipedia.

We, as a specialty, must speak with a bolder and clearer voice.

Another commercial touting "specialist" ("partialist"?) care

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.)