What’s up, Doc?

I happened upon this article on cnn.com — a primary care physician lamenting on why doctors are fed up. It made me even more grateful I recently found a PCP (internist) I like (after procrastinating for 4 years after I moved because I liked my old PCP where I used to live) as well as finding a new PCP (another internist) for my mother — one who admits to the hospital we favor and is closer than her old one.

I had an initial visit with my new PCP and liked him immediately — we compared notes on NordicTracking (which we like) and interval training (which we hate), among other topics. He’s not much older than I am. We “clicked.”

My mom’s new PCP is a wonderful, gentle man– we like his philosophy that at her age (90), the goal is to have her on fewer meds rather than more. She has been fortunate to have never been on many drugs (4 prescriptions before, only 1 now)  compared to my dad — who, when he died at 80, was on a dizzying array of meds that I managed (well, I put them in the pill minder for the prescribed day and time). There was no way there wasn’t interaction going on that likely shortened his life. Would that we had had more of a handle on things then — and a PCP with a “less is more” philosophy. (We blame my parents’ family doctor at the time, I call him “The Quack,” for not properly diagnosing or treating the high blood pressure my dad likely had for years. Apparently, according to the new doctor who took over his practice, this was an issue in many of his patients.)

I really do wonder,though, in this age of specialization, why anyone would choose to become a PCP. To spend one’s days seeing patients unwilling to do the basics (eat right and exercise) and convinced they know the best course of treatment (surely I need that name-brand med I’ve seen advertised 10,000 times or that expensive test a dozen people I know have gotten. And, you know, when I Googled it…). To deal with all the issues Dr. Harris writes about. It takes a special person to want to go through all that, and a smart, talented, committed one to be good at it.

In fact, I listened to a story about a month ago on NPR talking about this same topic — the dearth of internists and GPs. It interviewed several medical interns ready to go into their residencies, and only one was willing to take on the challenges that come from actually seeing and caring for patients day in and day out.

I consider myself medically aware. I read a lot about health topics. I try to take care of myself. And I admit, I’ve been disappointed that when I have sought medical care, it usually hasn’t made a difference (I seem to acquire maladies that are chronic, rather than curable). But it’s mostly been the “specialists” who haven’t helped — my PCPs and my OB-GYN, my first-line-of-defense, have been responsive and effective. I’d miss them if they were gone. The urgent care center is great when you just need relief in a hurry — like during my last couple bouts of flu — but it’s nothing like having someone who knows your history and follows you over time.

What a delicate balance — this business of treating ailments, restoring health, and prolonging life. And how scary that we will likely have fewer and fewer “good guys” to choose from in the days ahead, just when we need them most.

But nothing is more estimable than a physician who,
having studied nature from his youth, knows the properties
of the human body, the diseases which assail it, the remedies
which will benefit it, exercises his art with caution, and
pays equal attention to the rich and the poor.
~ Voltaire

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