Medicine
Not long ago, I attended the Shining Knight Gala, a fundraising dinner that benefited the trauma surgery and injury prevention programs at Virginia Commonwealth University Medical Center. The highlight of the evening was the dramatic presentation of the story of a young man who had suffered severe, life-threatening injuries in a car accident and, through the skill and dedication of first responders and the VCU trauma and rehabilitation professionals, was stabilized and over several months gradually restored to health. In recognition of their extraordinary efforts, all of the clinicians involved in this young man's care were awarded the "Order of the Shining Knight." As fire fighters, emergency medical technicians, emergency room physicians and nurses, trauma surgeons, and rehabilitation specialists trooped on to the stage to shake Virginia Governor Bob McDonnell's hand and pose for photos with their award (while their patient looked on happily from a nearby table), it was impossible not to be deeply moved.
It struck me later that there is no primary care analogy for what I witnessed that evening. General internists will not have the satisfaction of being recognized for the patients who didn't have heart attacks or strokes because of the blood pressure medications or aspirin they prescribed; family physicians and pediatricians won't be given awards of merit for all the children they "saved" from measles, mumps, polio, and a host of other vaccine-preventable diseases. While primary care physicians certainly provide acute care services for a variety of ailments, the greatest impact of our work is ultimately unmeasurable: all of the poor health outcomes that might have happened, but didn't.
Does this mean that there are no heroic family doctors? Far from it, but recognizing our behind-the-scenes efforts - and reinforcing the appeal of the primary care specialties to medical students - is certainly more challenging. But I'm cautiously optimistic that the past few years' Residency Match results, which showed modest increases in the numbers of U.S. graduates choosing residency programs in family medicine, general internal medicine and pediatrics, represent a turning of the corner. With the millions of people expected to gain health insurance over the next year, this country will need every primary care clinician it can get.
**
This post originally appeared on Common Sense Family Doctor on April 1, 2010. I am re-posting it in belated recognition of National Primary Care Week, which Georgetown is celebrating with a series of Family Medicine Interest Group events led by several outstanding physician colleagues.
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Medicine
Shining Knights and heroic family doctors
Not long ago, I attended the Shining Knight Gala, a fundraising dinner that benefited the trauma surgery and injury prevention programs at Virginia Commonwealth University Medical Center. The highlight of the evening was the dramatic presentation of the story of a young man who had suffered severe, life-threatening injuries in a car accident and, through the skill and dedication of first responders and the VCU trauma and rehabilitation professionals, was stabilized and over several months gradually restored to health. In recognition of their extraordinary efforts, all of the clinicians involved in this young man's care were awarded the "Order of the Shining Knight." As fire fighters, emergency medical technicians, emergency room physicians and nurses, trauma surgeons, and rehabilitation specialists trooped on to the stage to shake Virginia Governor Bob McDonnell's hand and pose for photos with their award (while their patient looked on happily from a nearby table), it was impossible not to be deeply moved.
It struck me later that there is no primary care analogy for what I witnessed that evening. General internists will not have the satisfaction of being recognized for the patients who didn't have heart attacks or strokes because of the blood pressure medications or aspirin they prescribed; family physicians and pediatricians won't be given awards of merit for all the children they "saved" from measles, mumps, polio, and a host of other vaccine-preventable diseases. While primary care physicians certainly provide acute care services for a variety of ailments, the greatest impact of our work is ultimately unmeasurable: all of the poor health outcomes that might have happened, but didn't.
Does this mean that there are no heroic family doctors? Far from it, but recognizing our behind-the-scenes efforts - and reinforcing the appeal of the primary care specialties to medical students - is certainly more challenging. But I'm cautiously optimistic that the past few years' Residency Match results, which showed modest increases in the numbers of U.S. graduates choosing residency programs in family medicine, general internal medicine and pediatrics, represent a turning of the corner. With the millions of people expected to gain health insurance over the next year, this country will need every primary care clinician it can get.
**
This post originally appeared on Common Sense Family Doctor on April 1, 2010. I am re-posting it in belated recognition of National Primary Care Week, which Georgetown is celebrating with a series of Family Medicine Interest Group events led by several outstanding physician colleagues.
- The Real Face Of Lack Of Access To Health Care
.I have often written about the fact that lack of health insurance is a major source of cost for the health system. People without insurance often cannot afford to pay doctors or buy medications, and so do not seek care for treatable illnesses until they...
- In Praise Of Individual Health Mandates
Last month, my family was involved in a scary traffic accident en route to the Family Medicine Education Consortium's North East Region meeting. I was in the left-hand eastbound lane of the Massachusetts Turnpike when a westbound tractor trailer collided...
- The Most Talked-about Posts Of 2010
Here is a recap of this year's Common Sense Family Doctor posts that received the most comments from readers (here or on other blogs such as Healthcare Headaches or KevinMD.com), in chronological order. Happy holidays and see you all in 2011! ** 1....
- The Best Recent Posts You May Have Missed
Every other month or so, I post a list of my top 5 favorite posts since the preceding "best of" list on this blog, for those of you who have only recently started reading Common Sense Family Doctor or don't read it regularly. Here are my favorites...
- General Surgery And Family Medicine Are In The Same Boat
In its 21st Report, Improving Value in GraduateMedical Education (1), the Council on Graduate Medical Education made an important recommendation. COGME looked at all of the data regarding the physician workforce and predictions of student specialty...