Thursday, March 18, 2010

When I was in college and the first couple of years in med school I got to know several of the doctors in my hometown. They would let me hang out with them whenever I was home for an extended time. One summer, I spent two days a week with one of them. I learned a lot; not much about medicine, but how a doctor acted. They were different in those days. Doctors were more professional in their conduct and how they were viewed in the community. They were highly respected and many were leaders in the community.

Doctors spent more time talking to patients. They couldn’t do nearly as much as today but at least they tried to make you feel better. They were sure respected for their effort and suits were very rare. The doctor was actually revered. They made house calls in those days and I remember my mother cleaning up the house before the doctor made his visit. She wanted everything to be in perfect order to make a good impression on someone of his stature.

As great as these doctors seemed to be, they were very limited in what they could do. Most of them had their office on the second floor above a drug store. I ask one why they had their office on a second floor with steep stairs and no elevator. His reply was that he figured if a patient could make it up those stairs there might be some hope in his being able help them. These docs were general practioners and would do most everything that could be done from delivering babies, and reducing fractures, to doing appendectomies and tonsillectomies.

These docs are a vanishing breed. They are now called Family Doctors and don’t do surgery. Most don’t delivery babies. They now confine their practice to the office and check your blood pressure and cholesterol. They tell us to lose weight and stop the bad habits that kill us, like smoking. They can treat many minor illnesses and follow patients with chronic conditions. Many have a physician’s assistant who does much of the work so the doc can spend their time filling out all the paper work and instructing the other office help to make it hard for patients to get an appointment.

Most medical school graduates don’t choose Family Medicine for a career because they are paid less that specialist and don’t have the same degree of respect by the public. With healthcare reform upon us, these docs are going to be in greater demand. The question is, where are they going to come from? All the uninsured who will now be insured are going to have trouble finding a physician. The emergency rooms may become even more crowded to care for the sick and worried well.

The only thing that may help with the patient overload is that folks will be unable to pay for the gas to get to the doctor because of their higher taxes and increase in insurance premiums. I’m just going to try and stay on the porch and eat salads in an effort to be safe and healthy.


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