The Good, The Bad, and The Ugly

Yesterday, I wrote about the good that is family medicine.  Recently, I pointed out a couple of bad apples (specifically, cardiologists & gastroenterologists) in the House of Medicine which hasn't done such a wonderful job of keeping its promise to put the patients' interests first.  However, it's been brought to the attention of the nation, and probably globally, by USA Today that there is an even uglier side to medicine whereby patients are actually harmed, gravely so in some very unfortunate instances, by doctors performing procedures without adequate training.  

There's that ugly word again, procedures.  But are procedures inherently bad, in and of themselves?  Dr. Glen Stream, the newly appointed president of the American Academy of Family Physicians, pointed out yesterday that the hands of the family physician are trained to deliver babies, inject joints, set fractures, and sew up lacerations; these, too, are procedures.  Moreover, these trained hands hold those of ill patients, and comfort others at the end-of-life.  So yes, family physicians do perform procedures.  We just haven't shouted loudly enough from the mountaintop that we do so.  

Unfortunately, there are clearly instances where a specialist is reimbursed dramatically more for performing the exact same procedure that a family physician performs.  I dare say that perhaps we should lay the blame on our current healthcare system (once more!) when otherwise good people/physicians succumb to greed because they can't get adequate reimbursement for their cognitive skills (not to denigrate the tremendous thinking required to perform complicated surgeries & invasive procedures).  After all, is there any stronger motivator than the want/love of money?

So we're human.  We're fallible.  We can be tempted.  We have a price.  I would posit, however, that most of us, the majority of us, all the attendees at this Scientific Assembly and those holding down the fort for us back home, are beyond temptation and have no price.  We are family physicians.  We chose the specialty of family medicine for the ability to do all that we do.  We did not choose family medicine for its reimbursement & remuneration.  You can trust us to look out for your best interest and place yours above all else.

How can you find us?  For starters, try the American Board of Family Medicine and your state board of medicine.  And if you can't afford medical care, don't go without.  Check out the "Low Cost Medical/Dental/Pharmacy Options" tab at the top of this page.  I can almost guarantee you that any family physician working in such a clinic or facility has placed you first on top of his/her own financial well being.  In fact, the AAFP Foundation has rolled out its Family Medicine Cares program in conjunction with Volunteers in Medicine to equip new free clinics around the country.

But just in case you still want that cosmetic procedure, consider what the USA Today recommends when searching for a plastic surgeon.  Ask your family physician what s/he knows about this physician and procedure.  And remember that you only have one body, so try not to make your decision based just upon pricing.