Tuesday 19 November 2013

Riled up

Lecture today by a doctor who quit family practice to become an integrative medicine consultant, working independently with patients to help them develop holistic approaches to illness. For example, treating a patient with irritable bowel syndrome not only with meds but also with nutrition and counseling. She emphasized the importance of taking a good history and developing rapport with the patient.

I mean, duh. We're totally on her side. (We are. We're only second years. We've been hearing about this from every clinical skills professor.) This physician was the first to admit that she left family practice because she was sick of seeing a new patient every 10-15 minutes and prefers taking up to three hours with each patient. So why, instead of putting a hand on our shoulders and looking forward to our careers with us, helping us to problem solve around the constraints of time and money that will be placed upon us, did she get preachy with us, implying that we'll want to treat diseases not people?

The real question is, "How do good people become bad doctors?" I see the problem in a healthcare system that reimburses physicians for prescribing rather than counseling, where income depends on volume rather than quality.

It turns out that this physician exclusively sees patients who pay out of pocket. For those of us who don't plan on that career path, what can we do?

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Madeline said...
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