WhiteCoat's post is called"Will Primary Care Be There When We Need It?". White Coat recently wrote a moving post called "The Little Things" which is both heartwarming and inspirational. It's this girl's opinion that anyone crossing this ER Doc's path will be all the better for it, whether as a patient, in his personal life or any blogger that might be passing through his site.
Everyone knows our health care system is a mess. Anyone perusing the med blogs is familiar with the concerns expressed by the physicians and other health care professionals. My stats show that my post on socialized medicine gets more hits than anything else I have written. Every day people are coming in to read that post which BTW is just my opinions/concerns expressed, but I added several informative links to docs who posted about the topic. Although... rivaling for 2nd place in my stats are people hitting on my kidney stone post vs any post I have written or joke I have put up about peeing. (some of the searches are hilarious and I may post them sometime-I will say a trend seems to be developing) I would also say that based on my stats on urological topics researched leading people to my blog, that urology is a secure field to go in to. We all need our plumbing to be in working order. :) But I digress and so here is The Happy Hospitalist's post.
I Am An Artist
This is my response to Anne on WhiteCoat Rants as he worries about "Will Primary Care Be There When We Need It?
Anne. As a physician I will be the first to say that part of being a great physician is knowing what you know but more importantly knowing what you don't know. I am a physician, someone who devoted a great part of my youth(my entire 20's) to learning the art of medicine. I trained in the footsteps of other great physicians, who themselves have devoted a great deal of their entire lives to training people like me. I am a physician, not a provider.
I am separated from providers by my vastly superior knowledge base, (let me repeat that, vastly superior knowledge base), my integrative training capabilities, my wide range of developing the differential diagnosis, my understanding of horses and zebras and when to look and when to look the other way. Medicine is not a book. It is an art. No matter how hard you try to package medicine, it will never be a book. I have learned the art of medicine and will continue fine tuning that art for the rest of my career. My service to you, as a physician is to promise you the art of medicine. You can think of me as a highly scientific painter.
No painter, no matter who hard they try will ever be able to paint the exact same painting, ever. Anne, you are my painting, for which my artistic brush has created, what I believe, to be the best possible picture of health, based my my artistic abilities. You are different from every other person on this earth. You are living art. And a great physician will treat you as their greatest painting ever, every time.
There is no provider of medicine, no matter how many years of practice, that will ever be able to promise you the art of medicine.
Anne, you can read a medical book yourself, but you will never be able to practice the art of medicine without the intense training, experience and knowledge base that medical doctors achieve by way of their rigorous training. Any provider who claims otherwise fails the first rule of being a great physician. You must know what you don't know. Nobody can Google their way to great painting, no matter how great the Internet is.
Having providers assume the role of primary care is flawed on so many fronts. (You are making the assumption that they would even want to based on the current decimated reimbursment scheme, but that is an entirely different post)
A doctor is so much more than prescribing drugs, ordering labs, and reading xrays. It is understanding why, why not, how, how much, how little, how come, how do you do, every time, all the time. When you see your doctor for that 10-15 minute visit, so much is going on through your doctors mind that involves the art of medicine, every time, all the time. Something a provider will never understand. What you see from a doctor of medicine is but the sliver of a tip of that ice berg of knowledge in your doctors mind, something a provider will never be able to offer.
When you see your doctor for one medical problem and you get upset that the fee is too high for the information received, understand that your information is but a minuscule aspect of thousands of bits of knowledge in your doctors mind, which he/she is inter playing with each other to determine the best drug, the best lab, the best test to evaluate. You are paying for the artist, not the book. And beautiful art priceless.
I have seen more cases of everything you can ever imagine in a vast array of situations (acute and chronic), in my seven years of post graduate training than any provider will see in a life time.
A provider is the single chapter of a library of books, but will never be the art. Wishing for providers to take over primary care, is like wishing for a field full of chapters of knowledge, but no artists.
Artists create a beautiful world by thinking outside that box of knowledge, driving innovation and forcing greatness.
If you pay a provider, understand what you are getting, but more importantly, what you are not getting. I am not arrogant, I am not eggocentric. And I am not God. I am reality. I am an artist and a damn good one.
I will leave it at that.