THE FAMILY DOCTOR’S PIVOTAL ROLE--
Once upon a time there was a GENERAL PRACTITIONER who took care of the FAMILY. Sutured lacerations, treated colds, took out the appendix and delivered babies. This GP was understandably the FAMILY DOCTOR.
As medicine became more detailed and intricate doctors started to specialize, and when the GP or Family Doctor needed help s/he referred the patient to the Specialist or asked the Specialist to see hospitalized patients, or asked the specialist to assist in surgery. Also the GP did lots of stuff in the office.
Specialists and Family Doctors conformed to a strict protocol of manners.
The patient was under the Care of the Family Doctor. That was understood.
The Specialist was there to help out.
The Specialist did not discuss the case with the referred patient.
Instead the Specialist said “I will communicate with your physician and s/he will bring you up to date on what can be done”.
Referred patients were returned to the family doctor, never referred to other specialists.
Thus the Family Doctor played a pivotal role in the care of the patient, refereeing procedures deemed unnecessary and in a position to exert some cost control. Indigent individuals were often seen free.
The advantage of this ethic was that the Family Doctor, familiar with the family, its medical history and social circumstances was positioned to manage its medical problems and guide patients through the medical process.
As medicine became more specialized the scope of General Practice was reduced accordingly. The GP /FP now referred to as the Family Doctor still performed many Specialty Office Procedures and continued as family counselor and friend.
With the advent of HMOs, physician panels and litigation flourished. The “Family Doctor/Practitioner” became the “Primary Care Doctor” limited to, referring, writing prescriptions and practicing Preventive Medicine. Specialists like it or not became de facto Family Doctors and the Ombudsman role of the Family Practitioner went into abeyance.
Retrieving the Family Doctor and putting responsibilities back where they belong could be achieved by encouraging the formation and distribution of Primary Care Medical Centers throughout the country.
This would assure every citizen of Primary Care Medicine,
Decongest emergency rooms,
Create a market for Term Health Insurance
Tort Reform would be evaded Litigation because physicians would be (albeit indirectly) government employees and law suits would be defended by the office of the Attorney General.