PDPC logo small.png

Beyond 7 minutes

I trained as a Family Doctor so that I would be ready to help patients with any challenge. The old school family doc used to take that skill set out into the community on house calls, sports sidelines, and town hall meetings. At some point the job description was boiled down into a job that started and ended with a 7 minute office visit. That setup is not good for patients, and it's not good for doctors. In this column I hope to start to push the boundary of where the doctor patient interaction takes place - onto the page, into the community, and beyond 7 minutes.

Posts tagged DPC
A Firsthand Perspective on Physician Burnout

Residency training is between 3 and 7 years. All Resident Doctors carry a medical

degree and have passed all the necessary training to provide medical services. In

fact step into any major hospital in the US and your treatment from start to finish is

likely to be carried out by a resident doctor.

Some might question how someone could become burnt out only 3 years into a

career that is supposed to last decades. Picture this: 28 of your last 30 days have

been spent in the hospital. Each of those days has consisted of waking up at 5AM

and facing one life-threatening crisis after another. After about day 14 of this you

think, “I’ve hit my breaking point.” The day consists of working, sleeping, and eating

in that hierarchy. You do this willingly day after day, year after year because that is

what doctors do. And after you think you’ve found a balance, where this just might

be sustainable, something breaks.

For me that breaking point was my Grandma getting critically ill. She was in the ICU.

It doesn’t take a doctor to know that it isn’t good news. Everyone processes these

kinds of things in a different way. I went to the chapel, closed my eyes and cried. I

cried for my grandma. I cried for my family who was about to enter a medical

system fraught with hard decisions that is all too often not personal. I cried for

myself because I was at the edge and I truly felt I had nothing left to give.

I am incredibly lucky to have a supportive family as well as colleagues. I write this to

illustrate that one unpredictable event in a physician’s life can push them from what

is already a stressful job over to the point of burnout. For me this story has a happy

ending. My Grandma is OK, she made it out of the hospital. I’m also OK. I have

chosen a career outside the hospital in Direct Primary Care where I have more

control over my hours and stress level. History has shown that the same cannot be

said for other Resident Doctors in my position experiencing burnout.

Being a doctor is a privilege and an honor. We do not deserve special treatment. In

fact, I think that we need better working conditions for all people. I can only speak

from my experience in my chosen career. At the very least there needs to be a shift

to accommodate bereavement time for physicians who find themselves in a position

such as mine. We should not encourage a system that pushes physicians to the point

where they are only one family crisis away from going over the edge of critical

burnout. It happened to me, I know it has happened to others, all I can hope is that

future generations of healers my have more protections than we do now.

A version of this story was also published in the June edition of the West End News

The Best of Both Worlds
bridge thumbnail.jpg

Direct Primary Care

The Best of Both Worlds

For many people the term ‘Direct Primary Care’ is something they have never heard of. Although the term itself may be new, the ideas behind it are tried and true. Our parents and grandparents remember a time when doctors would not only make a visit to someone’s home but would know everyone by name. There was a time when doctors had a list of services and associated prices so patients would know how much things cost right up front. There was a time when one medical office could handle most, if not all, of a person’s day-to-day health needs. It’s hard to believe this was the norm not so long ago.

The way we give and receive care has changed significantly in the past few decades. The modern doctor’s office is streamlined to accommodate large numbers of patients as efficiently as possible. Deciding what to charge for a medical visit has become so complex that most clinics hire specialists whose sole responsibility is to review medical notes to try and match a patient with a set of codes. In addition, providers are so far removed from the process of dispensing medications that all too often patients leave a pharmacy empty-handed when they find out a prescription their doctor has prescribed is too expensive or not covered by their insurance plan.

Over the same span of time there have also been some monumental advances in health care. We now have better and more far reaching ability to analyze and act on medical data for individuals and populations. We also have access to more evidence on which to base treatment decisions. There are studies being published every week comparing different medications and types of treatments, the results of which have the potential to help people live healthier and longer lives. Despite these advances, many people can’t help but feel neglected and left behind by the current medical system.

As a family doctor, I see Direct Primary Care (DPC) as the bridge between the old medical system and the new medical system. We can’t ignore the medical advances of the last century but at the same time, we can’t forget the incredible power of relationship-based care from a provider who knows you and takes the time to offer the best care possible. What this looks like in practice is smaller clinics with more time for doctors to give great care. If a medicine is prescribed, we can put it in your hand at an affordable price. It looks like full spectrum primary care for an up-front fee that is fair from both the doctor and the patient perspective. If something isn’t practical or safe to do in the office, it looks like having an advocate who will help navigate the medical system to find the best solution medically and financially, whether that means finding discount X-rays, MRIs or specialty providers who can give discount prices to DPC members. Direct Primary Care encompasses all of these time-tested ideas in a new package, giving patients and doctors the best of both worlds.