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What is the importance of new tests to diagnose and treat diseases? Or improved surgical techniques, faster emergency care and specialized doctors in various fields of medicine? The fact is that all the improvements in medical care make life easier for patients and save lives. But a long-awaited English report shows that the family doctor (FD) also helps to prolong life.
Sir Denis Pereira Gray, former director of the Royal College of General Practitioners, leading-edge research that analyzed 22 different studies. His conclusion, published in the British Medical Journal, states that a long-term FD who knows you inside and out decreases the risk of premature death up to 53%. So, in the era of cardiac transplantation, medical advances and pharmacotherapy, FD remains the solid foundation of patient care.
I admit that there is some bias. After my internship, I spent several months as a family doctor while a colleague was recovering from a heart attack. It was an excellent learning experience as he was always available to discuss difficult cases. I learned that he was not only a great observer of human behavior, but a clever diagnostician. We have become friends for life.
After this experience, I gave this advice to my wife. I told him that if I was seriously ill and that several specialists were discussing the best treatment, I wanted this FD to make the final decision. I knew that he would not accept questionable treatment, that common sense would prevail and that my life would not go on without reason.
During my first year at Harvard Medical School, I arrived home to find my father seriously ill. . He was traveling, complaining of abdominal pain and a doctor consulted did not suspect appendicitis. A quick diagnosis of his family doctor on his return required immediate surgery to remove a broken appendicitis. It made the difference between life and death.
I have never forgotten another case. I had performed surgery and later, I returned to the recovery area to check the status of my patient. I noticed that there were several anxious doctors debating the breathing of another patient following gallbladder surgery
The surgeon believed that the patient had pulmonary obstruction and had need an emergency tracheotomy to save his life. An ear, nose and throat specialist was also invited to give his opinion. He agreed that this procedure was urgent.
While the patient was being transferred to the operating room, his family doctor appeared on the scene and was informed of his decision. So he too was listening to the patient's breathing. He then looked at the specialists and remarked, "I have known George for 40 years and he has always breathed that way." The surgery was quickly canceled.
A family doctor can also save patients from questionable and potentially dangerous tests. Nowadays, many patients do not realize that a CT scan exposes them to the same amount of radiation as 500 X-ray routine lungs! Or 1,000 dental x-rays!
For example, in 1980, 3 million CT scans were performed in the United States. Today, they exceed 80 million. Experts say that one third of these tests have very little medical value. A family doctor may decide that an ultrasound or an MRI will provide the same information without any radiation exposure. Today, radiation is not a minor problem. Even radiotherapy specialists believe that some patients develop malignancies later in life because of excessive radiation. A long-term family doctor, who has a record of radiation exposure to the patient, is more aware of this possibility than a doctor in a "walk-in medical center" who knows little about the antecedents medical patient.
occurs when a serious illness strikes and that the care of a specialist is essential. It is at this time, as on many other occasions, that family doctors become essential. Now, you want the best care and, hopefully, another compassionate doctor. The trusted family doctor is the best person to refer patients to her.
Add everything and long-term family doctors are worth their weight in gold. They work long hours and rarely receive the praise they deserve.
I will be eternally grateful to the family doctor who saved my father's life. And George will never know how close he was to a useless operation.
Dr. Ken Walker (Gifford-Jones) is a graduate of the University of Toronto and Harvard Medical School. He trained in General Surgery at Strong Memorial Hospital, the University of Rochester, the Montreal General Hospital, McGill University, and Gynecology at Harvard. He has also been a general practitioner, ship surgeon and hotel doctor. See www.docgiff.com for past columns. For comments: [email protected].
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