Thursday, August 9, 2012

‘All in' the Family Medicine Paradigm

By Micah Howard M.D., UASOM Class of 2010

Those of us lucky to don the long white wardrobe have many to thank; our families, our mentors and the lineage of trailblazing physicians that came before us. The profession has always been one of service, and that is what I want to remind us of. We are in service to those needing assistance with the ills of life, and we assist in dissolving impediments to the powerful healing process that is intrinsic to human-kind. 

“A clinician is not someone whose prime function is to diagnose or to cure illness, for in many cases he is not able to accomplish either of these. A clinician is more accurately defined as one whose prime function is to manage a sick person with the purpose of alleviating, most effectively, the total impact of illness upon that person” - Nicholas J. Pisacano M.D.

Who was Nick Pisacano, MD? 
He was the man who through fierce devotion and perseverance founded the American Board of Family Practice and served as its Executive Director from 1969 until 1990. He believed in striving for an excellence that would be ultimately measured by the impact of the specialty on the health of the patients. He was well-read and even more well-spoken. His words remind me of a greater good I promised to give such a short time ago. When my job is dealing with the increasing complexities of health insurance litigation and the endless bombardment of pharmacologic marketing, I lose track of those ideals. So here I am, before your eyes, reuniting myself with the better part of my work, and in hopefulness inspiring others to join in their promise.

"The time has come when we must act to save medicine as a profession. We not only owe it to ourselves and to the youngsters who follow us, but we owe it primarily to the public, who needs a revered profession. Physicians as a group must reconsecrate ourselves to those ancient and cherished values of caring and giving. We must enforce continuing competence and proficiency, but, above all, we must rededicate ourselves to public service. We should embrace super-specialism and high technology only as they contribute to the welfare of human beings. We welcome and support scientific inquiry and new technology, but we must maintain a healthy balance between those advances and humanism. Let us not be drawn into mediocrity. Let us show the people that we hold high the staff of Aesculapius and that we can, and will, care for all who enter the health system with equal concern and caritas. These proposals are not foolish dreams. If we act to reconsecrate ourselves as physicians, think of the good that would be accomplished; think of what the public's image of us would be -- but most important, think of how you would feel -- Doctor!"  - Nicholas J. Pisacano M.D.

Family Medicine is now is more broadly distributed across the U.S. than any other specialty, with over 450 residency programs and over 120 academic departments. It is respected, well defined, and teaches the skills that allow a physician to confront large numbers of unselected patients with unselected conditions, and to carry on therapeutic relationships over time.

I am part of a group of specialized physicians that proudly focuses on:
–  Complaints which are obscure, vague, or undifferentiated 
–  Complaints which arise from potentially life threatening disease that has not yet been diagnosed 
–  Complaints which are out of proportion to physical or laboratory findings 
–  Complaints which are unusual, bizarre, non-physiologic, or non-anatomical 
–  Complaints which are persistent and disabling 
–  Complaints associated with marked anxiety or mood change 
–  Complaints which result from life change, conflict, or other family or social change 
–  Conditions which are incurable 
–  Conditions involving habits and the lifestyle of the patient 

I give my thanks to those that paved the way, and pledge my service to the intellectual and compassionate ideals that they held in highest regard. Our revered profession is one of grand sympathy and eternal conquest for deeper understanding of humanity. We all took the oath, and to our patients we must be true.

“Today we cure this patient, then her family, then the community, then the country, then the world” - Nicholas J. Pisacano M.D.

Micah Howard M.D.

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