I read an article recently in The New Yorker written by my favorite doctor, Atul Gawande. He's the author of the book (and the movement) "Being Mortal." The main thrust of the article deals with the power of incremental, long term, care. This is interesting because Dr. Gawande is a surgeon. We know these are the heroic, glamour guys and gals who swoop in and save lives.
However, when Dr. Gawande was telling his internist friend that he became a surgeon because he "would have more opportunities to make a clear difference to people's lives," the internist would have none of it.
Primary care is the medical profession that has the greatest overall impact, including lower mortality and better health, not to mention lower health costs.
How? It involves my doctor getting to know me including how I live and how I behave. It involves the patience to treat long term illnesses, with the frustration of possibly never curing them. In other words, it involves a caring, long term, relationship. One where, when the honeymoon's over the doc sticks around for the boring real life stuff.
Last week I had a bad bout of vertigo. After 24 hours of spinning and throwing up Dave drove me to the doctor's office. A nurse saw me struggle into the waiting room. She ran over with a wheelchair and stuck with me until the doctor could see me. Her care was almost as meaningful as the shot he gave me that knocked me out for a few hours.
My internist has earned his retirement. I just hope we find another one who is into long term relationships.
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