What is a family doctor?

I remember going to a "family doctor" growing up. He was actually a general practitioner with no formal training in family medicine. But, he embodied many of the characteristics I try to display in my family medicine practice.

He lived in the community where he practiced. I went to school with his kids. I worked in his office as a summer job. You would see him at the grocery store or church. He had immediate legitimacy because he knew where you came from.

He was available. If I stepped on a nail and needed a tetanus shot, my mom could just take me over right away. I wasn't turned away and sent to the urgent care clinic or the emergency room. He was my doctor and just provided what I needed.

He practiced a lot of "social medicine". Prescriptions were often given for social maladies - domestic violence, substance use, poverty, illiteracy. These are the true illnesses that patients bring to their doctors so often.

He was compassionate. He frequently "no-charged" patients who were facing financial difficulties. It drove his office manager wild to lose the income, but he was a true softie, and cared more for his patients than his checkbook.

He also displayed qualities I actively avoid.

He was always busy and always late. He routinely scheduled 4 patients every 15 minutes. I could not be happy doctoring that many patients that quickly. As much as possible, I try to schedule the actual time I will need with patients and stay on time with my appointments.

He cut some insurance corners. I remember one occasion when he charged a patient for a visit (she was insured through the state medicaid system) without actually having seen her. He did talk to her on the phone and provided a prescription, but did not see her face-to-face for a visit, which is usually required to charge for an office visit. I can now appreciate the temptation to do that since I sometimes can spend 1 or 2 hours in a day taking care of a patient without seeing that patient in the office. But, I play it straight with the insurance rules and regulations.

He was not home much. He worked long hours, burning the candle long after the clinic closed. I love my family and enjoy being with them. When my day is done, it is done. When I am on call, I perform my responsibilities but don't spend extra time doing non-essential things.

He did not pay attention to the business aspect of medicine. One summer when I was working in his office, I added up his outstanding bills. The total was in excess of $40,000.00. Wow. That is a lot of money. I try to attend to the balance between cost and income so that I am practicing in a fiscally responsible fashion. That said, the financial aspects of medicine in the U.S. are nonsensical and atrociously designed.

As a family doctor, I take care of the whole family. This both means that I frequently have entire families as my patients, but also that I "treat" the emotional and psychological aspects of a patient's illness in all of his or her family members.

I take care of patients from birth (sometimes even in utero) until death. That is really cool!

I take care of patients wherever they are - home, hospital, jail, nursing home, or my office.

I provide the majority of health care - labs, chronic disease management, procedures, acute care, form completion, patient education, counseling, and hand-holding.

Being a family doctor is the most fun kind of doctor you can be.