The Philosophy of Family Medicine
People often ask about the essence of Family Medicine, and wander about the scope of knowledge of family practitioners. Most can't tell the difference between a GP (General Practitioner) and a Family Physician. Does a family physician know just a little about everything ? Does he know less orthopedic medicine than the orthopedic surgeon or less ophthalmology than the ophthalmologist ? Is he "almost as good" as the cardiologist ?
And I say: NO
Who is the Family Physician?
I believe a family physician is THE expert in his field:
Primary medical care.Primary care is the science consisting of many elements:
Health promotion
Chronic disease management
Health education
Disease prevention
Comprehensive, integrative medical care
Management of acute common diseases
Community health management
All these are done almost exclusively by FP's, and almost never by hospital doctors, consultants, and experts in a narrow medical field. It is noteworthy that the average person spends less the 1/1000 of his life in a hospital, while the rest 999/1000 are spent at home, in the community. Thus the FP is the major medical caregiver throughout life.
Examples
A patient with Diabetes Mellitus needs lifelong medical care. Diabetes control can not be achieved in the hospital. While there, food, physical activity and stress levels are all different from normal. When the patient returns to his natural environment diabetes care begins (or resumes), and proper control can be achieved, usually within a few weeks.
A patient with several chronic diseases may meet many doctors, each will suggest medical therapy, medications ect. Contradictions are not rare, and the cardiologist might prescribe a drug that the nephrologist doesn't like, or it may interact with another drug given by some other physician. The patient will be confused, or even worse, harmed, by contradicting advice. The role of the FP will, in this case, be the integration of the medical care.
