How important are new tests for the diagnosis and treatment of diseases? Or improved surgical techniques, faster emergency care and specialized doctors in different areas of medicine? In fact, any improvements in medical care will make life easier for patients. But a long overdue English report shows that the family doctor (FD) also helps to extend life.
Sir Denis Pereira Gray, former head of the Royal College of General Practitioners, conducted cutting-edge research analyzing 22 different studies. His conclusion, published in the British Medical Journal, claims that a long-term FD that knows you inside out reduces the risk of early death by as much as 53 percent. During this time of heart transplantation, medical progress and drug therapy, FD remains the solid foundation of patient care.
I admit that there are prejudices. After my internship, I spent several months as a family doctor, while a colleague recovered from a heart attack. It was a great learning experience as it was always available to discuss difficult cases. I learned that he was not only a great observer of human behavior, but also a discerning diagnostician. We became lifelong friends.
After this experience, I gave my wife this advice. I told her that if I was acutely ill and several specialists were debating the best treatment, I wanted that FD to make the final decision. I knew that he would not agree to a questionable treatment, that a good mind would prevail and that my life would not be prolonged for no good reason.
During my first year at Harvard Medical School, I came home to find my father seriously ill. He had traveled, complaining of abdominal pain, and a doctor he consulted could not suspect appendicitis. A quick diagnosis by his family doctor on return resulted in immediate surgery to remove an appendix. That made the difference between life and death.
I have never forgotten a case again. I had completed a surgical operation and later returned to the recovery area to check my patient's condition. I noticed that several anxious-looking physicians were discussing the further breathing of a patient after gallbladder surgery.
The surgeon believed the patient had lung obstruction and required an emergency tracheotomy to save his life. An ear, nose and throat specialist was also asked for an opinion. He agreed that this procedure was urgent.
When the patient was taken to the operating room, his family doctor fortunately appeared on the scene and was informed of their decision. So he too listened to the breath of the patient. Then he looked at the specialists and remarked: "I know George for 40 years and he always breathes like that." The operation was aborted quickly.
A family doctor can also rescue patients from questionable and potentially dangerous tests. Today, many patients do not realize that a CT scan exposes them to the same amount of radiation as 500 routine lung x-rays! Or 1
For example, in 1980, 3 million CT scans were performed in the US. Today it is over 80 million. Experts claim that a third of these scans have very little medical value. A family doctor may decide that an ultrasound or MRI provides the same information without being exposed to radiation. Radiation is not a small problem today. Even radiation specialists believe that some patients develop malignancies later in life due to excessive radiation. A long-time family doctor who has a record of the patient's radiation exposure is more aware of this possibility than a doctor in a "walk-in medical center" who knows little about the patient's medical history.
Thinking of something? happens when a serious illness occurs and care by a specialist is essential. This is when, as on many other occasions, family doctors become vital. Now you want the best care and hopefully another compassionate doctor. The trusted family doctor is the best person to refer patients to.
Add everything and long-term family doctors are worth their weight in gold. They work long hours and seldom receive the praise they deserve.
The family doctor who saved my father's life will be eternally grateful. And George will never know how close he was to an unnecessary operation.
Dr. Ken Walker (Gifford-Jones) is a graduate of the University of Toronto and Harvard Medical School. He studied general surgery at Strong Memorial Hospital, the University of Rochester, Montreal General Hospital, McGill University, and Gynecology Harvard. He was also general practitioner, ship surgeon and hotel doctor. Older columns can be found at www.docgiff.com. For comments: [email protected]