In a recent post that I saw on HuffPo regarding the PR problem with family medicine. It was a very well written piece written by Dr. Ranit Mishori entitled Time for Total Medicine: Get Family Medicine Out of the Shadows. I thought it was a well written opinion piece and dutifully tweeted it to my all of 50 odd followers and 300 some friends on Facebook, thinking that it would be nice to bring it to people’s attention. While I was completely well intentioned in that act (as with twitter its hard to express much of an opinion other than “hey check out this story” in 144 characters), it was brought to my attention by Dr Mike Sevilla in his latest blog talk that merely re-tweeting is not necessarily enough. In order to enact change and understanding anybody who has a vested interest needs to make there own voice heard. So, Dr. Sevilla, challenge accepted.
First of all, I liked how she described a standard conversation trying to explain what a family physician does by essentially saying what they are not. They are not surgeons, cardiologists, gynecologists, dermatologists etc. yet deal with problems and procedures in all of these categories and more. Honestly, I feel that Family Docs really ought to be classified as all of the above, rather than none of the above. I see the mentality that Family Docs aren’t any of these specialists as a contributing factor to the popular feeling that if you are a smart medical student you should be a specialist rather than a generalist. This idea can’t be farther from the truth, yet it continues to be felt through out the medical community and the public.
For example, as a third year medical student (almost 4th year as the class above me has now begun their journey into their intern year), I have gotten the chance to rotate through various specialties. This is a standard practice and gives all medical students a well rounded feel of all aspects of medicine. It also gives an incite into how different docs in various specialties feel about docs in other specialties. The incite that I have come home with is a very mixed picture. Perhaps MCV (VCU to be politically correct) is a little more friendly to the idea of family medicine. Generally when I mentioned to any attending that I was interested in going into family medicine, they replied quite positively and informed me how much what I was learning on that particular rotation would come in handy as a family doc. There were still those that told me that there is no money in family medicine and I should consider something else or those that thought not doing procedures every day would be boring. However, those latter statements to me seemed to be more personal preference rather than an actual attack on family medicine.
I feel that many schools could learn from MCV in how it is able to portray the specialty of family medicine. I may be a bit biased as I was one of the co-presidents of our Student Family Medicine Association group, but I feel that as a group we helped to make the presence of family medicine known amongst the medical student body. However, there is still work to be done as I realized at the end of my family medicine rotation. We had a group discussion at the end where many students expressed how they never realized the breadth of knowledge and pathology that family docs see on a daily basis. Most students went into the family medicine rotation assuming they would be bored diagnosing colds, allergies and managing hypertension and diabetes all day. While those are a big part of family medicine it is far from everything. I saw and helped to work up a patient who presented in the earliest stages of being HIV positive (a strange viral prodrome), something that my preceptor at the time had never personally seen in his many years of practice. A classmate of mine worked up a patient who was diagnosed with Creutzfeldt-Jakob disease and other classmates saw numerous small procedures performed by their preceptors.
In talking with one of the family medicine program coordinators I was surprised to hear how many of my classmates (many whom I wouldn’t have expected) suddenly saw family medicine as a viable option for a career and no longer just a “back up” plan. It is this change in mentality that needs to be spread. In order for family medicine to come out of the shadows, medical schools need to be able to show students just how exciting family medicine can be. I know family medicine is not for everybody, but there are many people who don’t give it a second look simply because they don’t understand it. So I’m going to continue to do my part and spread the word of the Family Medicine Revolution and hope that more medical students hear me and give it a second look. I know I don’t have a big voice as a third/fourth year medical student but I will do what I can. Next year I am volunteering to help teach first year medical students basic clinical exam skills and hope to be able to mentor them on the benefits of family medicine. I will also continue to blog and tweet on the benefits of primary care and the joy of family medicine. Viva la Revolution!