My local newspaper prints the You Docs column 3 days a week and I’ve been reading it for over two years. I can’t say I’ve read every column in that time, but I can say most of them.
There is a clear pattern to their writing and thinking. In the column in front of me, a woman tells them a lab value and a list of symptoms not from the same organ system. They advise her to see an endocrinologist and dermatologist. In another column they advised a woman with vulvar problems to see a vulvologist (more or less, they probably didn’t use that exact word).
Any time they don’t mention a specific ologist, they just tell readers to see “your doc.” Only once in this entire time have I seen them actually write the phrase family physician.
This should come as no surprise given their educational and work backgrounds. Dr. Oz went to Penn for medical school and is currently a surgeon on the faculty at Columbia. Columbia doesn’t even have a department of family medicine, and only recently created a family medicine center. I suspect seeing a family physician at Columbia’s main teaching hospital would be similarly shocking as seeing a unicorn in the forest. Dr. Roizen went to medical school at UC-San Franscisco and did his residency at Harvard, which also doesn’t have a department of family medicine. All four of these institutions have some of the lowest rates of their graduates becoming family physicians.
If these two doctors rarely or never worked with family physicians, how could they possibly know the incredibly wide range of symptoms and diseases we care for?
If these two visible physicians cared about the enormous cost of American healthcare, they would quit encouraging a multi-ologist approach to healthcare delivery that only increases fragmented care and unnecessary waste. Pretty much all their columns covering symptoms or diseases should end with the recommendation “so talk to your family physician.”
I know. It will happen when pigs fly or the Columbia College of Physicians and Surgeons vigorously promotes family medicine.
However you choose to view this, it is a lack of respect for primary care medicine as well as a partisan push (either overt or subliminal)to encourage the use of high cost care from ologists.
There’s a lot of blame to go around – and a goodly portion should be laid at the doorstep of primary care medicine. I’ve heard a lot of complaints from primary care docs – family practice and pediatricians in particular – about how hard they work for relatively little reimbursement compared to the ologists. And it is true.
Quit whining and start making noise!!! Instead of scratching your heads and trying to be politically “prudent” or “correct”, start your own national campaign to harness the empirical evidence about how effective primary care is in putting a tourniquet on the hemorrhaging of health care dollars.
As I see it after 30+ years of working with physicians, is that the primary care doctors in this country have allowed themselves to be the 97 pound weaklings who get sand kicked in their faces by the ologist bullies. I have had numerous primary care doctor clients and friends call their own collective body of primary care colleagues – “wimps and weenies” when it comes to speaking out in a unified voice.
There is a chance afoot – for PCPs to divorce themselves from the ologist weighted rubber stamp approvals for high cost care, i.e., the RUC. So far, the state Family practice academy in New Jersey has summoned up the courage to petition the national Family Practice academy to boot the RUC. It also appears that Florida will take that step as well.
There is just so much that could be done to educate the public about how great a bargian primary care is – just do the work to make it known and get a better reimbursement deal so there are enough PCPs to go around.