There is a lot of talk about team based care nowadays, and I have seen some shining examples of that, most recently when a patient at my clinic had a suicide in the family.
I think.....I think this is getting to the very core of why Primary Care is in the trouble it is in. Yes, there are many factors - organization, payment systems, administrative burdens, clinical guidelines that make no sense for the patient's well-being, the destruction in front of our eyes of the "patient-physician relationship", the increasing sense of entitlement and decreasing sense of "duty" and "work" etc. etc - but the unwillingness to make and be accountable alone for a decision, the "grasping of the nettle", valuing the trust of a patient is surely a fundamental cause of the mess Primary Care finds itself in these days.
I remember very well during my medical education at McGill that all the "disagreeable" work - talking to patient and their families, announcing a death and asking for an autopsy, digging up lab reports, talking to radiologists for a differential diagnosis - were called "scut work". And Primary Care is scut work, heavily accountable at the deepest individual level. . Nobody in the right medical mind would want to do that all their carreer, right?. How much better, if and only if one must, work only in teams?
I have more thoughts for a later time, but keep digging, Dr Duvefelt.
I think.....I think this is getting to the very core of why Primary Care is in the trouble it is in. Yes, there are many factors - organization, payment systems, administrative burdens, clinical guidelines that make no sense for the patient's well-being, the destruction in front of our eyes of the "patient-physician relationship", the increasing sense of entitlement and decreasing sense of "duty" and "work" etc. etc - but the unwillingness to make and be accountable alone for a decision, the "grasping of the nettle", valuing the trust of a patient is surely a fundamental cause of the mess Primary Care finds itself in these days.
I remember very well during my medical education at McGill that all the "disagreeable" work - talking to patient and their families, announcing a death and asking for an autopsy, digging up lab reports, talking to radiologists for a differential diagnosis - were called "scut work". And Primary Care is scut work, heavily accountable at the deepest individual level. . Nobody in the right medical mind would want to do that all their carreer, right?. How much better, if and only if one must, work only in teams?
I have more thoughts for a later time, but keep digging, Dr Duvefelt.
Thank you. Absoulutely at the foundation of care.