Wednesday, August 19, 2009

Myths of Primary Care

Many people think they don't need to go see a primary care physician (family doctor). They think that specialists handle difficult diseases and so any simpler disease will be no problem for them. These people are wrong.

Dr. Erick Cassell wrote:

"A common error in thinking about primary care is to set it as entry level medicine... and, because of this, rudimentary medicine-for mostly (say) the common cold and imaginary illnesses. This is a false notion... The higher we go on the scale of a specialist training, the less complex the medical problem becomes... One should not confuse highly technical, even comlicated, medical knowledge-special practical knowledge about an unusual disease, treatment (complex chemotherapy, for example), condition, or technology-with the complex, many-sided worldly-wise knowledge we expect of the best physicians... The narrowest subspecialist, the reasoning goes, should be able to provide this range of medical services. This naive idea arises, as do many other wrong beliefs about primary care, because of the concept that doctors take care of diseases. Diseases, the idea goes on, form a hierarchy from simple to difficult. Specialists take care of difficult diseases, so, of coarse, they will naturally do a good job on simple diseases. Wrong. Doctors take care of people, some of whom have diseases and all of whom have some problem. People used to doing complicated things usually do complicated things in simple situations-for example, ordering tests or x-rays when waiting a few days might suffice-thus overtreating people with simple illnesses and overlooking the clues about other problems that might have brought the patient to the doctor."

(taken from How Doctors Think by Jerome Groopman pgs. 97 and 98)


kkrich said...

grats on the graduation! good luck with med school.