Well it certainly is long overdue for me to chime in on what most certainly started as a small blog about why my friends and I enjoy Family Medicine, yet has exploded into one of the best medical blogs around.
I was driving into work this weekend listening to the radio and heard one of the fancy adds that our hospital has been airing over the last few years of it's "Good People, Great Medicine" campaign. The add was talking about getting results for a patient recovering from a heart attack. Around central PA, this patient is far too common. And listening to the add brag about how quickly this patient got to the cath lab, how great our HVICU is, or even mentioning the fact that our hospital has a great cardiac rehab program I could only think of one thing: why did this guy have a heart attack in the first place? And that's when I heard it: _____ _____ Heart and Vascular Institute (name of institution left out intentionally).
It got me thinking, what is in a name? Why do our ivory tower, academic, tertiary care health centers insist upon having things like Heart and Vascular Institutes, Eye Institutes, Cancer Institutes, and well the list goes on. Calling something an "institute" to me makes it sound like a place where great minds gather to think about things and work on the cutting edge of science and technology. And I can only help but think that our patients are thinking the same thing. Why go talk to Dr. Smith the cardiologist at his solo practice when you can go to the Heart and Vascular Institute? Why settle for the ordinary, when the top of the line is right next door?
But are the cardiologists who work in our Heart and Vascular Institute any better than the other physicians at our hospital? Is the care we give to patients post MI any better than the care we give to the nursing home patient with pneumonia or the 15 year old with appendicitis, or even the 4 year old with type 1 diabetes. I would hope not! So what then earns you the distinction of being named an institute? Can anyone be called an institute?
This brings me to the question I asked driving in to work: why did this guy have a heart attack in the first place? Is it because his BMI was 28? or his LDL 183? or his BP 155/85? Is it because he, like many men, didn't routinely get a physical by his primary care doctor? He sounded all to pleased to come to our Heart and Vascular Institute, because in his mind it was the best there was, but what if our hospital had a Family Medicine Institute? or a Preventative Care Institute? Or maybe more to the point a "We keep you from getting sick in the first place Institute." Well maybe that one isn't so easy to say. But I think my point is clear - what if we in Family Medicine took advantage of the buzz words that seem to draw patients in to these tertiary care clinics and used it to bring them to our primary care clinics first? What if we finally owned up to the fact that what we do is just as state of the art and cutting edge: after all, we keep people from getting sick in the first place.