I hear so much about how the scope of family medicine is shrinking (see “The State of Family Medicine,” January/February 2012). In some aspects, such as obstetrics and procedures, it is shrinking in many parts of the country. But I've been hearing this for my whole career, dating back to the 1970s when family physicians gave up doing gallbladder procedures and hysterectomies. What is really happening is change.
Since 2009, I have been in a practice model that is providing the best and most intensive family medicine I have ever experienced or seen. When a family physician has 30- and 60-minute appointments, new things happen. Besides being sure that acute and chronic problems are addressed, I am able to address wellness. I ask my patients if they are at the health level they want to be. Most say no. Then we take the time to map out a strategy to meet their goals. All of my patients are connected with me online. This expands the relationship nature of our care into lifestyle modification and motivational counseling. These are new skills for family physicians blessed with practicing in an advanced medical home.
The essence of the family physician is to be a personal physician to individuals and families. In the past, that mainly amounted to stamping out disease. Now our role has expanded to being a health coach and advisor. This is a great time to be a family physician if we just get out of the box of the brief office visit and productivity-driven practice.