I have been meaning to write on this topic for some time. It is long overdue. As patients, and I include myself, we are desperate to find a health care provider that will provide ongoing and holistic medical care. Today, the harried practitioner has only about 10 minutes for an old patient visit, and often only 30-40 minutes for a new patient evaluation. And, even FINDING a provider to take on a new patient is difficult. Sometimes it is almost impossible for Medicare and Medicaid patients. Yet we all took an oath, at least in the old days, to provide the best possible care for our patients, no matter what! Alas, it appears that this ideal is severely threatened, if not lost altogether.
Knowing the patient is key to good care. Years ago a famed physician, Francis Peabody, wrote a classic monograph for all students of medicine, "The Key to Caring for the Patient is to Care for the Patient." It should still be required reading for all who aim to serve the sick. It is even of prime importance for the proper care of the well, who are trying to avoid disease and illness.
In the rush to write prescriptions to deal with the symptoms or other manifestations of disease, such as hypertension, the caregiver often ignores the patient that the prescription is written for. And who sees or ever gets to discuss depression, anxiety, frustration, sexuality, fears of the unknown, "stupid questions," of which there are none, or end of life considerations. It is also the key role of the holistic caregiver, whether primary care physician, physician assistant or nurse practitioner, as well as specialists to be able to coordinate and interpret all of the care that is necessary for consultants, in this complex medical era where high technology and surgical care are commonly needed. I venture to say that very few can find a care provider that will be interested or have the time to provide what is euphemistically called, "Holistic care." Yet, it is critical to the patient's well being and future.
I have written about some of these issues in these letters over the years. Often I can make some useful general suggestions. But what about the individual? I have no answer. I can only continue to try to help, in these pages and by answering the various communications that I daily receive from my patients, their families or friends. We must all try to search for the answer to Holistic medical care. (Said as a prayer.)
I will be in touch next month!
Thomas L. Petty, M.D.
Professor of Medicine, UCHSC
Co-Chairman, National Lung Health Education Program