A Vocation, Not a Job A Model for Primary Care from the Abbott Northwestern General Medical Associates What, exactly, is primary care? And what does it have the potential to be? In an age that is increasingly decentralized, specialized and efficient, how can primary care be relevant anymore? Surely, the notion of the general practitioner broadly-versed in medicine and familiar with the entire family is something out of heartwarming Norman Rockwell paintings. It is a role rooted in nostalgia: Endearing, quaint and impractical. Or is it? How many times have we, in primary care (Internal Medicine, Pediatrics, Family Medicine, or Obstetrics/Gynecology), been told by our front desk that a patient called to see if we could add them to our schedule for a conversation? Why? Because they have seen a specialist or have a galling, unresolved problem or are trying to navigate their care, and they want us to help them understand, help them decide, or simply help them to be confident that the chosen course is the right one. While we may glory in the amazing tools and therapies at a physician’s disposal in the twenty-first century — whether PET/ CTs, angiograms, LVADs, targeted chemotherapies, antibiotics, or monoclonal antibody therapy — we can never forget what we all want for our parents, our children and ourselves: a physician who knows us, a physician we can trust. Notwithstanding the virtues found in specialization, there is something utterly refreshing and indispensable in someone who looks at the whole picture. The danger By Tod Worner, MD and Michael Cummings, MD MetroDoctors
in a specialization devoid of general considerations is an imbalanced reductionism. A patient is greater than the sum of their component parts. The tools of the primary care physician transcend their familiarity with the pathophysiology of each organ system, the selection of diagnostic modalities, or the choice of therapeutic options. As Sir William Osler would remind, “The good physician Michael Cummings, MD Tod Worner, MD treats the disease; the great physician treats the patient who has the disease.” Our primary care practice is built The primary care physician, especially, around this fundamental truth: We want has to cultivate and rely on common sense, to be the physician for others that we would intuition and finesse that informs (and want for ourselves and our loved ones. chastens) clunky technique, algorithm and Abbott Northwestern General Medical efficiency. A primary care physician is not Associates (ANGMA) is a burgeoning west valuable simply because of his/her familiarity metro internal medicine clinic operating in with the manifestations and management of Edina (Center for Outpatient Care), Plymmultiple ongoing disease processes in their outh (West Health), and Minneapolis (Medcomplex patient population. Even more, it icine Clinic). The three pillars upon which is the primary care physician’s wise judgment ANGMA is built are: service, education and that comes from knowing the patient — truly innovation. comprehending the patient’s many probService: ANGMA’s first calling is to lems, level of understanding, and general serve the patient. Our clinic follows a traphilosophy of health — and integrating these ditional model where the majority of hours variables into a sensible approach to care. To are spent in outpatient clinical care. A subset a primary care physician, context matters. of our physicians rotate weekly on hospital And, we only understand context if we truly call caring for any and all patients admitted take time to understand the complicated from the clinic’s population. Both in and patient who finds himself in a given medical outside the hospital, we have cultivated a circumstance. warm collegiality with our specialist partners. Here is an interesting fact: If we were In building and enjoying these partnerships, to ask our patients why their primary care we have crafted a more thoughtful and nudoctor matters, the answers would vary but anced approach to each patient’s needs. From follow a common theme: My primary knows front desk staff, medical assistants, and lime; is smart; listens; cares; goes the extra mile censed practical nurses to registered nurses, and takes care of my whole family. I trust my primary care physician.
The Journal of the Twin Cities Medical Society
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