Who’ll be there to care for me?
By John Kurt Frederick, M.D.
He slowly totters into the exam room with his daughter-in-law in tow. The plastic grocery bag holds all his pill bottles and his metal walker looks like it has been well used. A faint smell of urine wafts from him and his shirt is stained with breakfast. He manages to make it into the room. With difficulty he turns stiffly and lands his bottom in the exam room chair.
He is my newest Medicare patient, an elderly parent of a friend. He recently moved to the area to be nearer to his only son, his existence now too difficult to manage alone. His medical problems are myriad and complex and he takes a recipe of pills several times a day. I smile and welcome him to Austin as I gently grip his gnarled hand. We converse briefly before I dive into the box of medical records and the sack of pill bottles, many expired, many duplicated, and all powerful and dangerous in their own right.more
It's the system, stupid
By Tom Banning
TAFP Chief Executive Officer/Executive Vice President
Health system reform—with the emphasis on the system, not the players in the system—is on the political precipice. In my previous column, I discussed how policymakers, patients, physicians and those paying for health care are so fed up with our floundering health care system that fundamental, systemic change is inevitable.
The good news is that among the policy experts who count and vote, there is a broad, evidence-based consensus that economic recovery and health care economics are inextricably linked. Every report accumulating on politicians’ desks, in their minds and perhaps in their hearts declares the restoration of primary care as fundamental to health system reform.more
Managing our practices as well as our patients
By Robert Youens, M.D., M.M.M.
TAFP President, 2008-2009
Hello again. This quarter’s missive is intended to provoke thought about family physicians’ position in the health care landscape of the future. My original intent was going to be to discuss little vs. big in the ideal provision of health care, making an argument that personal attention from a personal physician in a small practice environment is superior to attention from a team in a large bureaucratic institution. I’ll probably always feel this way but instead have some ideas to share about what the future may hold for our specialty and profession.
Throughout my career I have embraced the business of medicine and my fundamental belief that if we go out of business, we can’t provide care. It is also true that to manage a medical practice and achieve this outcome, someone must be in charge. It is my contention that the physician should be this someone.more