#1 Dinosaur thinks not:
The problem is that specialist do not do primary care very well at all. They find high blood pressure and refer to the cardiologist. They see an elevated blood sugar and refer to the endocrinologist. They all say “Stop smoking” and think of it as tobacco counseling. Virtually none of them do immunizations, especially gynecologists, who like to think of themselves as providing Primary Care for women. (Obstetricians can’t treat ear infections to save their lives, even in a pregnant patient. I’ve cleaned up more than one of their misadventures, though most of them just refer to ENT.) “Family Practice” rendered by specialists is nothing more than a circular exercise in mutual masturbation.
Related posts:
- Why primary care doctors shouldn’t be pain specialists
- Should primary care distance themselves from specialists?
- When specialists provide primary care, and why patients aren’t complaining
- Males = specialists, females = primary care physicians
- Should specialists be re-trained as primary care physicians?
- Will specialists sacrifice to pay primary care doctors? Are budget-neutral changes the only option?
- Will nurses be the new primary care providers?
KevinMD.com on Facebook
{ 7 comments }
Gotta to hand it to you Kevin, You are an agent provacateur par excellence!
I honestly think the problem is the exact opposite…that too many generalists are providing specialty care, or that too many practitioners are providing care in which they have no direct or inadequate training.
In my immediate 30 mile radius I can think of these examples:
(1) family docs that do C-sections after doing a 1 year fellowship in “obstetrics” but yet have no idea how to do a hysterectomy if they run into trouble,
(2) Ob/Gyn’s that offer anything from laser hair treatments to botox injections that deal with a body part as far away from the pelvis as you can get
(3) A plastic surgeon that joins a “hormone clinic” run by a local chiropractor.
Maybe these are singular to my locale. anyone else have similar or dissenting experiences?
-kir
Dr. Michael Balint described the “collusion of the consultants” in the 1950’s in England when their NHS took over. Very interesting reading, “The Doctor, His patient and the illness.” Sexist, I know.
The solution is to always have an answer for the question,”Who is responsible for the care of this patient.”
KIR mentioned Family docs doing c-sections… If you want to get territorial…let’s look at outcomes. Rates, complications, and compare. Or are we just a guild with lined off limits to practice?
You know the place is a mess when bright people look at a situation and see opposite causes to a”problem”.
The hormone clinic and lasers is just a guy playing the market, which is what docs like Kevin think will solve this mess. The market. And probably trying to make a buck to keep up with the lake house payments…
I agree.
“gynecologists, who like to think of themselves as providing Primary Care for women”.
The true is that many women do thik of their GYNs are providers of primary care.
I know one woman with advanced breast cancer, whose care was ignored by her internist (!) but was readily addressed by her GYYN.
once somebody has advanced cancer of almost ANY type, her/his primary care should be taken over by an oncologist, and internists/fps generally recognize this.
how about gynecologists that DON’T like to think of themselves as providers of primary care?
Comments on this entry are closed.