Family medicine needs to take advantage of buzzwords

I was driving into work recently listening to the radio and heard one of the fancy ads that our hospital has been airing over the last few years of it’s “Good People, Great Medicine” campaign. The ad was talking about getting results for a patient recovering from a heart attack. Around central PA, this patient is far too common. And listening to the ad brag about how quickly this patient got to the cath lab, how great our HVICU is, or even mentioning the fact that our hospital has a great cardiac rehab program I could only think of one thing: why did this guy have a heart attack in the first place?

And that’s when I heard it: _____ _____ Heart and Vascular Institute (name of institution left out intentionally).

It got me thinking, what is in a name? Why do our ivory tower, academic, tertiary care health centers insist upon having things like Heart and Vascular Institutes, Eye Institutes, Cancer Institutes, and well the list goes on. Calling something an “institute” to me makes it sound like a place where great minds gather to think about things and work on the cutting edge of science and technology. And I can only help but think that our patients are thinking the same thing. Why go talk to Dr. Smith the cardiologist at his solo practice when you can go to the Heart and Vascular Institute? Why settle for the ordinary, when the top of the line is right next door?

But are the cardiologists who work in our Heart and Vascular Institute any better than the other physicians at our hospital? Is the care we give to patients post MI any better than the care we give to the nursing home patient with pneumonia or the 15 year old with appendicitis, or even the 4 year old with type 1 diabetes. I would hope not! So what then earns you the distinction of being named an institute? Can anyone be called an institute?

This brings me to the question I asked driving in to work: why did this guy have a heart attack in the first place? Is it because his BMI was 28? or his LDL 183? or his BP 155/85? Is it because he, like many men, didn’t routinely get a physical by his primary care doctor? He sounded all to pleased to come to our Heart and Vascular Institute, because in his mind it was the best there was, but what if our hospital had a Family Medicine Institute? Or a Preventative Care Institute? Or maybe more to the point, a “We keep you from getting sick in the first place Institute.”

Well maybe that one isn’t so easy to say. But I think my point is clear – what if we in family medicine took advantage of the buzzwords that seem to draw patients in to these tertiary care clinics and used it to bring them to our primary care clinics first? What if we finally owned up to the fact that what we do is just as state of the art and cutting edge: after all, we keep people from getting sick in the first place.

“MaverickMD2012″ is a medical student who blogs at Future of Family Medicine.

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  • Margalit Gur-Arie

    “We keep you from getting sick in the first place Institute” doesn’t generate nearly as much revenue as a “Heart and Vascular Institute”. For hospitals to make money, disease must thrive.

  • Benny Little

    I found this article amusing. I have thought the same thing.  When I moved to the town I now live I found a place called the Endocrinology and Metabolism Institute.  I was impressed so I made an appointment to go there for my diabetes.  What I found was a very small office, with 1 Dr and very outdated equipment and practices.  I soon left that institute and went elsewhere.  

  • Rolf Olsen

    I hate to challenge you, but if family medicine and other primary care providers were so good at preventive care, we wouldn’t have such pervasive obesity and other preventable chronic conditions.  I agree fully that big medical centers naming some programs as ‘institutes’ or ‘centers of excellence’ is misguided and largely just self-congratulatory.  But I don’t think the solution lies in creating similar terminology for primary care.  What we need to do is find new and truly compelling ways to actually engage patients in their own health care.  (I should mention that I am on the marketing and communications team for an academic medical center. One of my ‘client’ areas is all of primary care – family medicine, internal medicine, general pediatrics.)

  • Pradeep Paul

    You nailed it, too much fragmentation of healthcare. Healthcare is being handled like a car factory production unit, where one unit attends to the assembling the exterior, another does the engine and another one does the painting job. It may work well with a car, but not with our human body with its multiple systems working together to sustain life. Super specialisation, unwanted diagnostic tests, at what cost?, healthcare cost is being pushed skywards because of the lack of common sense approach and because of the greed for power and recognition.  

  • Molly Ciliberti

    Excellent post. It is always easier to resuscitate a person who is still breathing. But it is all about money after all which is a sad commentary on us as human beings.

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