Marcus Welby, MD is still relevant today

The year is 2012. A 58-year-old veteran Family Physician who has just finished a day with more human heartaches than clinical triumphs settles down among the pillows with his wife in front of his MacBook to watch a movie, delivered wirelessly over the Internet:

“The year is 1969. A 62-year-old veteran general practitioner who has just seen his health threaten to fail him, speaks passionately to a group of doctors about how general practice is not dead and general practitioners are not dinosaurs. For the next 98 minutes he proves how much he cares, how well he knows his patients, and how often he is willing to go out on a limb when he feels there is an ethical stand to be taken.”

The pilot episode of “Marcus Welby, M.D.” was called “A Matter of Humanities” (how often do you hear that word in medical circles today?). In his passionate speech to the young doctors at the hospital where he had just been treated for his heart attack, he said (and I paraphrase):

We aren’t treating a this or a that, we are treating our patient.

That is pretty much what family practitioners say today, and we still aren’t dinosaurs. In fact, the “new” or re-born idea of the Patient Centered Medical Home and other such political reforms may make us more central to the health care machine than we have been since the days when the big HMOs wanted us as “gatekeepers”. Regardless of how our standing with the politicians and insurance companies has come and gone, our patients have kept on coming to see us.

In 2012 more than a few people speak disdainfully about how “the days of Marcus Welby are long gone.” Google has 17,600 search results for that exact phrase, if that is any indication. But many people seem to speak of him without actually having watched or at least remembering much of the show.

I have heard people scoff at his clinical understanding, and I remember once seeing an episode where he used a car battery to deliver a shock to a patient’s heart. But, this was Hollywood fiction – let’s not forget that Marcus Welby himself was a fictional character – and defibrillation and cardioversion were relatively new inventions.

Marcus Welby and his fictional colleagues obviously practiced with the medical knowledge of that time. We may smile at how his attending physicians kept him in the hospital for twelve days or more for a simple heart attack. That may seem archaic by today’s standards, but it may actually have been more humane than what we are doing today with our same-day surgeries and drive-by deliveries.

The purpose of most episodes of Marcus Welby, M.D. was not to illustrate the clinical aspects of a particular disease or its treatment. Most of the stories were about how disease affects people and how a wise and caring physician can help his patients, even in situations when there is no cure to be offered.

An interesting theme in the show is the mentor relationship between Welby and his young associate, Dr. Kiley. In spite of his youth, fashionable (for his time) hair and motorcycle, the younger physician represents a more conservative view than Welby. The older physician is more liberal, less distrustful of human nature, and more altruistic than his protégé.

It is obvious that doctors in 1969 had less advanced tests and treatments to offer their patients than we have today, but the ironic thing to me is that Marcus Welby’s patients got a lot more in a way because of his exceptional personal involvement, passion and courage. In that sense, the shows are totally refreshing. Medicine today, with its focus on guidelines and measurable data, has become a rather faceless bureaucracy. I think I know why many people still remember and mention the Marcus Welby character by name. He gave medicine a face, a personal flavor that people still want today. There is a lot of talk and theorizing these days about how medical care is organized and delivered. For example, we read about Accountable Care Organizations; whatever happened to accountable individuals?

Medical knowledge is always subject to change, but the ethics of medicine are a lot more timeless. Marcus Welby, M.D. tells the human stories as they relate to the medical facts of that era, and they are still captivating and thought provoking 43 years later.

My wife and I will be back for more of Marcus Welby, M.D.

“A Country Doctor” is a family physician who blogs at A Country Doctor Writes:.

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  • John C. Key MD

    I believe that most patients today are indeed looking for Marcus Welby. The goal of us who are generalists should still be to pursue that ideal. The Orwellian-named “patient-centered medical home” and “accountable care organization” are more indicative of the horrible pathology that has invaded healthcare than they are signs of pending improvement.

    Yes, much of Welby was hokey and impractical–but if physicians as a group are to regain the esteem in which they were once held, much can be learned from Marcus Welby MD.

  • http://briarcroft.wordpress.com/ Emily Gibson

    Thank you, Country Doctor, for your insights about the fact that Patient-Centered Medical Homes are the essence of the doctor/patient relationship no matter where that care takes place and Accountable Care is the heart and spirit of the family practitioner.

    As a family physician nearing 60 years of age myself, I grew up watching Marcus Welby M.D., understanding that the character and his patients were fictional, but I recognized his spirit of compassion and respect for humanity. In the fifties I was cared for by a female general practitioner in a small rural town and she did do house calls, sewing up cuts in people’s kitchens and personally transporting patients to the hospital since there was no ambulance service (my father with a strangulated inguinal hernia on one occasion and my mother in a thyrotoxic storm in another). She raised a family while caring for over a thousand people in our farming community. She knew her patients’ secrets and our not-so-secrets which aided her diagnostic wisdom as well as her determination of the best treatment for that patient at that moment. There could be no reliance on scans, instant lab tests, and evidence-based decision making. She actually had to examine the patient and know their family dynamics with a thoroughness that is rare today.

    I honor her with my decision to become a family doctor two decades later and now have over 30 years of work behind me as a primary care provider. I, like my first doctor, can provide patient care around the clock utilizing technology that makes possible a ‘virtual’ house call. We must never forget that the best health care is not just “by the book” but “by the heart.”

  • MarylandMD

    One note: the series “Marcus Welby, MD” was produced in co-operation with the
    American Academy of Family Physicians. The AAFP logo was displayed prominently at the end of each show. According to Wikipedia: “Members of the American Academy of Family Physicians served as technical advisers for the series and reviewed every script for medical accuracy.”

    We could use more positive images of physicians in the media…

  • Molly_Rn

    I grew up watching “Marcus Welby M.D.” and “Medic” an even earlier show about physicians with Richard Boone. They inspired me to want to be a nurse and not just a nurse but a caring nurse who saw all of her patients as people asking for help. As an ICU nurse, I would put up photos of my patient when they were well aroung the room (our end goal to return them to health) and a sign on the door (as most were sedated and on ventilators) asking the person entering the room to introduce themself and why they were there. Always see the humanity in the patient you are caring for.

  • http://www.facebook.com/jennifer.lezakmiller Jennifer Lezak Miller

    Bravo to Country Doctor as well as all those who commented. They are exemplars of the Aronld P. Gold Foundation’s mission to perpetuate the tradition of the caring doctor by emphasizing the importance of the relationship between the practitioner and the patient. Our objective is to help physicians-in-training become doctors who combine the high tech skills of cutting edge medicine with the high touch skills of effective communication, empathy and compassion.
    Here’s to Dr. Welby and all those caring professionals who follow in his fictional footsteps!

  • http://twitter.com/dalecoymd Dale Coy

    The contrast between the “old school” physician and the young, salaried doctors is a central theme addressed in Morton’s Fork, a new novel exploring the toll healthcare reform is taking on physicians. Which doctor is better? A doctor-patient relationship based physician is of course better, but in today’s medicine these doctors may be prone to burnout. No surprise Marcus was delivering his farewell at 62. An “old school” doc will die hitched to the plow.

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