I am frequently asked what I do at social gatherings. My response, naturally, is that I am a physician. The individual then asks what your specialty is and I respond that I am a board-certified family physician. Then, I hear, “Oh, you are a GP.” Really! After all these 35 years, I am perceived as just a GP. “Just” is the key word at social gatherings — implied or stated.
Well, I have decided upon further reflection that I am no longer just anything anymore and have an updated reply to all who inquire. I am not angry or remorseful of my specialty choice just slightly more enlightened and free.
My new response will be something like: “I am a physician and surgeon — as stated on my license — a doctor of medicine, a healer and teacher, a professional continuously dedicated to promoting and improving the health and well-being of my patients, family, friends, colleagues and my community. And, I do this willingly despite the ridiculous obstacles placed on me by our established and dysfunctional American health care system.”
What is wrong with a little self-definition that more accurately describes what I do?
Even as a physician, I am still in awe of the general and specialist physician who treats, cares for, advocates on behalf of and coordinates the best medical care for his patients. But I do understand a well-trained general family physician is the proven and best system of care for both quality and cost in all advanced countries, but the U.S. We diverged and patients are now paying the price. There are multiple causes, but the principal one had to have begun with the payer Medicare and reimbursement schedules which were subsequently adopted by private insurers. We, in turn, became a nation where care was more fragmented and irrationally addicted ourselves to specialty care without better outcomes to show its benefit.
The system calls me a contracted provider, gatekeeper, primary care, GP — and rarely a family physician. Yes, we understand the business need for labels, but I now reject all of them. I am not just a physician or a GP or a family physician or even an emergency medicine physician. I have had the pleasure of having been president of the medical group, chief medical officer, chairman of the board and a few other roles and labels. I am now over all of them.
For all you physicians out there — you are not just a physician. You have a wonderful legitimate story and a high calling. And you are never just a “just.”
Ronald A. Zent is a family physician.
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