Family doctors: not a career, but a calling

Tony Collins
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Our family doctor retired at the end of June. I’m sure in many ways it must have been an emotional time for him. I know it certainly was for me and my wife.

Before going down to the clinic for my last appointment, I had thought a great deal about what I could possibly say to him that would come anywhere near to expressing our debt of gratitude for the many years of care and consideration that he had extended to us in such a professional and gracious manner.

How long had it been, exactly? Thirty, 35 years? Sometime shortly after the birth of our first son —which was handled by another doctor — and before the arrival of our second, which, if I remember correctly, he was supposed to look after except he slept in on the night in question. (This was back in the days when GPs did that sort of thing — deliver babies, usually in the wee hours of the morning — and consequently most of them were in a state of near constant sleep deprivation.)

As it turned out, when I was leaving his office for the final time, we briefly shook hands and I said, “Thank you. Thank you for everything.”

And, of course, this being Gander, I added, almost as an afterthought, “I’m sure I’ll be seeing you around town.”

And then I turned and shut the door behind me. That was it. Finis. The end of another chapter. A bit anticlimactic, really, by way of closing the book on an occasionally stressful doctor-patient relationship (more so for me, rather than him) that had endured more than three decades, through the good times and the bad, in sickness and in health.

Perhaps more than any other profession, the role of family doctor demands a degree of commitment and dedication that wouldn’t be out of place in most religious orders. In that regard — and this applies equally well to most everyone involved in the field of health care — it’s more of a vocation than a standard 9 to 5 job, requiring a devotion to duty and a sense of responsibility which very few of us can even begin to comprehend.

In fact, it’s a wonder that any family physicians ever manage to make it to retirement age, let alone find the time and energy to raise a family and do all the other sorts of things that most of us take for granted in our daily lives.

The obvious question which comes to mind is how the hell do they do it, day in and day out, year after year, without going stark raving mad, ending up in an early grave, or both?

Consider, for example, the results of the National Physicians Survey released by the College of Family Physicians, the Canadian Medical Association and the Royal College of Physicians and Surgeons in 2004. It found:

• Family doctors see an average of 117 patients per week during regular hours.

• When on-call hours are included, family doctors typically work between 70 and 80 hours per week. More than 70 per cent of family doctors provide some type of on-call service in addition to regular hours.

• About 60 per cent of doctors said they are not routinely accepting new patients.

Another study published in the United States shows that the average American family physician will spend between 10.9 and 18 hours per day delivering preventive and chronic illness care, not including the time spent on the delivery of acute care for common conditions, such as upper respiratory tract infections and urinary tract infections.

In other words, the expectations and demands placed on family doctors now exceed the number of hours in the day, an impossible situation which doesn’t bode well for finding replacements for the present batch of retirees.

 And numbers alone don’t tell the whole story.

For most of us, it would be bad enough having to meet with 30 or 40 people a day for a coffee and a chat. But as a doctor, most of the people you see are going to have all sorts of serious problems, not all of which, strictly speaking, are of a medical nature.

And, (surprise! surprise!), they’re going to want you to deal with them. Not only that, but they are going to demand your full attention, as if you didn’t have worries enough of your own.

The family doctor, the good ones, at least, must be all things to all kinds of people.

They are expected to be able to ascertain the past, explain the present and foretell the future based on the modicum of information garnered from reluctant patients.

They must be a font of all knowledge, ready to dispense wisdom and diagnose the most bizarre of ailments and the rarest of tropical diseases at the drop of a hat — or pants, as the case may be.

In times of crises or of great mental anguish they must provide a shoulder to cry on and a sympathetic ear for overwrought patients attempting to find answers to questions to which there are really no answers to give.

In this secular age, it is the family doctor who supplies the solace of the confessional, forgiving the sins of the body and assigning penance based on the severity of the transgressions involved. Simply substitute a stool sample and a two hour wait in the lab for three Hail Marys and six Our Fathers.

Depending on the circumstances, your family doctor may have to be a counsellor, an adviser, a confidante, an expert, an advocate, a psychic, a psychologist, a mediator,  an instructor, a diplomat, a stoic, a philosopher, a detective, a saviour, a facilitator, a saint and, sometimes, a friend.

It also helps if he or she is a workaholic, can hold up their end of a conversation in the face of stiff competition and doesn’t mind listening to interminable stories with neither beginning nor end and no real relevance to the business in hand.

Above all, family doctors must be patient with their patients, and accepting of all the many frailties which are so much a part of the human condition. It’s a lot to ask of anyone, and yet we have come to expect it as a matter of course.

On Tuesday morning I waited in line for an hour or so to register my name with a new doctor, one who is originally from Gander and is now returning to set up his own practice.

Meanwhile, I still feel I haven’t sufficiently thanked his predecessor for all that he has done for us. Perhaps this column will help.

 And after all, what else is there left to say? Other than thank you again, Eric, from the Collins family. For all of the above. And more besides.

           

Tony Collins lives and writes in Gander.

He can be reached by email at tcollins75@gmail.com

His column returns July 20.

Organizations: College of Family Physicians, Royal College of Physicians, Canadian Medical Association

Geographic location: Gander, United States

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  • Bob
    July 06, 2013 - 18:36

    I hear y'uh Tony. Time was the family doctor would at least check your blood pressure. Not any more. He's too busy with appointments scheduled every five minutes. He writes out a prescription or sends you for bloodwork and says "see me in 3-weekis". But there was a time long ago when they had time to care, or greed took over.