Physician of the year still learning about doctor-patient relationship

Josh Pennell
Published on October 30, 2013
Dr. Roger Butler.
— Submitted photo

The College of Family Physicians of Canada (CFPC) has named this year’s Family Physicians of the Year and this province’s recipient is Dr. Roger Butler of St. John’s.

“It’s a real honour,” Butler says, adding that it’s humbling to be acknowledged by one’s colleagues in such a way.

The award celebrates family doctors for their outstanding patient care, as well as their significant contributions to their local communities.

The doctors also must show a commitment not only to family medicine, but to teaching and research.

Butler is an associate professor of family medicine at Memorial University.

Butler says he’s been reflecting on his career — the people who have taught and trained him — since he was notified of the award.

“I’ve been in practice now 34 years. And it’s only now I’m starting to learn about patients,” he says.

Butler is adamant that it’s all about the doctor-patient relationship. His expertise is in geriatrics, with a focus on dementia, Alzheimer’s disease, elder abuse and seniors’ care.

He has received an Award of Excellence from the Newfoundland and Labrador College of Family Physicians for his work with the Alzheimer’s Society.

“The more experienced you become as a physician, the more keen your hearing gets to listening to what’s really important,” he says.

There are subtleties in what a patient tells their doctor that need to be picked up on and that’s something you never stop getting better at, he says.

In one of his areas of expertise — dementia and Alzheimer’s disease — Butler has seen advances in his 34 years practicing, though not in every facet of treatment.

“The treatment is still very inadequate in terms of the pharmacological treatment, but the social supports and behaviour management strategies are getting better.”

While the diagnosis is becoming better in terms of how early it can be done and its accuracy, there is an issue that’s starting to put a lot of pressure on the health-care system, he says.

“The problem is the disease is manifesting itself in such huge volumes,” Butler says. “We know that if you’re 85 years of age, there’s a one-in-three chance of you being cognitively impaired and the most likely cause of that is dementia. And that number is doubling every 10 years for the next 30 years.”

With baby boomers approaching the 85-year age span, the next few decades are going to put pressures on health care that will have to be met in alternative ways, Butler says.

“We cannot build enough institutions to house the people that are going to be required.”

The strategy, in his opinion, is to find the attitude and resources to allow treatment for things such as dementia to be treated at home. Communities will have to take on the task, he says. It will be required to alleviate the pressure from the health-care system, which will have no way of keeping up with an aging population.               

Also, people with things like dementia will respond much better in an environment where they have had a life history, Butler adds.

While the task seems daunting, one reassurance is that Butler has no intention of retiring. He says he loves his work and, when you enjoy it the way he does, retirement is not something to pursue.