Every weekday at noon, I grab a cup of tea and a pile of charts and cozy up to my speaker phone. Thus prepared, I begin to call the family doctors who have referred patients to me. I speak with about 15 family doctors in the two hours between noon and 2 p.m., reviewing assessment results, possible medical conditions and other situations that may have come up during my team’s treatment of their patient. This activity has provided me with partnerships that have enriched my practice life and improved my patient care.
My patients are youth aged 16-18, more or less, and are experiencing serious mental health problems. Their difficulties range from anxiety so severe that they haven’t left the house in months to family problems that force them onto the street to live in dangerous and uncertain circumstances. Some of these difficulties are beyond the scope of my hospital’s team and so they can certainly be beyond the scope of a family doctor, even when the family doctor’s group has the support of a mental health worker. Having said this, after 25 years of practicing psychiatry, I have learned never to underestimate the capacity of a family doctor and their staff.
My own family doctor is no exception to that rule. I first met him when I started practice in Ottawa. He has looked after my mother, myself and now my children. When my children were young, he would examine their ears often proclaiming, “Did you know that there’s an alligator in there?” This ensured the stillness of a little head while an infection was considered or an ear canal examined. It is also what each child remembers most vividly.
After thirty-seven years of practice, my family doctor has decided to retire. We received this news in a letter sent by snail mail, but my family members and I are lucky. While it can be very difficult for a family doctor to find someone to take on their practice, my doctor has managed to do exactly that. Along with his letter, we received forms to sign up with the brand new, just out of residency, family physician who is taking over his practice. I have always been enthusiastic about the value of family doctors and much of that is based on the experience I have had. This was yet one more example of what the best primary care can be, in the best practice circumstances.
I have also never had any difficulty reaching my family doctor or collaborating with him as a specialist. Here are the reasons for this:
1. His office nurse/assistant usually answers the phone and helps me find a convenient time when I can speak with him.
2. When I call his office my assistant or I can leave a message if we have an urgent concern about a mutual patient.
3. He consistently signs out to and works with an after hours service and has done for all the years of his practice.
Several weeks ago, my youngest son, whom this doctor has known from the moment he was born, came home from his last physical with this doctor, the only doctor who has ever managed his healthcare. When I asked him how it had gone, his answer was, “Great news! I’ve been cured of the alligator in my ear!” Now that’s good primary care!
(Note: The above is dedicated to my family’s family doctor on his retirement.)