Medicine is a calling. For dedicated physicians, our responsibility to our patients, profession and society extend beyond regular working hours and occupy our minds outside of both hospital and clinic.
Traditionally, the sacred moment is the time we spend with each of our patients, our attention focussed on their wellbeing. Yet the patient-doctor relationship continues to evolve.
In the past, physicians used to give orders – for their patients to lose weight, exercise, eat better, quit smoking, limit alcohol and take their prescription medications, and when their patients would return many months later not having followed those orders, they would be labelled “noncompliant” and the doctor would repeat the same orders.
We no longer use that term; it harks back to the days of medical paternalism. The doctor doesn’t always know best. We have expertise in the science of medicine and experience in what has worked for most patients; however, patients are the experts on their own lives, their values and their priorities.
When patients fail to follow through on goals we have set together, I don’t blame them. Rather I question whether I had helped them choose the best goals for them. Were they the goals that matter most to the individual? Did I provide sufficient support for success?
Those old doctor’s orders were actually good recommendations for activities that would promote health, but achievable goals must appeal to the patients’ values and be appropriate to their circumstances. They must be tailored to the individual.
The Practice Support Program has been teaching family physicians new tools to help our patients make lasting positive changes. When most people think of health care, they think of the tip of an iceberg – acute care in the hospital, and that is where a large proportion of our tax dollars is spent. Yet 90% of professional organized health care takes place in the community, for example, in primary care clinics. Family physicians provide much of the medical care for most patients.
But professional health care itself is just the tip of an even greater iceberg. Self-management is the care that patients provide to themselves through the monitoring of their chronic conditions, nutrition, physical activity and self-education.
The key to improved health is to better support patients in their self-care.
The doctor-patient relationship continues to evolve with the advent of the Divisions of Family Practice throughout the province. With the support of the General Practice Services Committee, family physicians have formed non-profit organizations to improve primary care in their communities.
On Saturday, May 3rd, the Doctors of B.C. (formerly the B.C. Medical Association) will demonstrate their care and commitment to our patients and community with a free and fun 2 km walk at Kitsilano Beach Park in Vancouver at 9:30 am. I’ll be there with many of my colleagues along with our patients.
Even if your doctor isn’t there, you’re welcome to attend. All members of the public are invited, but come early to get your free pedometer. For more information about this event, check online at www.bcma.org/walk-with-your-doc.
Dr. Davidicus Wong is a family physician and Physician Lead of the Burnaby Division of Family Practice.