The other thing that it does: different than going on a trip or a vacation, it allows you to see a part of what it is to live, to be a part of the lives of people who live in a Third World country and to see the struggles that they go through day by day - and some of their own joys, too. It makes you appreciate the material gifts that we have here, to see the things that we look at as "big issues" and put them into perspective and realize that they're pretty trivial sometimes. We all need different perspectives sometimes. Some people climb a mountain to get a different perspective, or go on a vacation, or climb a tree. Missions trips are a great way to get a different perspective on things. Pure service is a great way to connect with people. You don't have all the government regulations and the documentation, the onerous things that sometimes get in the way of enjoying the practice of medicine. It's simply, "let's take care of your need and do the best we can do with the things we have." It's just a joy. On how to provide personalized care: It's a little easier in a smaller community, like I was in, because you get to know people in a much more intimate way: your kids may go to school together, or they may play on the same softball team. I was involved with sports medicine as well, so I got to see a lot of kids through that. You see them not only as a physician, but you see people in various aspects of their lives when you practice in a community like that. So that was an asset in terms of building relationships. I think the key, for anyone, is truly taking an interest in that individual person. I always tried
to find something that person did or liked, what their passion was, and I tried to remember that and ask them about it - to learn about their family, that kind of thing. I'd always try to find something fun about somebody. Everybody has a story, and I enjoyed hearing their stories as well, and remembering the stories that were important to them in their lives. Those were some things I found helpful in building long-term relationships. On the challenges ahead for family medicine: There's a loss of autonomy in family medicine. So many of us are in an employed situation, and the loss of autonomy has become a challenge. One of the most interesting things that I've found in surveying family physicians is that financial reimbursement is not by any means the number-one concern of most family physicians. I kind of sensed that, but to actually see that on paper was pretty enlightening to me. We, as family physicians, want to make the priority serving the health care needs of the people that we are tasked with serving. That's not the priority, always, health care systems. So I see a disconnect between what family physicians and others in primary care want and what health systems wants. Health care systems want to put up a veneer or give lip service to primary care, but they don't invest their money there in other ways that are going to bring greater profit to their organization. I also think that the employed relationship that many physicians have now has not been that fulfilling and gratifying to them, because they have very little control over their day-to-day work www.pafp.com | 13
