Sunday, May 5, 2013

To specialize

When I introduce myself as a student to patients, the more pleasant patients respond by asking what kind of doctor I plan to be. (There are much less pleasant ones too.) I say that I haven't decided yet.

One patient's family member told me, "Don't specialize."

I was so confused by this. I explained that the purpose of this year of medical school is to experience different specialties. He then explained that he thought I should do "general practice". I explained to him that family medicine is a specialty, so when I said that hadn't decided what to specialize in, I meant that family medicine was still on the table.

I was irritated because it was another example of the fact that family medicine is misunderstood. This was evident because this person didn't consider it a specialty. I see how people think that family docs are less "specialized" because they are see pediatric to geriatric patients. Most specialities are based on either patient population (e.g. pediatrics, OB/GYN, general internal medicine) or organ system (e.g. every field ending in -ology.)

Family physicians are specialists. They specialize in care for  all people with an emphasis understanding the patient's family and community. It saddens me that people don't think it's a skill to understand patients, to be engaged in the patient's community, to advise patients on lifestyle changes, to keep people healthy in the first place.

I also don't like it when people who don't know me at all think they should tell me what to do. I understand that probably they are trying to be nice since they're engaging me in conversation at all. This is better than complaining that they don't want to be seen by a student. But I don't think it's necessary for people to pinpoint what specialty I should do. I hate "advice" like that.

The best thing they could say to me also seems to be the most rare: 
I hope you find what makes you happy and good luck.


Bethany Lumbert said...

I really enjoyed this post. Short, but actually very informative. Thinking about it now, I am not sure if I was aware the family practice is a specialty. I love my Family Doctor and have had a lot of great conversations with him recently about diet and lifestyle changes. I can really appreciate his advice and I feel cared for in a way that only doctors can care.

I think that it can be difficult for families to find a doctor that they feel they can trust, which is a huge factor of whether or not the patient receives the right treatment. Or sometimes, even just the right advice and guidance.

CYW said...

Bethany, for how many years have you had a family doc? I actually never had one. I either had pediatricians when I was a kid and an internist and OB/GYN now as an adult. Pretty much everything I know about family medicine I learned in med school.

Jessieroo said...

Chen -- Love the recent updates to your blog!

Your post reminded me of a recent blog post on the Stanford Medicine's site (written by a medical student):

I think there are many ways in which perception of family medicine can change for the better -- in the ways you describe, and also in the notion that it is the specialty for people who didn't do well enough in medical school to be a specialist.

CYW said...

Jessie, Thanks for sharing with me that blog post. It's even more true of Stanford that fewer students choose family med. CHM is a very primary care oriented field and even within it, I feel little bit like I'm "too smart" for family medicine... or too stupid for choosing this field.

CYW said...

Oh also, I'd love to hear from you about your PhD and med school adventures. Update me via emial!