Since the time I was about halfway through elementary school, my family doctor’s practice has never been based in the city in which I’ve lived. It speaks to his skills as a physician, and the close doctor-patient relationship my family and I have with him, that he continued to be our doctor even after we moved to a different, more distant city. The distance obviously made it more difficult to see him with frequency, but annual check-ups were always attended, and we took more urgent matters to a local walk-in clinic. The arrangement worked for a number of years.
Once I began my undergraduate education, however, things started to change: my personal schedule became far busier, and I became more independent of family scheduling. I had classes scattered at random times throughout the week, my summer job was full-time, and I was involved in many extra-curricular activities that ate up spare hours – not to mention the time devoted to spending with family and friends. My schedule was not as easy to integrate with that of my family, so when annual checkups rolled around, it became easier for me to simply go to the on-campus heath services. The care I received on campus was always up to par – a rapport was built, I felt the physician’s consideration and concern, and experienced his or her good clinical skills – but that extra something was missing.
Now, it strikes me that this is more likely a global occurrence: as patients’ situations change, family doctor-patient relationship often shift or become lost, particularly with a young adult heading off to work or post-secondary education in another part of the country. From an emotional point of view, this seems very unfortunate, particularly after so many years of building a relationship with one’s family doctor.
Through my involvement as a member of the Family Medicine Interest Group at Schulich, I’ve had many opportunities to speak to a variety of family doctors about their lives and practices. I’ve heard countless stories about the life-long relationships fostered between doctor and patient. All of the stories have been inspiring, and the ability to form that sort of bond with patients, helping them work towards better health throughout their lives, is one of the reasons that family medicine appeals to me as a specialty in the future.
A dilemma, however, arises: what does one do as a family doctor when one’s patients must begin to seek care elsewhere? Obviously, from the physician’s standpoint, the duty of care is to the patient, and, regardless of the bond formed with the patient, if it is going to be more detrimental to his or her health, stressful, expensive, etc., care should be transferred to a different physician.
Putting myself in the situation of being a family doctor losing a patient from my practice, I imagine that I would find the situation emotionally difficult if I had a close bond with the patient. I worked at a summer camp for nine years, and during that time, I taught campers about science and technology, watched them grow as people, and shared in their fun. It was a treat seeing them come back every year, and hearing what exciting adventures they’d had. Eventually, the campers became too old for camp, and, if they didn’t start working as camp counselors, contact would be lost. This situation always came with a quiet reflection about moving on, but brightened with hope that the camper was going on to even more exciting things. Upon reflection, the camper/camp-counselor relationship is similar in many ways to the patient/physician relationship: trust, education, and care are involved, but so is the situation of loss of connection.
Inevitably, connections change, and we must move through them with the support systems we have in place, whether by reminiscing with friends, or spending time rebuilding connections that are lost. As a family physician, if patients move away, I imagine that a number of patients would keep in touch, though some would be lost to the world. In both cases, I think the best thing that can be done is to provide whatever support you can in the transition, and wish the best for them in wherever life takes them. As a patient, upon reflecting how I imagine a family doctor might feel after losing contact, I feel that there’s a letter I need to send.