Monday Medical: Family medicine creates a medical home
April 24, 2011
As many local families flow back into town after spring break, this seems like a good time to explore a medical specialty that often is taken for granted or misunderstood. That specialty is family medicine.
Family medicine traces its roots back to the days of general practitioners such as Dr. Frederick E. Willett, the beloved physician and philanthropist who served Steamboat Springs and Routt County from 1912 to the 1950s.
General practice evolved to family medicine, which officially was deemed a specialty in 1969. This designation covers education — undergraduate degree, medical school degree and three-year residency — and a board-certification process.
There now are numerous family medicine specialists based in Steamboat Springs including these three who share their perspectives.
Dr. Brian Harrington is the only family medicine physician in Routt County who delivers newborns. He also is the medical director of the Doak Walker Care Center and serves as the Routt County public health officer.
"Family medicine means comprehensive care without limits on age or gender," Harrington said. "When a mother comes in with a sick child, we can take care of the child as well as the mother, because we know the family.
"Like any other specialists, family physicians have three years of specialty training. Unlike other specialties, our training includes a focus on mental health, which allows us to take care of the whole person."
Dr. Phaedra Fegley is one of a growing number of women who are family physicians. She said she feels she is constantly drawing on her education and experience to diagnose and treat her patients.
"We see a broad range of ages and deal with a significant variety of problems day to day," she said. "Every day is different. I could see someone for a cold, do a well-child check, then see patients
who have diabetes or heart disease.
"Family medicine provides a central location for everyone in the family," Fegley said. "When we understand the family dynamic, this helps us view how a health issue can impact parent, child and extended family members."
Dr. Jim Dudley has served the Yampa Valley for 30 years as a family physician. He sees his specialty as a cost-effective way for people who can have several health issues to have them all addressed in one visit.
"A typical example would be a 40-year-old person with a cold, a sprained ankle and high cholesterol," Dudley said. "A family doctor can take care of those problems.
"We have a family history with our patients. In many cases, we know about their kids, their work situation and emotional things they may be going through," Dudley added. "We know them because we have been seeing them for 10 years."
This aspect of primary care is often called a "medical home." In a previous Monday Medical column, Harrington wrote that when a patient chooses a personal physician, this doctor is "responsible for coordinating care between various sub-specialists and health providers and serves as a patient advocate."
"Family medicine is like the hub of a wheel," Fegley said. "We definitely need other specialties, and the family doctor can refer patients to those specialists."
"If someone comes in with a significant allergy, I will call a doctor at National Jewish Hospital and get the best treatment for my patient," Dudley said. "If a wrist injury is more than a sprain, we will call the orthopedic surgeon's office and get the patient right in."
Family physicians play an important role in centralizing medical records and a patient's medical history. This can reduce or eliminate fragmented care that can be confusing or costly.
"We want to avoid people having the same tests several times," Dudley said. "We are getting better with integrating medical records, but it helps when one practice is overseeing most of a person's care."
"When people have a medical home, it is a place to go back to that organizes the information from several specialists and makes sure that something doesn't get missed," Fegley said.
What is the most rewarding aspect of family medicine? The physicians agree that it is the connection to individuals, families and the community.
"As community doctors, we feel we have a responsibility for improving public health," Harrington said.
Christine McKelvie is public relations director at Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.