Primary Concern

Recognizing the value of a good doctor

I spent a week with my dad this summer, helping him recover from hip surgery. At sixty-eight, he’s still a pretty tough dude. Watching him shuffle back and forth from bed to kitchen table, determined to enjoy his oatmeal and strawberries upright despite the pain of his incision, I knew he wasn’t going to need the walker he was pushing around for long. I think the mere thought of it as a permanent fixture in his life was enough to get himself back on his own two feet pronto. After all, the man has ballroom dancing soirees to attend—the retirement good life was waiting.

Not surprisingly, Dad was on a lot of medication. Looking back, we both agree he was pretty out of it. After a particularly sleepless night I suggested he talk to his regular doc about the dosages. He’s been seeing the same physician forever, and I could tell Dad felt better running the details of his recovery regimen by him. After all, it’s a primary care provider’s job to oversee patient health care, even when we’re in the hands of a specialist. No, especially when we’re in the hands of a specialist. It’s often these times when we’re at our most vulnerable, both physically and emotionally.

Three days after I got home I came down with a cold. Then a sinus infection. Then strep. I blew through my sick days like quarters in a slot machine. Cha-ching. Now it’s me on the phone with my doc, asking for advice on painkillers and neti pots—and it feels just as comforting as it did for Dad. While stuck on the couch, I read former Wisconsin Trails editor Harriet Brown’s moving memoir about the year and a half she spent nursing her anorexic daughter back from the life-threatening illness. Throughout the book her daughter’s doctor, Associated Physicians pediatrician Beth Neary, plays a recurring, real-life role as an intelligent, compassionate and collaborative doctor who helps Brown and her family navigate the confusing and terrifying situation they’ve found themselves in, which includes the battle with the insurance company over the callous treatment of a child with a devastating disease.

My dad and I, even Brown and her daughter—despite their struggles with coverage—are the lucky ones. We all have really good doctors. But there are frightening statistics out there about the future of family medicine. For one, how much longer it will take to schedule appointments (and many of us wait too long already), if we get them at all. That is, unless we recruit more med students into primary care to replace the ranks that are quickly dwindling, due in part to baby boom docs who’ll soon retire and the recent reform legislation that mandates insurance coverage for more Americans. The Wisconsin Medical Society has called the primary care shortage a looming crisis.

Fortunately, the reform bill also places more emphasis on prevention, the bread and butter of primary care, and less on fee-for-service medicine, the staple of specialty care that compensates health care providers for quantity instead of quality. In the future there will be more incentives for providers to help us stay healthy, which might translate into shorter waits to see your doc, longer, efficacious visits between you and your “medical home” team, and more medical students in the primary care pipeline because they aren’t spooked by the unrealistic pace, the paperwork, and messy reimbursements for Medicaid and Medicare.

Luckily, our UW medical school is retooling its program to train and mentor budding physicians who see the deep value and rewards of primary care medicine. It is with this in mind that we at Madison Magazine pay homage to general practitioners and the critical part they play in our lives by choosing to recognize two of them, Joan Addington-White and Bernard Micke, for their service to the profession and to the community, respectfully. Find their stories in our most recent roundup of Top Docs.

The aforementioned book by Harriet Brown, brave girl eating, (William Morrow, $25.99) is out this month, along with another editor’s memoir of sorts. IsthmusBill Lueders has pulled together some of his finest work—lively opinion columns, crack investigations and eloquent essays—from his audacious career as a journalist. It’s called Watchdog: 25 Years of Muckracking and Rabblerousing (Jones Books, $16.95) ... and that it is.

Brennan Nardi is editor of Madison Magazine. Comments and letters can be sent to 7025 Raymond Rd., Madison, WI 53719, or bnardi@madisonmagazine.com. Letters we publish may be edited for space and clarity.

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