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How important is what I like to call the “Total Family Doctor” (TFD)? For years, I’ve praised the hardworking family doctor for the role he or she plays in medical care. Now, many North Americans say it’s impossible to find a family doctor.  What has happened to them?

Prior to becoming a surgeon, I had the good fortune to spend time as a family doctor. And I nearly decided to follow this path. Why? Because I also watched Specialists performing the same task every day. It could become boring, I thought. So, surgery finally won. But I’ve never forgotten the challenges of being a family physician. I even experienced the roles of hotel doctor and ship’s surgeon during medical training.

I believe that people who are fortunate enough to have a family doctor have a better chance of living longer. Why? Because seeing a doctor regularly for checkups means they’re not playing Russian Roulette with their health. We all hope that nothing is going to go wrong with the only body we will have in this life. But when your family doctor finds you have hypertension, you can start to cut down on salt. Or when the doctor recommends you should avoid obesity, you can improve the diet and decrease health risks.

Getting a head start on problems cannot be overemphasized. Consider the woman whose breast malignancy is diagnosed early. Or the man who believes rectal bleeding is due to hemorrhoids. The “total family doctor” thinks otherwise and orders a colonoscopy which detects early cancer of the bowel. Or someone who believes a chronic cough is due to allergy. But an x-ray ordered by the family doctor finds early cancer of the lungs.

So give thanks to the Almighty if you have a “total family doctor” looking after you. Kudos if yours steers you away from the disease I call “Pillitis”, causing people to rush for painkillers at the first sign of a headache, ignoring the serious side effects of these drugs. Why not a cold towel on the brow? Or a quiet room to relax? And why the need to rush to the pharmacy after overindulgence in food? The family doctor may suggest just a change in eating habits as the right prescription.

It is also a plus to have a total family doctor who warns about the possible excess of radiation. He or she knows X-rays saves lives, but many patients are heedless of the damage of overuse. Patients should be hesitant to demand X-rays of the reluctant doctor.

Herewith relevant stories. Family doctors, because they know their patients well, are astute diagnosticians.  I’ve known many direct, decisive and empathetic TFDs. Patients appreciate these traits.

I witnessed a telling incident. Three specialists gathered around a patient were worried about his laboured breathing following gallbladder removal. They had decided the obstructed breathing was so serious it required an immediate tracheotomy to put a tube in his throat.

As they were about to wheel the patient into surgery, the family doctor arrived and listened to his long-time patient’s breathing. Promptly he said, “I’ve known Tom for 40 years and he always breathes that way!”  The operation was immediately canceled. Three embarrassed specialists departed.  This illustrates why continuity of care is so vital.

There’s another way family doctors can be of tremendous help, when the problem is beyond the TFD’s range of expertise. A fast referral to the right specialist is something people without a family doctor rarely achieve.

Let’s train more TFD’s, the backbone of medical practice! In another life, I’d be one of them without hesitation.

Dr. W. Gifford-Jones is a graduate of the University of Toronto and the Harvard Medical School. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health.

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