The Rise of Specialists in Medicine & Introduction to Family Medicine
Specialization in medicine began in the 1930s in America and in subsequent years specialists became higher ranked and received better compensation than general practitioners. This coupled with the more rigorous standards of medical schools, certifications, and higher costs led to more interest in specialized medicine than general practice. By the 1960s Americans saw the rippling effects of this with the public complaining about the shortage of physicians, difficulty accessing healthcare in rural areas and inner cities, high costs, as well as fragmented and depersonalized care. This public outcry along with the social justice movements taking place allowed for a resurgence of the general practitioner and family medicine. In 1969, Family Medicine got approved as a specialty by the American Board of Medical Specialties.
Taking Care of the Whole Person
Family medicine is the foundation of healthcare delivery and family medicine along with the adoption of direct primary care is the best path to holistic care and taking care of the whole person. Many DPC doctors in our community understand that better relationships with their patients and understanding the various factors that contribute to patients’ health improve outcomes. Additionally, removing the red tape of insurance and the provider administrative burden that comes with the territory of fee-for-service, helps patients receive more quality care and more time with their family physician. When patients have more time with their doctor, they are more encouraged to share their experience. Additionally, insurance stipulations or lack of insurance can often deter patients from even seeking the medical care that they need.
Specialties & Behavioral Health in Primary Care
Many doctors in the Hint community take a more integrative approach to their DPC practice and the flexibility and added value of direct primary care allows them to do this. It also gives room for doctors to expand their knowledge and bring more expertise to their patients. Take for instance, Dr. Emilie Scott who began integrating specialties into her DPC practice. More family physicians are also becoming integral to addressing mental health concerns. In fact, “family physicians perform nearly 40% of all visits by patients seeking treatment for depression, anxiety, substance use disorder and other mental health concerns.”
The AAFP has recently been advocating for Behavioral Health to be integrated into family medicine to address the mental health crisis in this country. There is no doubt that the mind and body work as one and compartmentalization of the two creates gaps in receiving adequate care. Although specialists provide great value to the medical community and are necessary, there needs to be a concerted effort to connect all of the dots with a family physician, who can best deliver care directly to the patient without the burden of the insurance fee-for-service model.
Cecilia Gutierrez, MD & Peter Scheid, MD, The History of Family Medicine and Its Impact in US Health Care Delivery