Today’s Family Physician

Healer/Advocate, Teacher and Leader/Mentor

By Samuel T. Coleridge, D.O., TAFP President

I am not certain that everyone is familiar with the complete definition of the word “physician.” Webster’s Dictionary describes three components: healer — the most common and generally the only role attributed to a physician; teacher — one does not immediately think of this characteristic but this is one of our main functions; and finally, learned person — indeed, in ancient times, the most learned individuals in the community were the priests and healers; often, one person played both roles. This also reminds me that, as physicians, we should have other non-medical interests and hobbies to keep us fresh as well as informed of local, state and national activities. As I review the three components of the definition of a physician, I recognize how clearly this describes the family physician and I realize how easy it will be for me to articulate my three priorities for this coming year: advocacy; prevention/public health; and leadership/mentorship.

It is my hope that as you recall the three components of the definition of physician, you will relate these to my three goals for the coming year.

1) Healer:

As healers, we must advocate for our patients. Many of us have developed close relationships with our local representatives and senators. This is enjoyable, meaningful and important. Some of you have invited them to visit your clinics, spending a few hours in your shoes, observing your clinical and hospital activities.

With few exceptions, none of our legislators are physicians and they need our assistance to understand the significance of bills presented by special interests that can negatively affect our patients’ ability to receive high-quality health care. They need our help to interpret those bills. We know how to do this and we are advocates for our patients.

Additionally, we need to advise, explain and interpret pending legislation to our patients. Proposition 12, medical liability reform in Texas, passed because our patients voted it so. The statewide margin was 33,005 votes. Tarrant County, where I reside, provided 6,233 votes (18.8 percent). This bill passed by a very slim margin, but we did answer our patients’ questions about this issue. In some of our offices, with the assistance of county medical societies, we provided literature to explain the extent of the liability problem and we talked to our patients. That made a difference! Patients may not be swayed by our recommendations for certain candidates such as governor or local representative, but there are many names with whom they are not familiar. They can and do look to us for advice.

The American College of Osteopathic Family Physicians is instituting a nationwide campaign to provide posters and patient information for offices on medical liability for other states facing the problem that we encountered in Texas. This is advocating for our patients. This is getting involved. It is not hard and we need to do this for our patients. Whenever we place our patients’ interests first, we are always doing what’s right for them and ourselves.

Does everyone realize the strength of our membership? We have over 5,600 members in TAFP and over 3,800 active members. The average practice panel is approximately 3,000 patients. If only one quarter of those patients are capable of voting, this equates to over 2.5 million votes; not everyone votes, but you can imagine what this suggests. We can be major advocates for our patients.

2) Teacher:

We do an enormous amount of teaching to our patients and the public. We provide information to our patients, legislators and to community organizations. Our responsibility and opportunity to increase teaching common-sense issues is so very important; we do it every day and we can do more.

The Health and Human Services program entitled, “Steps to a Healthier US” addresses a subset of the Healthy People 2010 objectives. Its goals are to reduce the burden of disease of six specific conditions: obesity, diabetes mellitus, asthma, cancer, heart disease and stroke. Additionally, it addresses four specific risk factors: (1) physical inactivity, (2) poor nutrition, (3) tobacco use, and (4) youth risk-taking.

It is not hard to emphasize these few issues in our practices. But we must also become more involved with the Department of State Health Services and our independent school districts. This includes legislation. The Legislature passed a bill to require physical education classes in our schools in 2003, but loopholes in the bill left it weak. Since then, Fort Worth ISD has cut physical education, art and music classes from its curriculum to save money. This is astounding! So, as teachers, we once again become advocates for the public — our patients.

My goal is to work with DSHS to encourage family physicians, residents and medical students to teach classes on prevention in the ISDs. Prevention equals family medicine! Our Academy’s Commission on Public Health and Clinical Affairs made a motion at this year’s Annual Session that was approved by the Board of Directors to establish a Presidential Task Force to address the primary issues in public health and identify special opportunities to better market the image of family medicine. I am excited! We should all be excited about this opportunity.

At the Academy’s annual business meeting and awards ceremony, the TAFP Public Service Award was given to Dr. Olga Duchicela of Weimar, Texas, for a five-year project in which she teaches classes to students in grades 1 through 12 on such topics as nutrition, obesity and exercise. What a selfless labor of love. This is prevention; this is family medicine!

Dr. Eduardo Sanchez, a family physician and a recipient of both the TAFP and the AAFP Public Health awards is commissioner of the State Department of Health Services. He is deeply interested in obesity education, as am I. If we work with DSHS and our ISDs to improve education about obesity, we can make a significant difference and gain credibility and visibility as family physicians.

3) Learned Person = Leadership/Mentorship:

We have received many years of training and we’ve practiced medicine, some of us, for quite a few years. As my former Army Deputy Division Commander BG Johnny J. Johnson would say, “You get paid for practicing! When do you ever learn to do it right?”

Family physicians are leaders, for our clinic staff, our patient families, our communities, our professional and community organizations, and for our own families. We each have a lot to give through mentoring our junior colleagues and even senior colleagues. I have been fortunate to have wonderful mentors in TAFP, like Dr. Leah Raye Mabry and Dr. Tim Lambert.

Spinoza, a German Philosopher, commented that the greatest attribute that a person can demonstrate in one’s lifetime is “to make the world a little better than it was before we arrived.” Today’s medical students and family medicine residents will be tomorrow’s family physicians and sub-specialists. We need to mentor these colleagues in hopes that they will grow to be the best physicians they can be.

Leadership is very important to me. I feel very strongly that one person does make a difference. Dr. Mary Frank, who recently finished her term as AAFP president, addressed a group of medical students and first-year family practice residents while in San Antonio for our Annual Session. In her speech, she quoted Margaret Mead, the well-known medical anthropologist: “Never doubt that a dedicated small group of people can change the world; in fact, they have.”

The TAFP Section on Leadership has agreed to continue a series of leadership workshops that we initiated this year, and to add a “Leadership Tips” column to TEXAS FAMILY PHYSICIAN. We also envision quarterly submissions of mentoring experiences by our members. This should be useful, entertaining and fun. We are also working to establish a message board on the TAFP Web site to share ideas for members involved in enhancing their skills in group practices and involvement in professional and community organizations.

For those of you who do not know me well, I ask that you please allow me to share some of my favorite quotes — nearly all of which I learned and memorized in high school, college or medical school. They have shaped me and may explain my perspective on life and how I might represent you in the coming year.

1. “No man is an island, entire of itself; every man is a piece of the continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friends or of thine own were; any man’s death diminishes me, because I am involved with mankind; and therefore never send to know for whom the bell tolls; it tolls for thee.” – John Donne
2. “GM = GU”: the Greatest Mistake is Giving Up. – TKE frater Bob Nettles sent this to me during my freshman year in medical school.
3. “And ever it shall be that if man cares and listens and looks, then he will rise above his peers to give strength to the needy and soul to himself.”
4. “The sterner the challenge, the finer the response.”
5. “Gather ye rosebuds while ye may, Old Time is still a-flying; and this same flower that smiles today, tomorrow will be dying.” – Robert Herrick
6. “Act well your part, there all the honor lies.” – Alexander Pope
7. “Vivez, si m’en croyez, n’attendez à demain, cueillez dès aujourd’hui les roses de la vie.” – Pierre de Ronsard (translated) Live if you believe in me, don’t wait until tomorrow, Gather together your todays as if they are the roses of your life.

And here are a few new ones:

8. “Never be afraid to try something new. Remember, amateurs built the arc; professionals built the Titanic.” – May 26, 2005 e-mail from colleague Gary Smith, Ed.D.
9. And finally, I stumbled upon this last quote while preparing to serve as Master of Ceremonies for this year’s John Peter Smith Hospital Residency Graduation ceremonies: “Live a good, honorable life. Then, when you get older and think back, you will enjoy it a second time.”

Thank you for the opportunity to serve as TAFP President. I look forward to getting to know more of you during the coming year and assisting you in doing what we all do best: healing and advocating for our patients; teaching, especially prevention, and enhancing the public’s health; and sharing our learning and knowledge with our patients, legislators, families and colleagues. That is demonstrating the natural leadership and mentorship that is so much a part of our wonderful specialty, family medicine.