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Dear Roger:
Paul Bergl's "Perspective" suggested that doctors in the hospital strive to move the patient to next phase of care, and they sometimes leave the business of improving the patient's overall health "to their ambulatory care colleagues." (1) That's us! What family doctors do is often undervalued, because we have difficulty quantifying our actions and effect. For example, the article "Quality of the screening process," did not contain a single NNT or NNH. (2) The Canadian Task Force on Preventive Health Care 'Clinical Algorithm's contain tables from which NNT's and NNH's can be calculated.
I propose that the Canadian Family Physician include a new section, devoted to NNT's and NNH's.
An editor, a librarian and maybe a statistician could be involved. The feature could be divided by organ systems (cardiovascular, respiratory, gastrointestinal and so forth.) For example, in the cardiovascular section, 120 people with mild arterial hypertension need to take medication for high blood pressure for 10 years for the treatment to prevent one MI, stroke, or death due to MI or stroke.
Dr. Mindrum recommended not doing Pap tests on women under age 21 or over 69. She did not provide an NNT or NNH. (3) I sent a request to the Medical Director of the BC Cancer Cervix Screening Program, Dr. Dirk van Niekerk, asking, "How many women need to have a...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: On the human family physician.RE: On the human family physician.
Well said Sir! I had similar thoughts when reviewing applications for Family Practice residency in a previous incarnation. How do we address that?
Competing Interests: None declared. - Page navigation anchor for RE: On the human family physicianRE: On the human family physician
I found Dr. Ladouceur's comments on the qualities (or at least experiences) demonstrated by family medicine applicants - and those qualities of a family doctor that appear to be valued by patients - highly enlightening! I very much suspect the same divergence applies to medical school applicants in general. Beyond the need to guard against the "superwoman/superman" bias in selecting medical applicants, I would actually suggest that such candidates could well make WORSE doctors. Although their strengths make them successful applicants, by definition they will be less able to sympathize with the "ordinary (but not mediocre)" patient before them. And that quality of sympathy, "an understanding and care for someone else's suffering" (Cambridge English Dictionary), may be the single most important quality a physician can possess.
Competing Interests: None declared.