Health care expectations in Newfoundland

I just had a chance to read the April 2011 issue of Canadian Family Physician and found much to disagree with in the correspondence¹ about the periodic health examination.^2,3 I was particularly incensed by the letter “A British perspective,” in which Dr Peter Gray tells of spending a short time in the colony of Newfoundland before moving on, as many of his kind do, to Ontario. I came from the United Kingdom many years ago and practised for a number of years in rural Newfoundland. My admiration for the people of Newfoundland started then and continues to this day. Dr Gray’s description of these people and their expectation of health care is quite different from my experience. Because many visits to family practitioners are for acute care and last 5 to 10 minutes, there is a lot to be said for an annual comprehensive assessment of the patient’s health. The visit is mainly to review the patient’s medical history in detail, including family history. The physical examination plays a very small part. However, the laying on of hands is a valuable part of patient care, and if there is no laying on of hands, patients are often rightly dissatisfied. This is illustrated by an elderly woman who told me when asked about her visit to another physician, “He didn’t even feel my pulse.” It is common to pontificate about avoiding laboratory tests and imaging studies, but a physician with proper humility will admit that such tests are sometimes the only clue to a problem.

• Copyright© the College of Family Physicians of Canada