Perspective on Being a Family Doctor

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=82 BGCOLOR="#666699" TEXT="#080000" bgproperties="fixed" background="1e328283.gif"> <div> <FONT SIZE="4" COLOR="#FFFFFF" FACE="Garamond" ><B>PRIMARY CARE PARTNERSHIP</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="PRIMARY CARE PARTNERSHIP"><B>home</B></A></div> <div> back to<B>  </B><A HREF="csh.htm" TARGET="_top" TITLE="Cathleen S. Hood, MD"><B>Cathleen S. Hood, MD</B></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#C0DCC0" TEXT="#080000"> <div> <B>Perspective on Being a Family Doctor</B></div> <div> <A HREF="id59.htm" TARGET="_top" TITLE="Parenting">Parenting</A></div> <div> <A HREF="id58.htm" TARGET="_top" TITLE="Parenting: Pleasures, Pains and Predicam">Parenting: Pleasures, Pains and Predicaments</A></div> <div> <A HREF="id54.htm" TARGET="_top" TITLE="Family Stresses">Family Stresses</A></div> <div> <A HREF="id55.htm" TARGET="_top" TITLE="Hand Foot and Mouth Disease">Hand Foot and Mouth Disease</A></div> <div> <A HREF="id56.htm" TARGET="_top" TITLE="Holiday Blues">Holiday Blues</A></div> <div> <A HREF="id52.htm" TARGET="_top" TITLE="Cold Weather Exercise">Cold Weather Exercise</A></div> <bR> <div> <IMG SRC="11549430.jpg" border=0 width="73" height="67" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </td> <td valign="top" height=398 width="100%" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> Perspective on Being a Family Doctor</div> <div> <I>Somerset Club Address - November 1993 </I></div> <bR> <div> When your representative Mrs. Gormally contacted me not long ago with her kind invitation to join you for lunch, a welcome process of introspection was begun. As I attempted to come up with remarks that I hoped would be worth listening to, I found myself in the midst of a very useful exercise- that of redefining my identity: what I do, who I am.</div> <bR> <div> When I responded to Miss Calder's letter earlier in the week, I said I hoped to have the opportunity to specifically talk about being a family doctor in this locale and in this day and age from a woman's perspective. It occurred to me that there may be some women in the audience who considered this course and some who followed it. I would love to hear all of those stories. We learn from one another in many ways, and there is a special brand of learning that comes from what we reveal of ourselves when we share tales of our goals and aspirations- those met and those unmet. In fact, that is very closely related to what makes the practice of medicine such a rewarding thing for me. But I've already gotten ahead of where I should be.</div> <bR> <div> In my early years my mother revealed to me that she would have liked to be a doctor. I had been looking through some old books of hers and discovered beautiful, meticulously traced anatomy and physiology charts and illustrations- the sort with superposing images on consecutive sheets of onion skin paper. I was intrigued. And, for the first time, I realized that my mother had other talents and interests than rearing the likes of me and my five brothers and sisters. Her decision to marry my father implied a choice against a career in medicine at that time. It was 1953. She taught school for a year after getting married, then embarked on her career of mothering. In 1974, about twenty years later, when I was applying to colleges, my mother was instrumental in helping me to decide on pursuing a medical career.</div> <bR> <div> I have often been asked if being a woman ever worked to my detriment in the course of my medical education. I have very rarely thought so. I generally hold to the premise that I will be treated according to the way I conduct myself- get just as much respect as I command, basically. Here is another topic I would love to have the chance to discuss with each of you individually. Obviously this is not always true for everyone. It certainly depends a lot on the caliber ( for lack of a better word ) of one's coworkers.</div> <div> In this respect I have been quite fortunate, however; it occasionally seemed to me that I was given deference, if anything, as a woman in medicine. Most recently, since joining the Westport Family Medicine group, I have been enormously gratified to hear over and over again from patients that they have sought out my services precisely because I am a woman. Gender does make a difference, I believe. It's a good thing to be gender-blind with respect to opportunity and compensation for work done, but beyond that, it seems to me that there is more in the differences between men and women to celebrate than to deny or ignore - another fine tangent for another topic of discussion some day!</div> <bR> <div> The honest truth about who I am and what I do is that my husband and my two children are my highest priority. So I am a wife and mother - a member of my family - above all. Although I can finally say that without feeling any guilt with respect to my chosen profession, I do feel compelled to justify it somewhat. It is true that I spent a long time learning the art and science of medicine - 10 years in training and 8 more years in practice - but I have found that having a secure and nurturing homelife is crucial to being able to summon up the compassion I need to be a good doctor day to day. So I approach the practice of medicine not as a second priority, but rather, empowered to do a better job because I am first and foremost an involved member of my family.</div> <bR> <div> This necessitates quite a bit of juggling, of course. This really has been true for women of every generation. There is no perfect solution to the problem of balancing personal and career obligations. I'll bet there are as many solutions as there are families confronting the challenge. More and more, men are figuring into the equation. My husband's involvement and support are substantial; he makes it possible for me to manage a demanding career in addition to my family responsibilities in large part by regarding all of the tasks of child rearing as ours to share. When I say this, I don't mean that we divvy up the chores. On the contrary, we both acknowledge them all as ours separately or together. It seems to take each of us expecting to give 100% all of the time to accomplish what we need to keep things running smoothly - well, pretty smoothly, most days, anyway. An added bonus of my husband's increased involvement with child rearing has been the positive effect it has on his relationship with the children. I believe this will strengthen the bond between them over the long term, and that is a very good thing. Having said all this, however, I will say now that I do believe that a woman's contribution to her family is unique, and irreproducible. And that as far as children are concerned, there is simply no alternative to putting the time in with them.</div> <bR> <div> Let's step back in time for a moment to consider what the practice of family medicine was like in the “good old days.” Being a family doctor was truly a vocation. Doctors were available all of the time to their patients. They regularly made house calls, didn't charge very much for their services, often accepting payment in kind, or even no payment at all. They stuck with their patients through thick and thin. Hospitals and nursing homes were utilized far less often. Insurers and payers had no where near the influence they do today. The life expectancy was ten to fifteen years less than it has become today. Doctors were usually male and they usually had extraordinary wives. The few women who did go into medicine were often unmarried and/or childless. There was really no other way to practice medicine. The “good old days” were low-tech days.</div> <bR> <div> It's hard to talk about those days without a sense of nostalgia, isn't it? And yet, it is also true that many more people died for relatively simple reasons- at least by today's standards. Since the “good old days” antibiotics have been discovered and sterile surgical technique developed. Obstetric procedures have reversed the ten percent maternal mortality that was once the norm. A healthy baby and healthy mother is now the expectation.</div> <bR> <div> It seems to me that medicine has come full circle in a curious sort of way. The astounding technological advances we have seen in this century revolutionized doctoring and complicated the lives of doctors and their patients by making available extraordinary means of diagnosing and treating common and uncommon ills. Those of you born in the first third of this century have witnessed all of this first hand. Perhaps a member of your family is alive because of it.</div> <bR> <div> Without minimizing the positive impact of this kind of progress, I would like nevertheless to suggest that there has been a downside. The inevitable specialization which was the byproduct of the modernization of medicine estranged doctors and their patients. Patients became “cases,” rather than “faces.” In such an atmosphere, there is a great danger of sacrificing a crucial factor in the healing process. To pinpoint just what that factor is difficult, but it is the very essence of what makes medicine worthwhile for me, and I suspect, for most family doctors. It has to do with establishing a rapport, a mutual understanding and respect. It is a very personal thing; without it, the healing process is vastly compromised, I think. It has to do with eye contact, and with connecting on more than a superficial level. This is important for patients, and it should be important for doctors. It's the part of the “good old days” worth preserving.</div> <bR> <div> As I peer into the future of medicine, I see great potential in recognizing the power which that special relationship between a doctor and patient holds. I think that I hear echoes of that recognition in the voices in Washington. I also hear the wary voices of many of my colleagues who are skeptical that any government- even one founded on democracy- can administer a program which would maximize the opportunity for doctors and their patients to interact in that important way. I wonder if perhaps the specter of government intervention might just be adequate, in and of itself, to instigate a thorough house cleaning of the  medical insurance industry and a cost-consciousness unprecedented among health care providers. That would be nice! Here in Southeastern Massachusetts we enjoy the best of both worlds in some ways. Medicine at its most sophisticated is not a far distance away; and yet in my family practice in Westport I am able to concentrate on trying to preserve what is good and irreplaceable about old-fashioned medicine. I am fortunate to be working in the company and counsel of Dr. Kirkaldy, whom many of you may know. As someone who has been in my profession for nearly 35 years he has weathered many changes and yet maintains the ability to focus on the faces, not just the cases he is treating. I hope that I do the same.</div> <bR> <div> Cathleen S. Hood, MD</div> <bR> <bR> <div> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="1" WIDTH="505" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 320 ><NOBR><div> <A HREF="http://www.nlm.nih.gov/hmd/blackwell/admission.html" TARGET="_top" TITLE="http://www.nlm.nih.gov/hmd/blackwell/adm"><IMG SRC="160b93a0.jpg" border=0 width="185" height="314" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A></div> </NOBR></tD> <tD VALIGN=TOP WIDTH="295"><bR> <div> <I>On the morning of Tuesday, January 23, 1849, a young woman ascended the platform of the Presbyterian church in Geneva, N.Y., and received from the hands of the President of Geneva Medical College a diploma conferring upon her the degree of Doctor of Medicine. Thus, after many years of determined effort, </I><A HREF="http://www.nlm.nih.gov/hmd/blackwell/admission.html" TARGET="_top" TITLE="http://www.nlm.nih.gov/hmd/blackwell/adm"><I>Elizabeth Blackwell </I></A><I>became the first woman to complete a course of study at a medical college and receive the M.D. degree.</I></div> <bR> </tD> </tR> </TABLE></div> <bR> <bR> </td> </tr></table></body>