I’m primary care and I see a patient in a 10-minute appointment who tells me she now has a disabled daughter who is 22, had a stroke, and currently cannot cope with all that her disrupted life is demanding of her. I am also expected to fill out that FMLA paperwork for that patient and respond to 20 back-and-forth portal messages on that same patient over the next two days, which I do, of course, without hesitation because I care.
I’m primary care, and I have an unplanned conversation with an exasperated son who is in complete denial about his mother with rapidly progressive dementia. I bring up hospice and goals of care, and discuss what the future will look like (in a 20-minute appointment). I will also be the one to then refer to hospice and sign all notes and recommendations.
I’m primary care, and I take care of a patient who tells me she was involved in a traumatic car accident where the other driver died (in 10 minutes) and is having PTSD, depression, anxiety, and completely breaks down during the encounter.
I’m primary care, and I respond to 100 different patient care messages daily without additional reimbursement.
I’m primary care, and I’m expected to “clear” a 9-year-old to go back to school after she makes death threats against classmates in a last-minute add-on appointment. No one sees the hour of work I do afterward to make sure that sweet, confused patient is urgently seen by a psychologist for a full evaluation the next day.
I’m primary care, and I am expected to order all the specialists’ labs and tests, and then I am also responsible for communicating with the patient about how the above services are not covered and their results.
I’m primary care, and no other specialist has the time to fill out FMLA paperwork, so I am the one that has to do it because I care about the patient, and without me, no one else will. I’m also the one that often has to try and explain the specialist’s recommendations because they didn’t explain them to the patient themselves.
I’m primary care (in America), and I talk about insurance limiting prescriptions or limiting access to medications 20 times per day.
I’m primary care, and for my patient that is adopting a newborn and wishes to breastfeed, I do an hour’s worth of research on inducing lactation, contact multiple specialists, and send 20 messages back and forth to the patient because I am absolutely thrilled for her and want her to be able to experience this.
I’m primary care, and over my lunch break, my administrators require me to attend a meeting where we discuss “physician wellness” for an hour. Of course, paradoxically, that’s time I usually spend catching up on charts, results, phone calls, etc., so I don’t have to take that work home with me and take time away from my husband and kids… wellness.
I’m primary care, and I am expected to do everything and charge patients nothing and understand everything about them and their history, and also make sure I don’t order anything that will cost them money or go against their deductible.
I’m primary care, and the number of messages I receive during a workday about prior authorizations is at least 30.
I’m primary care, and I process, approve, and sign repeat home health/PT/OT orders on hip replacement patients that haven’t been seen in over a year because ortho won’t.
I’m primary care, and I am expected to accept new patients despite a three-month waitlist to “keep the mid-level practitioners busy.”
I’m primary care, and I triage and address 10 surprise complaints brought up during a 15-minute wellness check because I care and genuinely want to help.
I’m primary care, and my friends and family routinely send me pictures of their body parts and request off-the-cuff prescriptions on nights and weekends.
I’m primary care, and people constantly expect me to make viral illnesses immediately better with a prescription after they already went to urgent care and received antibiotics and steroids.
I’m primary care. Specialists think that I’m dumb because I’m family medicine, yet my board scores and resume could have allowed me to do any subspecialty I wanted. I chose primary care because it was a calling. My heart and soul just wanted to be the one to be there and take care of patients.
I’m primary care. The underappreciated backbone of American health care. I do it because I care. It absolutely wears me down and tries to suck out my soul, but I still care.
Whitney Rowe is a family physician.
