Health care's quarterback

Where does good health start? With a family doctor.

As state and federal regulators continue to experiment with health care reform, Marylanders will be faced with tough choices about where we will seek care and how we will afford it ("Hospital rates vary greatly in Maryland," Dec. 6). Even though these decisions are becoming increasingly hard to make, a skilled primary care physician can help you select the best options for you.

Take, for example, a recent female patient who obtained insurance through the healthcare exchange. After not seeing a doctor for many years, she made her way to her family physician's office. She was frequently sick but did not know why. She was diagnosed with diabetes and high blood pressure. Her family physician was able to treat her diabetes and get her started on insulin and then get off of it as she worked with her physician on her diet and exercise. In addition to treating her diabetes and high blood pressure, preventive care was initiated including pap smears, removal of a benign skin lesion, treatment for arthritis and her strep throat. She is now back to work and enjoying a level of health that she hasn't had for years. She potentially could have seen five different specialists and an urgent care center. Generalist and preventive care by a qualified family physician saved her and the system money, but even more she was able to get her care with the same doctor who knows her and the status of her health well.

While many internists and pediatricians also provide primary care services, only family physicians are trained in the care of the entire person throughout the lifespan. We are present at the beginning of life — throughout pregnancy, during delivery and in the newborn period. We help patients get the best start at life — providing childhood vaccinations, monitoring growth and development and screening for threats like lead poisoning and child abuse. We continue care in the middle of life — managing chronic diseases like high blood pressure and depression, screening for serious health threats like cancer and helping patients overcome unhealthy behaviors like smoking and drug addiction. And our care extends into the twilight of life — supporting the elderly in aging gracefully within their communities and helping patients and families through the dying process once cure is no longer possible. We are often privileged to care for multiple generations of the same family, often at the same visit.

The services of a family physician are especially valuable to persons living with multiple chronic conditions. Family physicians can treat more than one problem in a single visit and can help you to make difficult choices if the best treatment for one disease risks making another disease worse. A family physician can address most of your health care needs but will help you to know when you need to see a sub-specialist, help you to pick the right one and make sure that you understand their advice so that you can benefit the most from it. Your family physician is the quarterback of your health care team. Once you decide on the game plan together, your family physicians will make sure all the other members of the team are working together so that your care is as successful as possible.

Board certification by the American Board of Family Medicine shows that your doctor has met the most rigorous standards for training and continuing education. Membership in the Maryland Academy of Family Physicians (MD-AFP; www.mdafp.org ) connects your primary care clinician to a wide variety of resources to provide the best care for our patients and to advocate for the health of Marylanders at the local, state and federal levels. Every day, in every corner of Maryland, the nearly 1,000 practicing members of MD-AFP fulfill our promise as "Able, responsive family physicians serving our communities." If you do not yet have a personal physician, please consider meeting your local family doctor at his or her office. To find a family doctor in your area, contact your insurance company, local community health center or the MD-AFP.

Dr. Kisha N. Davis, Baltimore

The writer is president of the Maryland Academy of Family Physicians.

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