A Cedar Rapids group will join fourteen others around the nation in pioneering a new way to teach beginning doctors. "P-4" is the name of as family medical residence program, "Preparing the Personal Physician for Practice. Doctor Gordon Baustian says newly-minted doctors who want to practice family medicine have come through schools that teach topics and techniques developed thirty or forty years ago.
"We used to spend a lot of time doing all these hospital rotations," he says, with residents spending most of their time in hospitals. But today many more patients are treated on an out-patient basis, and, he says, "that’s a different kind of medicine." He says it takes special training, and special talents.
Now with the population getting older and people living longer, we have more chronic disease to focus on. Rather than "taking everything to the hospital," he says doctors do more with their clients as outpatients, working to manage their conditions on a longterm basis. The family doctors working today, and the trainers who teach new physicians, have an opportunity to contribute changes to the way tomorrow’s doctors will be taught.
Baustian says some of today’s requirements and lessons don’t reflect "the way medicine is being done." "It’s just totally outmoded," Baustian says, "but it takes a long time to get the accreditation people to change." He says family medicine’s led medical-training innovation since the specialty was started. And despite the glamour and legendary income of heart surgeons and other specialists, Baustian says there’s nowhere else he’d rather practice.
"I enjoy cardiology, but if all I did was listen to heart murmurs I would not enjoy doing that day in and day out," Baustian says. "I enjoy taking care of people who have depression and psychiatric problems, but if I did that all day I’d go nuts. I really like the variety," he says. He says specialists have to order all kinds of tests and hope they can cure patients referred to them but they’re under pressure because they "only get one shot."
By comparison, he says the reward of being a family physician is the ongoing relationship with the whole patient and their family. The Cedar Rapids Medical Education Foundation family medicine residency program was among the 14 residency programs nationwide invited to participate in this progressive primary care initiative.