What Would Marcus Welby Have Done?

Real concern has been expressed about the growing numbers of Americans in this county who are aging and the projected shortfalls of caregivers and physicians we will confront in the next decade. In that regard, it should not be surprising that experts have been studying the career decision-making of today’s medical students and found that there are some distinct considerations that influence the student’s choice of primary care or specialty careers.

 

A number of factors such as student gender, race and ethnicity, socioeconomic status, rural or urban background, attitudes and values, curriculum and particularly exposure to required Family Medicine curriculum influence the ultimate choice of where students will affiliate. Educational debt has a significant pull on the direction a medical student will take. The higher income possibility offered by pursuing a specialty career has had definite appeal.

 

However, the “nature of clinical experiences in medical school and residency as well as the learning environment itself can have a positive impact on the likelihood of choosing careers in primary care,”1 George E. Thibault, M.D. , and President of the Josiah Macy, Jr. Foundation, which is solely dedicated to improving the education of health professionals.

 

After a three year Residency in Family Medicine and one year of Fellowship in Women’s Health at Case Western University, Anele Manfredini, M.D., chose to join Holy Cross because she liked the strategic plan she saw for the hospital’s new Center. “It integrated my own values of enabling patients the highest quality medical care, advocacy of healthy lifestyles and access to health education.” She also was attracted because of the outstanding reputation of Holy Cross and the opportunity to collaborate with highly regarded South Florida specialists on staff there. The fact that the hospital offered her support in continuing her education through its partnership with the University of Miami Miller School of Medicine definitely influenced her decision-making.

 

Stephen Babic, M.D., President of the Palm Beach Medical Society and a prominent cardiologist, says-“this is not your Marcus Webley era of medicine. Unfortunately, times have changed dramatically since the portrayal on TV in the 1970s of the always patient-focused family physician.” This much loved TV medicine pioneer never could have imagined the intervention of government or insurance providers or today’s economic demands on running a practice let alone the role technology would play, and “I would emphasize that these are some of the barriers we have to overcome to give the best possible care to our patients,” adds Dr. Babic.

 

Dr. Christopher da Fonseca is a third year resident in the West Kendall Baptist Hospital Family Medicine Residency Program. As a graduate of the University of Miami’s Medical School, he was looking to “maintain a true involvement with the community” similar to the example set by the much loved TV doctor. “One of my priorities was to find a facility where my colleagues would be collaborative and interactive, says Dr. da Fonseca. “Available technology and medical resources at hand also were very important,” he adds.

 

Dr. Jack Zeltzer, a highly respected Palm Beach County Vascular Surgeon who serves on the Palm Beach Medical Society Board of Directors says “Medicine is about personal interaction and the Marcus Welby old school of thought should hold true.” However, that has been pushed to the background in today’s medical environment of 80 hour shifts and electronic record keeping, the expense of technology, increasing costs, diminishing fees and the constant thread of more government regulation of healthcare. “It’s been the corporatization of medicine,” he adds.

 

By this fall, Dr. da Fonseca will have to make another key decision about where he will affiliate after his residency. The factors influencing his choice of Baptist Health will hold equal weight in his next deliberation. However, he has learned a great deal at Baptist Health, “My current experience has shown me that the practice of family medicine truly lends itself well to an outpatient setting.”

 

Both Doctors Manfredini and da Fonseca acknowledge the challenges attached to making decisions for their futures. However, establishing priorities when making these important choices will provide a doctor with a satisfying work-life balance. Affiliating with Holy Cross and Baptist have enabled that for these two committed physicians and fulfilled their professional objectives. They are happy with the difficult choices they made.