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Electronic letters published:
![[Read Comment]](/icons/misc/sectionDOWN.gif){kind=icon}
Who Works in Whose Home?
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G. Gayle Stephens, MD, Birmingham, AL. Professor Emeritus, Family and Community Medicine UAB School of Medicine
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David Loxterkamp’s writing voice is always in perfect pitch, especially when the subject is his practice and patients. He fearlessly chronicled and published the events that occurred in his tenth year of practice(1) and now he is sharing his second decade. I am especially drawn to The Dream of Home Ownership because the loss of control of one’s practice arrangements is the most serious obstacle to becoming the sort of family physician David is and other authors adumbrate in this spectacular issue. Physicians, especially family physicians, have lost more control of their professional ideals and virtues to employers than ever they lost to government, and that despite our pervasive fear of socialized medicine; a fear so entrenched that family physicians individually and collectively are all but silent about health care reforms under debate currently. The question for me is whether the current family physician workforce admires, wants and is qualified to follow in Dr. Loxterkamp’s footsteps. If the answer is ‘yes’ they need to mobilize themselves in their own best interests. If ‘no’ we all need to make the ideals real again. We need to recover the moral credibility that accrued to our account from physicians who lived and worked in real communities for a long time. Commuters, transients, and day-laborers are unlikely ever to know their patients so well or be trusted as much. There will be no point in creating medical homes that lack families. Who will be father and mother among the professional staffs? Who aunts, uncles and cousins? I can imagine a medical home morphing into a Dickensian orphanage, without mothers and fathers, and in their places Mr. and Mrs. Bumble, Fagan, Bill Sykes and the Artful Dodger- and Oliver Twist will still be singing “Where is Love?” The healing Pool at Bethesda is being troubled again as it was in 1993. Then it was poisoned by Harry and Louise. This time, “Everybody In!” 1. Loxterkamp, David. A Measure of My Days: The Journey of a Country Doctor, Hanover and London, University Press of New England, 1997. G. Gayle Stephens, MD Birmingham, AL. Competing interests: None declared |
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