DiscussionReflectionsA

The Myth of the Lone Physician: Toward a Collaborative Alternative

George W. Saba, Teresa J. Villela, Ellen Chen, Hali Hammer and Thomas Bodenheimer
The Annals of Family Medicine March 2012, 10 (2) 169-173; DOI: https://doi.org/10.1370/afm.1353

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  • The Article in Brief

    The Myth of the Lone Physician: Toward a Collaborative Alternative

    George W. Saba , and colleagues

    Background In the United States, the traditional image of the primary care doctor is that of the lone physician, black bag in hand. Although the reality of day-to-day life for primary care physicians is far from this idyllic image, the lone physician has gained mythic status.

    What This Study Found This essay proposes a new physician paradigm that acknowledges the current realities of primary care practice. A more collaborative alternative places the primary care physician in the context of a highly functioning health care team. It brings together the patient network and care team network, and fulfills the collaborative, interprofessional, patient-centered needs of new models of care. For high-functioning health care teams to develop and thrive, the administrative leadership of a clinical practice must view this paradigm shift as essential to providing optimal care.

    Implications

    • A new collaborative physician paradigm may help to ensure that the work of primary care physicians remains compassionate, gratifying, and meaningful.

  • Annals Journal Club

    Mar/Apr 2012: An Evolving Tradition


    The Annals of Family Medicine encourages readers to develop a learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care and then acting on those discussions.1

    HOW IT WORKS

    In each issue, the Annals selects an article or articles and provides discussion tips and questions. We encourage you to take a RADICAL approach to these materials and to post a summary of your conversation in our online discussion. (Open the article online and click on "TRACK Comments: Submit a response.") You can find discussion questions and more information online at: http://www.AnnFamMed.org/site/AJC/.

    CURRENT SELECTION

    Article for Discussion

    • Saba GW, Villela TJ, Chen E, Hammer H, Bodenheimer T. The myth of the lone physician: toward a collaborative alternative. Ann Fam Med. 2012;10(2):169-173.

    Discussion Tips

    This essay provides an opportunity for a younger generation to reflect on an apparently dying ideal and to resurrect its core values, reinventing their application for a new era and a contemporary way forward. You might want to read a contrasting article,2 as well as this one, to prepare for your discussion.

    Discussion Questions

    • What problem is addressed by this essay, and why does it matter?
    • Did the ideal of the lone physician ever exist? How does it persist?
    • What argument is made for the unsustainability or inapplicability of the lone physician model in the current era?
    • What alternatives are presented? What others do you see?
    • How credible is the essay? What provides or diminishes its trustworthiness?
    • How do you reconcile the story told in this article with the story told recently in another Annals Reflection on the life of Dr John Anderson?2
    • What are the implications for your life within a new collaborative paradigm? What are the implications for your contribution as a physician?
    • What are the implications for a sustainable health care system that provides the kind of care you'd like for your family?
    • What new role for the family physician is emerging or could emerge?
    • How might you reimagine and reinvent health care at the level of training, practice, system, and community to make this new myth a reality?
    • What support systems are developing to support a new tradition?

    References

    1. Stange KC, Miller WL, McLellan LA, et al. Annals Journal Club: It's time to get RADICAL. Ann Fam Med. 2006;4(3):196-197. http://annfammed.org/content/4/3/196.full
    2. Phillips WR, Green LA. A public celebration of a personal doctor. Ann Fam Med. 2010;8(4):362-365. http://annfammed.org/content/8/4/362.full

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