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Jim Mold's article on GOC and PCMH helps in understanding the evolutionary differences from PCMH. What GOC defines and operationalizes is the essence and foundation of medicine - a healing relationship. This is in contrast to a curing relationship that aims to fix a problem or achieve a health plan driven measure that may or may not be beneficial or meaningful to the person. This is what we all understand in primary care - the difference between what can be done and what should be done. GOC provides the tool to change our treatment strategies and engage our patients as their circumstance change, as it seems, from visit to visit.
I think we all went into medicine for both the love of science and the strong desire to help people. For many, the science is the focus. For me, the concept of helping has changed over time. Initially, I focused on relief of suffering as my charged outcome. Over time, I determined that facilitating healing was a truer path. Clinical knowledge and skills can make you a great physician but it takes wisdom, patient knowledge and compassion to become a healer.
Even the word physician has evolved from the Greek, phusike (knowledge of nature), to Latin, physica (natural science), to Old French, fisique (art of healing), to Middle English, fiscien (physician) in the 1200s primarily to distinguish a practitioner of physic from surgeons.
Over time, have we lost our connection with our patients? As our roles continue to evolve in this chaotic and disorienting health care world, our roots should remain to create an 'optimal healing environment’ (Samueli Institute 2004) for our patients, Healing can only occur by understanding the patient as a whole person. As we heal our patients, we too, as clinicians, will heal. GOC can reconnect us to our patients and profession. Our small PBRN will begin implementation of GOC this fall and start our journey.