“Just” a Family Doc

A twitter thread by Noel Grisdale, MD CCFP

Dr. Noel Grisdale is a rural family physician and Clinical Assistant Professor at the University of Calgary. For over 20 years he has worked in the clinic, long-term care, active care, and emergency room providing comprehensive care.

Family medicine is rooted on four main principles with the patient-physician relationship at the heart of it all. Dr. Grisdale and all family physicians, are here for you.

I’m just a family doc… I know a lot about a lot but probably don’t know everything about anything. I’ve spent 25 years solving the undifferentiated patient. My generalist lens gives me good insight into the human condition…I’ve seen the best and the worst, and everything in between.

I’m a keen observer of words people choose, yet more so of the ones they don’t. I notice non-verbal cues that tell me they are not ok despite the message they tried to send. These honed skills help me as I interact in other venues and at other tables.

It’s a privilege and a burden to be given access to a human being sometimes in their most vulnerable state. The role of guide, confidante, cheerleader, and expert often interchanged. Sometimes we must lead; yet to truly help, sometimes we must follow. Trust is at the heart of it.

Difficult conversations are not uncommon…mutual respect is felt. Compromise can be a victory because in the end it’s not about me, it’s about you – my patient and what you need and not what I want. Research has shown our relationship to save money and for you to be far healthier – I know you better than anyone else. I know when we have time to observe or when we need to be concerned. I try not to, but I often worry about you long after the day ends. I revisit decisions & why I made them many times over. Decisions need to be made, often without all the information.

The Doc that has all the information typically makes the diagnosis and looks to be the “smart one”. For you I’m always trying to be the smart one. Despite yours and my best efforts we sometimes have to wait…be patient… until more clues emerge. To be good at my job I need to recognize what I don’t know and when I need help from someone with specialized knowledge or skills.

I appreciate the excellent care provided to my patients by my specialist colleagues. I try to get the most value from their time and expertise by providing quality referral information.

 As we strengthen linkages between specialists & 1*care with I.T/EMR/virtual care we’ll have more efficient, high quality, cost effective care.

Regardless, I will always be here for you.

Sometimes I just need to be a reassuring or supportive voice, a familiar face in a system that can be daunting when you are plunged into it with a serious illness. I understand how our health care system works, how much of it is designed by and for providers, rather than by and for you, my patient.

Technology will help us to change that…we know we need to…you need to demand it. I work in the community and see and understand the gaps that are present and how the evolution of the medical home & medical community can fill those gaps, keeping you healthier in our community and out of the expensive daunting acute care system.

My patient says, “Doc you seem to know a lot about what needs to change & what needs to be strengthened…did you ever think of specializing instead of being JUST a GP”

“Nope,” I say, “I like being JUST a Family Doc”

Patient says,” that’s good because I’m hoping I’ll need you for a while.”