The life saving heroes of medicine

I saved a life today!

Although… I don’t know who it was or how I did it.

Maybe it was the routine pap smear that will come back as a high-grade precancerous lesion and be surgically removed before it turns nasty. Maybe it was the pertussis vaccination I gave to a pregnant patient that will save her future 3-month baby old from the potentially lethal germs of the coughing kid-next-door. Or perhaps it was the softly-spoken and profoundly depressed man who unburdened his woes to me before going home and deciding that today he won’t kill himself after all. 

In general practice, we don’t often get the adrenaline-fuelled immediate gratification of snatching patients from the jaws of death (although, obstetrics gives me plenty of that!). Rather, we leave our clinics each day knowing that the flaps of all those butterfly wings will prevent some unknown catastrophe from befalling some unknown patient at some unknown time in the future.

This kind of life saving is satisfying in its own quiet way, even if it doesn’t come with quite so many outpourings of praise and gratitude. 

The fact is, as a group, we are INCREDIBLY good at saving lives. International research consistently shows that regions with more primary care have lower mortality, greater life expectancy, better health outcomes, and at lower costs compared to regions with more specialist care. Yes – we humble GPs are better at saving lives than all those heroic specialists put together! 

Which is not to say that we don’t value and appreciate our specialists colleagues. By golly, we do. We need those fine folk doing the deep dives on our patients’ complex problems while we span the breadth. We definitely need those instant life savers – the trauma surgeons and emergency physicians and neonatal resuscitators and interventional cardiologists and the many others who work diligently around the clock to keep our patients alive. But, we must get the balance right to allow our communities to thrive.  

It’s not all about saving lives, of course. We GPs also get to do the deeply rewarding work of improving peoples health, in the complete sense of the word. We are there on the first and last days of people’s lives with our involvement in maternity and palliative care. And every day in between, we are there to help optimise both quantity and quality of life. 

As a newcomer to Canadian family practice from my native Australia, I’ve had the unique opportunity to observe the two health systems. In both, primary care is facing challenges on multiple fronts: an increasing administration burden, frustrating bureaucratic requirements, a narrowing of clinical scope, inadequate funding and incentivisation of quantity over quality. Our capacity to provide optimal care is further thwarted by barriers to accessing allied health services and essential treatments. 

Disappointingly, in both countries, specialists and hospitalists seem to be more highly regarded and are better financially remunerated than their community counterparts. No wonder we have retention and recruitment issues. Here in Victoria, the GP shortage is dire. Back home, there is also cause for concern

But despite these challenges, I know that if I want to have the biggest impact on people’s lives, the best way I can do that is by being a damn good GP. I hope our future doctors will see the light and join me in this noble quest. 

As the sun sets on Canadian Family Doctor Week, it feels appropriate to take a moment to reflect on the immense good that we do while we chip away in our consultation rooms one patient at a time. It’s time to pat ourselves on the back for being the lifesaving heroes that we are. 

Now, where’s my cape… 

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