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Family Physician Scope of Practice:
What can your doctor do for you?
Many patients don’t realize the breadth of knowledge and medical management that their family physicians (MD/DO) can practice. Especially rural family physicians (MD/DO), compared to physician assistants (PA) and nurse practitioners (NP), have more broad and advanced training in basic medical pathologies/diseases/ailments. Not all family physicians will practice to the broadest extent of their knowledge, some may choose to practice what they are comfortable with based on training or the amount of pathology of that type is seen or simply to keep their practice more easily managed. However, it is part of their training requirements before graduating, that all family physicians are exposed to the basic pediatric, women’s care, men’s care, geriatrics, acute care pathologies that are seen most commonly during their medical school training as well as residency training, which at a minimum is a total of 7 years beyond their basic college degree.
Family physicians are required to rotate and learn from other specialists during their training such as being in the critical care unit in the hospital, delivering babies in the obstetrics unit, intubating in the emergency room, etc. So when it comes to your family physician, make sure you establish what types of things you can come to them for and what things they expect you to go elsewhere for.
Family physicians are able to manage acute issues such as colds, flu, diarrhea, etc. Can suture and care for simple lacerations and injuries. If xray capabilities are available, they can use it to diagnose fractures and pneumonias. Other basic procedures such as casting broken limbs, biopsying concerning lesions, toenail care/procedures, wound care, etc.
What family physicians are well known for are wellness exams and health screening visits. Our bread and butter is trying to maintain health and prevent acute illness. The goal is always to partner with the patient and work on healthy living, good food choices, medication choices that will help extend life, but more importantly help improve quality of life. Family physicians should know best screening practices for cancers. Should appropriately recommend medications to decrease risks for heart attacks and strokes. But more importantly, many family physicians are the gatekeepers for further referrals to specialists.
Especially out in rural regions, specialists are hard to come by, so the health system relies heavily on family physicians to start a basic workup and identify which pathologies and ailments truly need higher level of care and exploration versus which can stay locally. Unless, completely out of the scope of practice, most family physicians will know how to start a basic workup of your concern, whether it is related to mental illness, intestinal complaints, heart concerns, breathing issues, pediatric ailments, etc. This not only helps make sure that the specialists are not overwhelmed with simple cases that could have been managed locally, but it helps save the health system money, but more importantly, helps the patient save on the financial burden of paying for a specialist visit and the cost to travel.
Here in Wautoma, I do prefer to keep patients locally if possible. My personal patient’s are always able to make a same day visit to see me as I am their designated primary care physician so I want them to have that ability to have access to see me if they need to. I try my best to keep my patients out of the emergency room and always remind patients that I fix lacerations and have xray in my office. I can remove fish hooks and ticks during the summer, I can trim toenails that have fungus, or remove ingrown toenails all together. I also see patients at the hospital at ThedaCare in Berlin, if they are patient’s of the Wautoma clinic, every morning before clinic. So the continuity of care is what I thrive for and love about practicing as a rural family physician. The takeaway is, to always clarify with your family physicians (MD/DO) or you may be following with a physician assistant (PA)/nurse practitioner (NP) and ask them what they are comfortable managing so that you know who and where to go/ask when the time comes and an issue arises.
Do you have any interesting, common medical topics you want Dr Nguyen to write about? Dr Nguyen hopes to keep topics short and succinct, to the point, so that it is easy for everyone to understand. Dr Nguyen will start with monthly topics for now and may increase depending on interest in the community. Submit your topics to: DrLongWautoma@gmail.com.
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