1\cadern~ - Local History Archives

Thursday I April 29 I 1982 ___ ~._~_?_~_~_EP O__ '_N_T_E__N_E_W_~ ._._. . ..__. _0
By Tom Greenwood
Family doctor makes a comeback
When the title "General Practitioner"
is mentioned to most
Americans, the medical image
conjured usually involves kindly
wise old "Doc" seated in a horse
and buggy, winding his way across
the prairie at all hours tend.
ing to his patients.
Ancient, wizen and reliable, "Doc"
knew everyone by name and issued no .
nonsense cures tor everything from
his mysterious black bag.
In today's micro-chip world, that
image is fading fast. In fact, General
Practitioners themselves almost disappeared
during the 1950's and 1960's
when medical school graduates rushed
headlong lnto specialty fields.
"Happily, that trend IS being reo
versed," said Dr. Lucian F.
C~~b!!!nN). ('l\j"f of {hI' ~p.artment
of Family Practice at St. John Hospl.
tal.
"It used to be that if a graduate decided
on famlJy practice, he was sort
01 looked upon as a 'dunce' by the rest
01 his classmates. Everyone knew the
big bucks were in specialiUltion.
"Consequently, a real need grew
among patients for a family doctor.
From lhls need, general practltioners
organiJ.ed the American Academy 01
Family Physicians. Today, about 15
percent of all medical school
graduates will become family physicians."
The family physician of toda~ is a
far cry from the general pracUtioner
of yesterday, B ccordlng to Dr.
Capobianco.
"The academy revlaed sIght5 and
.tandards for the physicians," said
Dr. Capobianco, an energetic man
with a quick smile. "In 1971, the first
board. in famlly practice were given,
The academy ha. 1llIIlted on continuo
ing education for all ita members, and
each mu.t accumulate at lealt 160
credit hour. of addltlonal education
every three years. When we t1~ or.
,anlled lhere were seven residency
Pl'OITamJ. Now there are 390 acrou
the U.S."
Unlike other medical disclpllnes,
'amily pbyJ1cIBlU are specialists because
of what they include rather than
what they exclude. Family practice
lncludea six broad areas of med1clne:
pedJatrics, Internal medicine,
psychiatry, sUT,ery, obstetrics and
gynecology and community medicine.
This educational background and
other practice orientations enable the
physician to olfer continuing and com.
prehenaive care to all patienu and
their families, regardless of sex or
age.
"U 1 have a female patient in here
with a lOre throat. Ichtng shoulder
and pelvic problems, It UIed to be 1M
HARVEY'S
Compleat Traveler
~1j5 FISHER RO/\[)
GROSSE POJ:- ..:T,E:
thing to have her see three different
doctors: ear, nOie and throat, ortho-
~d and ob/gyn," said Capobianco.
'Today, the family phyJ6clan can tend
to all these problems. We can handle
probably 85 percent of the problems
that walk through our dool'l,"
Family physicians have also found a
growing need to tend to psychological
and socia) problems confronting patients
and their families. otten illnesses
aIled famlties, and vice versa.
"I'U have a patient scheduled for a
half hour consultation," said
Capobianco. "He'll spend 29 minutes
describing aches and pains, this physical
problem and that. Then with his
hand on the doo~l he'll mention 'Qb by
the way, my WIle is leaving me and
my son was jusl arrested.' "
"There has to be a tremendous impacl
on his physical being and on the
rest of the family. We sit them back
..lnoo,~ .. ..A tAIll: h'lI true I can often
~~iy-'~-~patient for 15 minutes or a
halt hour at a time. But, we make up
for it by seeJ.ng them more often on a
continuing basIs. It's a continuation 01
care. I often Se4! or hear from patients
at aU hours of the day. It's part of our
philosoph y ."
A fascinating part of the family
physician care polley is the construction
of "genograms," a family treelike
skelch of family relationships
often coveri~ four generations. Briel
descriptions (includJng any physical or
mental ailments) of each member are
given, and social and psychological relationships
between members are described
via jagged (denoting strained)
or smooth Unes.
"ObvI0U51y. this type of sketch can't
be drawn for each and every family
that comes to .ee us," laid
Capobianco. "It'. very time cODlumloa,
but we do UJe It for .peclaJ caJeI,
One can lee at a glance the rough and
.mooth 81pectl of each family. The
use of ',enogram.' I. now being
taught in medical .choolJ acl'Oll the
COWltry."
Dr. Capobianco will u.tillze ",enograms,"
charta and other strategiel
this Augu.lt when be .pew on "Fam.
lIy ny.mica" before family phy.l.
clan. from the V,5., Canada, the
Caribbean, Latin America, Portugal
and Spain in San Juan, Puerto Rico.
"You know we must mean bualnesa
IC we're going to speak on famllr,
mediclne In Puerto Rico in August, '
he said ,,1th a smile. "We hope to provi