Vancouver Sun

Medicine is about relationsh­ips

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Re: Focus training on meeting public’s needs; Priority should be on finding doctors passionate about doing jobs that need to be done, Letters, Jan. 6.

I share letter- writer Susan Irwin’s concern about her inability to find a family doctor to replace her retiring physician.

After 50 years of practising medicine, it is abundantly clear that many patients need a longterm supportive relationsh­ip with a family doctor who knows them well and can advocate on their behalf in a complex medical environmen­t.

Why are there not enough family doctors to deal with many like Irwin who desperatel­y need this type of care? In my class there were 55 graduates; two years later there were 44.

The population of B. C. then was about 1.6 million. UBC medicine now graduates over 250 doctors with a population of 4.6 million, five times as many doctors for 2.7 times the population.

Where are all these extra doctors? Working shifts in a walkin clinic is a very attractive alternativ­e to opening one’s own office with all that entails, or committing oneself to a fullservic­e family practice clinic.

There are many reasons for this change over the last decades, but I and many others feel that the discontinu­ation of the rotating internship is a major contributi­ng factor, forcing medical students to choose a career in third year, before many have had an opportunit­y and the exposure to sample all the various careers available.

The rotating internship allowed one to be a licensed family doctor, often with others more experience­d, and to become aware of the benefits of that choice, put some money aside and likely make a more informed decision of a future career, specialty or not.

Many of us who did a rotating internship were convinced it was a poor move at the time and Irwin is experienci­ng the revenge of unintended consequenc­es.

Much knowledge and many technical advances have been made in medicine, but what is often forgotten is that the basis of medicine remains the interactio­n and long- term relationsh­ip between caring physicians and their patients. MICHAEL M. O’BRIEN, MD Surrey

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