Dr. Albert Chmielewski Explains What it Takes to Be a Family Practitioner
It is estimated that almost 25% of all office visits to see a doctor in the United States are to see a family physician, equaling more than 200 million appointments annually. With this staggering number of visits, some patients wonder what it is exactly that a family doctor does and what their role and responsibilities entail. While specialists and internists all have a defined role and specific subject area of practice, family doctors oversee all aspects of healthcare, for any age, gender, or illness.
Dr. Albert Chmielewski, a family doctor from Kansas, explains that the road to becoming a physician takes years of extensive training and education. After completing high school, students apply to colleges, usually for a degree in the sciences. While completing undergraduate studies, students must pass the Medical College Admission Test (MCAT), and then apply for medical school. During the final year of medical school, students apply for residency training in Family Medicine. Upon completion of residency training, physicians are allowed to then practice on their volition; in a private clinic, joining a larger private practice, or may even go into educating other residents in large university centers. A family physician may stay in general practice, or can specialize in fields such as Women’s Health, Geriatrics, or even Sports Medicine.
Primary Care Medicine
Being a family practitioner involves providing primary care to patients. During the mid 20th century, many physicians began specializing in fields, such as Cardiology, Nephrology, and Pulmonology. It was during this time that physicians began to realize the importance of the longitudinal doctor-patient relationship and continuity of care. Family Medicine begins to emerge as this venue of continuing care or holistic care. Family doctors provide care to their patients typically for years, knowing every bit of medical history, and providing care for all aspects of their health, coordinating with all of the other specialists involved in the care of said patient. Dr. Albert Chmielewski explains that he is not specialized to one organ system, or age population, and that he helps work as a patient’s advocate and patient’s holistic care taker. When needed, family doctors refer their patients to specialists for further care, including diagnosis and management, especially by specialists like cardiologists, pulmonologists, and endocrinologists. During this time a family doctor continues to stay involved, receiving reports and test results, coordinating care between the specialists, the patient, and medical staff; while doing this the family physician continues providing care for other aspects of the patients’ well being.
Dr. Albert Chmielewski states that a significant portion of his job as a family doctor includes diagnosing and often treating acute injuries or illnesses. Family doctors help provide care for common acute ailments such as ear infections, strep throat, sinusitis, bronchitis, pneumonia, influenza, cellulitis, and many others. Family practitioners are often the first to evaluate patients presenting with musculus-skeletal injuries, for example of the fingers, wrists, knees, elbows, shoulders, and ankles; if the injury cannot be treated in the office, the patient is typically sent to a specialist for further treatment. Many family physicians, like Dr. Chmielewski, also provide minor surgeries and procedures in their clinics such as wart removal, mole removal, skin biopsy, abscess drainage and packing, foreign body and cyst removal as well as knee and shoulder injections.
Being a family practitioner does not always involve simply treating patients, but also a great deal of preventative medicine. Dr. Chmielewski states that a significant portion of his job as a family doctor includes educating patients on disease prevention and health maintenance. It is the belief of Dr. Chmielewski that the holistic approach involving both physical and mental well being is integral to a healthy lifestyle. It is essential to educate patients about high blood pressure, diabetes, STI’s, contraception, depression, anxiety, obesity, healthy diet, smoking cessation, men’s health concerns, women’s health concerns, among multiple other preventable or non-preventable illnesses. Preventative procedures such as colonoscopies, mammograms, PAP smears, prostate testing, as well as coronary calcium scores are often discussed and, if needed, recommended at the appropriate intervals. Family physicians also help maintain and manage adult and children vaccinations making sure they stay on schedule, and giving boosters as required. Seeing patients from diverse age and ethnic groups, family doctors are able to make a large impact on helping prevent many diseases that are seen in a large portion of the population in the US.
Being a family doctor also means treating many chronic illnesses of their patients. Chronic illnesses are present for years, as opposed to an acute illness which typically goes away over a span of weeks to months. Some examples of chronic diseases that Dr. Albert Chmielewski sees on a daily basis include asthma, arthritis, diabetes mellitus, hypertension, hypercholesterolemia, migraines, undiagnosed pain, COPD, heart disease, hypothyroidism, and a plethora of others. Furthermore family doctors often diagnose and treat many mental illnesses such as anxiety, depression, PTSD, alcohol abuse/addiction, insomnia, and ADHD. Family doctors help provide ongoing and personalized care over many years, working hard to prevent the progression of disease, and helping to manage and balance multiple diseases and treatments at once. They are involved in helping provide regular diagnostic testing to assess the efficacy of treatment, making changes as needed. For example, for a diabetic patient, HbA1c is a marker of a patient’s sugar levels over the past 3 months, performing this blood work can help guide the doctor in the decision to increase, decrease, or even change medications. Other labs such as a CMP shows kidney and liver function and levels of important electrolytes which can be affected by chronic illness or medications. Urine testing can detect infections of the urinary tract, dehydration, pregnancy, or presence of illicit substances. A CBC can detect blood dyscrasias such as anemia or clotting disorders. Countless other lab tests can also be ordered on a case by case basis depending on the patient’s complaints or chronic illness progression. Presence of any complex disease process out of a general practitioner’s scope of practice can be sent to a specialist for further investigation and management, often resulting in a collaborative approach to treatment.
Family doctors primarily practice in small health clinics, either on their own or with other physicians. Many choose to work in larger hospital owned practices, as it can help provide support, better access to specialists, and allows for more flexibility in scheduling as well. Family doctors are also able to partner with local hospitals and become credentialed to treat their own patients when they are admitted, helping to further the continuity of care in the inpatient setting. On average, most family doctors work anywhere between 40–50 hours weekly, and this can add up to be more when factoring in the time required to complete paperwork, including completing notes, reviewing files and tests, and communicating with specialists or medical staff.