A recent editorial in The Journal of Graduate Medical Education reminded me of a classic Mark Twain quote. When confronted by reporters about rumors of his untimely demise, Twain, both irritated and amused, famously remarked, “The report of my death has been greatly exaggerated.” In “A Eulogy for the Primary Care Physician,” Forrest Bohler and David Blumenthal offer a tongue-in-cheek requiem for primary care medicine. In this satirical piece, the authors enumerate the systemic forces that have led to our specialty’s purported demise. While their “eulogy” contains elements of truth, it is greatly exaggerated, and more importantly, we’re not dead yet! Bohler and Blumenthal begin by lauding the noble idea that everyone deserves a trusted primary care physician to navigate the complexities of our healthcare system. They then explain the various threats to primary care, including physician shortages in rural and underserved areas, as well as the fee-for-service system's preference fo...
My father was a brickmason. As a teenager, I spent many summer days working as his assistant. I despised almost every moment—the heat, the drudgery, and my father’s company. My attitude was much like Mark Twain's, who wrote, “When I was a boy of fourteen, my father was so ignorant I could hardly stand to have the old man around. But when I got to be twenty-one, I was astonished at how much he had learned in seven years.” Looking back, I am ashamed of my adolescent disrespect for his hard work, skill, and meticulous attention to detail. One incident stands out vividly. He and his crew had just completed the hearth and chimney for an imposing multi-story home. A critical error in the blueprints caused the hearth to be misaligned by several inches, a minor flaw that compromised the living room’s aesthetic balance. The homeowners were adamant that this mistake be corrected. Unfortunately, moving the entire house would have been far easier than relocating the chimney. The only solutio...