News/Commentary

Pauline W. Chen, M.D., who writes the Doctor and Patient column for The New York Times, always is worth reading.

She never loses touch with what matters most in the patient-physician relationship.

However, in this case, she is writing about what doctors don’t do for family care-givers.

A doctor friend said in the early 90s, “Today’s nurses know as much as Marcus Welby, M.D. did.” (The Welby character in a popular 1950s TV show was the wise family doctor.)

The knowledge explosion in medicine began a process in which what was or is doctor’s work is turned over to registered nurses (R.N.’s) or nurse practitioners (M.S.N’s) because the doctor has newer specialty tasks to do, thanks to technology—ones which only an M.D. can handle.

The end result? A surprising amount of what used to be nursing work now falls to patient’s family members.

Much of the care formerly given in institutional setting now is delivered at home.

There is no College of Accidental Semi-Professional Family Care-giver Medicine.

That is Dr. Chen’s point.

Thirty-seven million people, give or take, fill this role with little help from physicians.

The New York Times

…”These “family caregivers” do work that is complex, physically challenging and critical to a patient’s overall well-being, like dressing wounds, dispensing medication, and feeding, bathing and dressing those who can no longer do so themselves. (Emphasis added)

“Many of these caregiving tasks were once the purview of doctors and nurses, a central component of the “caring professions.” But over the past century, as these duties increasingly fell to individuals with little or no training, doctors and even some nurses began to confer less importance, and status, to the work of caregiving. (Emphasis added)

“It comes as no surprise, then, that physicians now rarely, if ever, learn about what a family caregiver or health care aide must do unless they are faced with caring for their own loved ones. We doctors don’t know or aren’t always fully aware of what it takes to care for a patient after we leave the room. (Emphasis added)

“In other words, for the 37 million people attending to the health care needs of a relative, partner, friend or neighbor, our best care goes only so far.”

Source: New York Times, January 21, 2010