Family Medicine Pioneer G. Gayle Stephens, MD spoke at the 2012 American Academy of Family Physicians National Conference of Special Constituencies on May 3, 2012 in Kansas City, MO. I have heard a lot about this icon in the past, especially an essay entitied, "Family Medicine As Counterculture."
Even though this gentleman has given many lectures in the past, I could see (especially since I was sitting in the front row) that he genuinely looked nervous as he climbed the steps to the stage. He poked fun at the start of his talk by calling himself "Moses" and asking rhetorically, "Where did they dig up this old guy?" as the crowd laughed awkwardly.
He read his entire speech. But, as usually happens, speakers find their stride in the last part of the talk. In this case, it was the last eight minutes, which is the video above. The opening quote below was the best of the whole thing and inspired this blog post.
The first job is to give a damn about everything that matters to patients and about what the patient chooses to do or not to do about their condition. I've seen it happen that when the patient refuses medical advice, for those of us who believe strongly in patient autonomy, lose interest in the patient and say the patient should go somewhere else....
If the patient refuses a treatment, like chemotherapy, Dr. Stephens says, "[This choice] is not an ending of the doctor's responsibility, but the beginning of a new phase of patient care." He continues with concept like "Being There," how to "Talk" to patients, "Don't make promises you can't keep," Don't make rotten referrals," and "Stop Whining and Start Resisting." He closed with this ominous quote which made a lot of people think during and after his presentation.
Your turn to become a patient is inevitable. We're all going to be abused by this terrible system eventually. The closer I get, the more scared I become...
Family Medicine cannot look forward without looking back. Not only do I hope we remember Dr. Stephen's story, I hope that we retell it to our friends, our colleagues, and anyone else who will listen. The fundamentals of Family Medicine have not changed, and we cannot forget the pioneers like Dr. Stephens. Without them, Family Medicine would not be where it is today. Thanks Dr. Stephens for continuing to challenge Family Medicine to be Counterculture.