Preventive Care Can Happen Anywhere

When I struggled with the notion of giving up my longtime love of primary care to pursue a career in hospital medicine, one of the things I knew I would miss most was the opportunity to counsel patients on the importance of preventive medicine and leading a healthy lifestyle.

One of my most memorable moments was when a patient walked into my office, disappointed that he had to come in before his anticipated grand entrance. You see, he had lost 99 pounds and was hoping to have lost a full 100 prior to seeing me again after our last intense lifestyle counseling session. Finally! Someone had really listened. I relished the fact that he probably would live much longer and have fewer medical issues to deal with as a result of his tremendous weight loss. I was ecstatic to have played a role in his transformation. That, I thought, was what primary care was all about.

While I never regretted making the change from primary care to hospital medicine, I briefly toyed with the idea of switching back recently when a dear friend of mine was diagnosed with prostate cancer, metastatic to the spine and brain.

Less than 10 years ago I had watched him deal with the agony of losing his wife, his lifelong companion, to colon cancer at the early age of 43. Now, in his early 50s he, too, was diagnosed with terminal cancer. As nature takes its course, his new wife will lose her bridegroom, and his four children will lose their wonderful father within a few months.

I had to wonder why this was happening to such an awesome man. If he had gotten his prostate-specific antigen test and digital rectal exam each year without fail, would he and his family (and my family) be dealing with such devastation now?

And so, for a brief moment I seriously considered returning to the office, hoping to find an attentive audience who would listen to my pleas to get a mammogram, make an appointment for a screening colonoscopy, kick that crazy smoking habit, or schedule a prostate exam.

But as I sat there with tears in my eyes thinking about my friend, I realized that just because I am no longer a primary care doctor doesn’t mean I can’t counsel patients on preventive health issues. Later that day, I admitted a woman with pneumonia who had not seen a doctor in over a decade. I was elated to encourage her about the importance of getting a screening mammogram, Pap smear, and colonoscopy, and even offered to give her the names of some primary care physicians in the area who were accepting new patients on discharge.

Who knows if she will follow up on my recommendations? But I do know that it felt wonderful to encourage her to do something that may just save her life. And now, preventive medicine and healthy lifestyle counseling have again become a regular part of my discussions with patients.

Dr. A. Maria Hester is a hospitalist with Baltimore Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care.

When I struggled with the notion of giving up my longtime love of primary care to pursue a career in hospital medicine, one of the things I knew I would miss most was the opportunity to counsel patients on the importance of preventive medicine and leading a healthy lifestyle.

One of my most memorable moments was when a patient walked into my office, disappointed that he had to come in before his anticipated grand entrance. You see, he had lost 99 pounds and was hoping to have lost a full 100 prior to seeing me again after our last intense lifestyle counseling session. Finally! Someone had really listened. I relished the fact that he probably would live much longer and have fewer medical issues to deal with as a result of his tremendous weight loss. I was ecstatic to have played a role in his transformation. That, I thought, was what primary care was all about.

While I never regretted making the change from primary care to hospital medicine, I briefly toyed with the idea of switching back recently when a dear friend of mine was diagnosed with prostate cancer, metastatic to the spine and brain.

Less than 10 years ago I had watched him deal with the agony of losing his wife, his lifelong companion, to colon cancer at the early age of 43. Now, in his early 50s he, too, was diagnosed with terminal cancer. As nature takes its course, his new wife will lose her bridegroom, and his four children will lose their wonderful father within a few months.

I had to wonder why this was happening to such an awesome man. If he had gotten his prostate-specific antigen test and digital rectal exam each year without fail, would he and his family (and my family) be dealing with such devastation now?

And so, for a brief moment I seriously considered returning to the office, hoping to find an attentive audience who would listen to my pleas to get a mammogram, make an appointment for a screening colonoscopy, kick that crazy smoking habit, or schedule a prostate exam.

But as I sat there with tears in my eyes thinking about my friend, I realized that just because I am no longer a primary care doctor doesn’t mean I can’t counsel patients on preventive health issues. Later that day, I admitted a woman with pneumonia who had not seen a doctor in over a decade. I was elated to encourage her about the importance of getting a screening mammogram, Pap smear, and colonoscopy, and even offered to give her the names of some primary care physicians in the area who were accepting new patients on discharge.

Who knows if she will follow up on my recommendations? But I do know that it felt wonderful to encourage her to do something that may just save her life. And now, preventive medicine and healthy lifestyle counseling have again become a regular part of my discussions with patients.

Dr. A. Maria Hester is a hospitalist with Baltimore Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care.

When I struggled with the notion of giving up my longtime love of primary care to pursue a career in hospital medicine, one of the things I knew I would miss most was the opportunity to counsel patients on the importance of preventive medicine and leading a healthy lifestyle.

One of my most memorable moments was when a patient walked into my office, disappointed that he had to come in before his anticipated grand entrance. You see, he had lost 99 pounds and was hoping to have lost a full 100 prior to seeing me again after our last intense lifestyle counseling session. Finally! Someone had really listened. I relished the fact that he probably would live much longer and have fewer medical issues to deal with as a result of his tremendous weight loss. I was ecstatic to have played a role in his transformation. That, I thought, was what primary care was all about.

While I never regretted making the change from primary care to hospital medicine, I briefly toyed with the idea of switching back recently when a dear friend of mine was diagnosed with prostate cancer, metastatic to the spine and brain.

Less than 10 years ago I had watched him deal with the agony of losing his wife, his lifelong companion, to colon cancer at the early age of 43. Now, in his early 50s he, too, was diagnosed with terminal cancer. As nature takes its course, his new wife will lose her bridegroom, and his four children will lose their wonderful father within a few months.

I had to wonder why this was happening to such an awesome man. If he had gotten his prostate-specific antigen test and digital rectal exam each year without fail, would he and his family (and my family) be dealing with such devastation now?

And so, for a brief moment I seriously considered returning to the office, hoping to find an attentive audience who would listen to my pleas to get a mammogram, make an appointment for a screening colonoscopy, kick that crazy smoking habit, or schedule a prostate exam.

But as I sat there with tears in my eyes thinking about my friend, I realized that just because I am no longer a primary care doctor doesn’t mean I can’t counsel patients on preventive health issues. Later that day, I admitted a woman with pneumonia who had not seen a doctor in over a decade. I was elated to encourage her about the importance of getting a screening mammogram, Pap smear, and colonoscopy, and even offered to give her the names of some primary care physicians in the area who were accepting new patients on discharge.

Who knows if she will follow up on my recommendations? But I do know that it felt wonderful to encourage her to do something that may just save her life. And now, preventive medicine and healthy lifestyle counseling have again become a regular part of my discussions with patients.

Dr. A. Maria Hester is a hospitalist with Baltimore Washington Medical Center, Glen Burnie, Md., who has a passion for empowering patients to partner in their health care.