Whatever Happened to the Family Doctor?

If the medical home model takes off, it will have the help of a strong foundation of programs in Minnesota already in place. The Rural Physicians Associate Program, a nine-month elective training program offered to third-year medical students at the U, has become an internationally recognized model for introducing med students to the world of family medicine. “That program has a huge positive influence,” says Baird, noting that since its inception in 1971, 80 percent of its 1,000-plus graduates have gone into primary care, the majority in Minnesota.

The University of Minnesota Medical School’s Duluth campus has also been effective at seeking out what Foley calls the “young Marcus Welby types”—students from small communities who have seen first-hand the important role family doctors play in delivering health care. More than half of UMD's med school students go into rural primary care.

Residency programs, like the one at United Family Practice Health Center, may also play an important role in attracting family doctors to the Twin Cities and keeping them here. So do financial incentives such as the state’s loan forgiveness programs for primary care physicians who spend a few years in rural or underserved urban areas.

But saving the family doctor might also mean making family medicine a little more family-friendly. The New England Journal of Medicine recently estimated that it would take a family physician eighteen hours every day to provide all the chronic care treatment and recommended preventive care for an average population of patients, an overwhelming workload by any standard. “Doctors of my generation and previous generations worked sixty- and seventy-hour weeks, but the doctors of today see the toll that takes on families and they don’t want to be on call every moment,” says Foley. Already, physician recruiters are responding with job offers that include fewer weekend rotations, more flexible scheduling, and even two physicians working more reasonable hours, to take the place of one physician nearing burn-out.

“We talk a lot more than we used to about balance and having a real life outside of work,” says Rumsey. “You don’t want to be the doctor who is beloved by the community, but who never makes it home to see the soccer game or the school play.”

To model a more balanced life to the young doctors with whom he works, Rumsey tries hard not to come in on his days off—though he doesn’t always succeed. He fills notebooks (forty-five at last count) with stories his patients tell him about the history and great characters of West Seventh Street. He plays guitar with his band, The Rhythm Pups, at least once a week, singing Bob Dylan and Neil Young covers at the pub down the street. After eleven years, he’s also found time to complete his second novel, which he has titled Walking to Work. His first novel, Pictures from a Trip, centered on brothers who set out from St. Paul in search of dinosaur bones. Though it was received with some acclaim and a nod from The New York Times when it was published twenty-three years ago, Rumsey is careful to note that his new book is not a sequel about another vanished species.

“It’s about a family doctor,” he says. “And I don’t think we’re dinosaurs yet.”

Laura Billings writes Mpls.St.Paul Magazine’s Fit for Life column.