What Is it Like to Specialize in Family Medicine?

Hilton C. Ray, MDMy name is Hilton C. Ray, MD, and I’m a Diplomate of the American Board of Physician Specialties® (ABPS) and the medical director of Prowers Medical Center in Lamar, CO. I have been practicing family medicine since 1991. Although I have been interested in other medical specialties, I turned to family medicine as a way to continue serving a wide community of patients. As a family medicine practitioner in a rural setting, I see patients ranging in age from newborns to the elderly and can do much more than I could in an urban environment. Additionally, the specialty allows me to practice from a holistic perspective and impact health across generations of families.

Family medicine is a good fit for me because I like mental challenges, mysteries, and puzzles, and family medicine presents a variety of challenges for the physician. For instance, I see patients with conditions that span the practices of cardiology, orthopedics, rheumatology, dermatology, pulmonary medicine, and gastroenterology, just to name a few. This diversity keeps most days from being routine. I enjoy the different cases that come through my office as much as I enjoy the variety of people.

By far the most enjoyable aspect of family medicine is the relationships that I develop with my patients over time. The physician-patient relationship is at the core of traditional health care, particularly in the rural health care setting in which I practice. Seeing the same patients over a couple of decades or watching babies whom you have taken care of grow up and start families of their own is an amazing experience. While there are many things that I have done over the course of my career that I absolutely enjoy, such as teaching, I don’t think anything else compares to the long-term connection that a patient-physician bond fosters.

Currently, family medicine physicians face several challenges, many of which involve the changing nature of medicine and the requirements that we have had thrust upon us. Some of these have to do with electronic medical records and the need to report data to multiple health care entities including the government. While the benefits of these reports are being debated by legislators, lawyers, physicians, and pundits, the bottom line is that many of these activities have encroached upon the time that physicians can spend with their patients. This is in addition to the insurance companies that have their own set of requirements, including prior authorizations that take up physicians’ time and place further barriers between doctors and patients. The advancement of technology has been both a boon and a bane to medicine in general. These and other factors are changing the way physicians and patients interact, and not all those changes are for the better.

One of my more memorable experiences in family medicine occurred when I was working on Saint George Island, a small island with a population of 150 people located about 750 miles southwest of Anchorage, Alaska, in the middle of the Bering Sea. I went there to be the only medical provider for a planned two-week stint. I ended up staying on the island for nearly three weeks as the plane that was to take me back to Anchorage was unable to come because of bad weather. One day in my second week there, amid storms that made the seas very rough, a Polish ship arrived at the dock and called for the police chief. Because of the dangerous waves and a growing storm, the crew only had time to unload a sick crew member, and he spoke only Polish. He came to the clinic, where we quickly ascertained that he had peritonitis. The weather was too rough for a plane to fly in and evacuate him, so we kept him in the clinic. There was no hospital on the island, but the clinic did have a bed in the back room. We gave him fluids as well as ceftriaxone, the only IV antibiotic that we had in stock. Lots of phone calls and about 36 hours later, a plane was able to arrive and evacuated him to one of the major tertiary hospitals in Anchorage. According to a later report, he ultimately had surgery and did fine.

If I could give advice to a family doctor in training it would be, try not to listen to the noise. There is so much going on in health care today that it is easy to lose sight of one’s goal. Medicine has always evolved and will continue to evolve. The only difference is that, in this era, changes come with a lot of people shouting about different medically related topics. Between intrusion by insurance companies, pharmaceutical companies, and government agencies, there are many people who are vying for your attention as a new doctor. We must remember to focus on what is truly important – the patient. Do that and most of the noise will fade on its own.

Save the Date
House of Delegates & Annual Scientific Meeting
Innovation & Overcoming Challenges
June 10-15, 2022
Patient Care Is Our Priority

Medical organizations throughout North America understand that our rigorous certification standards prove that ABPS Diplomates are capable of delivering the best patient care possible.

I feel truly blessed and grateful to be an internal medicine board-certified diplomate with the American Board of Physician Specialties. Their ongoing, steadfast commitment to physician board(s) enhancement, forward focused vision, and tenacity is second to none. ABPS has become a recognized choice in Physician Board Certification.

Adam Rench, MD
Internal Medicine
To be the best, you must measure yourself against the best. Achieving Board Certification in Emergency Medicine by the ABPS gave me the opportunity to demonstrate mastery of the art of EM in an objective way. The high bar that ABPS sets for candidates to be allowed to take both the written and oral exam is a testament to ABPS's rigorous vetting of one's ability to practice Emergency Medicine at a high level. By maintaining these credentials, I've been able to instill confidence in my abilities at the department/employer level and ultimately with the patients that choose to seek emergency care at the facilities at which I practice.

Royce Mathew Joseph, MD
Emergency Medicine
The American Board of Physician Specialties has supported the entire field of Integrative Medicine in sponsoring our board. It has been so validating of the importance of prevention-oriented and holistic approaches to care while emphasizing the scientific basis of this specialty to have it recognized by ABPS. I am proud to have been one of the first groups to be board certified by ABPS in Integrative Medicine, leading the way for others committed to training in this specialty.

Myles Spar, MD
Integrative Medicine