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From a neurosurgeon: You need a family doctor - Sartell Family Medicine

John Spitalieir, DO / November 12, 2019

One of my favorite scenes in the recent Apollo 11 IMAX film was a dramatic panning shot of mission control moments before lift-off. Row after row of mission specialists, engineers, astronauts, communications technicians — all looking ahead in silent, unbreakable focus. All 100 percent dedicated to the three men about to lift-off into history. It was a truly mesmerizing portrait of teamwork.

While astronaut safety is the focus of every individual in that room, one has a particularly critical and even intimate role. He or she is known as the flight surgeon. Just like the anesthesiologist in my operating room, they monitor the astronauts’ vital signs in real-time. They knew Buzz Aldrin’s ECG readings at lift-off. They closely monitored Neil Armstrong’s heart rate as he navigated the final seconds of the Eagle landing (140bpm, by the way).

In-flight bio-telemetry monitoring isn’t all a flight surgeon does. No, far from it.

They also perform regular medical check-ups on astronauts, assess flight readiness, conduct research, and essentially serve as the astronauts’ personal physicians … they’re the guy or gal in the astronaut’s corner. Despite their name, surgery is about the only thing a flight surgeon doesn’t actually do. Nevertheless, this critical role has clear parallels to a medical team member we all know here on Earth — a person you know as your family doctor.

I dedicated over ten years of my life training to be a neurosurgeon, including an extra bonus year in an advanced minimally invasive spine surgery fellowship. Neurosurgery is one of the longest training programs in medicine, three to four years beyond what is typical for a family doctor. So, you may find it surprising that even this neurosurgeon always makes time for an annual visit to his family doctor. And so should you.

Every day I see patients arriving at my office with problems that likely could have been managed conservatively (without surgery), if only they were identified sooner. Now it’s too late, and surgery is the only option we have to alleviate their unbearable pain, or in some cases, to prevent irreversible spinal cord damage. When I ask them, “When’s the last time you saw your family doctor?” I’m met with familiar responses, “I wasn’t sick, I’m too busy, it costs too much, etc.”

The best professional athletes still need coaches to push them to their best, race car drivers need mechanics, lawyers hire other lawyers to represent themselves in court, and even surgeons and young, healthy astronauts still need regular check-ups by a trusted family doctor.

Five reasons everyone needs a family doctor in their corner:

1. Your privacy. By law, doctors and lawyers generally can not be forced to share your personal health information. This is not true about Dr. Google, Facebook, genetic testing companies, or your employer. With hacking, data breaches, and all the other threats to your personal privacy, go with the person who is legally and ethically bound to protect you (not to mention better trained and informed!).

2. Early detection. We haven’t cured cancer. Small problems are easier to fix early. Left untreated, problems down the road are much bigger and much more serious.

3. When you need a specialist (cardiologist, orthopedist, neurosurgeon, etc.), your family doctor is your best resource for finding the best one. They’re the expert food critic who’s been to every restaurant. They know who you should see and who you should avoid.

4. They can give you the tough love you need. Even surgeons like myself need a little push in the right direction. We’re busy with long and unpredictable hours. My family doctor constantly reminds me that exercise, sleep, and nutrition are not areas to be sacrificed for work.

5. They are in your corner. They know your medical history, they know you.

Imagine finding yourself (or a loved one) arriving at the ER late at night. You’re hurt, you’re tired, and people you’ve never met, strangers, literally have your life in their hands. Everything is confusing, and some of the most important decisions you may ever have to make await you. Wouldn’t it be helpful to have a doctor, a PA, an NP, a nurse, who you know? Someone who knows you? Someone you can call? Someone in your corner?

Your family doctor (or a member of their team) can be that person. Who else would you rather lean on at that difficult moment? Your insurance company, a stranger in the waiting room, the internet? No way!

Tips for having a great relationship with your family doctor.

  • They don’t know everything — but they do know more than you. Treat them like the professionals they are. If you really don’t trust them, then find someone you can.
  • Be honest and don’t hold anything back. They can’t help you with something they don’t know about.
  • Pay it forward. Be nice to everyone in the office. Why not bring some cookies for the staff? Be the person they want to help. Life isn’t fair, but people want to help others they like.
  • Don’t ignore their advice. If something doesn’t make sense, ask more questions.
  • Visit at least once a year. A full medical physical may or may not be necessary. This all depends on your age, existing conditions, etc. The frequency of your visits is something you should discuss with your family doctor.

Medicine is commonly thought of hierarchically. Like a pyramid, family and internal medicine doctors make up the bottom, while specialists and surgeons sit on top. I believe it’s the opposite. Think back to the mission control room. The astronauts (aka the patients) are the stars of the show. The flight surgeon, working for months prior to catch and manage problems early, is comfortably confident that everything is a GO. Surgeons like me? Well, failure is not an option, and neither is zero-gravity emergency surgery (at least not yet), so we’re in the spectator section, watching with wonder along with everyone else.