January is a month for new beginnings. We have inaugurated a new President of the United States, and elected a new Congress. Changes in the provision of healthcare are in the air in Washington. This leaves some hopeful and some fearful. It seems in my 22 plus years in practice that my practice has been ever-changing, in part, related to regulations of the government. Although physicians in the US have a vote, we have limited control of regulations. The ACOI offices are located in the Washington area, in part to keep our finger on the pulse of legislative and regulatory activities affecting medicine. Our monthly ACOInformation newsletter keeps us up-to-date with the government relations articles, and we have a standing committee working on these topics.
The health payors are beginning to address quality of care in payment plans, but one question is how to cross the Ts and dot the Is for covered benefits. The patients watch us viewing the computer screen while we type in the data of each case. Some patients see this as interference in face-to-face time with the doctor. They need care, and each patient cannot imagine what is happening behind the scenes. I often say in so many words: “What have I been doing (in the practice of medicine) for over 20 years?” I was carefully studying, working and educating in an effort to provide quality care. Providing quality care continues to challenge me with the massive amount of data to consider.
We must start by going back to the basics in osteopathic internal medicine. This is how we trained. Start at the beginning and dig deep into the information. As internists, we have been taught not just to put out the fires. A temporary band aid on the focal problem is not good enough. Take extended face-to-face time with the patient, family and anyone else with knowledge of the case. In-depth questioning into the history is imperative. After obtaining the chief complaint, it is important to go through six areas, which include the medications and medication allergies, as well as the medical, surgical, family, and social history. This is topped off by the review of symptoms, focusing in detail on symptoms that might relate to the problem.
Sometimes the patient hints at the answer to the overall health problem as the doctor uncovers information. The next step is the careful physical exam, which helps to clarify additional diagnostic information. In my specialty of endocrinology, focused lab is an important step. Also in endocrinology, imaging may be necessary after the lab confirms a relatively clear diagnosis. This is the classic history and physical, and as osteopathic internists we know how to use this information to get to the crux of the case. Hands-on medicine is extremely important to us, and patients sense the power of hands-on care. They expect us to spend the time to get the story, and the examination is very important to the patient, as well.
Although getting paid is very important, quality care is our focus. That is not a new thing for us as osteopathic physicians. We have been taught that from day one of medical school. At the American College of Osteopathic Internists, we value excellence, professionalism and integrity. We believe in leadership and service to our members in the advancement of osteopathic internal medicine. Promotion of quality care of the adult is in our mission. That is the foundation of our training programs and of our doctors. I like to think of the ACOI as Home Base. A place to come back to be with your osteopathic family. Home is cozy and warm.
This month I am introducing a new segment of the newsletter. It is an effort to celebrate grass roots osteopathic internal medicine. In each newsletter, I plan to celebrate what the ACOI is all about, by highlighting one of our members, practicing in the trenches.
Margaret Davenport, DO, FACOI is board certified in Internal Medicine and Critical Care by the American Osteopathic Board of Internal Medicine. She is what I consider to be a classic “southern belle.” Dr. Davenport has been in private practice in Anniston, AL since 1993. She has a Bachelor of Arts degree in biology from the University of Mississippi, and is a 1987 graduate of the Kirksville College of Osteopathic Medicine. She completed her internship and internal medicine residency at Deaconess Hospital in St. Louis, MO, where she was intern of the year. She then completed a fellowship in Critical Care at St. Louis University.
Dr. Davenport is presently serving as the site director in Anniston for the Alabama College of Osteopathic Medicine. There are 17 third and fourth year students in Anniston. Margaret is married to Blane Bateman, DO, an ENT and Facial Plastic Surgeon. He is also a KCOM graduate. They have one son, Richard, who is in his third year at the University of Chicago. In her spare time, Margaret enjoys reading and Pilates. She is also active in her community and in her church. We celebrate Margaret Davenport, DO, as she carries the banner of osteopathic internal medicine in the trenches, educating and practicing in Alabama.
Peace to you,
John R. Sutton, DO, FACOI