Art Of The Follow Through
In case you missed it on the weather channel, my college kid landed home this week sweeping through the house like a category 4 hurricane. I found an empty milk carton in the pantry this morning, a pair of dirty socks in the fridge and the trash bag I asked Jack to take out sadly sitting outside, near the barrel, half eaten by Fred the Squirrel.
“What’s with the trash Jack – couldn’t put it in the barrel, really!?!” “Wait, what?” he said groggily. “You wanted me to put it in the barrel?” …
Back in the day we used to follow through, didn’t we? We didn’t rely on others, because perhaps we didn’t have a choice. We balanced our books and PB&J on the handlebars of our Huffy all 2 miles to school. We didn’t have back packs or carpools or ubers and if our bike tire hit a pothole and flattened, we’d get off and hoof it to make the second bell….
….Healthcare was like that too once upon a time. Doctor Bloom used to do it all. I remember how he’d flag pop’s rising cholesterol and expanding waist line - how he’d remove that nasty foot thingy and treat that belly pain with a good ole’ coca cola. He’d make the spaghetti in the church hall after Saturday afternoon mass and hit flies to little leaguers on Sunday. Doc Bloom was part of the community, diagnosing us in the general store and following up on that itchy scalp outside the bank. He’d bring you the Sunday paper and check on that constipation. He knew too much and there was very little he couldn’t do for his patients and, well, in the rare chance he couldn’t figure it out, he’d send you to the emergency room. There was no middleman. There was no outpatient specialist or intensive therapy center, no community cardiologist.
As a teenager, Bloom was a starting pitcher on his city team near Springfield Mass – he’d begin the game, throw 150 pitches and after 9 innings, win or lose, he’d hit the showers, and in the rare chance his 90 MPH fast ball became a 70 MPH meatball in the 9th inning the coach would call to the dugout for an emergency reliever to stitch together the last couple outs. Like in healthcare, things are different now in baseball. You don’t pitch 9, there are set up pitchers, lefty specialists and guys whose sole job is to throw 3 pitches to close it out. Starters have to know a lot about batters, their tendencies, their injuries and whether they’ll swing at a high fastball, but they are less and less responsible for actually finishing the game.
Community doctors aren’t much different nowadays. Sure, they have to know a lot about us—our eating and exercise habits, our mental health and family history, our aches and pains, worries, warts and all—but they only have so much time with us and more and more often call in a relief specialist or refer us to a program. The art of the follow through may well be a lost one with the likes of my Jack, and probably the community doc, right? Maybe not….maybe we can change how we motivate our youth, and perhaps the latest wave of primary care at home models springing up are bringing us back to a time when our healthcare was sometimes more impactful, definitely more personal. When our doctors knew us, and we knew them…