October 23, 2014

From the Editor

David SendlerThis was when I was practicing medicine in the Boston area, and I had a woman patient with asthma, allergy, sinus and bronchitis problems. Sure, we addressed them, but we also talked about other things, getting to know each other on a more personal basis. One day, because she felt she could trust me, she admitted that she smoked marijuana every day. It helped explain why her lungs were not clear and got us on a path to working through her problem.

—Dr. Julie Southmayd, Naples internist

This anecdote raises a striking and timely issue for me as we run our annual "Top Doctors" cover story (p. 41), highlighting 110 outstanding Gulfshore physicians. As you can see from our cover, we represent them as heroic in their efforts to keep us well. And they’re surely masters of medicine’s ways to heal the body. But what about the human-being part, where people skills can play a major role in achieving a successful treatment? Do all physicians really act on this piece of their mission? We questioned three of our top doctors—Dr. Southmayd; Dr. Stanley P. Gulin, a plastic surgeon in Naples; and Dr. Debra Roggow, a doctor of osteopathic medicine in Fort Myers—on the subject. And we also asked about the most exciting new advances in their fields.

The Art of Medicine

Southmayd tells a story of another patient, a man with diabetes and high blood pressure who was more worried about his wife’s health than his own. "He came in to see me," says Southmayd, "and we ended up talking about lots of non-medical things, too. It was just a nice, friendly, personal conversation. And you know what? His wife called me later saying he felt so much better for having had that conversation. The point is to be caring about your patients. Learn about their stresses. You can make progress with this kind of commitment to patients—without prescribing a single pill. This is a big part of the art of medicine."

Looking ahead—Southmayd anticipates three positive developments: (1) government making primary care more attractive again, leading to those physicians taking responsibility for the full range of patients’ concerns, (2) genetic testing that will reveal predisposition to Alzheimer’s, heart disease, breast cancer and other afflictions and indicate how to turn those genes on and off, and (3) stem cell therapy progress in fighting diseases we currently don’t have good treatments for.

Not Just a Service Agreement

Gulin says he must be sensitive to each patient’s particular personality and concerns beyond the actual work he’s doing on them. "We form a relationship and not just a service agreement," he says. Gulin meets with patients several times before surgery to make sure they understand what features will change and what will remain the same. He wants to make sure patients are happy with the outcome.

"It should be something like ordering your 2009 Lexus," he says. "You sit with the salesman and say, ‘I’d like a beige interior,’—not ‘Oh, I hope I get a nice color.’"

Looking ahead—Gulin sees the trend for smaller procedures done earlier that will push back the need for more extensive surgery. He cites a variety of non-invasive dermal fillers that now last more than a year and are more reliable. Another trend? Moving toward the well-contoured face. "We’re looking at returning volume to the face," he says.

Needing a Complete Social History

Specializing in physical medicine and rehabilitation, Roggow says, "We need to know a person’s home situation. It will impact the rehabilitation goals. We have to take a complete social history." With physicians treating so many cases these days, she says, "patients feel as if they’re being treated like widgets. If you get to know your patients, they want to come back to you."

Looking ahead—Roggow says, "There are exciting new prosthetics and orthotics available and being developed that use electricity and biofeedback to help people walk. The Israelis just came up with a suit that compresses the body and helps completely paralyzed people walk." She’s also encouraged by endoscopic technology that’s helping stroke victims learn to swallow again.

So hail to our doctor heroes. We’re cheered by the many technical advances. And hope they all remember we widgets are people, too, and that caring counts in making sure we stay healthy.

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