DPC at the End
Author: Lara Kenney, MD
“The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.”
― Paul Kalanithi, When Breath Becomes Air
Direct Primary Care is exciting, inspiring, and empowering. It restores the sense of purpose and fulfillment that so many physicians seek, and it brings the joy of medicine back into the lives of those of us fortunate enough to practice in this model. I can promise you that you will not find a happier cohort of physicians than a gathering of Direct Primary Care Physicians.
I could write countless articles about the happy moments in my DPC practice, but today I want to talk about some of the heartbreaking moments. I want to talk about how Direct Primary Care has changed the way I care for my patients who are dying.
Primary care physicians care for their patients at birth, as they grow, and throughout their aging declines. The image of a humble physician keeping a quiet vigil at the deathbed has been captured in numerous stories and paintings. This was an integral part of the patient physician relationship for many hundreds of years. It was not so long ago that most primary care physicians were still following their own patients in the hospital, to the nursing home or home with hospice and doctoring them until their deaths.
Corporatized medicine has divided these moments into billable revenue streams; urgent care, primary care clinics, hospitalist services, palliative care consultants, and home health agencies.
DPC allows me to have genuine and authentic relationships with my patients, fostering a deeper level of trust and respect. DPC also gives me the autonomy to care for them on my terms. Now I can go to their bedside, offering comfort and reassurance during this vulnerable and sacred time.
The deathbed is a quiet, sacred place. In this intimate space, I find a sense of closure. I am allowed to celebrate and to grieve the culmination of life. I feel honored to have been a valued part of their story, a witness to their spirit and a part of their journey. The bitter grief is softened by the sweetness of the deep connections that were shared between us. True fulfillment lies in the relationships we form with our patients. These connections enrich our lives, reminding us that true fulfillment lies in the relationships we build and nurture.
The practice of medicine can once again be a testament to the enduring power of love and compassion.
