A missed opportunity?

books:


	• Heirs of General Practice John McPhee Farrar, Straus and Giroux, 1986 - 120 pages average customer review:based on 2 reviews view larger image
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First rate McPhee

A former student sent me this book after her first year in medical studies and said "finally someone who tells it like it is". Definitely NOT about urban Medibusiness or the world of HMOS and doctors too busy to doctor, instead McPhee focuses on the lives and work of young doctors in rural Maine, bringing us their story and that of their patients with compassion and without either the cloying sentimentality or the muck-raking zeal that sometimes clogs this topic. A quick read & well worth it.

A missed opportunity?

I come from a family of general practitioners - my mother was a G.P. and my sister followed in her footsteps - and I am a fan of John McPhee's writing, in general. So I expected to like this book more than I actually did. The book follows the standard McPhee schema - in-depth reporting on a very specific topic, in this case doctors who choose to work as general practitioners. McPhee provides vignettes of a dozen or so such doctors, almost all of them working in Maine.

McPhee is usually very effective in working from the specific to reach more general insights, and it is clear that he would like to do the same here. That is, by focusing on doctors who have opted out of the mainstream, he would like to illuminate some general truths about the practice of mainstream medicine. However, I think his success in doing so is limited, rarely rising above statement of the obvious. By focusing his microscope only on family practitioners working in Maine, the generalizability of any lessons they might offer is questionable. The needs of communities in Maine cannot be considered particularly representative of the U.S. in general.

So the book never really becomes anything more than a series of isolated vignettes of some individual 'maverick' doctors. Which is interesting as far as it goes, but I wish McPhee had been able to do more with the material. By the end I felt that an opportunity had been missed to write a book that would have been of greater general interest.

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Heirs of General Practice is a frieze of glimpses of young doctors with patients of every age?about a dozen physicians in all, who belong to the new medical specialty called family practice. They are people who have addressed themselves to a need for a unifying generalism in a world that has become greatly subdivided by specialization, physicians who work with the ?unquantifiable idea that a doctor who treats your grandmother, your father, your niece, and your daughter will be more adroit in treating you.?These young men and women are seen in their examining rooms in various rural communities in Maine, but Maine is only the example. Their medical objectives, their successes, the professional obstacles they do and do not overcome are representative of any place family practitioners are working. While essential medical background is provided, McPhee?s masterful approach to a trend significant to all of us is replete with affecting, and often amusing, stories about both doctors and their charges.

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