Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

The Physician-Citizen—Making Health Accessible to All


Part I of II: Why being “bedside” in our patients’ communities matters.

Health as a reflection of our social environment


At some point during medical training, every physician realizes that medicine alone can’t give health to their patients. Health reflects not only the wellness of an individual, but is also linked with a social environment that makes life meaningful. Inequities in levels of health in different communities are widening in the United States and around the world.


The physician-citizen


Most health disparities that face individuals and communities aren’t rooted in a biological solution, and thus the tools we’ve gained in training, from knowledge of pathophysiology to hands-on surgical techniques, can’t shrink the gap. Reaffirming medicine as a public trust demands physicians take on a dual role: that of physician-citizen.


Know your patient’s community


“Know the science, know the patient”…and know their community.  The quotation is from John Burton, MD—my addition of the community, I believe, is warranted now more than ever. How non-biological factors impact our patient’s health outcomes can’t be ignored as we train this generation of physicians. Knowing the complete spectrum of a patient—from individual to community—assures that appropriate care with adequate resources are allocated to them to achieve the best possible health.


Making health accessible for all will need physicians-in-training to be out in their patients’ communities. Doctors aren’t made by medical knowledge alone—it’s their interaction with patients and their bedside presence that creates and affirms the identity of a doctor. Similarly, becoming a physician-citizen demands we’re “bedside” in the community where our patients live and will continue their medical care.


Why I get out in my patient’s communities each week


Throughout my career, going into the community has felt like the right thing to do. It’s provided me great insight into the many variables that impact my patients’ health care, like access to healthy food, the safety of exercising outside, accessibility to a pharmacy, and public transportation options.


Joint accountability


I continue to go out into the community weekly, meeting with community members and leaders, and discussing how to best approach a specific health concern. We all have equal say in these community health interventions, which results in a joint accountability for the health of our local residents. The great doctor will not just treat the disease, but the patient who has the disease, and, by extension, help to heal the patient’s community.


Tomorrow, read top tips for how to engage in YOUR patient’s community.