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What happened to the family doctor?

Los Angeles Times, June 28, 2011

Primary-care doctors take care of the young, the old and the in-between; the sick, the well and the dying. Ideally, they're familiar with us and our family history, have a comprehensive overview of our various ailments and medicines and provide us continuity in the world of fragmented medical specialties. But their trade, they say, is getting trickier and more time-consuming, and that's fast making them an endangered species. Patients, they say, want more from their doctor these days -- more office hours, more email and phone contact, more follow-up, more coordination with specialists and insurers, more discussion about options and more expertise on more topics (aided and abetted by that constant TV-ad refrain, "Ask your doctor if X is right for you"). And the healthcare system expects more of doctors too -- more preventive services, more care for chronic diseases, more healthful lifestyle coaching, more screening for depression and risky behavior (guns? cigarettes? bike helmets?), more delicate discussions (prostate biopsy? end-of-life wishes?), more documentation and now electronic records too.