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SPRING 1993 ISSUE: FAMILY PRACTICE PHYSICAL MEDICINE & REHABILITATION PSYCHIATRY

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THE MECHANICS OF CARE

Motor City citizens know just what TV commentator and author Bill Moyers means when he describes modern medicine as

"the assembly line of diagnosis and prescription." Moyers'differentiates curing from healing. Healing can occur even when
curing is hopeless. It demands "touch, talk and caring."
Moyers could have written the manual for the Sinai Family
Physician. Unlike those who, in Moyers' words, "come in, look under the hood, change the carburetor and move on," the Fam-
ily Physician listens, observes and steers you into the context of your life — your joys and your sorrows.

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Examining Your Body And
Your Whole Life

64F amily Physicians can help keep

you away from the doctor."
Dr. Robert Levine sees no contradic-
tion in that statement. A staff physician
in Sinai's Department of Family Practice
Medicine, he explains its logic by exam-
ple:
A tired, frustrated, worried mother
came to Dr. Levine with a screaming
nine-month old, clearly in pain. The
mother had suspected an ear infection
and had initially consulted an ear spe-

Department of Family Practice Chairperson Sander Kushner, D.O., right, manages a staff of
physicians who take active roles in their patients' well-being.

Beginning April 19,
Kamran Zakaria, M.D.,
left, and other members
of the Department of Family
Practice will provide care
at the Family Practice
Center—Oak Park in
addition to the Main
center on Sinai's campus.

The Family Album

hile
some
doctors
take an
individual
snapshot of
a patient or
perhaps just a close-up of an organ,
the Family Physician compiles a
family album. The result is a to-
tal portrait of your life and needs.
And new pages are always be-
ing added to the album. "Many of
the babies I delivered are still with
me as adults," says Dr. Sander
Kushner, Chairperson of Sinai's
Department of Family Medicine.
"Now I treat their babies."
The Family Physician is trained
in a three-year residency to ad-
dress all of everyone's health needs

8

— from before birth through old
age, explains Dr. Kushner.
At Sinai the residency, exams
and mandatory continuing educa-
tion address a broad spectrum of
human health needs. The family
health specialists are proficient in
gynecology, pediatrics and inter-
nal medicine, among others.
And they pursue innovation.
"This department has taken the
lead in the city of Detroit in 15-
minute, non-scalpel vasectomies,
for example," Dr. Kushner says.
No matter how specialized the
service rendered by a Family
Physician, at Sinai, Dr. Kushner
asserts that the patient's concerns
are always first. "That's a person
in there. And we personalize each
individual's care," he says.

"All doctors learn this in medical
school," Dr. Levine says. "It's just that
a Family Physician can take the time to
observe and advise. Ultimately, it can
save the patient, the employer and the
insurance company a lot of money if a
primary care physician is consulted first.
"If you're in search of a simple answer,
you've got to begin with the basics," Dr.
Levine says. The family practitioner ex-
amines not just your body, but your whole
life. The causes of illness or its aggra-
vating accomplices may
overwhelm the healing
power of any medicine
that can be prescribed.
The information a fam-
ily doctor gathers from
years of knowing you and

cialist. But even after antibiotic thera-
py, the problem persisted, as did the
family's misery.
"As we were talking, she took a bottle
out and fed the baby," Dr. Levine recalls.
"I could see the baby was being fed ly-
ing flat on its back. In this position, when
the baby swallows, small amounts of for-
mula can get pushed into the ears' eu-
stachian tubes. This can increase the risk
of ear infection.

your family can aid the di-
agnostic process as well.
Dr. Kushner reflects on
the patient who comes in
with headaches.
"We avoid being symptom-directed.
We can do a million-dollar work-up," he
says hyperbolically, "with C-T scans and
MRI's, etc. But we may know the real
problem is that the patient's husband is
an alcoholic or she has a dyslexic child.
We examine the family dynamics as well
as the patient."
"We are genuinely devoted to the gen-
eral well-being of the patient," Dr. Levine
concludes. "We really love what we do."

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