Q and A with David Loxterkamp
May 2014
By: Dr. Lisa Belisle
Dr. David Loxterkamp is a founding member of the Seaport Community Health Center and author of What Matters in Medicine: Lessons from a Life in Primary Care and A Measure of My Days: The Journal of a Country Doctor. The father of two, Dr. Loxterkamp lives with his wife in Belfast.
Being a physician is so much more complex than many people realize. You explore this theme in your writing. Yes. It’s being a different kind of person, I think, to every patient who walks in the room. Some are looking for advice and some are looking for paternalism, some need encouragement, some are there just to argue with you and to question the value of your work. That is medicine. The truth is, most of the important answers lie within the patient. If we can just elicit those answers, if we can just bring out and support those answers to their own questions, I think we make more headway for patients.
You’ve developed interest in addiction medicine. Why is that? Living in a community, and practicing medicine in that community, draws you toward its problems. Around ten years ago, I began to realize how much addiction was shaping a part of my community that I didn’t even know was there. It draws me out of my comfort zone and impels me to work with people in a way where I am not the expert. I’m certainly not an expert on the legal issues they have, and the shame they deal with, and the early life experiences that are so different from my own. It’s been a huge learning experience.
Recently you wrote an article entitled “Humanism in the time of metrics,” about the challenges of maintaining patient relationships in an era when we are asked to measure and submit numbers for everything we do. Health care providers are required to keep tabs on everything from mammograms to diabetic blood sugars. Talk to me about this. I really have no quarrel with metrics. It’s just the choice of what we choose to measure. I think the challenge for primary care physicians is to take the lead in choosing what are the most important things to observe in ourselves, and observe in our patients. One of the things that I think is very important is face time. How much time do we spend looking at a patient and listening to them? Another really important thing is to measure the power of relationships. How does the relationship change outcomes, and in what way can we develop these relationships better to achieve better outcomes?
How is your practice unique when it comes to caring for patients? There are many exciting things happening. In 2006, we joined a National Demonstration Project and became one of 36 practices in the country to look at practice transformation. In 2010, we joined the Maine Patient-Centered Medical Home Pilot. The idea of the PCMH is to bring all of the essential ingredients of a primary care practice together in one place. Soon, we’re going to have a psychiatrist consultant in our office. In addition to behavioral health, we are looking at pharmacy, lab, x-ray imaging, physical therapy, and dietary education. We also became a federally qualified health center to expand our reach to the people of Waldo County and make health care more affordable.
Why is writing so important to you? Writing has always been a way for me to collect my thoughts, and to push away all of the ambiguity and uncertainty that having a family and a family practice can bring to one’s life, and organize it a little bit better. It’s been a recreation for me.