#1 Dinosaur wrote a really good post a few days ago about what the proper role of a doctor is. The ensuing discussion seems to show that there is no clear consensus among doctors about just what our job is. Is it an opthalmologist's job to counsel her patients on weight loss and smoking cessation - given the opportunity - or not? My take on this question is the following: the doctor's job is to serve the patient. To that end you, as a practioner, are functioning broadly within either one or the other of two capacities. You are either a) addressing a patient's complaint or b) identifying things for which it is appropriate to screen a patient and providing said screening. Capacity b) is relevant only in situations when a patient would want and expect to be screened for things. Examples would include routine physical's, well woman visits, well child visits, prenatal appointments, etc. Nobody ever goes to the emergency expecting to be screened for things. Nobody ever goes to their cardiologist expecting a refferal for a mammogram. Nobody goes to their dentist expecting a prostate exam. Or, maybe they do. In which case, by all means, take care of whatever primary care needs your patient has - one stop shopping, as it were. They'll thank you for it. But, the bottom line is, whether you're a doctor or any other kind of service provider, if you are trying to provide a service which isn't being requested of you then you're not doing your job very well.
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