Medscape Psychiatry and Mental Health recently published an article on Saving Primary Care that certainly got my attention.

Trained as a primary care doc myself, I firmly believe that as a society, we’ve got our priorities screwed up and the value chain inverted. Primary care doctors are the gatekeepers and guides for how patients use the rest of the medical system, and therefore, they are the first line of defense.

The discovery of antibiotics was found to be a first line of defense, and it revolutionized the practice of medicine.  So would a robust, thriving, and reformulated practice of primary care.

Supporting and investing in primary care docs for the time they spend as PARTNERS with their patients would reap enormous benefits to everyone. The educating, guiding, coaching, and healing that can occur through a great relationship with your primary care doc should be the amongst the most highly compensated interventions, not at bottom of the heap. For those are the activities that result in people learning how to take care of themselves such that they avoid coming down with chronic, degenerative, costly diseases that over time eat up huge amounts of medical resources.

What’s emotional intelligence got to do with it? There’s got to be a fundamental shift in attitude that drives how our broken medical system is rebuilt.

Just as all of us individually need someone to give us primary care [after all, why do we seek intimate and primary relationships?], primary care practitioners should get our deepest respect, translated into status and monetary value.

[Isn't this a "duh" moment?  I mean, isn’t primary care called primary because that’s what it is? It’s PRIMARY. It’s IMPORTANT, listen up everyone! Yeah, I know I’m being repetitive and yelling, but it seems like the powers that be still don’t get it.  That's why I started Heart of Healthcare, to facilitate leaders in making these kinds of fundamental shifts.]

Healing requires compassion and empathy. And today, primary care in particular needs healing, if healing is to become a mainstay of health care. Truly, it needs resuscitation.  Soon. Healing, based in wholeness and compassionate caring, is what allows people to become healthier. Healthier people are what will drive health care costs down. I can’t make it any simpler than that, folks.

[I tell you, it really gets me, how the most important jobs in society get the lowest (or relative lowest) compensation, childcare workers, teachers, ministers of all denominations who tend to the Spirit, and primary care docs. This speaks poorly to how we measure success as a society and a culture, but this is a post for another time.]

Of course, we need the highly trained specialists who spend 12 years in training to come in as the knights in shining armor to save the day when needed [And yes, I also believe they should be well compensated.]

But when will we start to value that which society and healthcare system need to flourish – healthy people able to take care of themselves because they’ve been educated, guided, tended to, and cared for by physicians who are there specifically to provide that most fundamental connection, guidance, and education for health?

We each need someone to “stand by me”, always, always, always. Well, primary care docs are those folks in healthcare, whether they’re on active duty or on reserve. If we want them there, we need to stand by them.

And in that spirit, I invite you to take 5 minutes to watch and listen to this gorgeous video that was produced by the group “Playing For Change.” Listen to this every day, and your life will change!

At one point on New Year’s Day, in a fit of zeal to create yet more order, I found myself lying on the floor cleaning out old wadded up Kleenex and a dense mat of cat hair that had accumulated under the bed (obviously beyond the reach of the vacuum cleaner, and yes, I am not a compulsive cleaner)

So there I was, lying on the floor, arm extended as far as possible, neck awkwardly cricked as I clawed and raked up the cat hair with my hand, compliments of Guy and Chloe, my two spoiled gorgeous long-haired cats.. Not coincidentally, as I was doing this, I was thinking about and feeling down about what I haven’t accomplished yet though have certainly intended.

I guess this habit comes from being Jewish and growing up with the significance of the ten days that begin with Rosh Hashanah, which marks the Jewish New Year, and ends with Yom Kippur, the Day of Atonement.

On the Day of Atonement, we seek to become at-one with ourselves and others for the ways we have missed the mark in the previous year. So it can be a time of mourning (even in small ways), giving ourselves forgiveness and seeking forgiveness from others, and subsequently, it serves as a cleansing. It is this cleansing that allows us to begin anew.

But where was I, oh yes, I was on the floor….when I realized what a great metaphor it was to be finding the floor again at this moment in the year when it is our collective obsession to think about new beginnings.

I mean it really felt good, crouching and lying in these awkward positions yet determined to clear out the gunk. Yom Kippur as the Day of At-Onement is all about paying attention to the details. [Not having a habit of yoga, but having done enough of it over the years to know, I think it’s fair to say that being on the floor like this was a kind of yoga.]

So here’s a secret of mine…I know this may sound a little weird but finding the floor is an ongoing life preoccupation of mine.

If there’s any possibility you’ve had less than perfect parenting (despite their best intentions of course), then you may have some holes in your floor or gunk (as in the form of relational, mental, emotional, energetic if not actually physical stuff) making it hard for you to find the floor.

I certainly do, and at times, I suddenly have this panicky feeling that I’ve fallen through the floor, and am quickly being swallowed up by a pit of quicksand. Now even though I’m trained as a psychiatrist (one of my many identities), I’m not sure just how many others have this particular experience, but I know I can’t be the only person who mostly always looks like I have it all together, yet inside we’re still wondering who the heck we are, or who we want to be when we grow up.  [At this point, however, I can unequivocally say that I have never wanted to think of myself as Ms. Peter Pan-nette].

My point is, that sometimes you really have to get back on the floor, clawing away the dirt, the muck, the cat hair, or whatever form of crud is keeping you from experiencing the solidity of your own floor to get back to that clarity and knowing of who you really are, your own solidity. You’ve got to get real. [I have always loved this quote from The Velveteen Rabbit]

And first, of course, you’ve got to look under the bed and to acknowledge that yes, indeedy, there is dirt [aka negativity] there - under the bed - where no one can see it but you.

In order to be a conscious human being, which has always been one of my aspirations (doubtless a legacy of being a child of the 60’s), you simply have to take the time to remember who you are, the Soul You, not the Personality-Wounded You.  And yet, at the same time, you have to acknowledge and have compassion for the Personality-Wounded You.

Connecting to the self, like vacuuming the floor including under the bed (sigh), is an ongoing discipline. It’s a mindfulness practice.

[This is kind of like going to the doctor, and being told that if you really want to feel good, you need to stop eating Kentucky Fried Chicken, stop smoking and caffeine (even if you're macrobiotic), eat lots of vegetables, and start exercising at least 3 times a week.  Now. Right. But hopefully, sooner or later, the pain of what’s not working requires us to let go of the old, accrued, gunk that keeps us from being the best we can be]

Some resistance is normal until, the new habit kicks in, and then, there’s typically a profound sense of relief and well-being that starts to feed on itself. That’s what we’re all looking for, right? More ease, more well-being, whatever those mean to you.

And of course, it’s very possible you will continue to feel resistance, and that’s okay as long as the resistance doesn’t become the habit.

Most of my clients and friends, know what practices keep them connected to who they are, that serve as their floor that supports them. For one, it’s playing her violin. For another it’s meditation and yoga. For another, it’s journaling. For me, I have come to learn that it’s exercise, meditation, and writing.

I talked in my last post about being in the flow, but to have flow, first you gotta get real and have at the floor!

I’d love to hear how you stay connected to who you are!