The staff at Roper St. Francis Physician Partners includes, left to right: Norma Fairchild, who is Dr. Wilson’s nurse; Dr. William Wilson; Dr. Demetrios Papadopoulos; Nancy Bennett, who is Dr. Feller’s nurse; Dr. Mitchell Feller; and Sandy Wagner, who is Dr. Papadopoulos’ nurse.


primary care clerkships because, “I had found out where my heart really was.” After receiving his medical


degree in 1977, Feller was accepted as a resident in the Department of Family Practice at the Medical University of South Carolina, a newly developed program that was attracting many of the brightest and most dedicated students from medi- cal schools throughout the nation. “The focus of our training was on the doctor-patient interaction, as well as on the diagnosis and treatment of particular disorders. Particular attention was given to teaching the essentials of the interview, or office visit, which was a revolutionary innovation at the time. Most important was how you spoke to patients, how well you listened to them and what you could do to facilitate their compli- ance. We learned to develop a


long-term care plan for each patient, based on where you hoped their health would be in 20 or 30 years and how you could help them get there. You learned to use everything at your disposal – your senses, your sense of humor, the power of hope, and, most of all, your undivided attention and ability to listen,” he explained. His residency in family medicine included such innovations as train- ing in family dynamics and family therapy, group therapy and role playing, virtually all of it videotaped and critiqued by more experienced attending physicians. “Te acute awareness that every


part of the encounter mattered and affected the outcome of the whole constantly forced your awareness into the matter at hand at that moment. We learned to be truly engaged,” he commented. “In family practice,” Dr Feller


believes, “you have to let people tell you what’s wrong with them. And it’s never a linear story. Tere are always detours and side trips. Te goal is to sort through the dialogue and shape a coherent interview with a plausible theory as to what’s wrong. In the words of medical icon Sir William Osler, ‘if you listen carefully to the patient, they will tell you the diagnosis.’ I think that for people to feel like their encounter with their doctor has been produc- tive, they need to feel like they’ve been heard.” In Dr Feller’s experience, a high


percentage of patients have emo- tional, psychological, socio-econom- ic or family-related issues that impact their health and are impor- tant to any meaningful diagnosis. Tat’s why a planned 15-minute consultation can often stretch to an hour or more, and that’s one of the reasons primary care is attracting


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