Family Practice is better than Family Planning: From a Doctor

Tuesday, June 10th, 2014 by Dr Joan F.

I am a family doctor by training.  The specialty of family practice emphasizes “patient centered care.”  Family doctors often have philosophical differences in how they approach medical care, compared to doctors from other Western medical specialties.

Family doctors believe:

  • A patient must be an active participant in their medical care.
  • The relationship between a doctor and their patient is a critical component of good medical care
  • Emotional health is not separable from physical health
  • A patient’s family and community are important participants in their health care
  • Noninvasive approaches are always the preferred option

I saw my first abortion during my third year of residency training in Family Practice in NYC.  I had the opportunity to get trained in abortion procedures at Planned Parenthood.  There were many excellent and caring staff and doctors, but I felt that the model of abortion services was not consistent with family practice principles of medical care. I observed what I would call a ”family planning” approach to abortion care, and I thought there should be a better way.  I realized that the field of family practice had an important contribution to make in the area of abortion services.

What is a “family planning” approach to abortion services?  Medical care is focused on the procedure, not the patient.  Everything is organized toward an efficient model of care.  Patients are seen by multiple staff members for vital signs and lab testing, ultrasound, counseling and consent.  The patient never gets to talk with the doctor about their options.  They meet the doctor in the operating room, right before their abortion procedure.  Companions or family members are not able to participate in any of the medical care.  A patient must see a counselor to talk about their decision, whether or not she wants to be counseled.

This “family planning” model of abortion care was inconsistent with my training in family practice.  I felt that the principles of family practice were especially relevant to abortion care.  It was important for a woman to meet her doctor and have the opportunity to talk about her decision, her abortion options, and expectations.  It was important to have a dedicated staff member, rather than multiple people involved in the abortion care.  It was important to be able to include a friend or family member in the medical visit.  It was important to use the most noninvasive methods available.  It was important that the emotional aspects of having an abortion were part of the medical care and not dealt with separately.  It  was most important that women have a positive medical experience while going through a difficult situation of an unwanted pregnancy.

In the next years, I developed the Early Options model of abortion care. Early Options is a pioneering family practice or primary care based approach to early abortion.

The Early Options model is consistent with principles of family medicine:

  • You meet your doctor to discuss your options and to feel comfortable with your medical care;
  • You have a dedicated clinical assistant to support you during your entire visit;
  • You are able to include your husband, family member, or companion in any part of your medical visit;
  • You are offered noninvasive,  nonsurgical early abortion methods: the Manual Vacuum Aspiration Procedure, and the Abortion Pill;
  • The entire visit is organized to support a positive physical and emotional medical experience;
  • Early abortion care is part of medical care, and not a “segregated” medical service.