Philosophy of Practice

What many patients want nowadays is personalized care, the kind that the family doctor provided back in the "good old days".

Dr. Fong provides personalized care by providing all-round and continuing care. That means, because he is a generalist family doctor, with broad training that cuts across all organ systems, he can take in most any problem that the patient presents and devise a solution for it. The solution may be a prescription, a treatment, a test, a procedure, referral to a specialist, or hospitalization. Because it's all-round care, the care can be personalized and tailored to the individual as a whole. Further, this all-round ability to take in all problems enables the patient to come see him repeatedly for different matters, and thus he gets to know all the patient's problems, not just those of one organ system; plus, he also gets to know the patient more personally. Thus, he becomes an "expert" on the patient, and can personalize any care he delivers.

All-round and continuous care also means that the patient is looked at, not not just as a body part or an organ system, but as a whole individual, and all the problems, not just piecemeal, followed up. All-round care means attention to how all the patient's different medical and other conditions, as well as the lifestyle and activities, interact, plus how all that and the proposed treatment may interact. Also, because Dr. Fong is a generalist doctor, he can follow up several problems at one visit, thus enabling him to balance all the treatments and conditions, and to intervene in a more timely manner.

This kind of all-round and continuous approach is especially important in older, sicker, more complex patients with multiple ongoing chronic medical conditions. Not only do multiple conditions often interact with each other to give confusing signs and symptoms, but also they require multiple treatment regimens that often adversely interact with each other. An all-round and continuous care approach is much better suited to efficiently following up on multiple conditions, figuring out the myraid signs and symptoms, fine-tuning and balancing or mitigating the contradictions that arise with the different treatment regimens, and thus optimizing the overall outcome. Further, the more efficient follow up of multiple conditions at one time can often mean that problems that arise can be dealt with early, without waiting, when they are still mild and easy to solve, which is often of critical importance in older, sicker, more complex patients.

Also, Dr. Fong believes that a generalist doctor, by dint of his broad, overall training, experience and outlook, which cut across all body organ systems, is often the professional to go to for figuring out which body organ system a symptom or a problem comes from, especially when the disease is at an early stage. Sometimes the source of a symptom may not be obvious at all, as the shoulder pain that is not an orthopedic problem but actually a cardiac one of angina.

Dr. Fong also believes that, again due to broad training, experience and outlook cutting across all body organ systems, a generalist doctor is often the professional to go to for evaluating and managing vague, undifferentiated symptoms that come from diseases showing up at a very early or a very mild stage. At such stages of disease not only is it often difficult to decide which body organ system such symptoms come from, but also it is often difficult and sometimes impossible to distinguish them, even with very expensive and potentially harmful invasive testing, from minor, transient illness or illness with a strong psychological component. A generalist doctor who is used to evaluating, managing and following such symptoms can avoid testing up a number of long expensive blind alleys and the subsequent delays to or even abandonment of timely diagnosis of potentially serious disease. Instead, skilled, close follow-up, along with appropriately timed and carefully chosen tests or therapeutic trials, can often lead to timely diagnosis and appropriate treatment.

Dr. Fong believes that the essence of generalist care is not comprehensiveness, as in one doctor doing it all, which is only a remote area or horse-and-buggy-day scenario. The essence of generalist care is first, a broad focus, on the overall patient, and second, training, experience and outlook that cut across all body organ systems.

Dr. Fong definitely does not consider himself to be merely a "gatekeeper".

Even when it comes to referral to a specialist colleague, Dr. Fong provides value by ensuring an appropriate referral, to the appropriate specialist. Also, by giving the specialist colleague input when necessary about the overall picture of the patient, Dr. Fong helps the specialist customize the patient's care. Furthermore, Dr. Fong can coordinate the care among different specialists.

To provide personalized, all-round and continuing care means that Dr. Fong sees his patients when they are hospitalized. He admits his patients to the John Muir Walnut Creek hospital and will go to the hospital to see his patients throughout their stay. When his patients are admitted under a specialist colleague for say, surgery or for testing, he will also go see them if requested and work together with the other doctors to provide all-round care during the hospitalization.

Again to ensure continuity of all-round care, Dr. Fong sees his patients when they go into the nursing home. He goes to all four nursing homes in Walnut Creek.

Also, to help ensure continuity and timeliness of care, Dr. Fong has extended hours on Saturday mornings.

Finally, as part of continuity and timeliness of care, Dr. Fong is available to be reached by his patients for urgent matters after hours.

Dr. Fong also deliberately keeps his office small, with one doctor only, so that the staff get to know the patients and their needs on a more personalized level.

Dr. Fong's commitment to personalized care is career-long and unchanging.

The Oath of Hippocrates (ca. 300 B.C.E.)

Dr. Fong stands by this famous oath. Click here to see the full text of the Oath.