In the first place, Dr. Guyther makes housecalls.
Sure, he's a small-town (Mechanicsville, Md., Pop. under 300) doctor who knows most of his patients and their families and even remembers the names of most -- well, a lot -- of the 1,950 babies he's delivered in 31 years of practice. But Dr. J. Roy Guyther is something more than Marcus Welby.
He started out, of course, as a G.P., happy to return to the Southern Maryland farm community in which he grew up. But now he's what the medical profession calls a "family practitioner." In fact, he teaches (part-time) at the Universtiy of Maryland medical school, working on a one-to-one basis with residents in the family-practice program, and he is medical director of a nursing home in St. Mary's County.
"When I first went into practice," he says, "I will tell you quite frankly, I didn't know a great deal about (promotion of heath). I took care of problems when they came in and then left a bill. I never talked to patients about health-hazard appraisal, such as, well 'If your mother had diabetes, now that doesn't necessarily mean you'll get it, but there's a 25 percent chance, but if you keep your weight down, there'll be less of a chance . . .'
"Now I spend a lot of time talking to patients and though I only see about half as many . . . I do talk to people and that's new, in a way, and it's important."
Dr. Guyther also talks to medical students about the importance of communicating, rather than just quizzing patients, and he draws from his own rich experience.
"What did your father die of," Dr. Guyther asked a patient. The answer: "complications."
Named the 1979 Family Doctor of the Year by the American Academy of Family Physicians and Good Housekeeping Magazine, Dr. Guyther's feeling for the importance of promoting health education led him to accept spokesmanship for Good Housekeeping's massive (928-pages) and rather costly ($19.95) Family Health and Medical Guide, which he feels is a good reference to help the layman understand what the doctor is talking about.
He described a recent study conducted for a year by senior medical students who sat in a physician's office and interviewed patients as they came out, asking such questions as "What did the doctor tell you about this or that?" or "What did he say to you?" or "What did he tell you to do?"
They found the patients remembered only about one-third of the physician's explanations and instructions.
Roy Guyther feels passionately about house calls."I know that so may (doctors) have given it up that a lot of people think that no doctors do it, but a lot still do. I understand those who say 'It's inefficient, not cost effective' or 'You can't do as good an examinaton,' but I think I get a lot of satisfaction and I have a lot of people who really legitimately can't come into the office.
"I think it's an essential part of family medicine. I'll wander around the house, maybe open the refrigerator and think, 'Why this person isn't getting enough to eat. There's nothing here,' or I'll see empty bottles in the trash can and I'll know, well, they're getting too much of some things. I may fuss on the way, but I never came from a house call that I didn't have a really good feeling about."