Futures Management in the Exam Room: An Improbable Agenda


  • Robert Cutillo

  • Robert Cutillo, “Futures Management in the Exam Room: An Improbable Agenda,”.


As a primary care physician, I believe that the place my colleagues and I most often lose or rediscover our relevance is the exam room of the modern-day office visit. This is the sacred space I enter over and over with the hope of giving meaningful care. But there is a growing agenda that threatens this hope—the elusive desire to control an uncertain future. Today, at the door of the health care visit, I pick up a long list of preventive health measures and carry them into the time-limited space where a real person sits with present problems. Heavy with confusing probabilities of risk and benefit, I often find myself unable to bear the load. Or maybe what I feel is the weight of irrelevance, and I am no longer willing to lift it. I wonder how this has happened and what it would take to regain relevance.