And the Best Health Care Director Is…

Having a great primary care doctor on your team is one of the best preventive health care measures you can take. If you’re like many Americans, though, you don’t have a primary care physician or you don’t see your doctor on a routine basis. Think of your health care as a movie production. You’re in charge of the picture, the vision, but you need someone to oversee the details of putting everything together. Who will you hire as your director? A primary care doctor can fulfill the role of directing your health care and help you have a blockbuster outcome!

You will always be the most important member of any health care team. After all, you know yourself and your body better than anyone else. Building a good relationship with your doctor has the benefit of letting someone else get to know you well. Your doctor will have a “big picture” vision of your health profile and be better able to address any needs you have or any illnesses or diseases you may develop. Your doctor can also be the director who coordinates all the other players—any other health care professionals assisting in your care—to be sure treatment is appropriate with your health profile and in line with your health care goals, and this big picture coordination can be increasingly important as you age.

The Dartmouth Institute published a study recently titled Our Parents, Ourselves: Health Care for an Aging Population that looks at health care use in different parts of the United States. The authors of the study say, “Older adults are more likely than ever to experience frequent, complex interactions with the health care system involving an expanded cadre of providers.” If you are an older adult, or if you’re caring for an older adult, you’ve likely found this statement to be true. The “expanding cadre of providers” the authors mention underscores the importance of having a primary care doctor who knows you and your health care profile.

When patients see many different doctors for different reasons, communication can be difficult. Without a point person directing and overseeing these interactions, problems can occur such as medication interactions or lack of appropriate treatment that takes into account all a patient’s diagnoses. What the Dartmouth publication also highlights, though, is that many older Americans (Medicare beneficiaries) don’t have a primary doctor to manage that “expanding cadre of providers.” According to the study, only about 57 percent of Medicare beneficiaries nationwide have a primary care physician. In the Greenville, SC, region, we’re doing a little better: about 63 percent of Medicare beneficiaries in the Greenville area have a primary care physician. Of those who actually have a primary care physician, though, most don’t take advantage of having an annual wellness exam. In the Greenville area, only about 11 percent of Medicare beneficiaries see their doctor for an annual physical exam.

The annual wellness visit is the tool your primary care physician uses to stay up to date on your health profile and any changes in your overall health or in your health care goals. Seeing your doctor year over year gives your doctor the chance to get to know you and ensure that you both are addressing any changing health care needs, accurately assessing any risk factors, and scheduling appropriate screenings. In addition, your primary doctor has the opportunity to review the care you’re receiving from all professionals, including keeping an updated list of all medications prescribed. This review process can reduce the risk of problems that arise from a lack of communication among health care providers.

Not convinced yet that seeing a primary care physician will be helpful in managing your care? On average, the Dartmouth study found that aging adults see about 4 different physicians for their care. That number increases to 5 different physicians for older adults who have chronic medical conditions such as diabetes, heart disease, or COPD. Yet those same Medicare beneficiaries are not, by and large, using the services of a primary care doctor to coordinate these different points of disease management. Having a point person to coordinate that many health care providers and to ensure all providers are knowledgeable about your overall health can not only lead to better management of any illnesses or diseases, but can also be a factor in preventing hospital admissions.

Of course, no one wants to be admitted to the hospital or sent for lab tests unnecessarily, but if we look at the numbers in the Dartmouth study, they reveal our overall avoidance of routine, preventive interactions with the health care system. Why is this? One factor the study points to is health care access for seniors, especially when they have multiple conditions and often receive information and recommendations that are confusing and perhaps even contradictory. Again, without the right person in the director’s chair, the health care system can be a bewildering maze.

Health care access is, indeed, a deterrent for many people in general and especially for seniors. What factors limit access? In part, limited access can come from the health care delivery system itself. Many people find it much easier to go to a walk-in clinic or urgent care physician than to get an appointment with their doctor when they need to be seen on an immediate basis. For seniors, access can be limited by physical challenges. Going to the doctor can be a painful and tiresome experience when seniors are frail, have mobility challenges, have memory impairments, or have transportation issues.

Another factor that might limit older Americans’ regular interaction with the health care system is their own mindset. For many of today’s seniors, going to a doctor without being sick is a totally foreign concept. They grew up in a time when people saw a doctor only when absolutely necessary. These seniors will be especially put off by having to see a doctor each time they need a prescription refilled, for instance. Older adults with this mindset may not be open to the role of a primary care physician, but establishing a rapport with a good primary care doctor has benefits for you and your loved ones, including

• Maintaining a comprehensive, “big picture” understanding of your overall health;
• Referring you to specialists if needed;
• Scheduling routine screenings specific for your age, gender, and personal and family medical history;
• Overseeing the full scope of treatments from different sources and keeping a complete list of all prescribed medications;
• Monitoring of any risk factors such as high blood pressure, high cholesterol, weight, and mobility; and
• Giving you greater odds of having a long, healthy life.

If you haven’t yet had your annual wellness exam, call your doctor and schedule an appointment! If your loved ones are resistant to seeing a doctor, help them overcome obstacles that may hinder their access. We all want to have a blockbuster health performance, and hiring the right director can help make that vision a reality. March 30^th is National Doctors’ Day, so it’s a great time to thank the good doctors who are involved in your care . . . or to start building a new relationship with your doctor.