Your Health Care Director

Do you have a primary care doctor you love? Are you happy to see your physician at least once a year for your annual physical exam? If you answered “yes” to those questions, you are already ahead of the game. There are many reasons why people avoid seeing a doctor at all costs, but having a good relationship with a primary care physician is increasingly important as you age because it gives you a “big picture” of your health profile that can be helpful in preventing and addressing illnesses.

Of course, you will always be the best champion of your own health, but having a great primary care doctor on your team is like hiring an award-winning director to make a blockbuster film. Just as a film director oversees the planning process and coordinates the details of filming, your primary care doctor will manage your health care in the same way. Your doctor can oversee a health care plan that addresses your goals and can coordinate the different pieces that can make those goals a reality. If you’re one of the many Americans who don’t already have a primary care doctor, or if you’re taking care of a loved one who is resistant to those annual wellness visits, read on.

According to a recent publication from The Dartmouth Institute, “Older adults are more likely than ever to experience frequent, complex interactions with the health care system involving an expanded cadre of providers.” The publication, Our Parents, Ourselves: Health Care for an Aging Population, explores health care access and use across different regions in the United States. The “expanding cadre of providers” noted in the study’s comments can be a big problem.

When multiple physicians are overseeing care, the likelihood of adverse effects increases. The study found that across the United States, only about 57 percent of Medicare beneficiaries actually have a primary care doctor who directs their health care. For the Metro Atlanta region, that number falls to about 55 percent. More worrying, however, is that only about 13.5 percent of Medicare beneficiaries in the Atlanta area see their doctor for an annual wellness visit.

An annual physical exam gives your primary care physician an opportunity to get to know you. Building a relationship with that doctor year over year allows your doctor to discuss your overall health, address any changes in your health status, determine health goals, assess any changing needs, assess risk factors, and schedule appropriate screenings. Like a great film director, your primary doctor takes charge. He or she can coordinate the care you receive from other physicians, including maintaining a comprehensive list of all medications prescribed and all diagnoses, to reduce the risk of adverse outcomes such as medication interactions. With a thorough knowledge of your health care, your doctor can manage the overall health care picture.

If you’re still skeptical about why you or your loved one might need someone to be your health care director, think about these statistics: on average, our aging loved ones see 4 different physicians for their care, and that number increases to 5 different physicians if a patient suffers from chronic diseases such as heart disease and diabetes. Having a main point of contact to manage your interactions with that many doctors is crucial in improving communication among your physicians and improving your disease management. The Dartmouth study also points out that many hospitalizations could be prevented if patients had better outpatient disease management—and that begins with a primary care doctor who can direct your health care.

No one wants to be in the hospital, and no one wants to undergo unnecessary or repetitive medical testing. Yet, our population as a whole tends to resist establishing a good rapport with a primary care doctor, and the statistics reported in the study underscore how few older Americans have a primary care physician or take advantage of an annual wellness visit. Why is this? The Dartmouth publication points to health care access as problematic for many seniors, especially those who have multiple chronic conditions who often find themselves getting conflicting information from multiple doctors. Yes, with many different scenarios at play, it can be confusing to keep track of everything without a good director.

Access is definitely a factor that deters many people from seeking health care. If you do have a primary care doctor, you’ve probably experienced frustration at not being able to see your doctor soon enough when you have an immediate need. It’s often easier to go to a walk-in clinic and see someone who has no knowledge of your medical history. When seniors do make the effort to see physicians, it’s often an overwhelming ordeal accompanied by mobility challenges, memory challenges, and transportation challenges. Getting in and out of the house, in and out of a car, and sitting in the doctor’s office for hours seems more like cruel and unusual punishment than a helpful affair for many seniors.

You may also encounter resistance in older people who grew up with the notion that doctors are seen only in case of emergency. Those seniors may not accept the role a primary care physician and annual wellness visits can play in maintaining their overall health. For instance, a senior who takes medications for a chronic illness will likely not understand why she must see the doctor every time she needs a refill. Another common deterrent to seeing a primary care physician involves patients who self-diagnose and believe they need to see a specialist for a specific problem rather than starting the process with a visit to a primary care physician.

Overcoming these challenges is worth it, though. Having a primary care physician has many benefits. Share these with your loved one if you’re having a hard time convincing him to schedule a wellness visit. The primary doctor can help you and your loved one have

  • A “big picture” understanding of your health care profile;
  • Appropriate referrals to specialists on an as-needed basis (instead of self-diagnosing, let the primary care doctor determine the best person to address your complaints);
  • Appropriate routine screenings for your age, gender, and personal and family medical history;
  • Oversight of all prescribed medications, regardless of prescribing physician, to ensure appropriate treatment and prevent medication interactions;
  • Appropriate routine monitoring of factors such as high blood pressure, high cholesterol, weight, and mobility; and
  • Increased chances for a long, healthy life.

Those are all great reasons to schedule an exam soon! Call your doctor. Help your loved ones take advantage of an annual physical exam. You can have a blockbuster performance with the help of the right person in the director’s chair. And this month is the perfect time to thank your doctor for the role he or she plays in managing your health care. Mark your calendars for National Doctors’ Day on March 30th and give your director a round of applause!