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UNPUBLISHED BY REQUEST-How to Choose a Primary Care Physician

For you and your family, selecting a primary care physician is an important first step toward managing your healthcare. Your primary care physician is the doctor that you will visit for your well visits, routine screenings, and those pesky illnesses that crop up. So it is important that you select someone with whom you feel comfortable, and with whom you can have an honest conversation.

Eisenhower Primary Care 365 is a medical practice dedicated to continuous communication with our patients. Our Internal Medicine and Family Medicine specialists and care team are available to serve the needs of our patients. Your relationship with your Eisenhower Primary Care 365 physician will be unlike any you have had before, with regular communication and unprecedented access that allows you to build a trusted and valued relationship together.

Joining the show to give you the questions to ask when searching for a new doctor is Joseph Scherger, MD, MPH. He is the Vice President for Primary Care at Eisenhower Health.
UNPUBLISHED BY REQUEST-How to Choose a Primary Care Physician
Featuring:
Joseph Scherger, MD, MPH
Joseph E. Scherger, MD, MPH, is a primary care physician with the Eisenhower Primary Care 365 program in La Quinta. Dr. Scherger is Clinical Professor of Family Medicine at the Keck School of Medicine at the University of Southern California (USC). Dr. Scherger is a leader in transforming office practice and has special interests in nutrition and wellness. He is the author of two books, 40 Years in Family Medicine (2014) and Lean and Fit: A Doctor’s Journey to Healthy Nutrition and Greater Wellness (2016, 2017). He is the 2017 President of the Riverside County Medical Association.

Learn more about Joseph Scherger, MD, MPH
Transcription:

Bill Klaproth (Host): When trying to find a primary care physician, what criteria should you consider? Here to help us out, is Dr. Joseph Scherger, Vice President for Primary Care at Eisenhower Health. Dr. Scherger, thank you, for your time today. Let’s jump into this. What’s one of the first questions we should be asking ourselves when choosing a primary care physician?

Dr. Joseph Scherger (Guest): Well, the first thing is to realize that your primary care physician is your personal physician. It should be the go-to person to help you navigate the healthcare system, coordinate your care. Usually, the primary care physician can handle about 85% of the reasons you might need a doctor – everything from getting your flu shots, to handling the flu, or bronchitis, or abdominal pain, or a headache.

And then if your care requires a specialist, the primary care physician can make that referral and coordinate the care. People often make a mistake thinking what specialist they might need. They might say they need a rheumatologist where an orthopedist is preferred or that they might need a neurologist when really, they need an allergist. It’s hard for people to sort that out, and obviously, your primary care physician can do that.

It’s also the person that should be helping you become healthier that provides your preventative medicine to lower your risk factors for disease – whether it be heart disease or cancer or even dementia, for that matter. It’s a personal physician, and the question is where do I find the right fit for me? Word of mouth has always been the best way to pick a doctor. Talk to other people, say, “Do you have a primary care doctor that you really like that helps you?” If they answer, “Yes,” well, tell me more about that person. It’s kind of like picking a member of your family. It’s picking your partner, and the chemistry needs to be there, even the philosophy of care should be there.

Bill: Such an important relationship, and I think that’s a great tip. You were talking about finding a personal physician. Dr. Scherger, is there a difference then, between a personal physician and a family medicine physician or are those one in the same?

Dr. Scherger: Well, primary care comes in different specialties, but the bottom line is it’s your first contact for care. Family physicians are able to care for adults and children, and if your family includes both, that can be quite convenient. Even if you’re adults -- if your grandchildren are visiting and have a need for a doctor, the primary care physician – if it’s a family physician – is able to do that.

Internal medicine physicians specialize just in adults, but a general internist does provide that primary care. There’s really no difference in the quality or standard of care between a family physician taking care of adults and an internal medicine physician taking care of adults. At Eisenhower, we blend family doctors and internists together in the same group doing the same thing with adults. I’m a family physician. A lot of people will say to me, “Dr. Scherger, you really are a good internist,” and I smile and say, “Thank you,” but I remind them that I’m actually a family physician. There really isn’t any difference in how we manage high blood pressure and high cholesterol, things like that.

To round out primary care, there are pediatricians that take care of only children and some gynecologists have become women’s health-oriented primary care physicians taking care of more things than just the reproductive organs. In our group, we actually blend all four of those primary care doctors, although, at Eisenhower, the family doctors do the pediatrics.

Bill: Okay, since you were talking about the primary groups, can you tell us about the primary care groups at Eisenhower? You’ve got Traditional Primary Care, Eisenhower Primary Care, 365, and Concierge Physicians. Can you tell us the difference between those?

Dr. Scherger: Yeah, the main difference is how much time and attention your primary care doctor is able to give you. One of the problems of just traditional primary care is the doctors’ time with the patient is usually limited to about 15 minutes in a visit, and that’s not always enough time to get everything done if you have five or six health problems and you’re taking seven or eight medications. You may want to what I say, buy-up your primary care, to get more time and attention from a primary care physician and also make that physician accessible even after hours.

The alternate of that is a concierge doctor where you have the doctor’s cell phone, and you’re able to call that doctor 24 hours a day, 7 days a week directly to their cell phone, not having to go through an answering service or covering other doctors who may not know you. To have that kind of a relationship, you pay the most money for a concierge doctor, and that doctor will only take care of between 200 and 400 patients to provide that intensity.

We started at Eisenhower as kind of a hybrid between concierge medicine and regular primary care that we call Eisenhower Primary Care 365. What we do rather than the cell phone is we do 24 hours a day, 7 days a week responsiveness online. We do have an on-call 24-hour number that we cover. I was on-call all last week and handled physicians’ phone calls last week, including over the weekend. The patients will communicate online, and within 24 hours, we always respond directly. You have this direct line to the doctor. You don’t have to go through other people to communicate directly to the doctor. That online platform for communication and care is quite convenient. Last week, I saw a patient who had a chest infection that I treated with an antibiotic, and over the weekend, the spouse of that person wrote and said, “I’ve come down with the same thing my husband has, what should I do?” Based on her symptoms, I immediately treated that over the weekend, so we could get her treatment early. Both of them, would be at risk of pneumonia and certainly, a more serious outcome. That kind of convenience--

But the other thing that – in 365 and Concierge – we can do very intense health coaching and preventative medicine in terms of nutrition, exercise, and lifestyle to keep people healthy. And again, we have more time to apply those things, but it does require a premium because insurance companies don’t pay primary care very well. It’s a very small percent of the healthcare dollar. A higher level of primary care is something that the patient has to buy into.

Bill: Well, that’s certainly an impressive level of care and options available, that’s so nice to have. You were speaking of word of mouth earlier when choosing a primary care physician. Can you quickly touch on geography and if we should consider gender in our primary care physician?

Dr. Scherger: Those are good questions. We divide the Coachella Valley into three regions. The West is Palm Springs and Cathedral City, and then the central part of the valley with Rancho Mirage and Palm-Desert, and Indian Wells, and then of course, out East in La Quinta and Indio. We have offices in all three of those regions, so depending on your age and your ability and willingness to drive, most people will pick a primary care physician in the region that they either live or work. That’s one thing to consider for the convenience of having your doctor nearby. Now, the age of the doctor – we have doctors right out of training all the way close to retirement. We even have one of our primary care doctors over the age of 80 who is still going strong. You might pick your doctor somewhat based on age and experience.

And then women – sometimes women prefer to be examined by another woman doctor – feel like a woman doctor might understand them and their concerns better. We have an even mix of men and women and a range of all ages, but I would recommend you don’t get overly fixated on that and keep an open mind because you may find that the best doctor for you doesn’t exactly fit the category that you might think right from the beginning. You need to test it out. It’s good to visit primary care doctors for a problem maybe before you settle into -- it’s kind of like dating, and before you’re going to pick your mate, if you will, as a primary care doctor, you might want to try out a few and see whether the chemistry is there.

Bill: That’s such good advice, Dr. Scherger. Thank you so much, for that. Just to make sure we cover all of the bases, just to wrap it up, I also want to ask you about other private practice physicians offer a fee-for-service option. Can you explain that to us quickly?

Dr. Scherger: Sure. I believe what you mean by that is what’s called Direct Primary Care where the patient pays the doctor on a fee-for-service basis. That is an amount of money per visit. That can be another way where your care is pretty similar to 365. Usually, those doctors have more time with patients because they’ve lowered their overhead by not dealing with the insurance companies. In many ways, most insurance companies are still fee-for-service, but the fee is determined by the insurance company, and the patient might have a copay. Usually, with insurance company fee-for-service, the primary care doctor is under pressure to see quite a few patients.

At Eisenhower, we prefer quality over quantity. Even in our regular primary care doctors, we do not have them seeing too many patients, like 30 or more patients a day, because we don’t think that’s high quality. It’s not Eisenhower’s Healthcare as it should be. WE, even in our regular primary care, in a fee-for-service model, give the doctor more time with the patient than you would find out in a lot of private practices.

Bill: Well, Dr. Scherger, thank you so much, for your time today. For more information, visit EisenhowerHealth.org, that’s EisenhowerHealth.org. This is Living Well with Eisenhower Health. I’m Bill Klaproth. Thanks for listening.