The Value and Role of Primary Care Providers

Are you one of those folks who call a gastroenterologist for a stomach
bug? Do you Google ENTs when you get a sore throat? Do you go
straight to an urgent care clinic for a minor health issue? The truth is,
a primary care physician (PCP) can help with the majority of your
everyday ailments.

In this podcast, Dr. Elizabeth Lowe, Medical Director of Primary Care
Physicians at MarinHealth, explains the value of a PCP, the doctor in
charge of your overall health. Find out how a PCP can help you
manage or even avoid common chronic diseases. Learn why it’s
especially important to have your own doctor during a pandemic. And
get tips on choosing the primary care provider that’s right for you.
The Value and Role of Primary Care Providers
Featuring:
Elizabeth Lowe, MD
Elizabeth Lowe, MD is the Medical Director of Primary Care Physicians. 

Learn more about Elizabeth Lowe, MD
Transcription:

The Value and Role of Primary Care ProvidersBill Klaproth (Host):  We hear the term Primary Care Physician or PCP. So, what does that exactly mean? And why do you need a PCP and what is their main function? Well let’s find out with Dr. Elizabeth Lowe, Medical Director of Primary Care Physicians at MarinHealth. This is The Healing Podcast from MarinHealth. I’m Bill Klaproth. Dr. Lowe, thank you so much for your time. So, let’s start here, can you explain to us exactly what is a Primary Care Physician or a PCP?

Elizabeth Lowe, MD (Guest):  Primary Care Physician is just like the words suggest, it’s the first person you would approach if you’re obtaining healthcare. Usually, it’s the first line of defense and the first person you should ask with any general medical question, be it Pediatrician or Adults.

Host:  Okay so a Primary Care Physician then is also what we would call a Family Doctor?

Dr. Lowe:  Exactly. More of an antiquated term is the Family Doctor. Now we separate it into categories. An Internist is general Internal Medicine, usually age 18 and over. Family Practitioner will span that whole age range from birth to death. A Pediatrician is anybody from birth to age 18. And then OB-GYN is usually lumped in with Primary Care because a lot of women of childbearing age tend to see their OB-Gynecologist for most of their routine healthcare, things related to that age group.

Host:  So, then why do people need a PCP, if they have the ability from their insurance carrier to self-refer, what does a PCP do for someone?

Dr. Lowe:  PCP because they are that first line into the field of medicine, is usually the primary place people should start if they are seeking medical care rather than going immediately to a specialist or a subspecialist. Generally speaking, a Primary Care doctor can answer a lot of the questions or begin to solve a lot of the initial problems and then they can determine if you need to be referred to a specialist or a subspecialist. And most insurances tend to frown upon direct referral. It depends a lot of times on someone’s insurance. So, if you have an HMO plan, you would be obligated to start with your Primary Care doctor for that then secondary referral. Whereas a PPO would refer themselves directly to a specialist but most of the time you over utilize the specialists if you refer directly.

Host:  So during COVID-19, it seems like we’re hearing a lot of call your physician if you have symptoms. So, it feels like now more than ever, it is important to get a Primary Care Physician. Is that right?

Dr. Lowe:  Correct. The Primary Care Physicians have really been the “frontline” workers outside of the hospital. They have been the ones in charge of having the up to date information for who should obtain testing, how it should be managed, and any advice given because the literature is constantly changing. That is the responsibility of the Primary Care doctor to have the latest information.

Host:  So, the CDC says that six out of ten adults in the US have a chronic disease and four out ten adults have two chronic diseases. So, it sounds like a PCP can help someone avoid being one of those statistics especially if the PCP is the initial problem solver. Is that correct?

Dr. Lowe:  That is correct. The Primary Care Provider is often the screener. We’re screening for any potential medical problems. So, we are screening for high blood pressure, we’re screening for diabetes, we’re screening for colon cancer, we’re screening for breast cancer or cervical cancer. Because we have made that diagnosis, it then becomes the responsibility of the subspecialist to then help treat those problems but we ideally, like to catch them very early so that we can either institute lifestyle changes, and exercise and diet in addition to any sort of medical medication therapy. And then we will, if it becomes more complicated, then we refer to a subspecialist. But for the most part, most diseases if they are caught early can be managed prior to seeing a subspecialist.

Host:  So, it sounds like a PCP really covers a lot of ground. Can you tell us what types of things a PCP can do for a patient?

Dr. Lowe:  A PCP can help comanage any chronic disease along with their subspecialist. A lot of times we communicate back and forth, and we will comanage a variety of illnesses. PCPs also maintain any sort of routine wellness exam ensuring that we are keeping our patients as healthy as possible according to their age group and recommendations. At routine health visits, we are monitoring vital signs with the hopes of catching early heart disease, early high blood pressure, early signs of diabetes or any other infection or disease. We do preventive care including immunizations, both of the pediatric population as well as the adult population. The Pediatrician is also monitoring closely the development of a child and can and will intervene early if the child is not meeting those developmental expectations. We are always taking family history, taking a social history, making sure that the patient doesn’t have um any increased risk at – for a disease based on family history or that their lifestyle or habits ate not compatible with healthy living. We are usually the single point of contact for a patient’s full medication list. Most subspecialists are going to be just looking at the medications they prescribe. We are usually and frequently tasked with trying to pare down a medication or make sure there’s not an interaction or make sure that we’re not doubling up on a medication because the subspecialist hasn’t had access to the complete medication list or hasn’t been speaking with other subspecialists. So, lots of times we are that single point of contact for as we say, polypharmacy, multi medications.

And then we also refer to specialists as needed based on a particular complaint or newly diagnosed disease.

Host:  So, if you are wondering why you need a PCP, there you go. What a list. Oh my goodness. So, that should convince you and explain to you why you need a PCP. Okay so, now that we’ve done that Dr. Lowe, what should be considered when selecting a Primary Care Physician?

Dr. Lowe:  If you think of the Primary Care Physician as the “quarterback” on your team, you have to decide what approach to your healthcare you like to take. So, I recommend finding someone either a referral from a friend or from a trusted family member or maybe your specialist as far as who they might recommend for you because someone who knows you well might be able to pair you with a provider who will be a match. Because it’s a long term relationship, a Primary Care relationship can be a very long term relationship. In my practice I have patients age 13 to 105. So, some people will state a preference such as gender. Obviously, you would want to know if someone speaks another language if you have another language that’s your first language usually that is made readily available whether or not a provider speaks a second language.

For a lot of people, especially the elderly, I recommend having a provider who is close by because if you need to get out to see your doctor, it’s always much nicer to have someone who is close by. I live across the Golden Gate Bridge and frequently some of my patients are in the city traveling to San Francisco and they will then decide to stay here in Marin county to find a provider because it’s much easier than crossing a bridge. And also accessibility, whether or not providers are taking new patients because sometimes that’s difficult to find a provider or based on an area who is currently accepting new patients. And more and more, these days with COVID-19, I would be querying whether or not the physician uses email or the phone or a Telehealth visit which is now more important than ever. And some will look at hospital affiliations. Most physicians are affiliated with a hospital but not obligated to admit their patients to a hospital.

Most Primary Care doctors now also use what’s called a hospitalist which is a predominantly hospital based physician who would care for their patients when they are in the hospital. Not all, but most do now. And then obviously, anyone who is contracted with your healthcare – health insurance.

Host:  Okay, well that makes sense. I love how you said that. You’re looking for the quarterback of your health. That’s a great way to put it. So, I hope you’re able to find your Joe Montana or your Steve Young or even your Jimmy Garoppolo.

Dr. Lowe:  Exactly.

Host:  And then last question Dr. Lowe and thank you so much for your time. Where can you find a list of physicians to select from?

Dr. Lowe:  So, I recommend either starting with your health insurance plan, but a lot of plans don’t always keep up to date with physicians who are currently enrolled in their plan or participating physicians. So, my first thought would be to based on name recognition if you are looking for a particular provider to look them up online or here at MarinHealth we have started a physician referral single point of contact hot line where you can call and be paired with a number of Primary Care Physicians who are currently accepting new patients. And that will hopefully streamline that process so that you don’t have to make a multiple phone calls to find a Primary Care Provider.

Host:  Yeah, the MarinHealth online tool is very useful where you can sort from affiliated physicians and this too has been very useful. Thank you so much for your time Dr. Lowe.

Dr. Lowe:  You’re so welcome.

Host:  That’s Dr. Elizabeth Lowe and for more information please visit www.mymarinhealth.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is The Healing Podcast brought to you by MarinHealth. I’m Bill Klaproth. Thanks for listening.