Who’s Directing Your Health Care?

written by Dana Herron

Have you had your annual physical exam yet? Do you know what routine screenings you need? Who’s managing your health care? Routine visits and screenings help provide a good, overall picture of your personal health, and, as you age, having a “big picture” vision becomes increasingly beneficial in addressing and preventing illnesses.

Though you are always your best health care advocate, having the right person sitting in the director’s chair managing your overall health has its benefits. A good film director oversees the vision and planning needed to create an award-winning film. In the same way, a good primary care doctor will oversee a plan for your best possible health and coordinate all the pieces that make that vision a reality. If you don’t already have a primary care physician, we’re going to give you some good reasons to find one.

Just last month, The Dartmouth Institute published Our Parents, Ourselves: Health Care for an Aging Population about health care access and use across different regions in the United States. The study claims, “Older adults are more likely than ever to experience frequent, complex interactions with the health care system involving an expanded cadre of providers.” That “expanding cadre of providers” can potentially by problematic.

Only about 57 percent of Medicare beneficiaries across the United States have a primary care provider who oversees their care. In the Metro Atlanta area, that number falls to about 55 percent. Perhaps more alarming is that only 13.5 percent of Medicare beneficiaries in the Metro Atlanta area have an annual wellness visit.

Ideally, the annual physical exam, or wellness visit, is a time to discuss overall health, outline health care goals, assess any changes in needs, assess risk factors, and schedule appropriate lab or other screenings. The wellness visit also allows a primary care physician to perform the role of health care director by discussing the care a patient receives from other physicians, including a comprehensive list of prescribed medications, and ensuring that the overall health picture includes the parts played by any specialty physicians so there are no health-compromising surprises. Annual wellness visits let a primary care doctor really get to know a patient to be able to coordinate care when necessary.

To understand how important care coordination can be, consider that, on average, our older population sees about 4 different physicians for care, and that number rises to 5 different physicians if a patient has multiple chronic conditions such as diabetes, heart disease, and COPD. Only when all physicians are in sync regarding a patient’s care can the patient experience optimum health with fewer risk factors that result from lack of communication among health care providers. As the Dartmouth publication points out, a number of hospitalizations could be prevented with better outpatient disease management, and better outpatient management begins with the person sitting in the director’s chair overseeing the big picture.

We all want to remain as healthy as possible and prevent unnecessary medical testing or hospital admissions, so why wouldn’t we all have a primary care physician to coordinate our health care? The Dartmouth study does mention that patients, especially those with multiple chronic conditions requiring complex care, find it difficult to access health care and may get contradictory information from multiple sources regarding diagnosis, medications, and medical testing or other recommendations. The health care process can be downright confusing.

Access is definitely an issue, but not just for those with multiple chronic conditions. It’s often much easier to be seen through an urgent care facility than to get an appointment with your doctor if you have an immediate need. For many older adults, getting to and from the doctor’s office is an ordeal that’s hindered by mobility challenges, memory impairments, and transportation challenges (especially in rural areas where access to health care is often not close to home).

Today’s seniors also grew up in a world where going to see a doctor was not the norm unless there was an emergency. Challenges in getting to the physician’s office and the mindset that care isn’t warranted will deter many older adults. When seniors are taking medications for chronic conditions such as high blood pressure and the physician insists on office visits before refilling medications, the patient may look for alternative clinic scenarios where they can get the medications they need without routine office visits. Another common deterrent to seeing a primary doctor is thinking that a specific problem will require the attention of a medical specialist. The patient believes they should seek the specialist’s care first.

Helping our aging loved ones—and ourselves—overcome these challenges and getting them established with a good primary care doctor has many benefits:

  • A comprehensive “big picture” understanding of your loved one’s health care profile;
  • Referrals to specialists on an as-needed basis (instead of guessing what specialty should investigate ongoing chest pain, for instance, your primary physician can help determine if the pain is a cardiac issue or, perhaps, a gastrointestinal issue);
  • Implementation of a routine screening plan that meets age, gender, and other factors based on your loved one’s personal and family history;
  • Routine review of all medications your loved one takes, regardless of prescribing physician, to ensure appropriate treatment and prevent medication interactions;
  • Routine monitoring of factors such as high blood pressure, high cholesterol, weight, and mobility (yes, those routine office visits that accompany medication refill requests are important in ensuring the medication remains appropriate and that risk factors are under control); and
  • Increasing your loved one’s odds of having a long, healthy life.

So if you haven’t had your annual wellness exam yet this year, put it on your calendar. If your loved one hasn’t had an annual physical exam, encourage him or her to schedule one. Don’t forget that your health is the star of your life’s award-winning production, and having the right person sitting in the director’s chair can make a positive impact. If you have a great primary care physician, you’re already ahead of the game. National Doctors’ Day is coming up on March 30th, so let your doctor know you appreciate the role he or she plays!

One Response to “Who’s Directing Your Health Care?”

  1. Metta Johnson

    This is a wonderful example of why seniors in particular need a Certified Care Manager of the Aging Life Care Association to assist in coordinating and overseeing care. Our company Metta Johnson & Associates is a Comprehensive Care Management Company.

    Reply

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