“The world moves at the speed of trust.” — Stephen Covey
Over dinner with some friends, we discussed how trust is essential to the healing process and a key to medical decision-making. It came up because their adult daughter had a cardiac issue that had been evaluated by multiple cardiac specialists at the Texas Medical Center and even the Mayo Clinic. It seemed there was no consensus on treatment plans.
What to do? My wife, the other Dr. Sierpina, insightfully asked, “Who is the quarterback?” In today’s highly specialized, technological fields of medicine, each expert knows their own field deeply but may be isolated in a silo from the big picture: Who is this person? What are the factors that play into her decisions? What’s her level of education? Her family’s knowledge of medicine? What are her personal preferences and fears and risk tolerance? What’s her overall health status?
The principles of family medicine and good primary care include compassionate continuity of care, comprehensiveness, context, community and cost-consciousness. Trust and relationship are birthed and develop over time from encounters for physicals, acute and chronic visits, broken bones and hearts, and sharing life-changing events in the family. Numerous studies show significantly higher health care status in those who have a primary care doctor. These include shortened hospital stays, improved quality of life, longevity and satisfaction with health care.
These days your primary care physician is making more house calls through the convenient and highly efficient process of telehealth visits, which save patients’ time, and reduce exposure to others who are sick in the waiting and exam rooms. Telehealth has become a substantial part of primary and specialty care that will continue, even now as COVID cases seems to be waning. Up to 20 percent or more of current visits are now held this way.
In my role as a primary care doctor, I also regularly make referrals to my specialty colleagues. This happens because of complexity of the case, need for certain procedures, patient preferences or other reasons.
Often, I’m looking for a “second opinion.” A fresh set of eyes on a problem and a different set of skills and perspective often yields benefits for the patient. Maybe a new drug or therapy that the specialist is aware of is an option. Sometimes though, the surgeon, oncologist, cardiologist, pulmonologist, nephrologist or other “–ologist” expert may offer opinions that are unclear, conflicting or at odds with the patient’s preferences.
This brings us back to the situation above. The patient is unsure what to do next, and high-powered, respected specialists cannot agree on the right course of action. It’s at times like this that a trusted primary care physician who knows you well can help clarify and interpret the situation. We can communicate directly with the specialist, review your records, look up the latest medical research, make current clinical recommendations and offer guidance.
Make your primary care appointment today. It can build a lifetime of trust and caring.