Primary Care Providers - The Cornerstone to Better Health Care

Bitterroot Physicians Clinic
A service of Marcus Daly Memorial Hospital
Allen Jones, MD
1200 Westwood Drive
Hamilton, MT 59840
(406) 363-1100


I know very little about the inner workings of a car; it has an ignition, a "go" pedal and a "whoa" pedal. As a teenager, I never learned to work around a car engine - I just had no interest. However, I did learn that to keep the car running well and not leave me abandoned on a Georgia back road I needed to take it to the shop for regular maintenance such as oil changes, tire rotations and brake checks. I had to rely on car mechanics to tell me what needed to be done to the vehicle to keep it safely running, and I needed to trust that mechanic. If I didn't trust the mechanic, I found one that I could trust. By the same token, some people don't know the difference between melatonin and melanoma, so they come to me for advice. (For the record, the first is an over the counter sleep medication and the second is a malignant skin cancer.)

Patients establish care with a primary care provider (PCP) to guide them through the quagmire that is our health care system. Let's say that you wake up one morning with a large knot on your neck. It is firm and protruding; concern and confusion can overwhelm you. You ask yourself questions such as - Do I go to the ER? Do I need a surgeon? Should I see a cancer specialist? Will a lab test or an x-ray tell me anything?

Who can you trust to help navigate you towards the most reliable, cost effective and safest option? You need a health advisor who knows you, your family medical history, your cultural and social preferences as well as any financial or insurance issues you may have. You need a primary care provider who will listen to your concerns and work with you to come up with an appropriate, individualized health plan for your needs. In addition, a PCP is there to celebrate good news with you as well as explain pertinent information and empathize with bad news. My sister's husband had brain cancer and he received treatment at a large, teaching medical center. However, she needed me, a family physician, to help interpret the neurosurgeon's medical jargon into simple terms she could process and understand. A primary care provider can be a family physician, an internist, a pediatrician, a physician's assistant (PA) or a nurse practitioner(NP).

How does one find a provider that can be trusted and relied upon? The process is not unlike what you would do to find a new favorite restaurant; you ask friends and family and you shop around. Providers have different personalities and values. PCP's can run the gamut from being warm and fuzzy to no nonsense and everything in between. If you feel that you are not getting the guidance and reassurance that you need, then look somewhere else-- -there will be a provider out there that you can connect to and trust.

My Father had appendicitis when vacationing in Europe. He went to the Emergency Room and found it empty; he was the only patient in the ER. He was treated promptly and professionally. In Europe you only go to the ER for emergencies and patients are referred to PCP's to establish an on-going relationship with a provider that gives them less costly and more thorough health care. This allows ER's to treat "true" emergencies such as cardiac events, strokes and emergency surgery as well as conditions such as pneumonia or congestive heart failure that will require immediate hospitalization for care. In America we fill our Emergency Rooms with everything from toothaches to back pain to simple acute problems. Such ER usage for minor care clogs up the system, increases wait time and sends the cost of health care skyrocketing.

Urgent Care Centers, or the so-called "Doc-in-a-box" centers, are intended to provide care for acute problems such as an earache, sore throats, fevers or lacerations. Other problems require a more detailed, intensive work up. For example, a headache can signify a migraine or tension/stress related event, but could also be an indication of a brain tumor, aneurism, infection or elevated blood pressure. What might, at first, seem like a simple problem, requires more attention and follow up and should be evaluated more thoroughly by a personal care provider familiar with your health history.

Most people have used "Dr. Google" or web based medical sites for health information. Such information can be quite educational. However, internet medicine can also increase confusion and lead to personal misdiagnosis when only a symptom or symptoms are plugged into the computer instead of a more complete picture resulting from the questioning and discussions with a PCP. I particularly advise avoidance of social media for medical diagnosis and advice. Such limited, and often inaccurate information, can plague health care issues including volatile topics such as vaccines and the use of Fluoride for strong teeth.

Although friends and family try to be helpful, they can give terrible health suggestions. On more than one occasion I have had a patient discontinue a medicine or treatment I had started because their mechanic's girlfriend's hairdresser, or something similar, had some vague side effect - thus concluding that no one should take that medicine when prescribed. I don't get my taxes done by my butcher, or my car serviced by my accountant and I don't take medical advice from non-medical people. It's just the rule I play by.

I recommend developing a partnership in your healthcare by establishing yourself with a PCP. In addition, I suggest routine physicals and preventative wellness exams. It is easier to keep healthy people well, than the more expensive option of treating a condition or disease. For example, smoking cessation treatments are more effective for longevity that treatments for lung cancer or COPD. Annual wellness visits are recommended and encouraged by Medicare for just such reasons.

In the end, it comes down to this-- - we all want to be as healthy as possible so that our lives can be as productive, disease and pain free and fulfilled as possible. By finding and establishing a relationship with a primary care provider that listens to your concerns and assists with your long-term health needs, you are taking an important, proactive step forward to achieving the goal of better health.

This week's health column is authored by Allen Jones, MD at Bitterroot Physicians Clinic, a service of Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton, MT 59840. Working together to build a healthier community!
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