Intro: Duly Noted, a health and care podcast, is the
official podcast series of Duly Health and Care. Each podcast features
physicians or team members discussing groundbreaking topics and innovations
that help listeners reimagine and better understand an extraordinary health and
care experience.

Joey Wahler (Host): It's a relationship that's important
in maintaining good health. So, we're discussing building trust with your
primary care physician.

Our guest, Dr. Scott Love, he's a family medicine physician
and family medicine department chair for Dewey Health and Care. And Dr. Rebecca
Uttermann. She's a Family Medicine Physician, both are with Duly Health and
Care.

This is Duly Noted, a health and care podcast. Thanks for
listening. I'm Joey Wahler. Hi Doctors, thanks to both of you for joining us.

Scott Love, MD: Yeah, good afternoon.

Rebecca Uttermann, DO: Thank you for having me.

Host: Great to have you. So first for you, Dr. Love.
What are some of the benefits of having a primary care physician that some may
not be aware of and why?

Scott Love, MD: Oh, I think, getting established with
a primary care doctor, gives you someone who's accessible for your daily
healthcare needs. Usually it's someone who can help coordinate care. Certainly
we take care of a multitude of issues. And oftentimes if we need another
opinion or a consultation or something we don't do, for instance, if we have a
patient with osteoarthritis who is getting to a point of needing joint
replacement, you know, a lot of times we've already put them through a series
of things such as x-rays and some anti-inflammatories. As the disease
progresses, then we can often connect them to that specialist that can help
replace their joint and take them to the next level of care.

Joey Wahler (Host): And picking up on that, Dr.
Uttermann, seeing a primary care physician when in good health for wellness
checks as they're called that includes regular screenings for illness
prevention. What are some important examples of things nowadays that a primary
care doctor provides there?

Rebecca Uttermann, DO: So as far as screenings go, in
medicine it's super important to catch illnesses early. Screenings occur
generally at like annual physical exams. We also do lab work to make sure that
the patient is currently healthy and identify any potential risks. As well as
doing screenings, we review the patient's lifestyle and emphasize changes they
can make, you know, if they're smoking or they have poor eating patterns, we
can analyze those and tell them how they're impacting their overall health.

Host: And so what would be just a handful of examples
of some of those screenings that are more important now?

Rebecca Uttermann, DO: Screenings change throughout
your lifetime depending on your age. For females, annual screenings are going
to be, making sure that you're doing following pap smear guidelines, every
three to five years, doing your annual mammograms. As well as, screenings when
you hit age 45, starting with your colonoscopies, and then continuing with
various screenings throughout your life, such as DEXA scans and making sure
that your immunizations are up to date.

Host: And so you just hit on it, Dr. Uttermann, the
needs of a patient from a primary care doctor are different in some ways
between men and women, right?

Rebecca Uttermann, DO: Yeah. Men and women definitely
have different needs at different points in their lives. Both men and women do
colonoscopies. Females have to do mammograms, they have to do PAP smears,
unlike men, but men also do prostate tests as well, which females don't do.

So you know, both males and females at the end of the day
have certain risks. They do have different risks, but either way, they should
be seeing a physician annually.

Host: Gotcha. Now back to you, Dr. Love. Speaking of
medical needs changing and differing between male and female patients. That's
true. Of course, also, as we age, our medical needs start to alter. And so what
are some examples of why it's important to have a primary care physician for
various stages of life?

Scott Love, MD: Oh, well in family medicine we get to
see them from birth to death. So some of my patients, I see them from day one
and start them on their healthcare journey. Providing, newborn vaccinations,
which are pretty heavy through their birth till two years of age. Then kids
continue to grow through school. That requires different vaccinations along the
line. And as they age, they tend to be pretty free between 20 and 40. And then
at 40, we start to see them for their routine screens. Start to develop
colonoscopy at, 45. PSA testing for prostate cancer screening at 50. Continuing
to monitor things like blood pressure as people age. Their risk for diabetes
and hypertension, dyslipidemia play a factor. We also take into account some of
their family history, sometimes based on ethnicity, based on parental history
of medical problems with regards to heart disease and diabetes, that sometimes
prompts us to order some additional testing to try to screen them a little more
intensively. Sometimes offering cardiac screening to our patients who have had
their parents with heart disease so that we can kind of diagnose early heart
disease and actually intervene with treatment, medications such as cholesterol
medications, working on diet, working on exercise. And so some of those things
occur as they get to middle ages and then, as people get older, we start to wind
down in our functionality and oftentimes are working with family members as we
start to discuss issues such as dementia and that they have inabilities doing
cooking, cleaning, bathing and trying to meet their needs in terms of providing
support services for things such as that.

Host: Gotcha. So back to you, Dr. Uttermann. We have
certainly covered some of the basic nuts and bolts of what you provide as part
of that patient primary care doctor relationship, but in terms of building that
relationship, just overall, what would you say your approach is informing that?

Rebecca Uttermann, DO: The relationship between a
patient and a physician is a two-way street. A patient definitely needs to be
able to trust a physician and the physician needs to know and understand their
patient, know their medical history, their background. The physician needs to
demonstrate empathy. You know, If a patient comes in or is recently diagnosed
with a disease, we need to show how compassion and how much we really do care
for that patient. At the end of the day, a physician does need to earn the
patient's trust in order to make a treatment and, to develop a plan with that
patient.

The partnership between the patient and the physician is
everything. When it comes to my personal approach, I really do like my patient
to take an active role in their healthcare. I try to educate my patients about
what's going on. I want them to understand if I'm starting them on a new
medication, what that medication is for. I want them to understand various
options and approaches to treating a certain medical illness in order to have a
good outcome.

Host: How about you, Dr. Love? Anything in your
career from your experience that's helped shape the way that you approach
forming that patient relationship yourself?

Scott Love, MD: Yeah, I think that's one of the
reasons I went into primary care was I had that personal desire to be
relational with patients. I think that just to share a story, like Dr.
Uttermann said, there is a two-way street. One is just knowing your patients
and, I had a patient who had a child that had major heart surgery. And so this
mom was very calm, cool, and collected and had been through, obviously a very
difficult pregnancy and difficult issue with the baby needing heart surgery. So
I, knowing her and knowing that history over the course of a decade, she
contacted me with a newborn, with her, and she called and came in and said my
baby just didn't seem to be breathing correctly

and, I wanted to come in and have her checked out and the
interesting thing is knowing her over the years and knowing that she was not an
alarmist, I kind of took that into my thought process. I examined the baby and
really could not hear any abnormalities in the lungs.

Heart sounded good and, going on my gut feeling knowing her,
I said, well, let's get a chest x-ray. Let's just make sure nothing's going on

 The next day ended up
having surgery.

And corrected the problem and currently is doing well today.
But, I think that was something where that relationship really, knowing her,
knowing her history really was a thing that prompted me to take the next step.
So, that kind of thing really can be helpful and useful.

Host: Absolutely. Great example. Appreciate that
story. Just a couple of other things, Dr. Uttermann, picking up on what Dr.
Love just mentioned. Primary care physicians, of course, also can be the point
person for specialist referrals. And so how big a role does that play in
serving your patients needs? And obviously you're much more comfortable. Making
those referrals when you've been seeing someone for a while, right?

Rebecca Uttermann, DO: Of course, we place multiple
referrals a day depending on the condition. A lot of times when I do place a
referral. It's because either, something is outside of my scope or the patient
has a new diagnosis of cancer and needs to see an oncologist, needs to have a
biopsy done of the lymph nodes, needs to have a PET scan ordered, or it's just
patient has uncontrolled diabetes and needs to see an endocrinologist, something
of those sorts.

Generally when I do refer a patient to a specialist,
sometimes during certain visits I have to refer a patient to multiple
specialists, and I feel like they might get a little bit overwhelmed. So I
always, try to reassure them if they have any questions or confusion, you know,
after they left the visit, to reach out.

Host: And finally, for you, Dr. Love, just in summary
here, if someone listening right now has no primary care physician, what's your
advice in finding and choosing one that's right for them?

Scott Love, MD: Oh, I think, there's many resources
online. Certainly our health group has an online resource where people can
really pick a specialty within our group, pick family medicine or an internal
medicine or pediatrics from a primary care standpoint. They can get the doctor,
they can review their education. They can review some of their interests.
There's things that sometimes people will connect on. And there's also
physician reviews that are well published just to see, you know, what have
other patients stated they liked about a physician. and so a useful tool.
There's certainly mom groups and other online resources that people will use
just as a research a physician prior to going to the visit.

Host: Well folks we trust you're now more familiar
with building trust with your primary care physician. Doctors a pleasure.
Thanks so much again.

Scott Love, MD: Well, thanks for having us.

Rebecca Uttermann, DO: Thank you.

Host: Absolutely. Thank you.

And for more information, please visit
dulyhealthandcare.com. Again, that's dulyhealthandcare.com. Now, if you found
this podcast helpful, please do share it on your social media, and thanks again
for listening to Duly Noted a Health and Care podcast. Hoping your health is
good health.

Joey Wahler (Host): I'm Joey Wahler.