Joey Wahler (Host): It's a great way to keep your loved ones all healthy together. So we're discussing family medicine. Our guest Daniel Touney. He's a Nurse Practitioner and Family Medicine Provider for Iowa Specialty Hospitals and Clinics. This is the Ish Dish podcast from Iowa Specialty Hospitals and Clinics. Thanks so much for joining us.

I'm Joey Wahler. Hi there, Daniel. Welcome.

Daniel Touney, ARNP: Hi, thank you.

Host: It's great to have you aboard. So first in a nutshell, what do we mean exactly by the term family medicine?

Daniel Touney, ARNP: With family medicine, I think it incorporates a lot of community health and just general wellbeing, in relation to, you know, we're doing physicals and trying to do immunizations to keep people healthy, trying to keep people healthy with physical activity, with diet. So it encompasses a broad range of you know, medical specialty.

Host: Hence the word family, as we mentioned. How important is it when possible to keep a whole family, at least an immediate family together going to the same practitioner? What are the advantages there on either side?

Daniel Touney, ARNP: So I think that with everybody coming to the same clinic, you get real familiar with your providers, especially from a real young age. You get to know their family, and get to kind of get to know their, their ins and outs and some issues that they're going through, and just different aspects of each individual person in there, which then all draws on and encompasses each other's care really.

Host: So you touched on it briefly, let's maybe follow it up some. What are the key medical interests within family medicine in terms of addressing the whole family's needs? You mentioned things like physicals, et cetera. What are, let's say a handful of the main things that everyone really needs to see you for on a regular basis?

Daniel Touney, ARNP: Routine physicals, getting checked annually for, you know, any chronic illnesses that may be lingering without really knowing it, you know, high blood pressure is one that really comes to mind of just assessing that. Making sure that you're getting your medications refilled at appropriate times so you're not lacking on those.

I think those would be kind of the two biggest ones I think they would start with.

Host: How about family medicine practitioners like yourself, effectively conducting a real comprehensive physical exam for accurate diagnostics? What are the things that go into that?

Daniel Touney, ARNP: So for the physical exam, yeah, it's just a good deep dive of talking to each individual person, looking and listening to them, right? So listening to their body, listening to heart, listening to lungs, listening to their belly, listening to, with their history of, you know, any, symptoms that they're kind of dealing with and trying to put that all into play.

Trying to accurately, and efficiently, you know, assess them as best we can.

Host: And when you talk about listening, Daniel, not just listening to their body, but listening to the patient, right? Because they know their body best and you want them to really openly express and feel comfortable in doing so, how they're feeling, right?

Daniel Touney, ARNP: Oh, definitely. Yeah, that's definitely a big part is cause as you did, I mean you stated they know them best and a lot of times when they just feel something that's off, your best to kind of try to dig into it and see what you can find.

Host: So, in what ways is men's health specifically uniquely addressed in family medicine and what preventative strategies are emphasized? There are certain things men should be doing regularly to stay out of harm's way if you will, right?

Daniel Touney, ARNP: Yeah. So with, you know, men's health. Mens health can be kind of a challenge to A, to get them there so that they can be kind of evaluated. And a lot of times those guys, we do have a hard time sometimes of just opening up to somebody and telling them, this is bothering me. This is what's wrong.

This is, something I don't like. And so that's kind of where it's hard, but hopefully as, a guy, that at least affords them the ability to come and talk and hopefully be more open, than they would to some other providers.

Host: Absolutely. Men need to be more mindful of their health, less mindful of being overly macho. Right.

Daniel Touney, ARNP: Yeah, to some degree, right? So I mean that,it affords them some, as they're younger, you know, it keeps them out of the doctor's office. But as they gets older, then they kind of pay for it down the road. And so then being able to look into those things and, you know, because as we get older right, we break down a little bit more and and there's things that we have to have evaluated.

Host: Very well put. The same machismo that helps you when you're younger can hurt you when you get older. So to know when the change is taking place, don't you?

Daniel Touney, ARNP: Yeah, that's right.

Host: So how do family medicine professionals like yourself approach the treatment and the management of common acute conditions, let's say like colds and the flu? Obviously certain times of the year, you see a lot of people for those things, from your standpoint. How do you stay on top of that and do what's best for patients based on what's available at that particular time?

Daniel Touney, ARNP: Education really more than anything else, just, really just looking at them, ensuring that there's no more serious thing going on that would require maybe antibiotics. But if we're just talking about, you know, common colds that really don't require antibiotics, a lot of times it's just reassurance that everything really looks okay. We don't see anything real obvious that we need to address. And then it's a lot of supportive measures then of, making sure they're hydrated, making sure they're getting Tylenol or, you know, those simple kind of things. And then just kind of ensuring that and reassuring that things will get better.

Host: How about the best practices or managing chronic conditions, say diabetes or hyper, hypertension within a family medicine setting? And of course, things like that are often hereditary and may be affecting multiple family members, right?

Daniel Touney, ARNP: Correct. So when it comes to chronic illnesses, again, it's through education and making sure that me as a provider, go to continuing education and get to know the most up to date, most effective care for, whether it's diabetes, hypertension, thyroid troubles, what have you. And just knowing the best way to address them.

Host: A couple of other things for you. How can patients benefit from seeing a nurse practitioner like you instead of an MD or even a doctor of osteopathic medicine for their healthcare needs in family medicine? What can someone like you provide for someone that is joining us and may not be aware of exactly what a nurse practitioner does?

Daniel Touney, ARNP: So in the realm of family medicine general care, us coming in as nurse practitioners in relation to MDs, DOs, you know, we can provide the initial diagnosis, management, lab work, initial evaluations of a lot, a vast majority of your chronic illnesses, acute illnesses, those type of things.

Cause then even sometimes in rural Iowa is where I work, sometimes they don't have access to an MD or a DO. And so then that's where then we come in is hopefully to provide that access and to provide that healthcare that they may not get otherwise.

Host: Speaking of it being a rural area, in that scenario, Daniel, you want to try to provide as many different services as possible, right? Because oftentimes in such an area, travel is an issue, especially for people that have difficulty getting around, people that are older, people that are alone, et cetera. Sometimes that's a big deal to try to get to and from a medical professional.

Daniel Touney, ARNP: Oh yeah, definitely. So especially in the area where we're at now. You know, we do have some towns closer with some specialties that we end up having to refer to, which those can be hour and a half, three hours away, depending. And so then just trying to be able to manage that person, to the best of our ability to hopefully keep them from having to drive back and forth those long distances is pretty key.

Host: So in summary, Daniel, what would you say is most rewarding about the great work you do? What's a good day at the office for you?

Daniel Touney, ARNP: I guess a good day for me in office is just making we get through the end of our day, each patient without chaos really. Right. We're managing everybody as best we.

Patient wise, if we are able, you know, the patient comes into the clinic, we have a good experience. We have lots of back and forth in relation to trying to manage their, whether it's an acute issue or a chronic issue. And getting them diagnosed correctly, I think is the biggest thing. At end of the day is ultimately is just kind of doing the right thing for the patient.

Host: Absolutely. Well folks, we trust you are now more familiar with family medicine, as we've discussed. Certainly takes on a whole extra level of importance in a rural community. Daniel, keep up all your great work and thanks so much again.

Daniel Touney, ARNP: Thank you.

Host: And for more information, please visit Iowaspecialtyhospital.com. If you found this podcast helpful, please do share it on your social media. And thanks so much again for being part of the Ish Dish Podcast from Iowa Specialty Hospitals and Clinics.