Heather Ly (Host): Hi there, everyone. Thank you so much for joining us for this latest episode of Medically Speaking. My special guest today is Avani Kanneganti, who is an internal medicine-trained primary care physician with General Physician. Thank you for being here.

Dr. Avani Kanneganti: Well, thank you for having me.

Host: We appreciate you making time in your busy schedule. I feel like these days, you're very, very busy with patients.

Dr. Avani Kanneganti: That is correct. Yes, winter months especially are super busy just because of acute illnesses that are much more during the winter months. And not just that, people also try to see the providers at the end of the year more so than early on, because most people think that they're meeting their deductibles by the end of the year.

Host: Ah, yes. Very important to keep in mind. But again, we appreciate you taking some time to chat with us. Let's start with sort of your background. What brought you into primary care?

Dr. Avani Kanneganti: Well, I trained in Buffalo for my residency. And I was kind of trying to see what specialty I wanted to do. And then, I finally realized that I like all the systems and ended up doing primary care, because it was much more elaborate in terms of what I can think with, deal with patients on a long-term basis, also to kind of build relationships with them.

Host: And I think a lot of people don't think about the full range of services that as a primary care physician, the different things that you deal with. It's not just a quick physical, you can get more in depth with certain diagnoses and different diseases, right?

Dr. Avani Kanneganti: Yes, that is correct. So, our role kind of consists of doing annual wellness physicals, doing our screenings, vaccinations, but also taking care of chronic medical conditions, which are common in this area, like high blood pressure, diabetes, thyroid concerns, which is a lot more in this area too, and high cholesterol as well.

Host: At what point does somebody need to—I guess, how do you decide between a primary care physician and when you would need more specialized care? Or does every diagnosis need to go to a specialist?

Dr. Avani Kanneganti: Well, that's a very good question. Typically, most patients are also kind of wondering if they need to see a specialist. Obviously, when they come to me, I'm able to decide for them to see if they actually needed a specialist's help to. Take the care forward. So, every symptom doesn't necessarily need a specialist's help because we are also able to kind of treat them appropriately initially. Obviously, if there's help, we do have specialists in General Physicians that we are able to refer them to.

Host: And sort of working together as a team. But part of what you do is also medication management because, again, you said not every symptom needs a referral. You can handle it, which for me, I feel like is good news because it's one less doctor, one less appointment. If I can go to you and you can kind of handle multiple things, what a great relief, and a time saver as well.

Dr. Avani Kanneganti: That is correct. And also, some of my patients, when they do start seeing specialists, they go to them for the initial management. And when things are stable, they come back to me for chronic management once things are stable so that I can manage the medications moving forward. So, it becomes easier for them too.

Host: We were chatting a little bit earlier. And there was a time, I feel like, in my life after college, after high school, you know, when you did the physicals and there was the required wellness visits. After I graduated, there was that gray area where I didn't have a primary care physician because I thought to myself, "I'm healthy. Why do I need a doctor?" What do you say to the folks that were like me back then that didn't have a primary care physician. And they're thinking, "Maybe I don't need one."

Dr. Avani Kanneganti: Well, it's very easy to not see one, especially with our busy lives when everyone's working long hours, and it's hard to go for appointments too. And making appointments is also not easy. So, I would rather say to try to establish care with the physician before something happens. So, you don't want to wait until the illness hits you, and then you don't know where to go at that point, then things get stressed out at that point.

Host: Yeah. You had used an analogy earlier, it is kind of like snow tires on a car, right?

Dr. Avani Kanneganti: Yes. It's almost like getting your car ready before the winter starts. You don't want to wait for the snow storm to hit before you check your tires.

Host: And before you start spinning out of control. And that's so important when it comes to personal health. Again, what are the things that you are looking for? If somebody comes to see you, let's say for the very first time, what are sort of those initial exams, readings? What are the things you looking for to make sure a person is where they need to be—a sort of baseline, I guess?

Dr. Avani Kanneganti: Yeah. The baseline things are usually the vitals is what we call it as making sure your blood pressure is normal for your age, your heart rate is normal and your weight is appropriate to your height. Obviously, if you're experiencing any symptoms or anything that's out at the ordinary, we also address that at that visit as well.

Host: How does one get a primary care physician if they don't have one right now? And how do you find the right one to match up to your needs?

Dr. Avani Kanneganti: I would probably say start off with your insurance first. Go to the insurance website and see if there's anyone in the area that fits your needs, number one. Number two, you can also touch base with your friends, family and see if there's anyone that they trust. Or the other way also would be to kind of see if your neighbor has seen someone that they trust, because it can also be with word of mouth, because a lot of my patients that come see me are through word of mouth at this point, just because I see friends of friends.

Host: And somebody has a great experience. Yeah. And they can say, "I had a great experience with Dr. Kanneganti, so you know, you should go and see her as well." We talked about baseline health conditions. But also, if there are any sort of issues, it's so much better to detect them early, so that you can get patients on that right course of treatment, right?

Dr. Avani Kanneganti: Exactly. Yes. That entails detecting cancers early or kind of getting to know if you have any chronic conditions early on. For cancers especially, we start screening based on the age for cervical cancer, breast cancer, or colon cancer, or prostate cancer. Or even lung cancer screening, if it's appropriate for the patient, obviously.

And for chronic conditions, we also try to detect hypertension early. And obviously, if we're able to detect hypertension or diabetes early, we're able to avoid the long-term complications of the disease per se.

Host: How often should somebody visit their primary care physician, or when should they call you if it's not for, let's say a physical, at what point should we pick up the phone and, you know, seek your help?

Dr. Avani Kanneganti: Obviously, once a year for sure, for your physical. And apart from that, obviously if you feel something's out of the ordinary, then giving a message or a call to the primary care is appropriate.

Host: Yeah. And again, talk about the role of primary care. You, in particular, have a full range of services. And I thought one of the interesting things was dermatology as well. How or why might somebody come to you for what kind of skin condition or issues and how could you help them?

Dr. Avani Kanneganti: So in terms of dermatology, we do have patients come in for as simple as something like rash, which could be allergic in nature or it could be a spot that they have had for such a long time and spots that are detected early on could be malignancy too. And I do biopsy them in the clinic and send them out for sampling to see if there's something wrong. And obviously, we can refer them to appropriate dermatology if this is something precancerous or cancerous.

Host: Yeah, I think the analogy that folks could really connect with here in Buffalo, you're kind of like the QB, you're the quarterback of medicine. Why is that?

Dr. Avani Kanneganti: Yes. It's almost like you can think of me as Josh Allen, I would say—not really like him, but it's almost like using an analogy wherein he's taking care of his team. And he looks upon to make sure his team is headed in the right direction. It's the same with me too. I'm trying to make sure that I take care of my patients and refer them appropriately to the specialists when needed.

Host: Yeah. And keep people off of the sidelines and keep them from having those illnesses or getting hurt. What is the importance of understanding your medical history? Because I feel like there are some folks that kind of turn a blind eye to family history, potential problems. And how do you encourage patients to stay on top of that and really know their body and know their risks and know about changes and keep those in mind.

Dr. Avani Kanneganti: So, family history is very important in certain health conditions. It could range from anything like simple hypertension to cancers.

Host: Sure.

Dr. Avani Kanneganti: Obviously, kind of knowing them early on helps us screen for those conditions early on, which means it's going to be early detection, less resource use, and it's better outcomes for the patients too. And obviously, they're going to spend more time with their families too, just because they're able to prolong their life just because we're able to detect things early on.

Host: Yeah. Preventative medicine is so, so important. And again, the folks that say, "I'm healthy, I don't need a primary care physician," your simple advice to them?

Dr. Avani Kanneganti: Well, establishing care as soon as possible so that we can detect things early.

Host: Yeah, absolutely. You mentioned immunization, screenings, and checkups. Any other things? How often should people do blood work, and that sort of thing?

Dr. Avani Kanneganti: It depends on the patient and the age group too. If it's a young patient coming in with no symptoms, we typically do it every couple of years based on how they're responding. Obviously, if there's some abnormality in the blood work that we have seen before, then we like to followup with every few months or a year based on what the abnormality is. But we do also have some complex patients. But for the complex patients, it's a little different wherein we might need the blood work done as soon as a few days or a week apart, just to followup, just to make sure that the kidney function is fine or their hemoglobin is improving in three months, if it is anemia, when we are treating them for that.

Host: There's been a big focus, I feel like, especially recently, a lot more folks talking—for good reason—about mental health. What is your connection with your patients there? And how do you work with them to make sure that their mental health isn't suffering? And what would be that course of treatment, whether it's through you or perhaps a referral to somebody else?

Dr. Avani Kanneganti: I think people also have lately realized that mental health plays an important role in your overall health. So, kind of understanding that has made patients discuss about them more frequently now, especially anxiety, depression or ADHD and trying to get the help that they need so that they're able to work appropriately so that it's not stressing their family life.

Host: Yeah. Because that mental health and physical health go hand in hand. I know that when I went for my physical, that's part of the questioning. You know, that they ask in the beginning, You know, not only any changes to your health history, but they ask, you know, do you feel anxiety? Do you feel depression? I guess, first of all, how important is it that folks not be embarrassed to share how they're doing when it comes to mental health, but to answer truthfully when you're asking them those types of questions?

Dr. Avani Kanneganti: Well, it's really important to answer these questions truthfully, just because it helps us guide therapy appropriately. And obviously, if it's something that's mild, then we can try to set them up with the appropriate counselors so they're able to walk through their difficulties that they're going through. Or if there's a need for medication, if the symptoms are severe enough, we can definitely place them on medications to make them feel better.

Host: Yeah, I have heard, you know, I've got some friends that say I get so anxious when I think about going to the doctor even just for a checkup. That healthcare anxiety. I don't know if that would be the right term for it, but they get so worked up and they're afraid to go, or they're afraid of what they might find out. How can you help ease somebody's concerns or their fears so that they do feel more comfortable to pick up the phone and make that appointment?

Dr. Avani Kanneganti: Well, I know that could be very hard, especially for people who are very anxious to come into the medical setting just because they could have had a past experience with their family member where they're like, "Oh, we had to go around the hospitals because my mom had this condition." And I think that's one of the biggest barrier for patients to come into a medical setting again. In order to kind of help with that barrier, I think, making the appointment with the right fit is important. And as long as they're able to make the right fit, that's going to make it easier for them to navigate through their health issues.

Host: Are there certain things that folks should be looking for when it comes to choosing a primary care physician aside from insurance? Any recommendations that you give them, you know, that can kind of check the box to say, "This doctor is a good fit for me."

Dr. Avani Kanneganti: Well, in terms of finding the right fit, that's very important just because you want to be comfortable with the physician that you're going to.

Host: Absolutely.

Dr. Avani Kanneganti: And in order to understand who the right fit is, you want to make sure it's aligning with your lifestyle. Are you comfortable discussing multiple things with the provider? Like, it could be common cold. Are you able to discuss about your diet? Are you able to discuss about your stress levels? Because those are some things that patients are not able to open up very easily.

Host: And I think for some folks too, having a male versus a female doctor in some cases might guide their decision. Sometimes women feel more comfortable talking with other women because you understand, you know, some of the things that perhaps I'm going through and can relate a little bit more. I feel like that could be, you know, one of the guiding factors.

Dr. Avani Kanneganti: Yes, absolutely. Sometimes also finding the gender-appropriate provider is important because, obviously, if I'm going through something that the other counterpart is going through, it's easier for me to give the advice, and it's taken more easily for them too.

Host: Generally speaking, or to recap, I guess, how could you sum up the role of a primary care physician, what you do and why it is so important?

Dr. Avani Kanneganti: I would say primary care is mostly to kind of help with preventive care so that we can catch diseases early on and to treat them appropriately so that we don't have to go to the extent where they're very ill.

Host: Yeah. Before something goes wrong.

Dr. Avani Kanneganti: Yeah.

Host: All right. Well, thank you so much for your time, Dr. Avani Kanneganti, who is an internal medicine-trained primary care physician. Thank you again. We appreciate you taking the time. And I'm sure that some folks will be listening to this and probably giving you a call to come see you if they don't have a doctor already.

Dr. Avani Kanneganti: Absolutely. We'll be happy to see them.

Host: All right. Thank you so much. And thank you for watching and for listening to this latest episode of Medically Speaking. We'll see you next time.