Importance of Establishing a Primary Care Provider
In today's discussion, Dr. Kim Guida talks about the importance of establishing a primary care provider and the incredible benefits of doing so.
Featuring:
Kim Guida, MD
Kim Guida, M.D. is the Medical Director of Pullman Family Medicine, part of the Pullman Regional Hospital Clinic Network. She worked at a rural health clinic in Buhl, Idaho for several years before moving back to Washington to join Pullman Family Medicine in 2002. She is board certified in Family Medicine, is a Fellow of the American Academy of Family Physicians, and enjoys a broad spectrum of practice, with particular interests in Obstetrics, Pediatrics, and Women's Health. Transcription:
Unknown speaker: With the relentless focus on excellence in healthcare, Pullman Regional Hospital presents The Health podcast.
Deborah Howell: A lot of people roll through life not having a regular doctor in their lives. If they break an ankle skiing or cut themselves while carving a turkey, they just go to the emergency room or the urgent care clinic. But is there a better way to go through life? To talk about the importance of establishing a primary care provider, today, we're joined by Dr. Kim Guida, medical director of Pullman, family medicine, part of the Pullman regional hospital clinic network. Welcome Dr. Guida.
Dr. Kim Guida: Thank you. It's good to be here, Deborah.
Deborah Howell: Lovely to have you. So what's the role of a primary care provider?
Dr. Kim Guida: Well, the way I see it, the role of a primary care provider is really threefold. First, they're going to treat you when you're sick. Secondly, they're going to manage your chronic health problems. And then finally, they're going to do their best to keep you from getting sick in the first place.
Ideally, they're going to have a long-term relationship with you and your family and know your history well, and thereby be able to develop an individualized care plan for you. Primary care providers are really experts in preventive health care. So they're going to understand your individual risk factors for disease and make sure you get the proper screening tests.
You know, your primary care provider should always be your first call when you have a health concern, like when you cut your finger carving a turkey, for example. They're like a home base for your medical care.
Deborah Howell: And sort of like a baseline too for tests and such.
Dr. Kim Guida: That's right.
Deborah Howell: And why is it important for people to establish care with a primary care provider?
Dr. Kim Guida: Well, it's actually been proven in studies that people who have a primary care provider have overall better health outcomes and lower healthcare costs than those who don't have a primary care doc. There are several reasons for this. First, it's less expensive to be seen in a primary care office compared to say an emergency room.
Secondly, people who have regular visits with that primary care doc are more likely to have things like cancer screenings like mammogram, colonoscopy, and they're more likely to have their chronic diseases managed well and under control. So he can manage disease and prevent disease. It's going to be a lot cheaper in the long run than presenting to the emergency room for a disease that's out of control.
Deborah Howell: Sure. And also those emergency rooms can get quite crowded and you might have to wait in a dire situation. So, people are going to say, "Can I just go to a walk-in or an urgent care clinic when I'm sick?" And what's the difference?
Dr. Kim Guida: Yeah, well, there is a big difference. I'd like to say that one in five Americans don't have access to a primary care doc, so they're forced to use urgent care clinics or emergency rooms, and that's pretty unfortunate. And I think looking at our broader healthcare system, definitely that needs to change.
But while urgent care clinics can fix the problem of the moment, they're never going to address the whole picture or take the long view to help you prevent the illness that may have brought you there in the first place. An example of that would be like, you go to urgent care for a foot infection, and you're going to get that treated with antibiotics. But they're not going to address the underlying problem of maybe poorly controlled diabetes. So if you're one of the lucky ones that have a primary care provider, it's really best to call them first. Lots of times, they'll be able to see you that same day, similar to an urgent care situation.
Deborah Howell: For sure. I mean, I know the value myself because my dad was a specialized GP. And to this day, I have people coming up to me saying, "Your dad, I mean, I went to him first and he was such a good, not only a doctor, but just a friend and a counselor, really."
Dr. Kim Guida: Right. They kind of understand the whole picture and they know you well. So it's not like seeing a stranger, you know, when you have something acute going on. It's nice to be able to see somebody that knows you and is familiar with your situation.
Deborah Howell: Yeah. And your entire family too. Now, how do I make sure it's a good fit with my new primary care provider?
Dr. Kim Guida: Well, that is really important because there needs to be a great deal of mutual respect and trust in the relationship. And it does take some time to build this. So ideally, a primary care doc is going to see you over multiple visits and take time to get to know you, asking questions that reflect an interest in who you are as a person, finding out about your backstory, your interests, and also your individual, healthcare goals.
So it will take some time and usually people will know, within a couple of visits, whether it feels like a good fit, whether they feel like they can put their trust in this person or that they're being listened to.
Deborah Howell: And almost sometimes you can just say literally to understand each other, there are language barriers in this country and find a doctor that you can really talk to that hears you and understands you.
Dr. Kim Guida: Right. Absolutely.
Deborah Howell: Is there anything else you'd like people to know about the specialty of primary care?
Dr. Kim Guida: Well, yeah, there's some advances that I, as a family practice doc, am really excited about in my own practice. The first is that in primary care, we're moving towards integration of other health services into primary care. So that's like developing a team approach to patient care. So that would include things like mental health services, counseling, social workers and then specialized nurses who can help with chronic care management for more difficult patients. So it allows us to be more of like a one-stop shop and provide better care for the whole person and the whole family.
You know, the second exciting thing that we're doing a lot of, mainly because of the pandemic, is telemedicine. And you know, we are providing a lot of virtual visits where we can touch base with our patients about their medications or about their depression or anxiety. And it's just been really helpful during this time to stay in touch remotely. We're really hoping that we'll be able to continue doing telemedicine visits after the pandemic is over, because it's just provides just a great tool for an opportunity to check in with people in between the in-person visits. I think it just provides a lot better care and improves the access to care for patients.
Deborah Howell: Sure. So someone can call you up and say, "Here's that turkey cut. Do I need to come in?"
Dr. Kim Guida: Right, exactly. Or, you know, "Is it deep enough?" And that sort of thing. And you know, the other thing about primary care is I'd like people to think about it as sort of a medical home base. A lot of patients come in requesting referrals for specialists because they think that their primary care doc can't handle or can't manage things like maybe a skin check-up or some mole checks and things like that. And so we'll help you determine if you really need to see a specialist. And if you do, we're going to help you get to them, and help you figure out which specialist is the best one for you to see and help with your referral process, because it can be pretty complex to navigate our healthcare system.
But, for the most part, I would say 90% of complaints and problems can be managed by your primary care doc and are not going to necessarily require a specialist referral. So just thinking about it again as a medical home base for the majority of healthcare problems,
Deborah Howell: Well, also for some tests like mammograms and colonoscopies, a prescription is required. So you have to get that from a doctor. So might as well have your own doctor who knows your history to give you that prescription.
Dr. Kim Guida: That's right. Absolutely.
Deborah Howell: Well, we're coming to the end of our time sadly here today, Dr. Guida. Is there anything else that you'd like to add?
Dr. Kim Guida: I would say that I would encourage people to utilize the preventive care benefits that they have with their insurance. So most people who have insurance will have a preventive care benefit. So usually it doesn't cost them anything out of pocket to go in once a year for an annual prevention visit.
And so that's the opportunity for you to establish the care with your primary care doc and get to know them and have them get to know you so that when you're sick, you've already done that background, you already know them, you've established that relationship. So it allows them to take better care of you when you're sick and you're not having to go to urgent care. So many people don't realize that, in the majority of cases, you don't have to pay a copay to go in for preventive care visit. And that would encourage people to take advantage of that.
Deborah Howell: How important is wellness aspect, that preventative care aspect to your practice as a whole?
Dr. Kim Guida: Yeah, it is super important. I mean, we've really focused on that in primary care because we want to prevent the diabetes or diagnose it early and help people make those lifestyle changes so that they don't end up on dialysis 20 years down the road. So it's more important than people think, because a lot of those diseases, you don't have symptoms from. And so like high blood pressure, for example, people can go around for years with extremely high blood pressure and it's not diagnosed until they have a stroke or a heart attack. So if they've got that preventive care relationship with a doctor, that's going to be picked up early and treated early.
Deborah Howell: Well, as the daughter of a doctor and a GP and a specialized one at that, I'm hearing everything you're saying today. And I really encourage anyone listening right now to make that contact for you and your whole family. Because, sometimes there are things, say, teenagers can't tell you as a parent, but they could tell your doctor.
Dr. Kim Guida: Yeah, I would definitely concur with that. We have a lot of teenagers and kids in our practice and building those long-term relationships to really make it easier to have that other adult to help with those teens.
Deborah Howell: Well, Dr. Guida, we so appreciate your time and your work in this field, especially during this very intense time in history. We thank you so much for being with us today.
Dr. Kim Guida: Thank you. It's been a pleasure, Deborah.
Deborah Howell: Find out more about Pullman Regional and more episodes like this at PullmanRegional.org. This has been The Health podcast from Pullman Regional. I'm your host, Deborah Thanks for listening and have yourself a terrific day.
Unknown speaker: With the relentless focus on excellence in healthcare, Pullman Regional Hospital presents The Health podcast.
Deborah Howell: A lot of people roll through life not having a regular doctor in their lives. If they break an ankle skiing or cut themselves while carving a turkey, they just go to the emergency room or the urgent care clinic. But is there a better way to go through life? To talk about the importance of establishing a primary care provider, today, we're joined by Dr. Kim Guida, medical director of Pullman, family medicine, part of the Pullman regional hospital clinic network. Welcome Dr. Guida.
Dr. Kim Guida: Thank you. It's good to be here, Deborah.
Deborah Howell: Lovely to have you. So what's the role of a primary care provider?
Dr. Kim Guida: Well, the way I see it, the role of a primary care provider is really threefold. First, they're going to treat you when you're sick. Secondly, they're going to manage your chronic health problems. And then finally, they're going to do their best to keep you from getting sick in the first place.
Ideally, they're going to have a long-term relationship with you and your family and know your history well, and thereby be able to develop an individualized care plan for you. Primary care providers are really experts in preventive health care. So they're going to understand your individual risk factors for disease and make sure you get the proper screening tests.
You know, your primary care provider should always be your first call when you have a health concern, like when you cut your finger carving a turkey, for example. They're like a home base for your medical care.
Deborah Howell: And sort of like a baseline too for tests and such.
Dr. Kim Guida: That's right.
Deborah Howell: And why is it important for people to establish care with a primary care provider?
Dr. Kim Guida: Well, it's actually been proven in studies that people who have a primary care provider have overall better health outcomes and lower healthcare costs than those who don't have a primary care doc. There are several reasons for this. First, it's less expensive to be seen in a primary care office compared to say an emergency room.
Secondly, people who have regular visits with that primary care doc are more likely to have things like cancer screenings like mammogram, colonoscopy, and they're more likely to have their chronic diseases managed well and under control. So he can manage disease and prevent disease. It's going to be a lot cheaper in the long run than presenting to the emergency room for a disease that's out of control.
Deborah Howell: Sure. And also those emergency rooms can get quite crowded and you might have to wait in a dire situation. So, people are going to say, "Can I just go to a walk-in or an urgent care clinic when I'm sick?" And what's the difference?
Dr. Kim Guida: Yeah, well, there is a big difference. I'd like to say that one in five Americans don't have access to a primary care doc, so they're forced to use urgent care clinics or emergency rooms, and that's pretty unfortunate. And I think looking at our broader healthcare system, definitely that needs to change.
But while urgent care clinics can fix the problem of the moment, they're never going to address the whole picture or take the long view to help you prevent the illness that may have brought you there in the first place. An example of that would be like, you go to urgent care for a foot infection, and you're going to get that treated with antibiotics. But they're not going to address the underlying problem of maybe poorly controlled diabetes. So if you're one of the lucky ones that have a primary care provider, it's really best to call them first. Lots of times, they'll be able to see you that same day, similar to an urgent care situation.
Deborah Howell: For sure. I mean, I know the value myself because my dad was a specialized GP. And to this day, I have people coming up to me saying, "Your dad, I mean, I went to him first and he was such a good, not only a doctor, but just a friend and a counselor, really."
Dr. Kim Guida: Right. They kind of understand the whole picture and they know you well. So it's not like seeing a stranger, you know, when you have something acute going on. It's nice to be able to see somebody that knows you and is familiar with your situation.
Deborah Howell: Yeah. And your entire family too. Now, how do I make sure it's a good fit with my new primary care provider?
Dr. Kim Guida: Well, that is really important because there needs to be a great deal of mutual respect and trust in the relationship. And it does take some time to build this. So ideally, a primary care doc is going to see you over multiple visits and take time to get to know you, asking questions that reflect an interest in who you are as a person, finding out about your backstory, your interests, and also your individual, healthcare goals.
So it will take some time and usually people will know, within a couple of visits, whether it feels like a good fit, whether they feel like they can put their trust in this person or that they're being listened to.
Deborah Howell: And almost sometimes you can just say literally to understand each other, there are language barriers in this country and find a doctor that you can really talk to that hears you and understands you.
Dr. Kim Guida: Right. Absolutely.
Deborah Howell: Is there anything else you'd like people to know about the specialty of primary care?
Dr. Kim Guida: Well, yeah, there's some advances that I, as a family practice doc, am really excited about in my own practice. The first is that in primary care, we're moving towards integration of other health services into primary care. So that's like developing a team approach to patient care. So that would include things like mental health services, counseling, social workers and then specialized nurses who can help with chronic care management for more difficult patients. So it allows us to be more of like a one-stop shop and provide better care for the whole person and the whole family.
You know, the second exciting thing that we're doing a lot of, mainly because of the pandemic, is telemedicine. And you know, we are providing a lot of virtual visits where we can touch base with our patients about their medications or about their depression or anxiety. And it's just been really helpful during this time to stay in touch remotely. We're really hoping that we'll be able to continue doing telemedicine visits after the pandemic is over, because it's just provides just a great tool for an opportunity to check in with people in between the in-person visits. I think it just provides a lot better care and improves the access to care for patients.
Deborah Howell: Sure. So someone can call you up and say, "Here's that turkey cut. Do I need to come in?"
Dr. Kim Guida: Right, exactly. Or, you know, "Is it deep enough?" And that sort of thing. And you know, the other thing about primary care is I'd like people to think about it as sort of a medical home base. A lot of patients come in requesting referrals for specialists because they think that their primary care doc can't handle or can't manage things like maybe a skin check-up or some mole checks and things like that. And so we'll help you determine if you really need to see a specialist. And if you do, we're going to help you get to them, and help you figure out which specialist is the best one for you to see and help with your referral process, because it can be pretty complex to navigate our healthcare system.
But, for the most part, I would say 90% of complaints and problems can be managed by your primary care doc and are not going to necessarily require a specialist referral. So just thinking about it again as a medical home base for the majority of healthcare problems,
Deborah Howell: Well, also for some tests like mammograms and colonoscopies, a prescription is required. So you have to get that from a doctor. So might as well have your own doctor who knows your history to give you that prescription.
Dr. Kim Guida: That's right. Absolutely.
Deborah Howell: Well, we're coming to the end of our time sadly here today, Dr. Guida. Is there anything else that you'd like to add?
Dr. Kim Guida: I would say that I would encourage people to utilize the preventive care benefits that they have with their insurance. So most people who have insurance will have a preventive care benefit. So usually it doesn't cost them anything out of pocket to go in once a year for an annual prevention visit.
And so that's the opportunity for you to establish the care with your primary care doc and get to know them and have them get to know you so that when you're sick, you've already done that background, you already know them, you've established that relationship. So it allows them to take better care of you when you're sick and you're not having to go to urgent care. So many people don't realize that, in the majority of cases, you don't have to pay a copay to go in for preventive care visit. And that would encourage people to take advantage of that.
Deborah Howell: How important is wellness aspect, that preventative care aspect to your practice as a whole?
Dr. Kim Guida: Yeah, it is super important. I mean, we've really focused on that in primary care because we want to prevent the diabetes or diagnose it early and help people make those lifestyle changes so that they don't end up on dialysis 20 years down the road. So it's more important than people think, because a lot of those diseases, you don't have symptoms from. And so like high blood pressure, for example, people can go around for years with extremely high blood pressure and it's not diagnosed until they have a stroke or a heart attack. So if they've got that preventive care relationship with a doctor, that's going to be picked up early and treated early.
Deborah Howell: Well, as the daughter of a doctor and a GP and a specialized one at that, I'm hearing everything you're saying today. And I really encourage anyone listening right now to make that contact for you and your whole family. Because, sometimes there are things, say, teenagers can't tell you as a parent, but they could tell your doctor.
Dr. Kim Guida: Yeah, I would definitely concur with that. We have a lot of teenagers and kids in our practice and building those long-term relationships to really make it easier to have that other adult to help with those teens.
Deborah Howell: Well, Dr. Guida, we so appreciate your time and your work in this field, especially during this very intense time in history. We thank you so much for being with us today.
Dr. Kim Guida: Thank you. It's been a pleasure, Deborah.
Deborah Howell: Find out more about Pullman Regional and more episodes like this at PullmanRegional.org. This has been The Health podcast from Pullman Regional. I'm your host, Deborah Thanks for listening and have yourself a terrific day.