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Prakash Chandran: A primary care provider is a person's main healthcare provider in a non-emergency situation. They're obviously a great resource and everyone should have one. But today, we're going to learn why. Let's talk about it with Dr. Kevin Flanigan, Medical Director for Ridgecrest RHC.

This is the Ridgecrest Regional Hospital podcast. My name is Prakash Chandran. And so Dr. Flanigan, really great to have you here today. Thank you so much for your time. I'd love to start by asking you how exactly would you describe the role of a primary care provider?

Dr. Kevin Flanigan: You know, to me, a primary care provider is two parts. One, it is the provider that is the focal point, but it's also the team of staff that work with that provider. And so the role of that team is to make sure that a patient has easy access to the healthcare system and that all the information generated in that healthcare system has a focal point to return to so that there's good coordination of a person's health care delivery.

Prakash Chandran: Yeah, that really makes a lot of sense. So there's the focal point of the provider themselves and then the team and staff that support not only them, but the patient to ensure success over time. Is that correct?

Dr. Kevin Flanigan: Right. That team is trying to make sure that the patient has the desired health outcome that they're looking for.

Prakash Chandran: So tell me Dr. Flanigan, why exactly should one person have a primary care provider? And talk to us about the importance of establishing a relationship with them.

Dr. Kevin Flanigan: So as a patient or as a person who's maybe not viewed themselves as a patient because "I've never been sick, I don't have a chronic disease," you really want to have that relationship so that when the need arises unexpectedly, if it should, you have someone to turn to that you already are familiar with, someone that you trust wholeheartedly and you know that you're going to get the information, you're going to get the response that you're looking for. It is so important to have that relationship before the time of crisis. Also, the primary care provider is the person who works hard with you to make sure that you stay healthy, do your screenings to make sure that you don't develop any chronic conditions so that you're not going to be necessarily overly susceptible to acute illness.

Prakash Chandran: So, you know, one thing that I wanted to actually ask you is I think what you may have touched on a little bit before, there kind of is this trend especially in the younger generation that they access healthcare on an as needed basis. In doing a little research for this conversation, I saw that 45% of young adults didn't have a primary care physician or provider, and instead they just went to the urgent care when something came up. What might you say to people that are operating in that way?

Dr. Kevin Flanigan: You know, as a physician, I get to talk to a lot of young adults who are in that very category as they come in for the first time and say, "Well, I've always gotten my care elsewhere and things haven't been going well" and no one knows them. And so the provider that they're seeing, whoever's next in line, isn't familiar with what happened last time. So, "I was in. I had a sore throat. I got treatment. It didn't work. I saw somebody else," and it goes on for two or three cycles before you finally get in to see someone who's going to take a step back and say, "Here's the picture that I've seen over time."

Most importantly, as a current example, I think this pandemic that we're getting through is a great example where if these patients, if these people had a chance to have a relationship, they would have known where to turn to get accurate valid information upfront from someone they trusted. And a lot of the angst might have been avoided that went along with the early onset of this pandemic.

Prakash Chandran: Yeah, that makes a lot of sense. So just expanding on that a little bit. Can you talk to us a little bit about how people should think about seeing a primary care provider versus going to an urgent care or the emergency room?

Dr. Kevin Flanigan: Right. So emergency rooms and urgent care certainly have their role. If you are away from your primary care provider and something acute comes up and you have to be seen, if an extended visit turns into an overly long visit and you're due to be seen, or something has changed and you need a medical opinion, wonderful. But you really want to have that relationship upfront locally so that if something changes, that provider knows you and is able to work with you, understanding who you are and what it is that you're trying to achieve as you go about managing your own healthcare.

Prakash Chandran: And how often should you be seeing a primary care provider? Is this that annual checkup or do you visit them more often than that?

Dr. Kevin Flanigan: Well, that really depends on who you are and where you are in life, right? So a primary care provider who's a family medicine doctor or is a pediatric provider, and it's a newborn who's going to see that newborn and that family every couple of weeks and then every couple of months and then slowly extend out to where it's just an annual visit. You referenced earlier young adults. They may only need to be seen once every year or every other year just to keep a handle on are they maintaining their health? If they needed to change some of their lifestyle decisions, how successful have they been with that? Can they partner with the provider and the rest of the office staff to attain a little bit more success in those goals? And then as we age, we sort of grow back into healthcare as you will. As you get older and older, you start having more and more need to be a little bit more vigilant about your health as some of your resiliency isn't there like it used to.

Prakash Chandran: So you touched on this a little bit, but I wanted to ask you about the different types of primary care providers. Can you briefly share the different roles?

Dr. Kevin Flanigan: Yeah, and I love talking about the different roles that each specialty plays. Within each specialty, there's going to be physicians. There's going to be nurse practitioners and physician's assistants. And patients should be very comfortable picking amongst them for whatever level they wish to engage. But more importantly, there's different specialties. So there's family medicine that has a strong focus on care for the entire family unit and the social structure in addition to excellent medical care for children as well as adults and then the elderly.

Internists basically have specialized their training in adult medicine. So they'll start when someone is in their 20s and then care for them throughout their adult lives. And then you have pediatricians who specialize only in the care of newborns through infancy and toddlerhood, childhood and into adolescence, but would not be likely to be caring for someone who is in their 20s.

Each of those three specialties then, as I said, has physicians, they have advanced practice providers, which are nurse practitioners and physician's assistants who all partner with the rest of the staff in the office to make sure that you're able to get the care that you need.

Prakash Chandran: You know, I've never heard it broken down that way before. And I feel like a light bulb just went off for myself. So thank you so much for that. You know, I just moved to a new city and I've been thinking about finding a new primary care provider. So let me ask a more general question, how does one go about finding one for themselves?

Dr. Kevin Flanigan: You know, a lot of times people turn to their family and their close-knit friends. You know, who do you see? And do you like them and why do you like them? And those are important references. But I think for children in particular, there's a great example in that parents, as they get into the final phases of a pregnancy, will frequently call up different providers' offices, whether it's family medicine or pediatrics and ask to come in and interview that provider. You want to know, am I going to be able to connect with this provider? Do I feel like I can trust my child's life to this person? And if not, you go and you interview the next person.

It does not happen as often when we're talking about adults, but it should, and we should be very comfortable calling up our provider's office and saying I'd like to meet with the provider sometime outside of hours and talk about is this type of provider going to work with me and help me achieve my goals? And then always, sometimes you get one or two visits in. And if you don't feel like "I can just wholeheartedly entrust you with my life," then you should try looking for another provider. No one's going to be upset, as providers, we all know that we're not the perfect match for every patient, but a patient needs to entrust their life and be comfortable in trusting their life and their life's decisions to that provider and the staff in the office that provider works with.

Prakash Chandran: Yeah, that's so interesting. So you're saying that it is common practice for that provider to be interviewed by the patient. And you have an understanding, as a primary care provider yourself, that you're not a perfect fit for every one. So if it doesn't work out, it's no problem. Someone can leave and go find someone else that's a better fit. Is that correct?

Dr. Kevin Flanigan: Oh, absolutely. And again, it's far more common in the pediatric world with our children. We always worry about our children far more than ourselves. But we should be very comfortable asking these questions about what am I looking for? And can you meet that need?

Prakash Chandran: Let me ask some more nuanced questions. So, you know, I I just turned 40, but I also have two kids. And so if I'm looking for a primary care provider for myself, how do I distinguish between whether I should see an internist specialist versus someone in family medicine?

Dr. Kevin Flanigan: Sure. And this is one of the dilemmas that young families face, is, you know, do I want my family's care to come from a singular office and we only have one place to coordinate with. And that's very attractive for very busy young families. But some people, especially those who already have an existing relationship with an internist and adult medicine doctor before having the family, they'll have their children go to a pediatrician or a family medicine, and they'll maintain the relationship with the doctor they had. Sometimes there's a drift away from the doctor I used to have to the one that my children see, just because of ease of which it is to coordinate. And sometimes you just feel better as you get to know that provider. You know, like, "Hey, you know, I think I'd be more comfortable trusting my life to you today than I am with the doctor I've trusted so far for all these years." So it's a changing thought process that every patient and person goes through. But find the one that's going to fit your family best. Is that together where you see family medicine as a single unit? Or do you feel best having your children see a pediatrician and I see an internist?

Prakash Chandran: Now, before we close here today, Dr. Flanigan, there's one thing that I always like to ask, you know, given all of your experience as a primary care provider and now as the medical director for Ridgecrest RHC, what is one thing that you know to be true? You know, especially given this topic that we're talking about today, what do you want our audience to take away from this conversation?

Dr. Kevin Flanigan: The thing I would share is because I'm both an internist, adult medicine we've been talking about and a board-certified pediatrician, it is very clear to me over the years now that I've been doing this, that if the patient doesn't wholly believe in the doctor and in the practice that they're attending, it's not going to work well. There's always going to be doubt. There's always going to be questions. There's always going to be the sense of if only or what if. And so it is always my encouragement to patients and their families, really find the provider and the practice that you're willing to trust your life too, because I promise you, your healthcare will be better if you totally believe the direction that you're agreeing to in managing your diseases or your medical condition. And if you have any doubt at all, your health is too important to have any doubt, it's the short answer.

Prakash Chandran: Yeah. I'm so glad you mentioned that because, in many ways, it is a shift in thinking for us patients. You know, I think that so often, and maybe this is just due to our experience, we may have gone to primary care providers where we feel like it's just very transactional. It's in and it's out, and we don't have that relationship with a primary care provider. But one thing that I've learned from you today is that it doesn't have to be that way and you shouldn't settle for less than finding a provider that you can wholeheartedly trust. So I think that is a wonderful message to end on. Anything else that you want to say regarding that?

Dr. Kevin Flanigan: You know, and for some people, they're most comfortable with that transactional basis. "I just want to go in, be seen and be out and I don't care who it is," and that's their comfort level and wonderful. But for almost everybody, very large percentage, it's the relationship that allows for the best possible desired health outcome. And so I obviously wholeheartedly agree that it's the relationship that has the greatest impact on you achieving your best health outcome. So please find a primary care provider that you can relate with, get that relationship started and then keep it going for the decades to come.

Prakash Chandran: Well, Dr. Flanigan, really appreciate your time today. Thank you so much.

Dr. Kevin Flanigan: Thank you for the opportunity to speak with you.

Prakash Chandran: That was Dr. Kevin Flanigan, Medical Director for Ridgecrest RHC. Thanks for checking out this episode of the Ridgecrest Regional Hospital podcast. To learn more, you can visit rrh.org. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. My name is Prakash Chandran. Thanks again for listening, and we'll talk next time.