Transcription:
What To Expect From Your Primary Care Visit

Joey Wahler (Host): Primary care doctors serve as a point person for your basic medical needs. So we're discussing what to expect from your primary care visit. This is Riverside Radio HealthCast, a podcast from St. John's Riverside Hospital. Thanks for listening. I'm Joey Wahler, our guest, Dr. Klaudia Nowakiwskyj. She's an outpatient internal medicine physician for St. John's Riverside Hospital. Dr. Nowakiwskyj, thanks for joining us.

Dr Klaudia Nowakiwshyj: Thank you for having me.

Joey Wahler (Host): So first, how often should most people see their primary care doctor for a regular checkup?

Dr Klaudia Nowakiwshyj: I usually recommend, my patients to come in yearly. If you're healthy and generally younger than 50 years of age, you can even stretch it to two to three years. The yearly checkup would be more for, reassurance that you're doing good. You have a healthy lifestyle, you're up to date with your vaccinations, whether you need any screening tests that need to be done, and in general, just to make sure that you're doing the best you can to stay healthy, active, and live as long as possible for yourself. Once you get older, definitely yearly. And if there are any medical problems propping up, depending on the condition, every month, 2, 3, 4 months, you should come and see us.

Joey Wahler (Host): Okay. Now, if someone is between primary care physicians and in need of a new one, what do you think they should look for in choosing?

Dr Klaudia Nowakiwshyj: I think location is important. You have to choose somebody who is accessible, in terms of your schedule, in terms of your whereabouts and your lifestyle. Also it depends on whether you have any needs of one particular physician or you just wanna have healthcare done. I usually recommend to try to stick to one person because you have a more personal relationship than with the doctor. My personal preferences is going for a smaller practice in that sense. But location and time is definitely important so that you can access the physician whenever you need him or her.

Joey Wahler (Host): Now you mentioned their personal relationship between doctor and patient. Primary care doctors, of course, become familiar with a patient and their history, and then they can act accordingly. So what are some of the things as a physician that you benefit from in seeing someone on a regular basis?

Dr Klaudia Nowakiwshyj: I definitely get to know their style. I get to know their complaints, I get to know their physical exam. Some people do not have an absolutely perfect physical exam, so once you know that, certain examinations are normal or abnormal. You can follow up and say whether this is an improvement or a deterioration for that particular patient. You also will be more comfortable, to reaching out to different personalities. Some people like to have a more firm, guidance in terms of their healthcare. Some people need more encouragement. Some people need more scolding in a good way, to make sure that they do everything that is best for them and healthiest for them.

Joey Wahler (Host): Interesting. You sound a little bit like a coach in a sense. I've heard coaches in the sports world say some athletes need a kick in the butt and others need a pat on the back. Right?

Dr Klaudia Nowakiwshyj: You know, it's funny, when my husband, we always joke about this, that he considers, he is also in primary care. He considers himself more of a mechanic to fine tune patients. I consider myself more of like a mother to help and guide and grow or improve upon one's health.

Joey Wahler (Host): There's the difference between men and women in one sense, right? He thinks of himself as a mechanic. You think of yourself as a mom. Love it.

Dr Klaudia Nowakiwshyj: Absolutely.

Joey Wahler (Host): So primary care visits include preventative screenings, regular testing. What are some of the most important ones? And of course, you mentioned vaccinations and never before have they been more important? What are the basic things that people need to get done on a regular basis in case maybe they've forgotten it's been a while, whatever the case may be?

Dr Klaudia Nowakiwshyj: For young people again, generally speaking, under 50 most important thing, vaccination updates, blood pressure check every two to three years at least. Also monitoring cholesterol, sugar. Reminding them about healthy lifestyle. That I find it very, very important, best treatment is prevention. So I always try to talk to my patients about what needs to be done to prevent getting anything you know, optimally, you will never get high blood pressure optimally. You will never get obesity or diabetes, and that's the best way to achieve is by diet and exercise. Some people need more frequent reminders for that.

And I think a doctor's visit is also good for that. Unfortunately now with covid, mental health screening is important to check for anxiety, to check for depression. and I think I already said vaccination updates. Once you reach 45, 50 and older, we start talking about cancer screenings. Mainly breast and lung cancer and colon cancer screening, depending on your risk factors and also for younger women, cervical cancer screening.

Joey Wahler (Host): And men also as they get older, need to have their PSA levels checked for?

Dr Klaudia Nowakiwshyj: Prostate cancer screening is a discussion if you follow the guidelines or you should follow the guidelines that it should be also part of the discussion, depending on your risk factor, symptoms on how to follow through for prostate cancer screening.

Joey Wahler (Host): You mentioned mental health and there's a lot more attention being paid to that in recent years and rightfully so. So speaking of which, short of going to a psychiatrist, if a patient wants to investigate, starting medication for that, or perhaps changing medication for that. Again, a primary care physician would be the first stop along the way. Right?

Dr Klaudia Nowakiwshyj: Yes, you have to be aware of your limitations. If somebody has Severe depression, severe anxiety. Sometimes you do need to reach out for a specialist, a psychiatrist, psychologist, for easier, more simple places. Yes, primary care is adequate and again, that patient relationship comes into strong play that you can notice smaller differences and smaller changes and concerning changes in a patient's mental health.

Joey Wahler (Host): Doctor, how about the fact that nowadays, I guess especially during covid, for a variety of reasons, it's become in a lot of areas, much more difficult to get an appointment with a doctor in a timely manner. Oftentimes doctors are backed up and, you're seeing many, many patients in a given day. With all those challenges going on, with all those numbers that you face, just in terms of sheer volume, how do you maintain that relationship that you've mentioned a couple of times is so important when oftentimes, you're at it all day?

Dr Klaudia Nowakiwshyj: Yes. You just have to do it. You just have to keep on trying. Once I know my patients, I know who requires a little bit more time, who requires less than the alloted time. So hopefully sometimes I can guide the schedule accordingly. sometimes you need to do follow up phone calls just to make sure that the patient is on the right track and. If it's something very time consuming, very complicated, you just have to make sure that they come back more frequently or sooner. And reevaluate on a much shorter interval.

Joey Wahler (Host): Couple of other things. Primary care visits can also be beneficial even when we're well, because if nothing else it confirms that gives us a little peace of mind. Right?

Dr Klaudia Nowakiwshyj: Correct.

Joey Wahler (Host): What would you say to people who are like, I don't love going to the doctor. I'm fine. I'll see in a couple years. Don't do that, right?

Dr Klaudia Nowakiwshyj: No, don't do that. I love, for instance, the flu shots because that gives you, An opening and a reminder that, you know what, just coming in, have a flu shot. If anything comes up, we'll talk about it. and I think that that's a nice opening or a nice way to get patients back. And then just, Remind them that it's not a bad thing. I also, if somebody comes for routine physical and everything goes well and they hate coming to the doctor, I always tell them, I'm like, look, that wasn't so bad. Now you can check it off of your to-do list, then let's do it again. I'm not hurting you. You're not hurting me. We'll be friends.

Joey Wahler (Host): That's great. And then speaking of flu shots, as we tape this, it's at the time of year when it's flu shot season, there's also yet another COVID booster shot available. Right? So I just got my booster. I still have yet to get my flu shot. What's the best timeframe for getting those two if you know you need both?

Dr Klaudia Nowakiwshyj: You can take both of them even at the same time. I have had multiple patients who have gotten both, one arm one, the other arm the other. I usually ask if anybody experienced any adverse events afterwards in terms of just feeling under the weather, more pain, maybe a little bit of fever next day. If that's the case, I tell them. It's okay if you keep a week or two in between the two shots, but medically speaking you are more than okay to get both of the shots and they will work just as well if you get them at the same time.

Joey Wahler (Host): Gotcha. Well, folks, we trust you are now more familiar with what to expect from your primary care visit, Dr. Claudia Nowakiwskyj. Thanks so much again.

Dr Klaudia Nowakiwshyj: thank you for having me. Nice talking to you.

Joey Wahler (Host): Same here. And for more information, please do Call St. John's Riverside Hospital's Physician Referral Service. They're at 914-964-4DOC D O C. Again, that's 914-964-4DOC or you can email them at Findadoc@riversidehealth.org. Again, findadoc@riversidehealth.org. If you found this podcast helpful, please share it on your social media and thanks again for listening to Riverside Radio HealthCast, a podcast from St. John's Riverside Hospital, hoping your health is good health. I'm Joey Wahler.