Remember the good old days of Marcus Welby, the 1970s family physician whose beloved character painted an idealized picture of small town medicine? Back then, doctors were friends of the family, even scoring invites to milestone events like weddings and birthdays. I started my career in 1984 as a primary care physician (PCP), and a lot has changed since then. In some cases –– that’s probably not a bad thing. Technology has certainly come a long way, creating huge advancements in medicine. But, unfortunately, not all change has been for the better.
From the very start, I saw fundamental problems in the primary care model, and those problems have only worsened in the past few decades: rushed visits and dissatisfied patients; overworked physicians unable to deliver the care they deem necessary; and little to no emphasis on prevention. They all add up to an environment in which PCPs simply can’t provide the kind of care that inspired most of us to get into medicine.
Physicians in a traditional primary care practice are no longer able to develop meaningful relationships with patients. Instead, the approach to care is more akin to a never-ending conveyor belt, getting patients in and out as quickly as possible and addressing problems when they arise -rarely before.
My observations about the problems plaguing this model were reaffirmed in a new national survey of 1,049 baby boomers, conducted by the independent market research firm Ipsos Public Affairs on behalf of MDVIP. We focused on baby boomer health because nearly half of our patient population falls within the 51 to 69 age range – and I think a better primary care model has the greatest potential for improving health and quality of life for baby boomers.
Here is my take on some of the baby boomer statistics revealed by the survey:
While 94 percent of boomers believe preventive care is an important part of staying healthy, a significant number aren’t taking the steps they should to reduce their risk for chronic disease and maintain their quality of life.
It’s not too late for boomers to shape the course of their health. Early detection is incredibly important, but it’s still detection of disease that has already taken hold. Prevention is the key. By age 85, you’re likely managing a problem, not preventing it. But as a boomer, you still have time to make a significant impact on your health and prevent issues from ever arising. The problem is that even though we have greater health consciousness these days, many of us continue to make unhealthy lifestyle choices.
We all know we should get 30 minutes of physical activity a day, sleep seven to eight hours a night, eat a healthy, balanced diet, and get preventive screenings… but the survey showed a major disconnect between what boomers know they should be doing, and what they actually do.
That is what sets MDVIP’s proactive approach to primary care apart from the reactive conventional practice of medicine, and why I decided to become a part of it. Affiliated physicians become a health coach and ally for their patients, instead of just someone who can hopefully “fix” them once something is broken. People in their 50s and 60s can truly benefit from spending quality time with a physician, undergoing an in-depth annual wellness exam and having access to a variety of health resources. Combined, all of these elements help the PCP and patient work together to customize an actionable health plan based on achievable goals.
One in five boomers say conversations with their PCP are like talking to a boss who is running late.
Though it saddens me, I’m actually not surprised – that’s in line with the way medical care is often done these days. For some PCPs, it’s easier to send a patient to a specialist because there’s not enough time to treat complicated conditions. I chose internal medicine in order to care for the whole person, and I became one of the first MDVIP-affiliated physicians in order to build doctor-patient relationships that could improve my patient outcomes and save them and the healthcare system money.
A third of respondents said they spend more time in the waiting room than with their doctor.
And 18 percent said they spent more time on Facebook! Time can be both a blessing and a curse. For a physician, it can be a very unforgiving constraint. When you are given enough time, you can maintain a level of clinical excellence you can only strive to reach in a traditional practice. Professionally, it is very gratifying. It renews your commitment to patients and reminds you why you became a physician in the first place.
One third of survey respondents think their PCP wouldn’t recognize them on the street.
I saw this in practice when my newer patients would reintroduce themselves, thinking I wouldn’t know them. In a traditional practice where a physician might have 2,000+ patients, I can see how remembering names could be a challenge. But at MDVIP, our physicians see 600 patients – or fewer. We make it our job to get to know each patient fully, medically and personally. It’s the type of relationship our parents and grandparents had with their physicians over 40 years ago. MDVIP represents the modernized Marcus Welby, leading a shift back to that type of relationship, because it’s the heart of medicine at its best. Our patients should feel like we’re trusted friends with whom they can share anything without fear of being judged or embarrassed. If we don’t create that relationship, we could miss important details.
This is more than theory – it plays out in very powerful ways. I had a patient I’d been seeing for many years who struggled with alcoholism. I’d seen her admitted to inpatient rehab programs several times. After three to six months, she’d go back to drinking. Every single time. Finally, after one failed attempt, she opened up to me about her past marriage. I knew she was divorced, but I was unaware that she had been abused by her husband – so badly, in fact, that he went to prison. I asked her what the therapists in rehab had said about this, and she revealed that she never told them, nor had she told her children. Just like that, everything became clear.
This was the reason for the drinking, and, just as importantly, it was the reason for the cycle of failure in rehab. I never would have learned this vital piece of clinical data if we didn’t have the kind of relationship that allowed her to confide in me. I guided her through the emotional process of calling her daughter to explain the guilt and shame she felt and supported her through her tears. We then sent her back to rehab, and she’s now been sober for 11 years. Relationships make all the difference – that’s real healthcare.
I believe personalized, preventive healthcare has the ability to fill many of the gaps boomers report in their current primary care experience, because I’ve seen it work. It’s the kind of physician-patient relationship that people want and need.
I’m a boomer myself and I can tell you, I feel like I’m just getting started. I’d hate to have my life plans cut off at the knees by an unexpected diagnosis or the development of a chronic disease. And as a leader at MDVIP, it’s my mission to help our patients avoid that too. Many of them are just starting to embrace retirement and explore life after 50. Our mission – always – is to help them achieve their best, healthiest selves so they can truly enjoy all life has to offer.