Why You Need a Primary Care Doctor: Expert Q&A

Why is it important to have a go-to primary care doctor you can trust to care for all your basic health needs? Our experts in caring for children, adults and the elderly will offer insights and answer your questions. A primary care doctor provides preventative care, basic treatment options, and education when you have a question or a concern about your health. They also manage anything from chronic conditions, like diabetes or hypertension, to acute illnesses and injuries, like the common cold or a sprained ankle. We have several primary care doctors joining us on this ATF Live. They're ready to answer your questions. That's coming up right now on At the Forefront Live.

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And we want to remind our viewers that today's program is not designed to take the place of an actual visit with your physician. We've got a lot going on in the show today. We have four physicians joining us, and as usual, we're going to try to do our best with social distancing. So we'll do two physicians the first half of the show, and two in the second half. Let's start off, though, having each of you introduce yourselves and tell us a little bit about what you do here at UChicago Medicine. And Dr. Thurman, you're relatively new to the team.

I'm sixth week here. And Dr. John Thurman. I come originally from Iowa, where I practiced last. And I'm right now working at UChicago River East location. We're primary care. We're seeing everything from birth till the end of life. And [INAUDIBLE].

And we have some beautiful new locations. River East is a perfect example. So these are just fantastic places for people to go and get care. Dr. Angeles, you're actually on the other side of the studio as we social distance. Tell us a little bit about yourself.

Hi, hello. I am Dr. Jennifer Angeles. I'm actually in internal medicine, an internist. And I work as a primary care physician at Dearborn Station, another new member of the family of University of Chicago. And I also wear a hat of being the medical director of that practice.

Great. And one of the things that I've been reminded that I need to mention, and we'll mention this throughout the show, but our primary care sites do offer same-day appointments and extended hours. So we try to make it very convenient for people to get in and see a physician. And that's something we're pretty proud of. So Dr. Thurman, you're at the desk. We're going to start with you.

Yeah.

Talk to us a little bit about family medicine in general. I kind of alluded to it in the open to the show, but a physician who is practicing in family medicine sees a little bit of everything.

Right. And the evolution of family medicine, I initially wanted to be a pediatric oncologist. Don't ask. It just was something that really reached out to me. But family medicine is where I trained in my third and fourth year of med school. And what you're taught is the family is like the foundation of family medicine. And what I saw there is physicians that are trained to be able to be in a rural location, and maybe not a major hospital 50 to 100 miles, but they can take care of pretty much everything, or get you stabilized to where you can get transported out.

So the idea of that was really alluring to me. And so family medicine, I look at it-- I played college football, and I kind of look at it as kind of like the quarterback of the team, in a way. So we can manage most things, but if we need to, we can reach out to our subspecialists and get them to see patients if there's something that's more complex. But basically taking care of everything from the beginning of life to the end of life.

So I've got to say-- and this is going to sound weird, but I'm going to do it anyway-- I feel like you and I have kind of a strange connection because you were in Wichita. I'm from Wichita.

Yes.

You lived there for many years.

Iowa connection. I lived in Iowa, as well. It's just a small world. So anyway, we're glad to have you here. This is great.

Thank you.

All right, so Dr. Angeles, talk to us a little bit about-- I'm kind of curious why you chose internal medicine, primary care. And talk to us a little bit about your location, because that's also an exciting new spot here at UChicago Medicine.

Absolutely. Thank you. So I will start with primary care, why did I choose primary care? Primary care, they always say that we are the door to health care. I agree with that. That's very important. But more than that, it is more of a commitment, and it's actually more of a partnership with patient. And that's the reason why I wanted to be a primary care. When you commit to the partnership, you are in charge of a whole range of patients' care, health care, including the preventive care.

And so being in internal medicine, which is the next question, I take care of adult medicine. So 18 years and 120. After that, you're on your own, as I always tell the patient. But this is a journey. I always tell them I am going to be part of your life. Internal medicine takes care of a broad spectrum of diseases that targets different organs. Not just one, different. And I take care, diagnose and treat these patients with all these complicated cases of diabetes, hypertension, and all of that sort.

And when there is a need for a specialist to see you, I will be there standing by. And like what my colleagues say, we will find the cure, we will find with you the treatment, prevent the progression of the disease, prevent the disease. And when there is no more-- you know, you're on the terminal side, we will be there with you, not alone, and with dignity and hopefully pain-free. So that's what we are for.

So I do want to remind our viewers we will take questions. So just type them in the comment section. We'll try to get to as many as possible over the half hour. Dr. Angeles, I do want to follow up. You made some interesting points there. And one of the things that kind of strikes me-- and I think this is so important, but I want you to expand on this a little bit-- is just that value of having a relationship with your primary care physician. Talk to us about the importance, from your standpoint, having that relationship with the patients.

As I mentioned, medicine is so beautiful. Think of it this way. We are trained. We are backed up with powerful science. We are scientific people. We are scientists, in a way.

But you are given that opportunity to mold the science into an art, into being human, with passion and caring for patients. And this is very important. It is a gift.

And so when you say Dr. Angeles, it's important for you to have relationship with the patient, vice versa, it is a known fact that a patient with a very good patient-doctor relationship are benefiting better in health care. Why? Because if you trust your doctor, you trust your patient, vice versa, there is a-- they called the dynamic share, and also the trust, if you have that.

You can better-- how to call it-- create your own care for the patient, which is very individualistic, very unique for that patient. And that's very important. So now you can talk. Patient can actually tell all their, why they did not take the medication, without even being judged. And so that is very important.

Again, that relationship of trust is integral, and communication.

Yeah, I think it's--
It's so important.

It's like you form a team with your family. Whether it's dealing with adult medicine or geriatrics or pediatrics, you're at the center of people's lives. And it's a very precious thing. And being able to advise them, being able to nurture and go along the journey of life with them is so important.

And I think people in primary care-- like she said. My colleague talked about us being kind of like the gatekeepers. And if people do ride along with us and follow our advice, you see really good outcomes. And I think patients do better. Their families do better. And I think it's just a win-win.

It's got to be tremendously rewarding for you as well. Because you're there at some very important times in a person's life, some really good times and some not so good times.

Right. So you think about a newborn. We're trained in family medicine to deliver babies. So that's this joyous occasion, just euphoria. And in family medicine, we're also trained to do palliative care. And I've done hospice care. And so there's joy to be found in that stage as well. And I think being able to navigate, negotiate that with families and lead them through that is so important.

And it's very rewarding, because-- if you lose a patient, that can obviously be self-defeating. But at the same time, if they you're there with your doc-- I've got patients still in Iowa sending me messages about a patient that had passed. And it's nice to just be a part of that and be a part of the families.

Absolutely. So Dr. Angeles, question from a viewer. So I'm kind of curious about this one. Do primary care physicians get involved and work with hospitalists when patients are admitted to the hospital?

Absolutely. I mean, the idea of the old medicine is that we see the patient-- the traditional medicine. And when your patient unfortunately get admitted to the hospital, you round with them. That is not the case in the present time, as you know. People are being taken care of by the hospitalists.

But the beautiful thing now, what's happening in University of Chicago, is that when you get admitted to the hospital, we have dedicated people now to make sure that there is a good transition of care. So even if I am your primary doctor, and I'm not able to see you there, number one, we have a very good Epic system. I can actually see what happened to you there. I see the medication, changes of medication, what they did to you, your lab tests.

And so there are, again, dedicated people, upon your discharge will make sure that you will have a follow-up visit with your primary doctor. So it's a very good transition. I may not be physically there, but we can assure that when you get out of the hospital, the care is never interrupted.

That's great. So I'm curious, most of the time when we think of doctors, we think of MDs. You're a little different situation here. It says DO after your name.

Yes.

Talk to our audience what that means and what you can do with that.

So I'm a doctor of osteopathy. And essentially, osteo means bone. So basically, it's the study of the musculoskeletal system. What that actually means is when we go through medical school, we're experiencing all the same classes in anatomy, histology, pathology, biochemistry, all of the same classes that our MD colleagues experience. But on top of that, we also learn to utilize manipulation with our hands.

So it's not chiropractic, but it's a way of interconnectedness, of evaluating the patient. If your elbow hurts, well, how is that connected to the rest of you? There could be anxiety that comes with that.

And so the idea of osteopathy is to try to use our hands as another modality in terms of caring for the patient. So maybe if I can use my hands, I don't have to use a pill.

It's very interesting, because I've been to River East a few times. And just opened up a brand new section of it on the first floor. And there are a lot of different things that are offered there that maybe are-- I think we think of UChicago, we think pretty traditional. But there are some things that are maybe not as traditional there.

So the first floor is where our primary care is located. The second floor is where we have all of our subspecialists. So we've got EMT. We've got OB GYN. We've got urology, cardiology, and some others. We've got weight loss management.

And all of the specialists down in Hyde Park will actually come up to us, whether it's once or twice a week or once or twice a month. But you do have that ability to see a specialist a subspecialist there as in addition to seeing our primary care.

And we also have extended hours. We're able to see patients Monday through Friday all the way up until 8:00 PM. And then we do also have a Saturday morning clinic. So what we're doing is we're trying to ensure that our patients do have a vehicle for their care, so that we're providing the most opportunities for them to be seen.

Great. More questions from viewers. [CLEARS THROAT] Excuse me. Do you have any advice on how a patient can identify the right primary care physician for their needs and how to go about getting an appointment when PCPs seem to be very busy. And Dr. Angeles, I don't know if you want to take that one.

Absolutely. You know, it's hard to say. Like what I mentioned, it's always different strokes for different folks. But most likely, you would be able to look into, what do I need as a patient? And what is this particular doctor offering as a service? I think that's a very important thing, to know where you're going into.

And then as you go on, I always tell patients, give this relationship a chance. This may be something that you could actually feel on your first visit. Are you able to trust this doctor? Are you able to communicate with this doctor? And you could do that. You could feel that in your initial visit.

And yes, there are different ways now. We are high tech now. You can have many ways of getting an appointment. Definitely you can call by the central scheduling system. And there is what we call the other opportunities in the internet. There is a Zocdoc that you get an unbelievable appointment. You could just get your phone, click the name of the doctor, get an appointment. That's easy.

Fantastic. And then I think also on the UChicago Medicine, we also have physician-- we have our bios. We also have video bios, so you can watch the video bio and see, is this someone that I would like to establish a relationship with?

That's a great way to learn a little bit about the personality of the physician. So thank you for bringing that up. I appreciate that.

Another question from a viewer. For patients over 50 or 60 years old, do they have different needs from a primary care physician? What should they look for in primary care? And we're also going to talk about geriatrics a little bit later in the program. But I don't know if one of you wants to take that one.

A patient 50 to 65 seeking primary care, they can go to an internist. They can come to a family medicine physician. And they could probably-- if they're getting closer to the age of 65, absolutely can see a geriatrician.

I think it also depends on the physician, but as a whole, we see all of our patients without any issues. And that age range I think is a perfect age range to be seen by someone that fits the qualifications of the physicians on this set today.

Great. So we're about out of time for the first segment, but Dr. Angeles, I have one more question for you. And I want to talk to you a little bit about COVID and vaccines and just kind of get your thoughts on things that people should know, particularly since we're seeing vaccines for younger kids now. Any thoughts there?

Absolutely. I can only say-- we can talk about it the whole day. We can pull articles left and right. But I'm going to tell you one thing, everyone. COVID vaccine helps. It definitely helps prevent the disease. Prevents you from giving it to someone, people you love, your colleagues, people around you. And it is safe. I mean, we can go on and on about this. But yes, it works.

And number one is we have ways to get the vaccine. Different clinics at the University of Chicago, UCM, all of these are available now for you to get-- Dearborn Station, specifically, like you mentioned, Tim, before the beginning of the show. We are open. We have evening hours. We have Saturday hours. So we welcome everyone. If you have questions, we are right here.

Fantastic.

And I think the pediatricians can go more into this. But the vaccines, we're opening up 5 to 11 now. And there is no evidence of any myocarditis that was found in any of the patients that were studied. It's safe, just like my colleague said. Get the shot.

Yeah, fantastic. All right. So we have a patient story we're going to run now. And this will be an opportunity for us to swap out physicians. You two are awesome, but we do have a couple of other physicians we want to get on the program as well. So John, let's go ahead and roll the patient story. And we'll be back in a couple of minutes.

So my daughter-- Dr. Jamen is my primary care provider for my kids. And she has been extremely important in their life, especially my daughter. Because she makes us feel comfortable whenever I have any questions. I've known her for 11 years. And it has been the most comfortable relationship I could possibly have with a doctor. She's never made me feel like a question is too small for asking, especially with my daughter being my first born.

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She said she took one look at her, and she could tell something was a little off. So she had my husband take her downstairs to the X-ray, to just get an X-ray done. And when it came back, it looked very, very blurry. You couldn't see any of her vital organs on the picture. And so she knew something was blocking the vision of her being able to see everything in the abdomen area.

Dr. Jamen has been a part of the process since the beginning. And so along the way, she told me any time I had questions, it didn't matter, that I could call her. If it was something I didn't understand-- especially with a lot of medical terminology, there's a lot of words we don't understand. And so she made it very, very comfortable that I could come to her. She'll explain it, break it down for me.

She even came the day of the surgery to make sure everything was OK, even helped out with the baby, because my son was still an infant. So she was there to be supportive for that and for my daughter.

We have been celebrating coming up on eight years of remission. It's the best feeling ever. So within the last eight years, Dr. Jamen has been completely essential in my life. My message for people that don't have primary care providers is that it's extremely important to get it, to have somebody there that you can call for big things or little things.

It's so important, because it keeps us healthy by just getting simple labs done once a year or simple checkups. We can kind of stop things from progressing even further. Had I not mentioned to Dr. Jamen about my daughter's fever, because we had that comfortable setting, I don't think I would have been able to catch the cancer as quickly as we did. Small things could lead to bigger issues.

That was a great video, and one of your patients.

Yes. Yes. I'm Dr. Erin Jamen-Esposito. I've been here at the University of Chicago for a couple of months now. This family is very familiar to me. I absolutely adore them.

It's been a long road with them. And mom's right. That shows the importance of why primary care and why well-child visits and having a really good rapport with your physician is so important for kids. She didn't have an appointment with me. She was there because of her sibling. And it was just a passing conversation that came up.

And I knew the child well enough to know something was wrong. And had we not had that rapport, it wouldn't have been caught.

Yeah, and a pretty significant illness.

Yes, very significant.

Yeah. Well, that's fantastic. Dr. Stacie Levine also joins us on this half of the program. And your specialty as geriatrics, is that correct?

Yes. Yes. Out of all my colleagues here, I've been here the longest. I've been here for 20 years, practicing at South Shore Senior Center. So yes, it's good to be here.

So I'm actually going to start with you, Dr. Levine, because we had a question in the first half of the show that was kind of interesting. And that was, patients over 50 or 60 years old, they have different needs for primary care physicians. And what should they look for? When does that line start for geriatrics and care for older folks?

Absolutely. So I'm a trained internist. So I'm trained to take care of people aged 18 and over. But I realize in my training that to really manage complex patients, those that are developing dementia, osteoporosis, worsening hypertension, diabetes, that I really wanted to go back to train more and increase my skill set.

So I'm focused only on 65 and older. And that's who comes to see me in my clinic.

Great. So kind of curious why you chose pediatrics as your specialty. But I think I see why, with that last video.

Kids are amazing. I mean, I absolutely love being around them all day long. When I'm having a stressful moment, even in clinic if I'm having a stressful moment, it just takes a smile from my patient to make things so much better. And it goes with the old saying that do what you love, and you'll never work a day in your life. And I definitely have that to my advantage with working with kids all day.

And just that relationship that clearly you develop with your patients and their families. Again, it was shown in the video, but it's so critical.

It's incredibly critical. Not only do the parents need that relationship, so that they can ask you the questions that they may even be just embarrassed to admit that they don't know, but it's good for the kids too. Because they need to learn to have that relationship with their physician as they get older, as well.

As a baby, obviously not so much. But when they hit the toddler stage, you don't want them to be afraid of us. You want to have that rapport. And then when they get into being teenagers, of course, we have to worry about them starting to go through puberty and embarrassing things happening. And if they experiment with drugs and alcohol and changes in life, we want them to have a relationship with their doctor, so they can ask these questions that they may or may not be able to ask their parents or feel comfortable telling their parents that's going on in their life. So it's really nice to have that rapport with our patients.

And Dr. Levine, I want to get your thoughts on that same thing, I mean, just developing that relationship with your patients and their families. And in particular, I mean, it's kind of-- we're talking about two extremes here. But in your situation, I'm sure it's very important to talk to family members as you deal with some of the patients.

Absolutely. All of us have parents. And mine are aging as well as everybody else's. And I worry about things with them. I worry about their functional mobility. I worry about their mentation. I worry about their mood, especially in the setting of the pandemic. And having the availability to see a geriatrician to assess them for any of their complex medical needs is really incredibly important to me with my own particular patients and my parents.

Can you talk about the Memory Center Clinic and the Safe Care Clinic? Those are two things that are pretty interesting.

Absolutely. So we have a gem of a clinic. It's wonderful. We have lots of resources. We have geriatric social workers, nurse practitioners, several physicians. We have a pharmacist on site. We have a physical therapist on site.

We can do a memory screening. We have a neurologist who comes on site to evaluate for memory disorders. We have the SAFE Clinic, which is the Successful Aging and Frailty Evaluation Clinic, the SAFE Clinic. And in that clinic, we do a comprehensive geriatric assessment. We look for frailty. We look for mobility. We look for their cognition. We do a home safety evaluation, nutrition evaluation. All of these things comprehensively to help with people living longer with better quality of life.

So I want to talk with both of you about COVID and the impact on families that you've seen and any thoughts that you might have for people watching as to how to mitigate some of the negative impacts. Let's go ahead and start with you Dr. Jamen-Esposito. Because I'm sure kids have really felt this pretty hard.

Yeah, we talk a lot about the social impact that parents have been undergoing with work and having to socially distance. But the kids have really been hit hard with this, because they don't truly understand what's going on, especially the younger children. They just know that they haven't been able to go out. They haven't been able to see their friends. They can't play like they used to. Or they may not have been able to see their grandparents for a few months.

And that takes a toll on the kids. They are not meant to be kept away from everybody. They want to go out and play. And fortunately, it's been a rough time for these kids. So they haven't had a chance to be a kid yet.

Well, I bet we'll have impacts that I'm sure that we'll see for years to come. Because for these kids, this is an important time to learn about socialization and dealing with other folks. And some of them haven't-- they've missed some of that.

Yeah, I have a four-year-old child at home. And when all this happened, he was two. And we didn't send him to preschool. We had pulled him out, because it was a little too dangerous having elderly grandparents. And just watching him struggle as he re-entered school, being a little bit behind some of his peers who had gone to school.

And I didn't appreciate that until I saw it through my own son's eyes. We had gone out one day, and he had seen a bunch of people. And he's like, mommy, look at all the people out here. And then he hid under the table, because he wasn't used to it.

So we have to be careful with our children, because they just don't have the same understanding of the situations that we're going through right now. And fortunately, things are starting to get a little bit closer to normal, which makes me very happy now that the COVID vaccine is available for these ages 5 and up. And it's so important to get them vaccinated, so we can get our children back to the normal childhood.

Yeah. So Dr. Levine, I want to talk to you. Same question. For seniors, particularly seniors who have really experienced some isolation, it's got to be pretty damaging.

Very, very hard. I'm dealing with a lot of anxiety and depression right now. With my dementia patients, having some behavioral issues because of the social isolation. I mean, you don't realize how much social contact is important in people's lives until this sort of thing happens to them.

So we're finally getting out of it. People are getting vaccinated, which I strongly agree with everybody here on this panel. Please get vaccinated. I know that my own patients have been doing very well with the vaccine. And I think it's really helping get people outside some more, getting them out to the grocery stores and getting to the movies, feeling like they're a normal person again.

So one thing I think that is common-- and maybe this is more true for older generations. I could be wrong. But sometimes it's difficult to admit that you are struggling, particularly if it's a psychological issue or an emotional issue. And I think, again, the isolation can be a really challenging time. What kind of advice would you give to maybe family members who are worried that they've got an elderly relative that is suffering?

Please reach out to your doctor. That's what we're here for. Every single one of us here in primary care, we know what you're going through right now. We see it in our clinic. Please do not be shy. Just call us up, and we'll get you some help.

So we've only got a few minutes left. But I want you to kind of tell us about the space where you work. It's one of the newer areas. And it's pretty nice over there.

Yes, it's wonderful. I'm over at the Dearborn Station location. It's about at 8th and State. It's 47 West Polk. I'm there with Dr. Angeles. So we have a variety of physicians there, family practice, internal medicine, OB GYN, pediatrics.

It's a wonderful clinic. There's parking behind us, which is also great to find a spot in the Loop where it has actual parking for our patients is phenomenal.

It's fairly unusual.

Yes. And it's a nice little community over there.

And you guys offer all kinds of help for folks.

We do. We do. And so we've been able to access all the specialists still at the hospital too. So we work so much with them that we get the same services at our location as you would at the hospital as well.

We only got a couple of minutes left. This 30 minutes has gone by extremely quickly. I want to give each one of you an opportunity for a parting shot. And Dr. Levine, we'll start with you.

Just wonderful being here today. And if you have any thoughts or questions about the Geriatric South Shore Senior Center, please call the main number at the University of Chicago, and we'll get you all hooked up with us.

Great. Dr. Jamen-Esposito?

Yep. And like we talked about earlier with the vaccination process, if you guys have any questions or concerns regarding your COVID vaccines for your children, please reach out to your pediatrician or call us over here at the University of Chicago.

And I said this yesterday, and I'll say it again today. Everybody in this room got the vaccination. So if there were any physicians who believed that it was dangerous or the wrong thing to do, you wouldn't have done it yourself. And you wouldn't have gotten it for your family. So go get vaccinated.

Absolutely.

Great. Well, we are out of time. Special thanks to our physicians for being with us today. And I want to thank you for watching, and those of you who participated in the program and asked those great questions.

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Please remember to check out our Facebook page for our schedule of programs coming up in the future. To make an appointment, go online at UChicagoMedicine.org, or you can call us at 888-824-0200.

Thanks again for watching us today. I hope everyone has a great weekend.