Does Your Primary Care Doctor Really Know You?


The Importance of a New Patient Intake

With all the changes in healthcare and health insurance, most of us have had several primary care doctors over our lifetimes. Plus, many of us living here in Southwest Florida are not native to the area, so we had to seek out a new primary care doctor when we moved here. That means we should have gone through a new patient intake more than once, and that intake should have given our new primary care physician the opportunity to really know our body well. But, tell the truth, how well do you feel your doctor knows you, your body, or your ailments?

We’ve written quite a bit about the fact that as your concierge doctor, we are able to take more time with our patients. This is true from the first moment you meet us for your new patient intake and physical. So let’s take a look at what that looks like when you become one of our patients at PremierMD Care.

We will start by sending you for a comprehensive blood work panel before you even come in for the first time. The blood work panel will include blood count, a complete chemistry panel, full thyroid panel, Vitamin B-12 and vitamin D levels, and for men we look at their PSA and testosterone levels. We may add more tests based on your past history, symptoms or ailments you may be complaining about, or medications you are on. Sometimes, a symptom requires testing that is not the run of the mill testing, and we will do that testing.

Our initial intake and physical usually takes a full 60 minutes due to the extensive information we collect. The session begins with questions about why a person is seeking out a concierge doctor as their primary care physician. This is because we want to know what their expectations are.

Some people come with one specific condition in mind that they feel needs special attention. For example we’ve had people come in because they have severe rheumatoid arthritis, and they want a referral to the right rheumatologist, or they are in pain and they want to be sent to the right pain-management specialist. So they want someone who will take the time to interact with other specialists on their part.

We’ve had a lot of patients come to us because they have not been feeling well for a long time, but no other doctor has been able to give them a satisfactory answer as to why they feel this way.

Finally, sometimes people want preventative care. They have a strong family history of cancer or heart disease and they want to know what their risks are and how they can prevent it.

After finding out why someone has chosen us as their concierge doctor, we will go over details of their blood work with them, answering any questions they may have etc. Next, we will focus on getting their full medical history, which means their family history of disease, and all of their documents from past doctors, any hospitalizations or surgeries they’ve had in the past, and their history of chronic disease or ailments. We always make sure to get outside records from other doctors the patient has been to over the years, and we read through all of it thoroughly because that gives us a lot of information that is good to have before looking at symptoms that might be popping up now. That’s another thing we do that takes a lot of time that other primary care doctors may not have the time to do.

Next, we go over their medications in detail, how long they’ve been on them, why they are taking it, side effects, and talk about any allergies to medications. We review all of their internal systems, and talk about any aches or pains throughout their body. And after this, we  do a full physical exam. It’s a typical physical, but we do take extended time to feel the thyroid, and focus on looking over the entire body, doing a thorough exam with every patient.


Doctoring Like a Detective

Because of the time we take with our initial intake, we’ve often discovered chronic disease and conditions that other doctors have missed. And the main reason for this is that we take the time necessary at all stages, from asking the questions, to doing a through physical, taking more time to being able to think through the results of testing. The additional time allows us to sit, and get thorough with our questions, and also the time to problem-solve. It really does take time to put in the thoughtfulness to think through all of the information from testing, to what the patient says. When we were not concierge doctors, and we had fifty patients in a day, we did not get the time to think through things in the way we wanted to, and we were too exhausted to do it when we got home from the office. A lot of our work is like detective work. We have to look at all of the symptoms, all of the test results and then we must figure out what is actually wrong, what must be done to correct it, which specialists might have to be brought in, and what are the next actions we and the patient must take to make them well. All of this requires time. A typical doctor may send you off to a specialist and may not have the time to do all the follow up necessary, which adds more time to figuring out the problem. So they may send you to a specialist, but then not get to follow up on the results for a couple of weeks, and then if that test doesn’t give them the answer, they must send you somewhere else, and then that takes another few weeks to follow up. And we already know that some diseases need to be handled right away, so this is not an efficient way to handle it, but it’s all the time they have to do it.

So, just having the time to do the detective work necessary to truly figure out a person’s problem is important, and by being concierge doctors, we are able to keep our patient load to a minimum, so we have the time to do it right. For example, we recently had a patient come in with abdominal pain and heartburn, and it had been going on for a long time. Unfortunately, his primary care doctor didn’t do the basics, didn’t order a colonoscopy, didn’t do a prostate check, didn’t check the PSA levels, so he just didn’t do the basic things.  We don’t think we do extraordinary things, but we do know we do the basic things really well, and better than some other doctors are. Because ultimately, we are all trained the same way, the difference is, as concierge doctors, we just have the time now to do it thoroughly, and that’s having us discover things for patients that other doctors miss. So this individual came to us with abdominal pain and heart burn, but with examination, we felt his bladder was much bigger than it should be. So we checked his prostate, and sent him for those other tests, such as the colonoscopy. In the end, it wasn’t a bladder issue, it turned out to be a prostate issue, which was causing kidney failure, and the prostate issue was actually cancer. So this was something that had been totally missed, and it could have been caught sooner if someone had been doing what they should be doing all along.

A lot of this really comes down to time. When you have too large a patient load, you are too exhausted at the end of the day to do the detective work and thinking that needs to be done to truly figure out what must be done to cure patients. This is one of the primary reasons to consider having your primary care physician be a concierge doctor. Call us today to schedule your complimentary consultation and find out why our physicians are a step above the rest! 239-466-MDMD (6363).

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