Carolina: Cruising Past 70: WOW: Choosing a Family Physician for Better Health

Monday, October 28, 2013

WOW: Choosing a Family Physician for Better Health

image of punctate keratophathy
my right arm
The biggest disadvantage of the full time RV cruising lifestyle that we had in the past 4 years was inconsistency of healthcare.  And, more than Bill who has needed specialists, my chronic urticaria, especially, has badly needed a family physician who knows my history. This is one of the reasons we are in Phoenix for 6 months. I want to find a good family physician to be the foundation of my healthcare.

In Orlando, Florida I found the Filipina Dr. Concepcion, referred to us by Bill’s cardiologist Dr. Siddiqui, to be a good one. Unfortunately, we had to leave Florida. In Pittsburg, Kansas, Bill’s hometown and where his sister Rosemary lives, I was fortunate to see Dr. Carlson, Jack’s family doctor, for a while. And, in Seattle, I consulted with Bill’s family doctor, Dr. Chen. Prior to these health issues I had not been used to seeing a family care physician. We had no such a system in the Philippines or I was just not aware.
Cornerstone Family Medicine

Dr. Crawford
From a web search of Health Grades, Health Ratings, etc. Bill chose Dr. Rustin Crawford, D.O., 47, of Cornerstone Family Medicine. He has earned good ratings from his patients (3 out of 4) and has 11 years solid experience. His clinic is part of the Banner Health System, winner of the 2013 Top 5 Health Systems in the US, large health system category (Banner is a network of 22 hospitals in the region, based in Phoenix). My early consultations have resulted in reducing my medications for my chronic urticaria to just OTC drugs, with special aids only upon the incidence of flare ups.

Arizona Optical
Lab results from blood draws has also revealed mild hypothyroidism which is now currently under treatment with thyroid hormones. Good news is that  my mammogram is normal! Dr. Crawford has also referred me to Dr. Jackson, an ophthalmologist who is monitoring my dry eyes (old age and dry desert environment) that has also revealed I have Thygeson's superficial punctate keratopathy (TSPK) in both eyes, a condition where tiny lumps can be found on the cornea. In 3 weeks she will install a punctum plug so that natural tears can lubricate my eyes longer, easing the symptoms of blurred vision.

But the best news is that, beginning November 1, I am covered by Medicare. With a smaller amount for Plan F and Plan D as supplemental plans, my coverage shall even be greatly expanded, both for prevention and care. Together with Social Security benefits, this makes me feel very comfortable about retirement here in America.  Good and affordable healthcare is such a boon for old age.

Primary care is given by a provider who acts as the principal point of consultation. Such a professional can be a general practitioner or a Family Practice physician. It includes maintenance of optimal health and care of all kinds of acute and chronic physical, mental and social health issues. Consequently, the provider must possess a wide breadth of knowledge in many areas, exercise continuity of care, and develop collaboration with other specialists. This results in better health outcomes and lower spending.

A family physician is a primary health care provider devoted to the care of the individual and his family across all ages, genders, diseases, and parts of the body. It is based on knowledge of the patient in the context of his family and his community, emphasizing disease prevention and health promotion. Nearly one in four of all office visits are made to family physicians, 208 million office visits each year, 83 million more than the next largest specialty.

It was in 1969 when family medicine was recognized as a distinct specialty in the US. After World War II, medical specializations became increasingly popular. At the same time, the many medical advances raised the concern that four years of medical school plus a one-year internship for general practitioners was no longer adequate. A residency program added to their training not only gave additional knowledge and prestige, but also board certification, which had been increasingly required to gain hospital privileges.

Family physicians complete an undergraduate degree, medical school, and three more years of specialized medical residency training of rotations in internal medicine, pediatrics, obstetrics-gynecology, psychiatry, and geriatrics. The specialty focuses on treating the whole person, acknowledging the effects of all outside influences, through all stages of life. A program called the "Maintenance of Certification Program for Family Physicians" (MC-FP) requires family physicians to continuously demonstrate proficiency.
Family physicians perform their mission as a patient’s central person for referrals, records, and history through regular visits and good patient history. Thus we will stay in Phoenix for 6-8 months in a year to give our family physician a basic context of working with us. Cornerstone Family Medicine has uploaded and is maintaining our records in so that it can be accessible from any part of the country (or the world). Not just a database of records, it provides a place for continuing dialogue
The bad news, however, is that by 2020 the demand for family physicians will exceed their supply. In 2006, when the nation had 100,431 family physicians, a workforce report indicated the US would need 139,531 family physicians by 2020. To reach that figure 4,439 family physicians must complete their residencies each year, but currently only half that is being achieved. The waning interest in family medicine is likely due to several factors, including less prestige, lower pay, threat of malpractice suits, and the increasingly frustrating practice environment which forces them to try to take care of patients in just 10 minutes. 

the pumpkins we carved!
Obamacare will even exacerbate this problem. As it seeks to expand health insurance coverage by 32 million people by 2016, the success of the program depends largely on the availability of primary care physicians. Unfortunately, according to the Association of American Medical Colleges (AAMC) without it the United States would have been short roughly 64,000 physicians by 2020; with it, 91,000. Hopefully, Bill and I would have become established patients of Dr. Crawford before then.
@ Halloween Dance