‘She gives me peace of mind’

Joanne West has had a primary care provider since she was 19, but she’s never been more grateful to have one than she was this past year.

The 66-year-old Westwood, Mass., resident has some chronic medical conditions and recently had surgery, chemotherapy and radiation to treat breast cancer – treatment she underwent alone due to COVID-19 rules.

Her PCP, Dr. Nadaa Ali of Atrius Health, has been with her through it all.

“She’s my quarterback,” West said. “She knows the plays, and she knows the players. I can’t imagine having tried to navigate through the years without her. She has recommended specialists, helped coordinate care and made sure all of my questions are answered.”

Even before her cancer diagnosis, West says Ali was a valuable advisor on a range of health issues.

“She’s on top of my overall well-being, and if it’s time to call in a specialist, she’s always ready with two or more recommendations,” West said. “She’s also just a very compassionate, very caring, person who looks at you not as a patient but as a person.”

A vital partnership

The value of having a primary care provider is widely recognized by health care organizations.

Blue Cross Blue Shield of Massachusetts covers preventive care services with PCPs, usually with no out-of-pocket cost.

“PCPs are your ideal on-ramp to the health care system. They can help you get the care you need for nearly any health problem, either by handling new problems themselves or by making referrals, and they are invaluable as coordinators of your care to make sure you and your providers are all on the same page,” said Dr. Mark Friedberg, a primary care physician and head of performance measurement and improvement at the nonprofit health plan. “By establishing a long-term relationship with your PCP, every aspect of your health care can be improved. Subspecialists are experts in specific areas of medicine; your PCP is the expert in you, as a complete human being.”

Better outcomes, lower spending

As West found, there are a wide range of health benefits to having a PCP. They improve health outcomes and restrain the growth of health spending.

Patients with an established primary care doctor are more likely to receive beneficial preventive services. They have fewer hospitalizations and lower rates of emergency department utilization. They report greater satisfaction with their care. They may even live longer lives.

PCPs typically hold annual visits with patients to check on their health, discuss any new or worsening symptoms, review their immunization status and conduct or coordinate preventive care, such as screenings for breast cancer and colorectal cancer.

“At times, we play the role of detective because often we are the first person to hear about a problem,” Ali said.

Once health issues are identified, PCPs help patients manage conditions, such as asthma, COPD, diabetes and high blood pressure, through medication and lifestyle changes so they don’t turn into bigger health issues down the road.

“I coach my patients on navigating healthy lifestyle choices in the real world,” Ali says.

As West found, if patients need to see specialists for certain medical issues, PCPs often coordinate that care. They also follow up with patients after a hospital or emergency room visit.

“When there are many specialists or health systems involved, I can help advocate for my patients,” Ali says.

More and more, PCPs also are treating patients for mental health conditions such as anxiety and depression.

“I see myself as the first line of defense for mental health concerns, which definitely increased during the pandemic,” Ali says. “I ask about mental health at every one of my physicals and do a depression screening. If someone is waiting to see a psychiatrist, I can connect them with talk therapy, start medication and monitor their response while they wait.”

A lifelong relationship

Ali, who has a PCP herself, says there is value in it at every age: “As a young, healthy person, having a PCP is a way to make sure you stay healthy. As you get older, we can help improve your health or prevent problems in the future. If a health concern arises, we can help diagnose and treat it.”

Although it can take time for a patient-PCP relationship to gel, Ali believes there’s something to be gained: “Sometimes connections with patients are immediate, and the patient feels comfortable sharing information with me right away. Other times it’s not as easy. I do my best to try to listen, be empathetic and gauge where the patient is, and recommend small steps they can take to improve their health while we build understanding and trust in our doctor-patient relationship.”

Based on her experience, West would encourage everyone to get a PCP.