Melissa Larson, MD, is a primary care physician at St. Elizabeth Physicians. She sees patients at Primary Care in Walton.
Q: Why is it important to have a primary care provider (PCP)?
A: Both immediate and long-term care are essential to your overall health. As a PCP, we’re your first point of contact for preventive care like cancer screenings and routine blood work. We also play a key role in wellness, helping to catch potential issues early. And when you’re feeling sick, your PCP is the first healthcare professional you turn to. They have training to assess your condition quickly, determine if you require specialized care, prescribe medication refills and help you get back to feeling better fast.
We care for patients, from newborns to older adults. And in my practice, we follow up on patients when they are in the hospital. For those with chronic conditions like diabetes, heart disease or COPD, a PCP helps with ongoing management. We’re like a parent managing a family calendar, ensuring that each aspect of your care is in sync, coordinating with specialists and aligning treatment goals. This coordination is critical because a patient’s needs and preferences change over time.
Q: What is advance care planning (ACP)?
A: Advance care planning involves making decisions about the care you want to receive if you cannot speak for yourself. This process often includes choosing a healthcare proxy or durable power of attorney for healthcare who can make decisions on your behalf. It’s part of documenting your healthcare wishes before you need them. I believe it’s a step toward ensuring your healthcare aligns with your values and wishes, in order to provide peace of mind for you and your loved ones.
Q: How can your primary care provider help you with advance care planning? A: An important aspect of a PCP’s role is in advance care planning. ACP is especially relevant for chronic illnesses that may be life-limiting. We discuss each patient’s end-of-life preferences,
focusing on quality of life. These conversations include discussing how patients wish to live their remaining time, and addressing concerns like comfort, suffering and preparing family members for what lies ahead.
Because a PCP gets to know you over time – understanding your health history, lifestyle, personal preferences and health goals – we’re the ones who can initiate the conversation about advance care planning and end-of-life care preferences.
When multiple healthcare providers are involved in your care, PCPs ensure everyone knows your advance directives and care preferences. And if your situation changes, your provider can help review and update your plans to reflect your current wishes.
Q: When should a person consider advance care planning?
A: Advance care planning should be a routine part of your healthcare, discussed periodically with your primary care provider. Any adult should consider it. There’s a common misconception that ACP is only for older adults or those with serious illnesses. However, certain circumstances and life stages make it particularly important:
- Chronic health conditions: Some long-term conditions can lead to more complex health situations in the future.
- Diagnosis of a serious illness: Illnesses, such as cancer or a progressive neurological disorder, can impact your future quality of life.
- Before major surgery: If you plan to have surgery or face a hospitalization, your healthcare team and family need to know your wishes.
Q: What’s surprising about your specialty that people might not know?
A: One aspect of family medicine that might surprise people is its relatively new specialty. It was only officially recognized in the late 1960s. Family medicine provides comprehensive and continuing care for individuals and families across all ages, genders and diseases. This field bridged a gap left by the increasing specialization in medicine and ensured that patients had a consistent healthcare partner for a variety of health needs.
Primary care and family medicine physicians focus on preventive care, wellness, and sudden illness and injuries. It’s important to visit your doctor even when you’re not sick, so we both understand what is normal for you. Because we understand your family history, lifestyle and other factors, we can provide the personalized care critical in early detection and prevention of health conditions. Also, regular blood work and metabolic screenings help us assess your overall health. These tests help identify potential issues early, allowing for timely intervention.
Q: What is St. Elizabeth Healthcare doing in this field that is innovative, unique or leading edge?
A: As a PCP, we recognize the benefits of understanding our patients holistically. One important aspect that helps those we serve is our involvement in cancer prevention and care, including genetic screening. With advancements in medical technology, a PCP can provide more tailored advice and referrals based on a patient’s genetic makeup and family history. For instance, we offer the Galleri test, a multicancer early detection blood test. This simple blood draw looks at DNA in your blood to determine if any of it may have come from cancer cells. Our genetic counselors are a great resource to talk with, and your PCP can provide a referral.
Some additional health screenings we talk with patients about include:
- Cervical cancer screening: Starting at age 21, we recommend regular Pap smears to screen for cervical cancer.
- Breast cancer screening: At age 40, regular mammogram screenings for breast cancer are recommended.
- Colon cancer screening: Screening for colon cancer is advised to begin at age 45 for both men and women.
- Lung cancer screening: For smokers or those with a significant history of smoking, a low-dose CT scan is recommended starting at age 50, depending on the duration and intensity of their smoking history.
Q: What is currently on the horizon for your specialty? What advances might we expect in the next few years?
A: Advancements that will enhance patient care include expanding virtual care. The technology makes sense for those with acute needs who don’t require an in-person visit. Also, remote patient monitoring, such as using a smartphone, will become more important. It will enable providers to track a patient’s health in real time. However, the importance of personal connection in healthcare remains critical. Patients appreciate the reassurance that comes from a physical presence, like a reassuring hand on the shoulder. PCPs build relationships with their patients over time, which leads to a trusting, strong connection.
