I will admit that for the last ten years or so, I have been a bit of a hypocrite.
A few days ago I made my first primary care provider (PCP) appointment since saying goodbye to my pediatrician at 18 (I just turned thirty). I know, I’m in healthcare. I should know better. I realize that this admission also sounds odd considering I have a list of medical diagnoses a mile long (with the most random things, of course) but I have always seen specialists for my medical care since I was diagnosed with UC at 22 years old. It’s not that hard to imagine; you have specific needs and so you only see specific providers for those needs. But then other underlying, asymptomatic needs go untouched.
I currently have an OBGYN, a women’s health NP, and a gastroenterologist that I visit regularly. For the handful of times I’ve been sick in the past eight years, I have gone to the walk-in type clinic at my work (when I still worked there) or have just asked my GI to manage an issue that wasn’t directly related to my UC, although many of my issues have been. And since I have good relationships with each of them, I have managed to get by for the past eight years since I could mostly already tell them what’s wrong with me. It wasn’t a perfect system but I had made it work.
But recently, I’ve had a change of heart. I have seen a flaw in my rationale, my need for a primary care provider, notably my need for continuity of care. And this is slightly ironic and very hypocritical considering I’m training to be a primary care provider. I am learning right now to look at the full picture of a patient, to weave together bits of information about someone to create a healthier whole. I believe in having a relationship with a PCP. I believe in continuity of care. I believe in a holistic, comprehensive view of medicine. And I hope that I can show my patients the value of these things, whether in clinical soon or in practice later on. So, in an effort to be transparent, I’m admitting my ignorance here and repenting of my errant ways in hopes that you will not make the same mistakes that I have.
My first and most bland excuse is: Time and Money. I already go to a plethora of appointments. I think you can probably understand this one- I visit the GI twice a year or more frequently depending on how I’m doing, the OB constantly when I’m pregnant (I’m considered high-risk), go to the hospital every eight weeks for my Entyvio infusion, and have had to do several stents of weekly physical therapy for some lingering, childbirth-related issues. I am sick and tired of not only paying copays (hands up if you meet your deductible every year!) but of physically driving to all these appointments. And since I get my preventative care taken care of at my well-woman or OB visits, I haven’t feel the need to make yet another trip to an office. And, just for the record, most primary care is covered 100% by your insurance so my excuse really falls apart there.
My next excuse is: Fear. Dear God, if I get some routine labs drawn and find out I have something else wrong with me, I will lose my mind. Seriously. It’s sort of the mentality of what you don’t know won’t hurt you. Again, I KNOW. I’M GOING TO BE A PCP. IT’S A RIDICULOUS EXCUSE. Undiagnosed hypertension, as an example, hurts a lot of people who have no idea that their blood pressure is through the roof and now they’ve got end-organ damage. I often think about what I would tell myself if I was a patient. I can picture this entire scene perfectly- I’m sitting in a cushioned chair, my hands tucked politely in my lap as I listen to the person on the exam table, smiling gently as they relate the same excuse. I nod a few times, looking empathetic, not wanting them to feel judged or condemned for their faulty thinking. Then after they finish, I sit forward in my chair a little bit and reply, “I realize it’s hard to have to manage so many medical issues but coming to see me consistently will help both of us take better care of you, not only today but in the long run.” And then the patient will smile, trust me (hopefully) and keep coming back. So there, I just disproved my own point. I have no excuse for that one.
My last excuse is: DENIAL. This is very closely related to fear because one feeds off of the other. Here’s what I mean: It’s extremely difficult to look your disease or dysfunction in the eyes. To acknowledge that your body is broken, will only continue to deteriorate, and will not be fixed this side of heaven. I have known I needed to see the PCP for some other underlying issues but I haven’t wanted to admit that I need even more help. That I can’t control or fix myself. If you’re like me, you find every option to put your disease in a box, to manufacture a scenario (eating healthy or not drinking or any other modifiable risk factor) that will keep you healthy. But that’s not how it works. And it’s actually better for you and me both mentally and physically if we admit that we cannot cure ourselves (most of the time). There is freedom in seeking help and being honest, even if it’s with someone you don’t know. I hope that people will one day feel the same willingness to be open and honest with me. I pray that the Lord will give me the right things to say.
So there you have. I’ve been full of bs excuses but it’s time to shed those: to not fear the future, to admit where I am weak and need help, and to suck it up and pay those copays rather than getting that new purse. I need to take care of the one pathetic body I have, for myself and for my family. I hope I’ve convinced you that it’s worth it. Go find a PCP you like and stick with it. I’ll do it with you, I promise.