The Unexpected Benefits of Primary Care

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Annual visits to a primary care physician starting early in adulthood can pay large dividends later. Consistent monitoring of weight, blood pressure and other vital statistics tell a story for which a clinician can help write a positive ending. Family medicine doctor, Susan Ratay, DO, explains how starting a relationship with a physician early can impact unforeseen issues later in life. Preventive care can actually be lifesaving.

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Macie Jepson
You know, Pete, it wasn’t really until I became a mom that I got the notion having a physician is a lifelong journey. I mean, I had a pediatrician when I was a kid, and then really nothing unless I needed something like a physical or, you know, gynecologist’s exam. Then my kids came along and let me tell you, they haven’t gone without a doctor since the day they were born. And they’re in their 20s, and they’re healthy. So, it really makes me wonder, do we really need a doctor past the age of hitting all those milestones and getting all those vaccines? What is the argument for a primary care doctor when you’re young and healthy?

Pete Kenworthy
Yeah. It’s a great question. You know, the question is, are there consequences to not going to the doctor in your 20s? Or what about your 30s or 40s or 50s, right? What’s the value in that annual physical or checkup for younger people and an annual wellness visit for older people? Hi everyone. I’m Pete Kenworthy.

Macie Jepson
And I’m Macie Jepson, and this is The Science of Health. Today we’re talking about the value of taking one hour out of your year to be proactive with your health instead of reactive. Essentially, today’s discussion is about whether having a primary care doctor can actually keep you healthy. That means preventing illness and disease instead of reacting to it.

Pete Kenworthy
Joining us today is Dr. Susan Ratay, a family medicine doctor with expertise in community health and preventative medicine. Thanks for being here.

Dr. Susan Ratay, DO
Thank you so much. Glad to be here.

Pete Kenworthy
So, let’s start with this. Lots of people in their 20s, 30s and 40s have gone for many, many years without getting sick beyond things like the flu we’re talking about, and they know that they should see a doctor every year to get like a blood test baseline on things like cholesterol or sugar, have their blood pressure checked or keep an eye on their weight, but they don’t. This is lots of people. How do you convince people about the value of preventive care? Is it that some of them aren’t as healthy as they may think? Is it a family history? What is it in those discussions with these people?

Dr. Susan Ratay, DO
Yeah, so most definitely. So, it’s not uncommon for me to have a younger patient, and by younger, I mean someone under 50 to come in and say, hey, I haven’t been to see a doctor for five years, 10 years and then they always feel like they need to justify why they’re there. So, my wife made me come. You know, I’ve had this lingering fill in the blank: cough, ankle pain, knee pain, hip pain, headaches. And so that’s kind of a good starting point. But typically, when they come in, that’s a good captive audience now to talk about preventative. Right? So, kind of going from head to toe, and a lot of times we pick up or we find things that they’ve been dealing with and it just becomes second nature to them. That’s their normal life routine and didn’t even think twice that there might be something we could do about it. Right? That we could basically resolve it or cure what’s bothering them.

And not to mention in your 20s, you need to start thinking a little bit about catching chronic illness and disease early, which could greatly alter the course, the duration and the treatment of those for the next 20, 30, 40 years to come. For example, blood pressure. Right? So, your blood pressure may look relatively good, but if you look back when you were 20, it might’ve been five or even 10 points lower. So, we’re looking at trends as well. So, talking about, okay, well, does high blood pressure run in your family? What does your diet look like? Do you consume a lot of salts? Are you finding time to exercise? What is your stress level? All these other kind of lifestyle behaviors that can greatly affect or contribute to some of these chronic diseases and ailments. So, it’s a good platform to talk about those things. And even if you’re coming in just for your physical, we kind of still go through some of those same questions.

Every visit starts with vital signs, and they’re vital for a reason. Right? They kind of give us a little snapshot of how you are this moment as far as your blood pressure, your pulse. Sometimes patients’ pulses are very high, so you kind of dig into that. Maybe are you really nervous? Do you have some underlying anxiety? What makes you anxious about coming to a doctor? You can find barriers, too, why patients may not have been to the doctor. Maybe they’ve had a bad experience. Maybe they’ve come to doctors with complaints that were written off as something not important or wasn’t given a good thorough workup. And so, they felt like, eh well, they didn’t do anything me last time; why are they going to do something for me today? Or as my patients tend to get a little older, you start caring for your parents, and you start seeing how your parents maneuver the healthcare system, which can be quite frustrating as we are well aware. And so, kind of going through that and kind of feeling through maybe what are some of the barriers or why they haven’t been there may also be part of how you improve how they care for themselves and how often they get preventative screening and tests.

Pete Kenworthy
And one thing I heard you saying there is the value of the annual visit isn’t even necessarily what’s happening at that particular visit, but it’s being able to look back on the year before, two years before, five years before, 10 years before, when you’re talking about things like blood pressure, that may not be that bad or this little tiny tweak in my knee or this little cough that is really nothing because I can handle it. But if we compare that to other years where we continue to see you, we can see some things that we wouldn’t have seen if we had seen you for the first time 10 years later.

Dr. Susan Ratay, DO
Exactly. And to go with that, too, is weight. Right? So, typically obesity is a very slow progressive disease because it’s now considered a chronic disease. And so, by looking at the velocity in which people gain weight or if they’re able to maintain weight, kind of says a lot, too, about what are they doing outside of that doctor’s office. Are you maintaining some sort of physical activity? Have you had a job shift? How did COVID affect you? I know we have to bring up COVID any time we talk about medicine these days. But looking at the trends, so there are medical reasons to explain sometimes weight gain or fatigue or dizziness or fill in the blank. And so, those are good opportunities for us to do. Even your screening, preventative blood work can screen for some of those things. And then patients also…this is a big thing as a barrier for coming to see the doctor…they don’t want to be weighed. How many women don’t want to go to the doctor because they don’t want to know what their weight is?

Or they don’t want to know what their blood pressure is, because they’re living in this little bit of a world of denial, and they actually come in anticipating something to be abnormal. And so, that is also a barrier to talk about that sometimes people don’t think about. And if it’s that big of a deal, most people, most providers will say, hey, if you’re very uncomfortable getting your weigh today, that’s okay. I still want you to go talk to the doctor, and if she or he feels like it’s necessary to wait because of X, Y, Z of what we’re trying to treat you for, then we’ll reassess that at the end of your visit. So, I think that’s an interesting concept, but I know a lot of women may be listening right now or can relate, that’s a source of anxiety with going to the doctors, especially if they know that over COVID they’ve gained weight or they haven’t been as active.

And I want to say another thing, too. We use those vital signs, again, not only for weight gain but weight loss. So, I sometimes get really concerned if a patient of mine has lost a significant amount of weight over a period of time, because may be something else drastically going on in their lifestyle, especially if they’re doing it unintentional. Right? This is not an unintentional weight loss. And if they’re doing it intentionally, that’s a great opportunity to kind of reward them by saying, hey, you’re going to get your blood work done and I bet you it’s going to look so much better. So, we use some of just those vital signs also as a reward, like I said, sometimes when you’re doing a weight loss program, getting weekly weigh-ins is an opportunity to reward good behavior over the week or two to say, hey, look, you’re doing really good. This is a good objective finding for how well you’re kind of doing those things. Whereas if it’s a little bit higher or a little bit, it’s nice because if you go every year, we can say, hey, wait a minute, let’s take a break. Let’s take a look. What have we done differently? What can we maybe make some changes so that it’s not worse the next time, that we can put the brakes on a little bit, do a little assessment and see if there’s anything we can do intervention-wise that’s not crazy.

Macie Jepson
So, you’ve touched on three things that we can expect when we come in to see you, and that is vitals. We can expect some blood work, weigh and then a good long conversation about what’s happening in our lives. So, what do you tell a 20 or a 30 year old who is feeling all invincible, thinking, I don’t need that?

Dr. Susan Ratay, DO
So, we go through our normal assessment. So now with a lot of the preventative medicine, or sometimes we call it your physical exam, your wellness exam, your preventative health exam. So, we’re giving it a lot of different names, all kind of for the same thing. And physicians now we’re using a lot of templated notes or documentation of that visit. And so, you can expect either the medical assistant or the nurse or even the physician to go through a screen for your mood. So, have you been feeling depressed, anxious? So, that’s a nice opportunity for some of these younger patients who may be quite stressed. I know a lot of 20 year olds are struggling with some anxiety and depression. The 20s and 30s is a very influential time of your life where a lot of things are happening. Right? You may be finishing your education. You may be starting a new career. You may be settling down with a partner. You may be even thinking about starting a family.

So, there’s a lot of things going on in those age where your mood may be affected. We ask about sexual health. Right? Have you been up to date on any of your cervical cancer screenings? Is there any reason or concern for sexually transmitted infections that we should screen you for? And those can be actually considered preventative. In a younger population that is considered higher risk, not because of promiscuity, but because you’re dating. You may have multiple partners over the course of a year or two. And that’s a good time to kind of just make sure everything’s looking good and that there’s nothing that’s going to prohibit your health moving forward or affecting further relationships in the future. So, that’s kind of something we definitely go through with younger patients.

We also touch upon family health. So, your parents. Usually it’s first degree relatives, and some people don’t understand what that means. So, first degree relative is anyone that is basically your parents or your siblings. So, if your parents suffer from any chronic disease like thyroid, blood pressure, cholesterol, diabetes or they’ve had any unforeseen or unfortunate events like strokes, heart attacks, diagnoses of cancers. Those are all things to let your primary care doctor know so that we can be a little more aggressive or screen you a little more frequently or even start screening you earlier depending on what age your parent was when they were diagnosed. So, that is something, too, to get you thinking about that. And I have a lot of patients who have no idea what some of their parents’ or siblings’ health is. They have no idea. So, again, it’s kind of opening the discussion and saying, hey, I highly encourage you over this next year when you’re home for the holidays or you’re sitting down with Mom or Dad, like ask them, what are some of your health, what are of the things you take medications for? What are some things that you’ve had or you’ve had to have done that would maybe affect or improve my ability to detect early? And so that’s one.

Another thing we talk a lot about alcohol and nicotine use. So, that’s a really, really big thing to start talking about in early ages, because we know the longer that you smoke, the more detrimental it is to your cardiovascular health and increases your risk for some particular types of cancers, lung and bladder being one of the two more common ones associated with smoking. And alcohol use; what does your relationship with alcohol look like? Is this something where you feel like it’s inhibiting your ability to do as well as you could at work? Or is it affecting any of your relationships at home or with friends or with family members? And just, again, taking a moment to assess that, provide resources. We do have resources for these, although people sometimes don’t know that. We have medications we can help with smoking cessation. Some insurances do actually cover nicotine replacement therapy, which is the patches and the gum. And you can definitely discuss that with your physician or come back at a later date and discuss literally just that. There is reason to just meet with your doctor about smoking and what that looks like.

Pete Kenworthy
All right. How about this? Are there patients who you see…you talked about these patients who come in and say, oh, I haven’t been to the doctor in five or 10 years. So, you see patients for the first time sometimes in their 40s, and you think to yourself, wow, if I had seen this person in their 20s, we could have prevented X, Y, or Z. What are those things, because that means there’s consequences to not going to the doctor. But again, you’re back in those invincible days that Macie talked about. Right? You’re in your 20s, your 30s, you feel fine, but little things are going on that if you had been going every year, we could have prevented them seen for the first time in our 40s.

Dr. Susan Ratay, DO
Yes, correct. So, one of the biggest ones I see in this particular age range is cholesterol. Cholesterol is one of those big ones. It kind of sneaks up on you. It’s very highly linked to family history, very highly linked to diet, very highly linked to lifestyle. And so that’s usually when I start to really start seeing some numbers shift in that screening or preventative blood work. And it kind of gives us an opportunity for discussion to say, hey, look, if you’re a male, you’re already at higher risk when you approach into the 50s timeframe. Again, let’s touch upon your family history. Let’s take a look at what kind of diet you’re on and the lifestyle you’re on, and do you really want to start a medication for this? Because if it continues to go up, we might have to do that to reduce your chance of some of these events occurring in your life.

And so, that’s a good opportunity. I see that a lot. Other patients in their 40s, unfortunately, that’s usually when a woman has kind of presented herself with thyroid disease. And that is typically screened with a test called a TSH, which is a thyroid stimulating hormone. And that tends to start creeping up. And that gives us kind of an indication that maybe there is some need for supplemental thyroid, look for other reasons and maybe why the thyroid may be stressed or strained. It’s also a good time, I’ve been seeing a ton of sleep apnea. Right? So, sleep apnea starts to creep up on patients in their 40s and 50s, and usually it’s a precursor to cardiovascular stress and strain later on in 50s and 60s and even 70s. And if I would’ve said, oh dang, if we would’ve treated your sleep apnea 20 years ago, it may not have put enough strain on your heart for 20 years that you have AFib now, or you have heart failure now or you have extra high blood pressure, or you may have actually felt rested for the last 20 years of your life and not felt like you’re dragging.

So, these are some things where we can sometimes assess the likelihood of patients having sleep apnea, for instance, by just looking at the circumference of your neck and looking in your throat, because some patients, anatomically speaking are very narrow in their airway. So, it doesn’t take a whole lot for that airway to block off when you’re sleeping very soundly. And again, you can just ask simple questions. We have a ton, a ton, a ton of questionnaires we use in medicine to give us a little bit of, a little more probability of a test being positive. So, for sleep apnea, you may ask questions like do you feel rested when you wake up? Do you ever wake up in the morning with headaches or multiple times to get up to urinate? Some of these can actually be signs or symptoms of underlying sleep apnea. So, again, we would like to find some of these underlying causes, again, so if your thyroid is low, that also tends to increase your weight, may make you feel tired, which then you’re less likely to exercise.

So, it’s one of those things where, again, if we’re doing these routine blood work, we can detect all of these. And then depending on who your provider is and how your discussion goes, they may even do a little further testing based off of symptoms you may be having. And for example, I test almost all of my patients for low vitamin D, because I always say one of the risk factors of having low vitamin D is living in Northeast Ohio. And about 80% of my patients, if not more, because the ones who are probably not the 20% were already taking some form of vitamin D, either in multivitamins or doing it on their own accord. But the average range of vitamin D is 30 to like 100. And so, people are squeaking in at like 32. Well, that’s not good enough for me. I want you to be in 60 range, especially as we move into those post-menopausal ages where now we’re worried about osteoporosis. So again, making sure that your calcium intake is good, you have good adequate vitamin D to maintain that bone health for the next 20, 30 years down the road. So, then you’re at less risk for developing osteoporosis.

So, another thing to remember in your 40s is that at the age of 40 is when we add a blood test to all men’s preventative screening, PSA levels. And PSA stands for Prostate Specific Antigen. And I will say, not all physicians order this, so that may be one you may need to request, but it’s a good time to get a screen, like a baseline level of this in your blood because what it helps us detect is cancer in the prostate. So, as a man’s prostate ages, that level tends to go up. But again, what we like to watch is the velocity. How fast is that number going up to make us be a little suspicious that there’s some accelerated growth in the form of a cancer?

So, that is a nice blood test that is a screening test that is included in your regular routine blood work. And then at age 40 is when we recommend all women start annual breast screening through a mammogram. And this is something that the recommendations have kind of changed throughout the years, but now insurance is covering it on a yearly basis. And again, it’s good to get that baseline mammogram, and you want to continue to go to the same system, because the radiologist can compare from year to year to make sure there’s no changes in the tissue of the breast. So, these are things that, again, are good to start right when they’re able to be screened for an initial baseline and then you subsequently recheck those on a yearly basis to monitor for change.

Pete Kenworthy
And it goes without saying, the earlier you catch cancer, the better chance you have.

Dr. Susan Ratay, DO
Oh, most definitely. Most definitely. Yeah.

Macie Jepson
I’m curious to know about women’s health and whether or not they need both a gynecologist and a primary care physician.

Dr. Susan Ratay, DO
So, that’s an excellent question. So, sometimes female patients come to me and they say, look, I’ve never been to a primary care doctor since I was younger, but I’ve had two or three kids, and I’ve been seeing my GYN and they’re ordering my mammogram for me. They’re doing my PAP when I need to. They’ll order some blood work for me. And that’s awesome. That’s great, because I want you getting those preventative services however you’re getting them. And if you have a really good relationship with that person, by all means, keep going and seeing them. They are the expert of that area of your body. However, they are not going to talk to you about all of the other things we had previously mentioned. They may, but they may not. And also, as a primary care doctor, if a woman is low risk and not having any problems as far as vaginal bleeding or discharge or abnormal PAPs in the past or abnormal mammograms, a primary care doctor is fully equipped and trained to do those screening PAP tests and pelvic exams and ordering the mammograms and resulting those mammograms.

And so, you would want to, if you were on the market for a, like you said, one- stop-shop primary care doctor, you may want to just make sure that particular provider does women’s health PAP exams, because not all of them choose to do that. But I would say most of them do. And all of them have been trained in it. And the other part is that if your primary care doctor does testing and it comes back abnormal, it would not be uncommon for them to say, hey, you know what? Maybe you should establish with a GYN. Maybe you should make sure that they’re not seeing things that I don’t see. And they have, they’re equipped to do other tests like biopsies or other kind of procedures that may be indicated for your condition that was detected on your screening.

Pete Kenworthy
Okay. Listen to this stat. According to the CDC, if everyone received the recommended preventive care, more than 100,000 lives could be saved each year. A hundred thousand people saved each year. What are those things? What are the things we’re talking about that the CDC puts that stat out there?

Dr. Susan Ratay, DO
I think most of it is your cancer screenings, 100%. Like you said, you hit the nail in the head. Early detection makes the world of difference. If you have a small lesion in the breast, for instance, there’s a chance you could resect or remove, it’s called like a lumpectomy, that entire abnormal tissue. And then be on more frequent surveillance to detect any subsequent recurrences or anything like that. And also, sometimes when you get one cancer, it can help us guide you for any other subsequent cancers that may be associated with that. So, we can do additional testing. We can do, I’m sure everyone has heard of the BRCA testing, so that genetic link to cancers. So, that’s one just example. Again, sometimes my patients get these routine blood work and say their kidney function is off or their liver function is off. We didn’t talk about that. Right?

Those can be indications of some underlying autoimmune diseases. Maybe there was some sort of injury or trauma to those organs. Think of infections. So again, we’re kind of doing a general screen to make sure some of those very important organs are staying healthy. And then we also can utilize those levels. So, say you have a little reduced kidney function. It may change what medications we can use to help prevent further injury to that organ. It may affect doses of different medications that are metabolized in those organs. So again, it gives us a little bit better. it gives us a more, what do we say, individualized care so that we know when we’re treating you, we’re treating you the best of our ability because we have more information.

Macie Jepson
Let’s talk about diabetes for a minute. I read that in the United States, about 30% of people who have diabetes don’t even know they have it. And almost half of those being treated aren’t even controlling their disease. What’s the risk there?

Dr. Susan Ratay, DO
Oh my. So, I do a lot of diabetes management, and actually I love diabetes. I think it’s very interesting. There’s a lot of new medications out there. They’re kind of pushing the envelope for kind of understanding the association with neurochemicals and other hormones in the body that may be contributing to diabetes. But if you have diabetes and it goes untreated, typically that means you have very high or elevated sugars in your blood. And things that do not like high sugar are little tiny blood vessels and little tiny nerves in the body. So, if you look at the structures that get affected: the brain, the eyes, the kidneys, the fingers and the toes, mostly, are the areas that get affected because those are the most susceptible to injury from these high levels of sugar. And over time, some of that injury can’t be reversed. So, diabetes in the United States is the leading clause for, let’s say, blindness, leading cause for needing to be on hemodialysis for kidney failure, one of the leading causes, or contributors, I should say, to heart attacks and strokes.

And let’s talk a little about peripheral vascular disease. People can’t feel if they’re on the verge of having a stroke. They can’t feel if their kidney function is declining. But peripheral vascular disease from diabetes is very uncomfortable. It’s painful, pins and needles. And then when the nerves get severely damaged, you can’t feel your feet at all. And now you’re at risk for having ulcers and injuries and wounds that won’t heal very well. So again, if we can keep those blood sugar levels suppressed or down or functioning, your body functioning on a more level to be able to control those sugar levels, I get 10, 20, 30 years down the road, you can affect the outcome of all those other conditions that we just described, which costs A) lot of money to treat, but also affects the quality of someone’s life tremendously.

Pete Kenworthy
I mean, I continue to hear in your answer to everything…little things can become big things.

Dr. Susan Ratay, DO
Of course. Yeah.

Pete Kenworthy
That’s kind of the constant message throughout.

Macie Jepson
This conversation about diabetes makes me think about COVID and a couple of years of people not going in and being checked out. And I do wonder if you have seen the consequences of that and what that looks like.

Dr. Susan Ratay, DO
Yeah. So, the first and foremost is when patients, say, have a condition. Let’s say diabetes or high blood pressure or high cholesterol, and you’re not getting those routine checks either in the form of like an A1C, which is a three month blood sugar check, or checks on their cholesterol levels, checks on their blood pressure, if they may not have a way to check their blood pressure at home, those can tend to be a detriment to patients being motivated to continue working on that. Right? So, out of sight, out of mind kind of thing. Sometimes patients say, oh, I haven’t been there for a year. She’s not going to fill my medicines. So, I’ll start now cutting back on the number of times I’m using my meds or the amount, cutting things in half. Right? And so, by not seeing a provider, we can’t adequately or progressively increase medicines, decrease medicines, switch medicines based off of cost and also give you, like be your little cheerleading squad and say, hey, you’re doing great. Or hey, maybe we should tweak this a little bit. Let’s get back on track.

Because I know a lot of us had some problems like getting to the gym during COVID and eating healthy food, going to the grocery store, or we had a lot of extra stress, or maybe we were drinking a little more alcohol than we normally would, and all those can affect sugar, blood pressure, cholesterol, all those things we just described. Right? And so, I think now that we’re kind of starting to get back into our doctors on a more regular basis for those of my patients who have been doing that, we’re kind of getting back on track. And then also it’s a good opportunity for me to say, hey, let’s get back to the gym. You were doing so good before COVID, and we’re going to get things moving again, get things grooving again so that we don’t have to next visit, increase your medicine or add another medicine.

Pete Kenworthy
Sure. So, how are things changing as we get even older? And you talked about the different name for the physical or annual checkup or whatever. But then as you’re older, it becomes that annual wellness visit or the Medicare annual wellness visit. What’s covered there and why is that important? I mean, I think most people realize the older you get, the more important it is to kind of be with a doctor, because things start happening more as you get older. Right? And we talked about how some of that could be prevented. But what is the Medicare annual wellness visit?

Dr. Susan Ratay, DO
So, yeah, a lot of people get confused by this. And when you turn 65, you could be eligible for Medicare. And so, it’s called a Welcome to Medicare Visit. And the questions, like we said before, there’s a templated documentation of your visit. And when you’re younger, we may be more inclined to ask about family history, because that could be impactful on how we kind of treat you for the next 20, 30 years. When you’re 65, usually most 65 year olds, if they had a strong family history, they’ve kind of presented themselves by now. If your father had elevated prostate, you probably have some elevated prostate by the time you’re 65, at least kind of are hinting at it. Or you have some sort of presentation if you were at higher risk for developing those.

But when someone gets to be 65, they tend to be on a little more medications. So, we take a little extra time to review those medications and make sure there’s no interactions, make sure that those aren’t contributing to any further risk for dizziness or falls or confusion or things along those lines. And then those screening questions change, and they’re geared more towards have you fallen in the last six months? And maybe why did you fall? Is it a stability thing? Is it a pain thing? Is it a medication thing? Is it a heart thing? So, the reasons are kind of limitless, but in the same regard, we want to detect patients who are increased risk for falls, because we know the consequence could be fatal in some instances.

We ask a lot about kind of cognition. How’s your memory? Maybe your family member’s in there, and they can kind of justify, yeah, memory’s good. I’m not forgetting to turn off the stove, or I’m not forgetting where I’m driving. Maybe screen for family history of dementia and see if that might be a higher risk for that population of patients. We ask about ADLs, which is Activities of Daily Living. Like are you still doing your own banking? Are you still doing your own cleaning? Are you still doing your own cooking? What does that look like? So, this is kind of the time where people tend to progress with arthritis. What does that look like? Can you stand long enough to cook and clean? And how are your hands opening jars and just kind of other ADLs, the daily things you do that you don’t normally think twice about when you’re in your 30s, 40s, 50s, into your 60s. And then we ask things like, do you have a healthcare power of attorney? Do you have a living will? What would you want to do in the event your heart or your lungs stopped? Have you had that conversation with your family and friends?

And so that’s kind of how the questions are a little bit different. So, it’s a little bit less preventative and a little bit more, I would say, proactive. And so, that there’s not kind of this culminating event that leads patients to be hospitalized.

Macie Jepson
And clearly those conversations at 65 are much more effective when you have a relationship with that doctor that spans the years. So, that’s the takeaway that I get from this is the relationship, the trends, the feeling like you can open up and you have a partner in your healthcare. Is there anything else that you want to share about…are we missing anything?

Dr. Susan Ratay, DO
I think you made a really good point. So, some of my patients come in and they’re very hesitant to do some of these screening tests, let’s say colonoscopy, right? No one’s excited to do a colonoscopy. And sometimes I see a patient one, two, maybe three times kind of feel out what I call their philosophy of health. Are they a person that wants to take a medicine and cure something with just taking a pill every day? Is it someone who wants to avoid pills and they’d rather do lifestyle stuff? Is it someone who is willing to do a combination of both? What’s their motivator for health? Is it to get on the floor and play with their grandkids? Or is it to lose weight or whatever that may be? So, I think if you have a relationship with a primary care doctor, and you start to feel comfortable with them, you’re more likely, I’m more likely to convince my patients that these sorts of tests are important because they trust me. There’s some sort of trust in there. And so, I think it kind of goes both ways. So, I have to trust you that you’re going to kind of take this what I’m talking about and take it home and actually apply it, versus you have to trust me that I’m only going to do what I think is best for your health, and that if anything comes up, we’re going to treat it or approach it together.

Pete Kenworthy
That was awesome. Thanks so much for your time. Dr. Susan Ratay, a family medicine doctor with expertise in community health and preventive medicine. Thank you for being here.

Dr. Susan Ratay, DO
Thank you so much. I enjoyed it.