Growing up in rural Mississippi I knew all too well how hard it can be to find a hospital. The closest hospital from where I lived was 19 miles away. This made it difficult to access healthcare for me and my family. Similar to me, this is common in rural areas like where I grew up; usually the nearest hospital for rural Americans is on average 10.5 miles away from where they live according to Pew Research Center. Just like many of these rural hospitals, our local one was limited and did not provide critical care, OB, or cancer services. So, when my grandfather was diagnosed with cancer when I was 14 years old, we had to travel over 40 miles for his care.
Those long trips were fascinating to me as I got the chance to see areas I never would have traveled to. As we waited in the hospital room where my grandfather received care, I would look at the adults’ faces and hear their soft-spoken conversations. I would also observe the many nurses and doctors that would go in and out of his room reviewing monitors and hanging bags of medicine along with reviewing charts. I wanted to know what all of that meant – the medical jargon, the medications, the beeps of the machines. I found it interesting when we’d get home hearing my family discuss all that had happened regarding my grandfather’s care. Among these conversations was still a sense of not understanding all that had happened in the many discussions we had with my grandfather’s medical team. I found earlier in my life the disconnect between medicine and the patients who are being cared for. Through this experience, I decided I wanted to become the much-needed medical translator for patients like my grandfather. I decided I would become a doctor so I could learn what all the medical jargon meant, provide care to people when they were sick, and support their families. My goal was set as I aimed to educate people about their health and look at ways of explaining health so that it would make more sense than what my family seemed to receive during a very difficult time in my grandfather’s life.
After practicing in a traditional primary care setting having about 15 minutes with each patient and spending another 15+ minutes on documentation for 10 years, I found myself limited in the time I had to provide the much-needed conversations my patients needed from me. Many conversations were delegated to the nursing staff which made it difficult for follow-up questions to be easily answered. Patients were then encouraged to schedule an office visit to discuss their concerns further, but they often avoided follow-up appointments due to trying to avoid additional copays. This sometimes led to their issue getting more out of control. I needed to provide a different way to manage my patient’s care. As I read more and more about direct primary care (DPC), I felt this model of care would allow me to focus more on each person with less of my time going toward documentation to meet administrative requirements of insurance companies. I can spend an hour with a new patient and get to know them and their goals while supporting them reach those goals by them having direct access to me via text and email. I can also devote 30 minutes with each person for follow-up visits to review their health concerns and start planning as a team instead of rushing on to the next person. Developing and explaining a care plan often takes more than the 5 minutes as I was previously able to carve out of my visits in the traditional model setting. People need time to process what’s being said and the opportunity to ask questions. DPC allows for extended visit times to facilitate this dialogue between patients and their physician while also simplifying communication when questions arise after the visit.
It is challenging to open a new practice especially one with a new model of care. As my practice is growing and I have more time to focus on each individual patient, I am better able to support them in their wellness goals and provide sufficient time for questions about the plans to achieve their goals. My patients are no longer afraid of having to pay an unnecessary copay if their concern turns out to be something minor. My patients are able to avoid taking off of work if something arises that can be handled over the phone or through a video chat. My patients aren’t afraid to email me if they need more information about their health. They have the time and space to ask questions during and between visits. Each day in my new practice reminds me of how the loss of my grandfather guided me to my purpose in choosing medicine.