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The Power of Primary Care

Have to share this story/moment/experience related to PCBH, well, maybe more related to primary care (and, my mind thinks I shared the first part of this story already, so sorry if duplicated at the beginning!). A few months ago, I took a handoff from a provider for a patient that we would definitely say was complex. Side note, what is so awesome is how I got the handoff as it occurred as the MA was rooming the patient (presenting problem was a rash). Just by talking with the patient, the MA could tell there was a lot going on. Thus, the MA suggested she meet with one of the BHCs today, which the patient agreed to. When I came over for the handoff, the medical provider actually had no idea that the handoff was even requested/needed. Literally, a true team that allowed the MA to connect to the patient, the PCP to deal with the rash, and the BHC to help support the patient dealing with a lot of different stressors... literally the meaning of holistic/team-based care!

Okay, back to the original point; during the handoff and via the Contextual Interview, the patient disclosed significant ACEs, domestic violence, and other life hardships. And, still, somehow, someway, they were working full time, a single mom of multiple children (doing a great job with her kids), and was still connecting with family/friends. During the visit we discussed how it would be weird if she wasn't anxious right now and how, through our eyes (i.e., the health system), we didn't know how she was able to do what she was doing; it was truly impressive. In a moment of relief, the patient commented, "so, it's okay that I am feeling this way?" After a few additional visits over the past two months, we met recently and it was clear just how well she was doing. Engagement in values was off the charts and while not the primary outcome measure/goal, her headaches, anxiety, and depression had all shown remarkable improvement.

At the end of the visit, I told her, "you know, my mind just wants to let you know how incredible it seems that you are doing; and, my mind is curious, do you feel like we need to follow-up again?" Panic, quickly, showed on her face (yes, even through a mask), and she responded, "um, I'm not sure about." In that moment, I realized just how much I value primary care and PCBH and how freaking cool of jobs that we have. The reason she was hesitant about not scheduling a follow-up, as we would discuss, was because she was worried "what if I need to talk again? What if things don't stay this good?" "Well," as I said and we discussed, "that is why we are here. We are like your PCPs, when you need us, you come in. If we schedule something for three to six months out but tomorrow you need to come in because something came up, guess what, you can." That same relief I saw during our first visit when she said "so, it's okay that I feel this way?" showed back up as she said, "I really like that. I like being able to access you all when I need it."

Talk about the power of primary care, talk about the power of being accessible and on demand... talk about a freaking cool job that we have, in that we get to meet people in the moment, as discussed before, often in their darkest hour, and reassure them, "hey, you are doing great and we will always be here for you." We have freaking awesome jobs, indeed!!!

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