Podcast: Why everyone should have a primary care doctor

It’s important to get linked to a primary care provider, even if you are in your 20s and 30s, and consider yourself relatively healthy.

In this episode of Meaningful Medicine, Dr. Austin Sherman, a family medicine physician with Novant Health New Hanover Primary Care, shares some of the ways a primary care physician can support your overall health and wellness.

Primary care physicians put a focus on prevention, from taking steps early to ward off chronic illnesses to ensuring preventative screenings.

Maggie McKay (Host): Meaningful Medicine is a Novant Health Podcast, bringing you access to leading doctors who answer questions they wish you would ask. From routine care to rare conditions, our physicians offer tips to navigate medical decisions and build a healthier future.

Today we're speaking with Dr. Austin Sherman, primary care physician about primary care. Thank you so much for being here, Dr. Sherman.

Dr. Austin Sherman: Maggie, thank you so much for having me.

Host: So just to start off with some reports, say up to a third of Americans do not have a primary care provider. Is that concerning?

Dr. Austin Sherman: It is concerning Maggie, and honestly, it sounds about true. I would say there are a lot of people that are out there and, still need primary care access.

Host: So why do you think it is that people don't have a primary care provider?

Dr. Austin Sherman: It's a good question. You know, there's probably a lot of reasons. I think some of the reasons that stick out to me is you can actually get medical care in a lot of different areas, right? We see a lot of surge in like our emergency departments and urgent care settings where people go and they don't necessarily feel sick, so they kind of just go to those settings and try and get some medical care and feel like, what does a primary care really offer and what do we need from them? So it could be maybe a lack of understanding, lack of access, or just going to those EDs and those urgent cares and trying to get some medical care, which I would advise against for a lot of routine stuff, but.

Host: Right. And like you mentioned, I understand some younger aged groups, individuals in their 20s and 30s, maybe are more likely to treat needs at urgent care centers, like you said, when they need it, but they haven't established with a primary care provider. But, is it important to get linked to a primary care provider even if you consider yourself young and otherwise healthy? Because when you're in your 20s and 30s you think, nah, I don't need a doctor.

Dr. Austin Sherman: Yes, I totally agree. I think it is very important to get connected with primary care and I think everybody needs a primary care physician for a lot of reasons, but even those healthy patients, like you said, we're not just treating a bunch of chronic conditions, which some people think primary care is all about.

A lot of it's about prevention too, and talking about things that you can do to help better your health and improve the things that you're doing to try and really set yourself up for success when you do get older and hopefully can kind of prevent some of those chronic diseases from even coming up.

So I do highly recommend anybody, really could use a primary care physician, especially those in in their younger 20s and 30s. That's a good one.

Host: Definitely. Well, I imagine what happens at each visit would look different based on individual circumstances, but in general, what should a patient expect at an annual checkup?

Dr. Austin Sherman: Yeah. It's funny you mentioned that because every day of work for me is literally different than the last. But in terms of a general checkup, really what we're looking for is, one I always ask somebody is, what are you concerned about? Right? What are the things that are really concerning to you?

And trying to iron that stuff out. So people can have their concerns addressed. Because like you said, I mean, some people only come to the doctor once a year if that. So really trying to get those kind of ironed out first and foremost. Then, generally, we go through just routine screening tools. So what's important for your age group?

What screenings do you need? What preventive things can we do, and how can we change up some of the things that you might be doing that might be potentially detrimental to what's going on with you? Generally, I'll also try to get yearly blood work on most patients and just kinda check things and make sure that behind the scenes that everything still looks good.

And then we generally end with a nice general comprehensive exam, make sure everything sounds good, heart, lungs, no ailments, no bumps or bruises or anything like that that could be kind of hiding or lurking around there.

Host: Dr. Sherman, what are some of the most common chronic illnesses you see in patients?

Dr. Austin Sherman: Good question. There's a bunch, right? I would say some of the more common things that we're seeing on a day-to-day basis would be things like high blood pressure, hypertension, diabetes, cholesterol, and then also mental health. I think that's one that kind of gets glossed over a little bit, but, mental health issues, definitely a chronic condition. Definitely affects a lot of patients that we see. And definitely very real problem that can be addressed with your primary care.

Host: Well, thank goodness. It seems to me, correct me if I'm wrong, but it seems like, the issue of mental health has really come out in the public and people are talking about it and addressing it and there are more programs for it, so that's good. Do you think that's accurate?

Dr. Austin Sherman: I would totally agree with that. I am starting to see a lot more patients come to me and ask about it, and that's patients of all age groups, even your younger adults all the way up into your 90s and 100s. You know, patients are dealing with this on a day-to-day basis, and sometimes they don't always have the tools to kind of deal with it or even recognize what might be going on.

So I would say, I don't know if the prevalence is higher than what it used to be, but I think situational awareness for people is definitely improved and people are talking about it more, which, which is good for us, and, it's helpful for a lot of patients to try and help iron some of that stuff out.

Host: Absolutely. Why is it important to monitor and treat conditions like diabetes or high blood pressure?

Dr. Austin Sherman: Right. Very good question. So, a lot of these chronic conditions, they can actually be pretty detrimental to people's lives and how that life looks. And, my general goal, I think the goal for physicians is to make sure patients are healthy and have a pretty good life, and don't have ailments and concerns.

Things like untreated diabetes, that can lead to a lot of other issues. Heart issues, sight issues, sensation in your feet. Those things can start to go. But generally speaking, if you get to control a lot of those chronic conditions, patients generally live lives as if those conditions were not there.

So it is extremely important to get those things checked up on, try and get them under control as quickly and safely as we can. Whether that be with medications, lifestyle changes, or whatever else your doctor's recommending for you. But yeah, I mean, you can see a lot of difference for someone who is uncontrolled versus controlled.

Host: And speaking of prevention, there are a number of cancer screenings from colonoscopy to mammograms, thankfully, and over time, the recommended screening ages are lowered so people get screened even earlier. Why are these screenings important?

Dr. Austin Sherman: Yes. So the whole point of a screening is to really catch something before it happens, right? That's the general consensus. So when you're screening for these diseases, like you had mentioned, mammograms and colonoscopies and things like that, it's trying to help prevent anything like a cancer from coming up and creating issues later on. Most of those screening tools that we've just talked about are for cancer specifically. There are other screening tools that we use for other conditions, but generally speaking, it's really just to try and protect those patients against getting something that could be very detrimental.

And these screening tools have been vetted for years and are very reliable at helping prevent you from getting those diseases or at least catching them early on where it can be in a treatable stage.

Host: I'd also love to spend a minute on vaccines. There's the pneumonia vaccine, annual flu vaccine, shingles vaccine. Are these offered at primary care clinics?

Dr. Austin Sherman: Yes. I don't know if I can speak for all primary care clinics, but we do offer them here at our Novant Health facility. And vaccines are great at also preventing diseases. There are some small populations that it would be contraindicated for, but I would say most people are able to get vaccines and do just quite well with them.

If you ever have a question about those vaccines, I always recommend that you reach out to your physician and see if they're something that's appropriate for you.

Host: Just yesterday I was working out, we work outside, in a group, like a bootcamp situation, and someone brought up the shingles vaccine and then somebody else was saying, well, if you're over this age, you should have it. And then someone else said, if you never had the chickenpox, you don't need to have it because there's a blood test. What is the story on the shingles vaccine? Who should get it?

Dr. Austin Sherman: Yes. So shingles vaccine, their general recommendation is going to be the older population, and you are correct, right. If you've never really been exposed to chickenpox, your risk for shingles is generally lower than the general population. But you can never say it's zero. My kind of thing with vaccines is always, they're very low risk, right?

And there's only potential benefits that I can see from vaccines, especially the shingles vaccine. It can reduce your risk of getting shingles, which is pretty gnarly disease process, by a pretty significant amount. So if you are in the older population, or if you're in the immunocompromised population, definitely something you should ask your doctor about because it could be a good option for you.

Host: And as we prepare to close, I'd love to know how family medicine became a passion of yours. What drew you to the specialty?

Dr. Austin Sherman: Sure. So, growing up I come from a pretty large family. I'm the youngest of six and my parents are pretty medical. So my mom is a pharmaceutical sales rep and my dad is an emergency room physician by trade. So I was exposed to medicine at a very young age and pretty much since I was 5, I kind of knew like, there was no other option for me and trying to find the right specialty for me, one of my biggest passions in life is not necessarily just medicine, but actually having that human connection and, getting to meet people and get to know them over a period of time.

And family medicine uniquely allows you to do that. Where you have to establish relationships with patients. You have to know them on a very, intimate level, more than some of their family members know them. And having that ability and having patients have faith in me as their provider to kind of continue their care, not just for that day, but for the rest of their lives, presumably, is something that I really hold in high regard.

And something that really satisfies that need for me to kind of like continue to meet people and just keep growing our community. So, yeah, I think that's, probably one of the biggest reasons for me.

Host: All great reasons, and you kind of become part of their family, some of your patients, right? You're kind of one of the family members after years.

Dr. Austin Sherman: Exactly. And I'm very much in the community. I am the PCP for many people in my neighborhood, and they see me. And, it's really cool. It's such a unique opportunity that I get and it's one of the biggest blessings I have in my life. Being able to provide medical care to people and, for them to look to me for advice. So, yeah, I absolutely love it.

Host: That's gotta be so rewarding. Well, thank you so much for sharing your expertise today. We really appreciate your time.

Dr. Austin Sherman: Yeah. Thank you for having me on the show. I really appreciate, I had a lot of fun.

Look forward to doing another one on another topic. Again, that's Dr. Austin Sherman, and if you'd like to find out more, you can check out nh.team/primarycare. If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. To find a physician, visit novanthealth.org. For more health and wellness information from our experts, visit healthyheadlines.org.