Should I always see the same provider at Student Health?

cardiophile.com

Q: Why do the appointments people always try to get me to see the same provider?

A: While familiarity might breed contempt in family and friends, it breeds better care from your doctor.   

To do my job well, I have a bunch of balls to keep in the air. First, there’s sorting out whatever brought you in for an appointment.  You tell me this, I ask about that. I listen to this, poke that, move another thing, gathering as much objective information as I can to figure out what is wrong and how sick you are. This is usually the most straightforward part of an appointment. 

I also have to cover historical information. Your past medical issues, your family history, medication history, tobacco use, surgeries, etc. The first time I see you this can take a while.

I’m also trying to figure out you. This is hard work, as I have a limited amount of time at any one appointment. Who are you? Where do you live? Who do you live with? Where do you come from? What has your experience with healthcare been? Are you formal or casual? Big words or a minimalist? Native English speaker?  Nervous? Relaxed? Suspicious? Assertive? Informed and interactive? Taciturn or frightened? The more I know about who you are, what you bring to the table, and how you think, the better I’m able to tailor an effective treatment plan and sell it.

Now, this might not all seem relevant for a sore throat or an ankle sprain – and it might not always be.  But I can’t become a “you” expert in one appointment; I pick up clues over many visits. Sure, your visit today for a runny nose might be easy, but I used the time to dig into how stressed out you are about your research, which helps me in a month when your hair is falling out or you can’t sleep. Once I really get to know you after that first information-intensive appointment, little nuggets of useful, often vital contextual information fall like raindrops in a thunderstorm.

Care with the same provider is usually more efficient. It saves both of us time if you don’t have to answer the same 8 billion questions about medication reactions, chronic health problems, etc.  I can really dig into the problem at hand, whether it is a cough that just won’t go away or diabetes that you and I have been beating into submission over years. 

Of course, I’m not here all the time. I, like you, am a mere mortal and have been known to get sick and take vacations. For self-limited problems-ankle sprains, the occasional cold, rashes-it’s okay to see somebody else in a pinch.  Occasionally it’s even helpful to have a fresh set of eyes look and think about complicated problem.  But in general, even though any other health care provider can open your chart and meet the “virtual” you, it won’t compare to how well I know the real thing. 

Victoria Rentel, MD (OSU SHS)

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