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Video: Continuity of Care

23/10/17 Michael R. Wasserman, M.D., CMD, Chief Executive Officer for Rockport Healthcare Services

Transcription: Dr. Mike Wasserman Video

I’m Doctor Mike Wasserman. I’m a geriatrician. I’m also a chief medical officer for Rockport Medical Services and I’m on the editorial board of the Manual.

I believe that continuity of care is arguably one of the most important issues for any consumer of healthcare but in particularly older adults. The reason I believe that continuity of care is so important has to do with our renewed focus on person-centered care. In order for a physician or a nurse practitioner or a PA to deliver person-centered care, they have to know who the person is.

Choosing a doctor, to me, is one of the most interesting things that I can talk to patients about. I think it’s really important that a patient go into a doctor’s office with the idea of ‘How do I feel with this person? Am I comfortable? Am I relaxed? Can I talk to them when I’m not following their instructions?’ Those are important things, and I think the single most important aspect of the doctor-patient relationship is the comfort level.

Every team needs a head coach, and in healthcare today, the primary care physician must be that person, especially when it comes to treating an older adult.

One of the biggest problems that I’ve seen over the years, and especially in older adults, is that they see multiple physicians. When an older person is seeing multiple doctors and multiple specialists, they treat a problem, the patient has a side effect from the treatment or the medication, and then they see another specialist for that side effect and they treat with a new medication and so on and so forth. Oftentimes, we’ll see people on ten to fifteen to twenty medications for this very reason and in my experience, we’re able to reduce the medications and people feel a lot better.

Older adults really need to take proactive action for their healthcare as it relates to working with their physicians and their nurse practitioners, physician assistants. Number one, I think when they go into the doctor they need to have their list with them. What’s bothering them? What’s most important? Hand that list right away to the clinician they’re seeing so that clinician can look and say ‘okay, what you have time to talk about today? Let’s prioritize.’

It’s also really important that one know what medications they’re on, have your own list of medications available, and share that list with the doctor. Then finally, I think it’s really critical to have your goals, your wishes, your dreams, and the things that matter to you written down so that your doctor can really get to know who you are as a person.