Call us first

Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Rajay Seudath and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Rajay Seudath.

CARMENN MILES
Hello everyone, and welcome to the award winning Docs in a Pod. I'm Carmenn Miles. Thanks for tuning in today. For those new to the show, each week we look at a variety of health and wellness issues as they affect people of almost any age, but predominantly those who are 65 and older. Our resident co-host, Dr. Rajay Seudath, is with us today to help us understand the importance of calling your primary care doctor first when you have a medical event. First, a little bit about Dr. Seudath. He's a board certified family medicine physician. He's a proud Tampa native and the lead physician at the University location for Optum. He brings great passion to primary care, he's a wealth of knowledge and he makes health issues simple and so easy to understand. Dr. Seudath, how are you today?

DR. RAJAY SEUDATH
I'm doing wonderful. This is a passionate topic that I have a lot of feelings on, so I'm very happy to be here.

CARMENN MILES
I know. I could listen to you talk about college sports for hours. Again, we're talking about a simple, short phrase that can make a big difference in your health care. And that phrase is, call us first. If you're a WellMEd patient or care for someone who is a WellMed patient, you've probably heard this message before. Dr. Seudath, help us understand what we really mean when we say call us first. When should patients call? And how does it help patients get better care?

DR. RAJAY SEUDATH
So, this idea of call us first, it was initially an organizational push. We wanted patients to feel like they could call us if they have a problem. So many times, patients would say, oh, I just didn't want to bother you. I had this issue, and I didn't want to bother you. Who are you bothering? I'm your doctor. This is the one thing I want you to call me for is when you're sick. Or, for instance, they had an appointment coming up, and they canceled their appointment, and they're like, well, yeah, I don't want to come in. Well, why donÕt you want to come in? I'm sick. What do you mean you're sick? That's when I want to see you. How long you been sick? I've been sick for, like, the last week or two. What do you mean? You've been sick for two weeks that you didn't call me? No, call us first. When you are sick, we want to help you. My patients say, oh, doc, I love you. I love coming here. Yeah, that's great. Come here and see me. But when you're sick, that's when I love you. That's what I want to see you. When you're feeling bad, that's when we want to help. So, call us first was just an initiative to get patients to feel comfortable calling us when they had a problem. You are not a nuisance. You are not a burden. You are not bothering us. We are here to support you. We are here to keep you healthy. That is what we're doing this job for. So, the major push was to let our patients know we want to serve you. We want you feeling good. We want you living long lives. We want you to have a high quality of life. but we can't do that unless you call us. Unless you tell us when you're having a problem. So, that's where the call us first came from. Then it started to move into an initiative of yes, you're sick, we want you to come in. We started to see that then we did that, there were all these other secondary improvements. So, people coming in to see us when they felt bad, we were able to prevent problems from getting worse. A person who said, Doc, I'm vomiting. I can't stop vomiting. What's going on? They come in. Oh, they're sugars in the six hundreds. They're vomiting because your body's trying to get rid of the acid in their stomach because they're acidic. They have too much sugar. The sugars turning to acid. Wow. That prevented that person from going into the hospital and getting very, very sick because we were able to give them fluids. We were able to bring down their sugars. We were able to do all that in the clinic. So, those are some of the things that we can do for a person. Other things can be like if a person is not feeling well because their medicines are not where they should be. Oh, I was taking my medicines three times a day. Well, the bottle says once. Well, I figured three is better than one. Why not? No, that's not right. Come and see us if you're feeling bad, we can try and figure that out. So, the idea is we were seeing that we were preventing major problems by having people come in. The other issue is when people are coming in, they're not ending up in the hospital. For American medicine, there's an idea of people heal best at home. So, that's it. We want to keep people healthy at home.

CARMENN MILES
I love it. Let's take a moment to welcome those who may have just joined us, youÕre listening to the award winning Docs in a Pod presented by WellMed. Docs in a Pod is available wherever you listen to your podcast. You can also find us on the radio and several Texas and Florida markets. I'm Carmenn Miles alongside the Dr. Rajay Seudath of the Optum in Tampa, Florida. Today's episode is all about helping you feel confident and knowing who to call, when to call, and why it matters. As you mentioned up here at WellMed, we want our patients to call us first. Dr. Seudath, this doesn't mean to ignore serious emergencies, right? It's WellMed's way of making sure that our patients get the right care at the right place and at the right time. So, Dr. Seudath, this is the message we want our patients to receive and adopt. Dr. Seudath, why is this message so important at WellMed? You said a lot of that already, but I know you've got much more to add to that.

DR. RAJAY SEUDATH
Absolutely. If you could see our video right now, you'd see me bouncing with enthusiasm here. We were just talking about going to the hospital. Well, I can just go to the E.R. Why shouldn't I just go to the E.R.? They're open all the time. I'll just go there. I don't want to bother you guys. No, you're not a bother. First and foremost, you're never a bother for your primary care office. More importantly, the hospital is where we have what's called hospital associated infections. Those are the viruses that are resistant to treatment. I'm sure people have heard the word MRSA, Methicillin Resistant Staph Aureus. What does that mean? That bacteria is resistant to the antibiotic we usually use for that bacteria. So, that makes it more difficult to treat. It makes it more virulent. It causes more complications. By virtue of keeping you out of the hospital for a reason that doesn't necessarily need to be in the hospital, we are decreasing your risk of MRSA infection. The problem with being in that area, even if you don't get a MRSA infection, you can become what's called MRSA colonized. So, being in and out of the hospital just by being in that space. Touching the bedsheets, touching the rails, using the door handle to go into the bathroom, you can get MRSA on your hands, you wipe it on your face and now you're colonized with MRSA. It's not necessarily causing an infection, but it is living in your body with you. Should you develop an infection, it can be now become a MRSA infection. So, every time you're in the hospital that is a possibility of getting an infection that is very difficult to treat. MRSA can be on the skin. MRSA it can also be a lung infection. So, it can kind of affect you anywhere it kind of wants to. It depends on how it travels. You can also get what's called a hospital associated pneumonia. Let's say you go to the hospital for an unrelated issue, but you are exposed to a bacteria that is difficult to treat. It is resistant to antibiotics, it gets into your lungs, and now it's growing. A week later or two weeks later, we see you have an ammonia. Where'd you pick that up from? Have you been to the hospital at all? Oh, I went there because I had a rash and I wanted to go and have it looked at. Now, this person has been exposed. So, what could have been a simple visit in your primary care office for a rash has turned into a hospital associated pneumonia. So, that that's happened. We've seen that in our patient populations. Different populations, different people with different diseases are more susceptible, but the idea is if you call us first and we treat you outside of the hospital, that risk of getting it is not there. So, that's one of the things. Another one is urinary tract infections. Well, doc, I'm at the hospital because I cut my arm, and I needed to get some stitches. What are you talking about? Why would I have a urinary tract infection? It can happen just by virtue of you being there. You can get a urinary tract infection that is now resistant to antibiotics. So, I had a lady who had incontinence as a prior disease that went in for a cut that needed stitches. We could have done the stitches here. She came back, and it was the first time she ever had a resistant bacteria in her urine. That was almost directly because she was there. How many times have you heard somebody say, oh, I had a problem, I went to the hospital, I was there for eight hours, and they didn't even put their stethoscope on. They didn't check on me once, and then they sent me home. They didn't do anything. That's the story I get so often. I mean, I'm sure you've had friends or family who've gone to the E.R. and said, I went there, they didn't do anything. They just sent me home. That's true because if it's not what we would consider an emergency, the emergency room is not necessarily where you need to be for that. So, we always tell patients, come here, come to the clinic. What takes them for hours sometimes just takes us 40 minutes. If you think about it, your primary care office, I might see 40 patients in an hour. They're seeing like 400 patients in an hour if it's a busy hospital. So, that's the difference that I call I have the luxury of time, whereas the E.R. doesn't necessarily have that. So, that's one of the things that we talk about. Coming to your primary care office, calling us first. It starts with the call. It starts with making that connection and letting us know that something is wrong. Then once you make that connection, then we can decide on, well, what's the next step? Should you have a tele visit? Do you need to come in person? Is going to an urgent care where you need to be? Or do we need to send you directly to the hospital? So, I think that's one of the things that some people often stumble about trying to figure out, well, what should I do next? We'll call us first and we can direct you on that.

CARMENN MILES
Absolutely. Perfect time to take a break. When we come back, we'll talk more about WellMedÕs call us first call to action for all patients. We'll be right back in just a moment.

AD
For over 35 years, WellMed has redefined health care for older adults and people on Medicare. We're physician led and nationally recognized as an Age-Friendly Health System. Our doctors take time to listen and support your unique needs, working with Medicare and select Medicare Advantage plans to keep you healthy and independent. With 24/7 nurse support, telemedicine, in-home, and office visits. Care is always within reach. WellMed. Compassionate care, proven results. Visit wellmedhealthcare.com to learn more.

CARMENN MILES
We're back on the award winning Docs in a Pod, presented by WellMed. Thanks for sticking with us through the break. We are sharing WellMedÕs call to action to all patients, call us first. It's not a slogan. It's WellMed's approach to health care that focuses on prevention, coordination and keeping patients healthier at home and possible. Dr. Seudath, there are some simple steps that patients can follow that can make a big difference in a patient's care, starting with simply saving a phone number. Let's talk about that.

DR. RAJAY SEUDATH
Yes. We were talking about this on the break. I often tell patients on your fridge, you should have your local pizzeriaÕs number, and right next to that you should have your primary care offices number literally right next to each other. I want it nice and visible so if you're having a problem, you just look at the fridge and that's the number. I remember there was one lady, I was asking her what's on your fridge? She was like, oh, well, I've got pictures of my grandkids, and I got a bottle opener I got from Spain, and I was like, andÉandÉandÉ. She was like, no, that's it. That's all there is. I said, no, and you should have my number with a magnet on your fridge so when you have a problem, you could call me. And she laughed, but it's true. Several months after that she had an issue. She called it, and she said, I'm using the magnet with your number right on it, so I'm calling you. That's for any primary care office. You should have their number visible. You shouldn't be rifling for a business card somewhere. Just right on your fridge.

CARMENN MILES
That's the worst thing you want to do when you're not feeling well, right?

DR. RAJAY SEUDATH
Exactly.

CARMENN MILES
Simply save the phone number on your phone and have that magnet on your refrigerator. I love that. Obviously, once you have the phone number, you need to make the call, right?

DR. RAJAY SEUDATH
Yes. Let's say you're having an issue. It could be numerous different problems that could have you to call us. Once you call, your provider is going to determine if this should be a telehealth visit. Right now, I'll tell you across the board I want my patients to come in. I want to see them in person. I want to talk to them. I want to give them that personalized touch. I want them to be able to speak to me and to get that real human connection. But there are times when a telehealth visit is appropriate. For instance, you're wondering about your test results. We did some test results before and you're like, I'm kind of worried about that. I don't know if this problem I'm having is related to that. So, you call up, we do a telehealth, we go over your test results, everything was fine. It's not a big deal. Everything's okay. That's appropriate. Or let's say that you're supposed to get a wellness visit and you can't come in for that. You're having an issue because of scheduling. We could do a telehealth for that. Things that I want to see a person in front of me. If something is making you feel bad. You know, I'm having a lot of coughing. I'm having nausea. I'm having some vomiting. I want that person to come in and see me. Anything that that requires an examination. Should I listen to your stomach? Should I poke on your stomach? Should I listen to your lungs? Should I feel your pulse? If there's something that I want to do to get more information to find out what's wrong with you, absolutely I want to see you in person. Building on that, do I need to do some laboratories? If you say doc, I have a urinary tract infection. I felt this before. It feels like I've got a flamethrower down there. I just want you to give me something so I can get this over with. Just send me some antibiotics and it'll be fine. I've had this before. That may be true, and you may know the exact antibiotic that works for your body, but it may not be. There is a level of what if. So, I want a person to call us first, come in, give us a urine sample. I'll give you the antibiotics. I'll treat your symptoms. But what if what I'm giving you doesn't work? What if you have a bacteria that that antibiotic doesn't cover for? Not that it's resistant. It just doesn't cover for that one. So, we can find out what the culture results are. This is the guy that's causing your problem, we give you the right antibiotic, and you are better. As opposed to, we'll just try to do it over the phone and hope you get better, right? I would say most health care providers are not the let it ride kind of person. Let it ride is typically not how I deal with your health care, and I don't think any of my colleagues are on the idea of let it ride. We want to make sure we're keeping you healthy. So, that's kind of some of the reasons why I want a person to come in and see us.

CARMENN MILES
I think a lot of our patients don't understand that there's no limitations to call us first. Some patients may think, oh, they mean from 8 to 5 during business hours. I mentioned to you earlier that I live in Houston, ranked number six on the worst cities in terms of air quality. So, I'm a little asthmatic today. I have a little cough, shortness of breath. Let's say this happened at two in the morning, but it's not severe. Instead of going straight to urgent care, am I to call WellMed at that hour first or should I go to urgent care?

DR. RAJAY SEUDATH
I'll tell you when people are on call, they are not supposed to be in Vegas gambling. When people are on call, they are not supposed to be at a concert partying. When people are on call, they are supposed to have access to your chart. I'll tell you from experience, if you are feeling sick, as the on call person, I want you to call me. I often patients always are so surprised when they call me and I'm the guy on call, and theyÕre like, Dr. Seudath, do you ever sleep? Yeah, I sleep. I was sleeping and you woke me up, but I want to know why you woke me up. Because if you're up and you're not feeling well, that's a reason for me to be up too. So, yes, even if it's a 2 a.m. Now, of course, if you've been having this problem since 8 a.m. and you wait till 2 a.m. to call me the next day, I'm not going to be happy about it. Or if it's been going on during business hours and you're like, well, yeah, it's been really, really bad. I just felt that I'd wait until 10 p.m. because I couldn't take it anymore. Oftentimes that's what it is. Oh, I just couldn't take it anymore. We want you to call us first before it gets to that point. Before it gets to the, oh my gosh, I don't know what to do with myself. If you're having an issue, call us. But yes, we have an on call service for a reason. Most practices have a 24 hour on call service. So, I like to empower patients by saying, you have a doctor, you have a nurse practitioner, you have a provider in your pocket at all times. So, if you're having that issue, if it's during business hours, it goes straight to the clinic. Usually, the person who's doing acutes, they will pick that up. If it's after hours, it's going to go to the answering service. Yes, there is an annoyance. You have to leave a message, and they will call you back. But most health care providers have a rule that you have to get called back within a certain amount of time. For us, it's 40 minutes. So, if we don't call you back in 40 minutes, we're going to get a second page. So typically, we'll call you back. That's the thing is we want to give you that guidance because if you're having an issue and you say, doc, my blood pressure is high. Well, when do you last take your blood pressure. Two days ago. Well, what happened? Why didnÕt you take it? I didnÕt feel like taking it. Okay, take your blood pressure now. Take your medicine. Let's see what it looks like in the morning. Contact your provider. That's one of the things we can do. If it's something like, oh my God, doc, I feel like I have crushing chest pain. I feel like there's an elephant stamping on me. I can't catch my breath and my heart's racing. Okay, you need to go to the hospital. You need to hang up. We need to call the E.R. right now. We will have an ambulance come take you. So, there are some things that, even if you call us, calling us first will allow us to guide you. I often tell patients your primary care office is selling guidance. We are the people who are guiding you through this health care system, and it's a complex labyrinth of things. Oftentimes if you're having an issue, you need that guidance because the last thing you want is to end up in the hospital, and now you have a hospital associated infection for something you didn't need to. Or you go to the hospital and you're waiting there for 12 hours and they don't do anything and you go come back and you see me and say, I went there and they didn't do anything. They're all useless. I hate these people. I hate the health care system. I'm never going to a doctor again. That's the worst thing I hear. I'm like, no, no, no, that's not it. Call us and let us know. We want to serve you. So, what's the in between seeing your primary care office or the E.R.? The in between is the urgent care. You'll hear comedians, they talk about. Well, I have a problem. It's kind of an emergency. ItÕs urgent to me. An urgent care can be a good bridge between the two. So, let's say you have an issue. It's after hours. You call up our on-call service. The on-call service for your health care provider says, yeah, that sounds like you should have that looked at now. It's not an emergency, but it's something you should have looked at. I think you should go to an urgent care. So, that could be something like I'm having a urinary tract infection. It's burning. It's Friday night. Your primary care office isn't going to be open until Monday. Can you go two days with that burning when you urinate? It could get worse. Yeah, let's have you go to an urgent care. Let's have them do that. Then on Monday your primary care office can follow up with that. They can get the records from the urgent care right. We can see what did that culture grow or did they even do a culture. So, those are the kind of the things that we can do, and we can direct people to an urgent care to kind of bridge that gap. But I tell my patients, if it's between 8 and 5 and you're having a problem, you need to come and see me.

CARMENN MILES
That's right.

DR. RAJAY SEUDATH
I am a jealous doctor. I don't want you seeing other people when you have those problems.

CARMENN MILES
I love that. A jealous doctor. We've just we've discussed at length what it means to call us first, but we I just want to clarify, however, and be clear about what call is first does not mean. It does not mean to delay emergency care. We're telling you to call us first in a non-life threatening scenario. Let's talk about what it's not. We know what call us first means and what the expectations are and what you know what you should get out of it, but what what does it not mean Dr. Seudath?

DR. RAJAY SEUDATH
Some of the things, like we just said before, if you're having crushing chest pain. If you are having such problems that you can't breathe. You feel like you can't breathe at all. It's so difficult to breathe. Those are some of the issues where you need to go to the hospital. Or stroke like symptoms. If your face is drooping, if you're having difficulty speaking, if you have numbness in one of your arms. Any of those things, time is brain cells. In that case, head immediately to the E.R. But for other things like coughing, sneezing, nausea, vomiting, call us. We want to be the ones to help you.

CARMENN MILES
That's right. Call us first, listeners. We are here to support you and partner with you. Thank you all. We are out of time. Thank you for listening to this episode of Docs in a Pod. Again, you can listen to Docs in a Pod wherever you get your podcasts, and you can also catch us on the radio in several Texas and Florida markets. Thank you. That's our time for now. Until next time, stay well.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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