I am a family physician who cares for older adults in the Houston area. During office visits, I’ll take my patient’s blood pressure, heart rate, listen to their breathing and do a blood draw, among other physical tests.
While these exams are important indicators of health, what they can’t tell me are the struggles my patient may be facing in their daily life that directly impacts their health.
Not having enough or the right kinds of food to eat, being isolated and lonely, not living in decent housing or having adequate transportation – these are all common contributors to poor health. One in five seniors in Texas is at risk of hunger, among the highest rates of all states in the nation. In Houston, 20% of those served at the Food Bank are age 60 or older.
Homelessness also disproportionately affects older Americans, with 45% of seniors nationwide economically vulnerable and at risk of homelessness. Anxiety and depression are on the rise among the elderly, especially during this time of the pandemic.
While most physicians recognize that the health of our patients depends on addressing these “social determinants of health,” many are unable to do so. There is no prescription we can write to alleviate hunger or provide secure housing, and few doctors have time in their day for the in-depth conversations needed to uncover these problems or the resources available to help address them.
Doctors can’t do it alone. What’s needed is a team of health professionals, including social workers who can secure basic needs and social services for patients, and mental health experts who can provide counseling. I know what a difference it can make because I practice here in Houston at Partners in Primary Care, a senior-focused primary care center that uses this “whole-person” approach. The needs of seniors are a little different from other age groups, so we make a conscious effort to address all the factors that can affect their health. Less emphasis on procedure X or cure Y. More emphasis on prevention and living their best life.
As a physician on a care team, I spend about 45 minutes with each patient during their visit – much more than the average 17 minutes doctors usually get to spend with their patients. Having the time to go beyond the usual questions and really get to know my patient helps build a bond and trust between us.
Most patients are hesitant to speak about their non-medical challenges, often out of a sense of pride or shame. Forming that strong relationship with a patient is critical to getting them to open up about these issues. If our discussion reveals a need for food or housing, the social worker on our team can help connect them to low-income housing and food stamps or food pantries, and other required supports. If the patient is struggling emotionally and in need of mental health services, we can call on our behavioral specialist to help.
My goal as a physician is to improve my patients’ health, but unless I can also help fill the gaps in their daily needs, there’s far less chance of realizing those good outcomes. Fortunately, this holistic approach to senior care is gaining ground. Partners in Primary Care has opened four centers in the Houston area in recent weeks, with four more to go by January, including one opening at 8555 Memorial Blvd. in Port Arthur in October.
All our centers are open for in-person visits and have implemented rigorous safety measures in accordance with CDC guidance to protect our patients during the pandemic. However, we also offer telehealth options that provides access to our full care team.
While not every visit requires these added services, the fact that they’re available when needed is a great benefit to my patients. As a physician I know that it takes far more than my time and expertise to care for the health of seniors. It takes a team.
Brienne Loy, MD, is a family physician and Partners in Primary Care regional medical director for the Houston area.