Delivering primary care for adults 65+ in innovative and tech-friendly ways
Good primary care for adults 65 and older starts with relationships. It begins with getting to know each and every patient, as well as their loved ones – their goals, their values and their preferences – and creating a plan that helps them thrive and age independently at home. This guiding principle is what inspired Patina’s Chief Health Officer, Neil Patel, MD, to reimagine the journey of aging through Patina, a primary care provider of virtual and home-based care that is tuned to the unique needs of older adults.
During a recent episode of Honestly Aging by VigR Health, Neil shares what older adults should expect from primary care, how Patina provides this in new and innovative ways, and the role of technology in delivering high quality care to this demographic. The following includes some highlights of the conversation between Neil and Cheryl Proska, host of the Honestly Aging podcast, which has been edited for clarity and brevity.
Can you share what inspired you to want to work with older adults?
I've been a physician for about two decades. I was drawn to medicine and to serve folks who didn't have as much access to care. After I settled in New Jersey, where I was born and raised, I shifted my focus professionally to serving adults who are 65 and older. I'm just having a great time! It's a fascinating phase of life to begin and travel through, and it's an honor to be on the journey with folks as they retire, as they age, and as they live their best lives in that phase.
How is the team at Patina reinventing primary care for older adults?
One of the great advantages of starting the company from scratch is that we get to decide what we are about. Patina is a medical practice that starts with relationships. We want to get to know each patient and their goals, their values, and their preferences. We want to get to know their families and loved ones and bring them into discussions and decisions. Relationships are at the core of how we provide care, and everything else will come from that. The prescriptions, the treatments, the recommendations for specialists or surgeries…all of that comes out of a real relationship and truly understanding each unique patient.
The idea that healing comes out of relationships isn't something that we've invented. It’s old fashioned and predates modern medicine. At Patina, I feel like we've sort of found our way back to that. And because we're starting over, we can make sure everything we do is rooted in that strong healing relationship with the patient and their loved ones.
So there's the care that older adults should be receiving. And then, there's the care they actually receive in the current healthcare system. Can you address the disparity often experienced between the two?
Generally speaking, we have an incredible workforce of people in healthcare. But at the same time, we have failed ourselves. We haven't built the system of care that we deserve or that we want for our parents. There's a lot of harm that comes out of the system. There's a lot of waste that comes out of the system. And, really, there's a lot of indignity sometimes that comes out of the system. The current healthcare system is really built around people like me – the doctor. The office is a really great place for me because I can have a waiting room. I can have multiple exam rooms and I can see patients faster. But the system isn’t really built for the patient, and I think we have to acknowledge that.
At Patina, we decided from the very start that relationships are the most important aspect of our practice, giving us freedom to rethink things from the perspective of a patient and a loved one. We specialize in older adults and take a whole person approach – the mind, body, and spirit – and address their unique needs and preferences.
Patina employs people who understand the physical changes that happen to the human body as we age. The psychological changes that happen to the human mind, the social changes that happen as we go through retirement or as we age further and maybe are finding ourselves unable to drive…simple things like that are really important. We understand those things and are able to bring that context to our patients. We can help people to understand what's happening and build a care plan to address their needs as they change. Everyone deserves that.
Why is primary care so important at this later stage of life, and what should people expect from their primary care provider?
Primary care is important at every stage of life, but is so much more important as we get older. We have to navigate everything ourselves – all the changes that are happening to our bodies, our families, our communities, our careers, our income and even the healthcare system itself. There are so many changes happening, and it's all very confusing for regular people to make choices. And as we get older, we're often dealing with chronic illnesses…hypertensions, asthma, arthritis. We're living with things that maybe can get better. We're living with things that maybe aren't going to get better. And we have to know the difference. We have to adapt.
All of this is a lot for any of us to handle. Primary care can function as your partner. Primary care can help you to simplify the complexity, sort out the mess and put it in order, help you to take control of your own health, make sure your needs are met, make sure that your care plan matches your own values and preferences, and so on. For many of our patients, those values and preferences include living independently at home.
So primary care is in a great position to help you to live and age independently at home. We have the advantage of being able to look into the future a little bit. Part of that 20 years of experience for me as a practicing physician is many, many patients who've gone all down different paths. And I can help my patients to understand, "Well, here are the ways that you can stay independent at home. Here are the things that put you at risk, and here's how you might be able to reduce that risk. Here are all your options."
Can you talk about the role of technology in delivering high quality care to older adults?
I love technology and the ease of a telemed appointment. But it’s not always enough in medicine. There's a role for hands-on care. There's a role for listening to the lungs and listening to the heart. At Patina, we think it's important to balance those two things.
While a lot of our care is delivered through video visits, phone conversations, and chat messages, we also visit directly in the home. Rather than having our patients come to us, we send a nurse with a medical bag to the house. Even if the primary care practitioner is in her office, the nurse can put the stethoscope on the patient at home, and we can all listen together through the magic of a video visit.
We've found ways that we can be accessible, make things easy, and build relationships while using technology to keep things simple and consistent. We don't want to make compromises. So when you need an exam, you deserve an exam. Pure telemedicine might not be enough for every problem that our patients experience, so we do come to the home and I think that's really important. We're able to provide the same level of care at home as you'd receive in an office or clinic. Technology is a great enabler that doesn't have to be complicated or hard to use.
Above all, Neil reminded listeners that the key to staying healthy and independent as we age is to work with your PCP to create a plan that’s right for you – and to stay accountable. That may look different for everyone. For one patient, it might be starting an exercise plan. For others it might be a new diet, practicing meditation, or something else entirely. According to Neil, the trick isn’t getting the right recommendation, it’s sticking with the plan. So, think about something simple, make it specific and achievable, ask someone to hold you accountable, and do it.
This episode of Honestly Aging by VigR Health explores additional topics on primary care and how Patina is reimagining the aging journey for older adults. To listen to the podcast in its entirety, please click here. To learn more about primary care with Patina, watch this video.