IBX: The Cover Story – My Family Doctor Saved My Life

Peter Panageas (00:07):

If you’re looking for timely, relevant conversations about the most important topics in health coverage, you’ve come to the right pod. This is IBX, The Cover Story, from Independence Blue Cross, hosted by me, Peter Panageas. By day, I oversee all of our national commercial business here at IBX. I’m also a caregiver and a patient. We always say that healthcare is personal, and it is. So my guests and I are exploring how the big picture and the big issues affect our everyday lives and the wellbeing of those we all care about. Together, we’ve got this covered. So let’s get started.

Peter Panageas (00:46):

Hi, everybody. This is Peter Panageas, and welcome to episode nine of IBX The Cover Story. In this month’s episode, I’m going to talk to you about the importance of having a primary care physician, or what many call a family doctor. A family doctor is someone you’ll typically see once a year for an annual checkup, or whenever you’re sick or have a health concern. To help educate us on the importance of having a family doctor, joining me today is my own personal primary care physician, Dr. Ryan McCormick.

Peter Panageas (01:11):

Dr. McCormick comes to us as a primary care provider in the Virtua Health network and is practicing family medicine in Southern New Jersey. He received his medical degree from Rutgers Medical School, completed his residency at Thomas Jefferson University Hospital, and he’s been practicing family medicine for about 18 years. As I’ve mentioned in prior podcasts, I was diagnosed with stage four Merkel cell carcinoma. It’s a rare form of skin cancer. And I first came across it at an annual physical with Dr. McCormick. As I’ve shared with all of you in prior podcasts, I thought it was a sports hernia, and during my physical with Dr. McCormick, I had asked him to check it out, not thinking anything of it. And he did his thing and came to me and basically said, “Pete, I think this is something a little bit different than what you think it might be.”

Peter Panageas (01:53):

His recommendation was to get it checked out immediately. And it was at that point where I thought, wow, this is something pretty serious. And so I did, and it was shortly thereafter that I was actually having surgery to get at the mass removed. I’ve said this once, and I’ve said it many, many times in the past, Dr. McCormick and anybody else I’ve talked to about this, that Dr. McCormick saved my life, and I genuinely believe that. Had it not been for my annual physical and sitting with Dr. McCormick and him checking out with what I thought was a sports hernia, is the reason that I’m here today.

Peter Panageas (02:24):

This topic’s timely, because February is National Cancer Prevention Month. Our family doctors can help us take steps that’s going to help us prevent cancer, and frankly, in my case detect it. So with that, it’s my distinct honor to introduce each of you, to Dr. Ryan McCormick. Dr. McCormick, thanks so much for being with us today. It means a lot to me personally and professionally.

Dr. Ryan McCormick (02:45):

Thank you so much for having me.

Peter Panageas (02:47):

Dr. McCormick, look, let’s start off with from your lens why it’s so important to have a primary care physician. Can you answer that for us?

Dr. Ryan McCormick (02:56):

Sure. I think there’s a few answers to that. I think that at the core, it’s really good to have a home base in your healthcare, somewhere that you can build trust and feel comfortable bringing up issues. In primary care, we try to be your first line of defense against problems that can range from chronic conditions like diabetes and high blood pressure, asthma, depression, anxiety, early signs of problems, even cancers. We try to be a place where you can coordinate your care among specialists. And a lot of times, when you get out of the hospital or emergency room, there’s follow up that needs to happen, maybe issues that need further discussion. So we try to coordinate all that care, and increasingly there’s home care services that we’re involved with and physical therapy and things of that nature.

Dr. Ryan McCormick (03:37):

So I think having a home base is really critical, and the old adage of an ounce of prevention being worth a pound of cure, I think really applies to primary care. I knew you were going to ask something like this, so I did a little stats and studies for you. I will set a few statistics here. Some studies have shown that adults with a primary care provider have something like a 20% lower odds of premature death than those adults who only see specialists. I never mean that to be a dig against specialists. We all rely on their focused level of expertise, of course. But adults with primary care providers also spend less on healthcare. Some studies show up to 33% less, and that can be attributed to reduced emergency room visits, hospital care, specialist visits, and hopefully catching problems early and preventing problems in the first place.

Dr. Ryan McCormick (04:23):

It’s a huge amount in this country spent on healthcare, and if every adult had a primary care provider, some estimate that we might even save up to 60 to 70 billion dollars a year. So I think it’s really important for the individual to have a primary care doc, and I think as a society it’s really important to value a primary care system that’s built on a foundation of primary care providers.

Peter Panageas (04:51):

Dr. McCormick, can you share with us what type of care and/or services a primary care physician can provide?

Dr. Ryan McCormick (04:58):

Yes. We definitely, just in terms of specifics, we do things like chronic disease management, we do checkups, preventative care, like we’ve discussed. We do physicals, we give shots, immunizations. We do a lot of mental health care actually, and of course referrals to appropriate specialists when those are needed. We order and follow up on tests and imaging studies, prescribe and monitor treatments, and I think most importantly, we try to act as educators. The Latin root of the word doctor, as you might know, is teacher. So I think that’s a big part of our duty.

Dr. Ryan McCormick (05:29):

And then I guess in just a larger picture, we try to really work on that doctor-patient relationship. And I think that’s really at the core of what we do. Try to get to know you, your problems, maybe personality and preferences as you go through care. I think really that’s really what builds trust, and I think the system doesn’t work without that core human need for trust. And that’s unfortunately what we’re seeing with the pandemic. There’s been lots of authorities, lots of expertise out there, lots of good advice, but it hasn’t really translated to people following that advice in some ways, although a lot do. But I just think that the trust that gets damaged in the system really gets restored, I hope, in a primary care relationship. That’s really what we try to do, is build trust, so that when we give advice it comes from a source that you believe in.

Peter Panageas (06:14):

Dr. McCormick, as I had stated in my opening comments, you single handedly saved my life, and when I started this journey, you were there every step of the way with me. The work that you did, and I love the analogy of the home base, right? You have been and will continue to be my home base personally. I’ve seen it firsthand as I’ve gone through that journey with you and the experience I’ve with you in navigating through it, and you asking me the types of questions on this journey that I’ve been on.

Peter Panageas (06:43):

I’d like for you to share some examples of that you do with many of your patients, obviously including me, on that journey when you uncover something as serious as I had and the journey that I’ve been on and the role that you play. I think it’s so important for our listeners to really hear firsthand, because look, there’s a lot of our listeners who don’t have that home base, who do not have that Dr. Ryan McCormick in their corner, and it is so critically important, and I’m saying that firsthand. I’d like for you to share anecdotally just some things that you do in one’s journey as they’re fighting cancer or any other major illness that one might be going through. Could you talk to us a little bit about that?

Dr. Ryan McCormick (07:19):

Well, that’s first of all, super humbling. So thank you so much for that. That sort of relationship between me and another person, that really is what keeps me going. So, that’s super rewarding, and thank you. I think you, as I always say, you give me too much credit. I think you have been just a tremendously resilient, determined person in taking care of your own issue when it came up. But just sort of being there for people at certain points in their life. I think we all have a lot of fear of illness and what looms ahead, and so I think that, once again, having that sort of trust with somebody that you can open up to and share fears with, and sort of be somebody who’s in your corner during your journey, or maybe during your fight, is just really critical.

Dr. Ryan McCormick (08:03):

I think professionally, it’s an honor to be involved in people’s care like that, and just personally, it’s really fulfilling. There’s a lot that is not fulfilling about healthcare. I’m not going to say it’s easy, and the system can be very broken at times, but at its core I think the interpersonal relationships that develop and, once again, the journeys that we go on in some ways together are really, really amazing. I mean, I think that this comes up, I sometimes joke I wish I could be that, sort of aspire to the credit you gave me there. I think that it’d be nice to live two parallel lives, one where I’m a full-time doctor doing nothing, but being the best I can be, and then the other where I’m taking care of family and friends and that sort of thing. But I think finding that balance and still being there for people is really a challenge, but when it works out and when you have somebody as appreciative and connected as you are, it really makes it all worthwhile. That’s really why I went into this job, so thank you for that.

Peter Panageas (08:59):

That’s awesome. Thank you. Thank you. Look, recently you were quoted in the Philadelphia Inquirer, obviously COVID-19 testing, Omicron, there’s a lot of moving parts there. Talk to us a little bit about what you are quoted on the Philadelphia Inquirer and some of the caution that you’re sharing with many of your patients.

Dr. Ryan McCormick (09:19):

Sure, absolutely. I was definitely approached by Virtua. The Philadelphia Inquirer wanted to run the story about rapid antigen testing as it pertains to coronavirus, and sort of all the confusion that’s around that, how do we use these tests? And so I’ve spent a lot of hours keeping up with this as a lifelong learner and someone who’s very interested in professionally and personally knowing what’s going on with this pandemic. I was happy to be a trusted professional source of more information for them, so that was fantastic. I think it’s just really important for primary care docs, once again, as the theme of the show, is really just being someone who can be trusted and someone who can help educate and maybe translate some of this information as it evolves.

Dr. Ryan McCormick (10:03):

As you know, it’s really been evolving by the day and even by the hour sometimes. So I think that the trusted sources of journalism, like the Inquirer and places like that, are really essential, and I think that if we can support those institutions and get our information from those sort of trusted sources, I think we’d be in a lot better shape. But that was a fun little interview, and basically just commented on some of the pitfalls of relying on rapid antigen testing for making plans and mitigating COVID risks. That it’s definitely an important part of the puzzle, but it’s not 100% accurate, so there’s some nuances that there that people need to tease out.

Peter Panageas (10:41):

Dr. McCormick, I’ve actually subscribed to your newsletter and some really great research that you do, and I actually look forward to it and I know a number of my family and friends who also subscribe to it as well. Can I ask you to talk a little bit about your newsletter and what was the catalyst behind it?

Dr. Ryan McCormick (11:01):

Sure. All right. Well, thank you. And yeah, just started out as a fun little project this summer. I just was, kind of like a lot of healthcare folks, feeling like I needed to maybe communicate in a more broad way with patients or the public at large, and just felt pretty weary by all the misinformation out there. I just also feel like there’s such a constraint with office visits. We get 20 minutes, maybe 30 minutes, and so the amount of time there to really get through a lot of issues and current things, and issues of wellness and health and how to be happier and just all the sort of holistic things that we really aspire to, just it’s so hard to do that in 20 minutes.

Dr. Ryan McCormick (11:38):

I really felt like a newsletter might be a fun thing to try, so I’m glad you’ve checked it out. It’s been pretty fun to write and I made a lot of nice connections with people there and a lot of back and forth too. For me, it’s actually, selfishly it’s been really great too, because when you teach something, you are able to master it a little bit better and keeps me on my toes a little bit more. I think once again, it just kind of falls into that whole trying to build a little bit more trust and communication between people rather than just stats and data and cold recommendations from authorities that maybe you don’t know.

Peter Panageas (12:14):

Well, I’ll tell you, I think it was last month, and I might be getting it mixed up, but in one of your most recent, I think it was last month when I was reading it, a great story about the personal journey of COVID and what it meant to you and how you’re navigating through it. And it really just broke it down in a way that is just very readable, very accessible, and it was really, really helpful. I was very, very impressed with it.

So look, as I mentioned in our introduction, February is National Cancer Prevention Month, right? So talk to our listeners about what can you, as a primary care or other primary care physicians, play in the role of cancer prevention?

Dr. Ryan McCormick (13:14):

Absolutely. I think it’s really great that you’re doing this podcast. It’s a very timely topic based on February being that month. I think that in terms of asymptomatic people versus symptomatic, I think there’s a little difference there. As family docs and primary care doctors and providers, we try to follow standard guidelines. Some are put out by the US Preventative Services Task Force, for example, and they recommend screening for the most common cancers like breast cancer with mammograms, colon cancer with colonoscopy, maybe Cologuard. Skin checks for skin cancer at the time of physical or when somebody finds a spot. Prostate cancer, which I know in a prior episode you did a great deep dive on that. And then there’s the symptom based workups, when someone comes in with a sign or symptom that might be concerning, trying to rule out cancer, or if it is found, treat that early and catch it early.

Dr. Ryan McCormick (14:06):

I think that another role that we have is sort of helping people navigate the bewildering options that are out there. There’s so many new technologies, there’s blood tests that are being advertised all the time, and I think it is moving pretty fast, and sometimes these tests are recommended before there’s a lot of risk to benefit analysis. I think one of the jobs of primary care docs and providers is to, a classic example might be a full body CAT scan. For a while, people would come in and say, “Hey, just check me for everything. I want to make sure there’s nothing going on inside.” And that sounds great, and the idea of that, I would love to do that, but if you look at the analysis that experts have done, a lot of times you find questionable little spots that then need additional testing, additional follow up, maybe even biopsies, which by themselves can cause more harm, both physically and even in terms of your wellbeing, your anxiety that’s created.

Dr. Ryan McCormick (14:55):

So when they look at the risk versus benefit of cancer screening, it’s really important to tease out what does the evidence show helps people live longer and catch things earlier, versus what actually can create harm and over-testing. I think that’s a fine line that we walk, and we really try to follow the expert guidance on that and different guidelines. And then hopefully people value some of the old fashioned preventative counseling that we do, cutting down on drinking, cessation of smoking, reinforcing healthy diet, exercise, good sleep, which would be great to get, but those preventative rock things that we all sort of know, but it never hurts to hear it again.

Peter Panageas (15:36):

Well, it’s certainly something you always reinforce with me when I see you, whether it’s my annual physical or periodically, a checkup with you during the year. All the basic things and things that sometimes that you just have a tendency to overlook. Right? I know you often tell me about my healthy diet and how important that is, and I’m listening to you. I’m trying as hard as I possibly can, but no, it’s great counsel and it’s great advice. And certainly, it is some of the basics and having that reinforcement as a primary care as my home base, and for our listeners for your home base, I think is critically important. So I think your spot on there, Dr. McCormick, thank you.

Peter Panageas (16:10):

It’s interesting, when I take a look at listings within healthcare providers in a primary care office, I often see a nurse practitioner next to a physician’s name. Can you talk to us or explain and share with us what the role of a nurse practitioner is, and the role they play in primary care? We know it’s a very, very important one, and sometimes it’s a little bit overlooked, and love to get your perspective on that alignment between you and nurse practitioners who are part of your practice.

Dr. Ryan McCormick (16:37):

Yeah. Great question. I think nurse practitioners or physician assistants, which we are a little bit different in training, I’ll just call them NPs and PAs, super excellent parts of a collaborative team. I think that’s really where healthcare and primary care in general are going, is collaborative team. NPs and PAs really help with the workload. Depending on their training and maybe the nuances of each office, they might take care of more acute problems or handle specific things that really maybe free up the physicians to spend a little bit more time perhaps with their most complicated patients, folks that get out of the hospital and maybe need more of a comprehensive visit.

Dr. Ryan McCormick (17:12):

They really do help the work flow, and they’re very well trained for that purpose. I think the other thing too, is that with our healthcare system under a lot of strain right now, even before the pandemic, but the pandemic has only accelerated it, we definitely need help. I think one statistic I saw was that one in five healthcare workers have left the field in last two years. Things from burnout to maybe poor pay or unsustainable stress. That’s among all healthcare workers, so I think that having the additional energy and expertise and the excellent care that a nurse practitioner or physician assistant can contribute to the team is really essential. And the ones that I’ve worked with are just great colleagues, so really appreciative to have that.

Peter Panageas (17:50):

Dr. McCormick, thanks so much for that insight, and I couldn’t agree with you more. To our listeners, I got a special guest with us today, young lady on our team by the name of Melinda Bryan, who has been the architect behind our entire podcast series, working very closely with a number of folks here to support this, but really has been the driving behind this. I’ve asked Melinda to join us today and share with all of us a very personal story with her and her family and the role that a nurse practitioner played in the care for her mom.

Peter Panageas (18:20):

Melinda, if I could, first of all, welcome, and thanks so much for being here and really looking forward to hearing the story. So if you could share with our listeners the impact and what it meant to you and your family, of the NP, that’d be great.

Melinda Bryan (18:32):

Sure. Thanks, Peter. My mom was diagnosed with brain cancer about five years ago, and within the last few months it had advanced to a glioblastoma. And in the last few months of her care, she was introduced to a nurse practitioner who really was a very important part in her care journey. She was very open with us. She provided her cell phone number to our family, just in case if we ever had a question and the doctor’s office wasn’t open. When she needed to get a scan done at Penn, she needed an MRI, the nurse practitioner was actually able to call over to Penn to explain the severity of her condition and got her in on an appointment the very next day.

Melinda Bryan (19:19):

Even one time we were in the ER at midnight, and we got a phone call from the nurse practitioner saying that she received an alert on the portal that my mom was in the emergency room and just wanted to call in and check in on us. It was very touching to know that we had somebody that we could call and rely on during that time.

Peter Panageas (19:39):

Melinda, thanks for sharing that story, and it’s a testament to how beautiful your mom was and your family is, and it’s certainly a testament to, and Dr. McCormick, I offer this to the Virtua team, the Virtua network and the importance of the role that a physician and a physician’s assistant or a nurse practitioner plays. Obviously, this individual made an impact to Melinda, you and your family, in a really, really, really difficult situation. I think it was profound it actually changed the course of healthcare for your dad. Can you share with our listeners a little bit about that?

Melinda Bryan (20:17):

Sure. After my mom’s healthcare journey, my stepdad recently changed his primary care physician to the nurse practitioner that my mom had saw at the end of her journey.

Peter Panageas (20:49):

And that’s just, I would imagine, just one of many, many examples, Dr. McCormick, that you see every day with what your colleagues do in the healthcare and the journey of what Melinda and her family had to endure and what her mom was going through and her journey, and just love to get your feedback or comments on that.

Dr. Ryan McCormick (21:06):

Yeah, absolutely. That’s a really touching story, and I think when you have somebody like that, that’s really in your corner, that really is just tremendous. That’s such a hard thing to go through. But yeah, I would say that I really trust that level of care too. We have a physician assistant that you may have seen in our office, that’s fantastic. She’s just very dedicated to her patients really on a very humanistic level, but professional obviously as well. I think that, once again, just having that extension of capability for the office.

Dr. Ryan McCormick (21:37):

We’re all a little overwhelmed at times with the amount of work that comes through a primary care office, and we wish that we could give that level of care that Melinda’s mother received to all of our patients. We kind of reserve it for the times when is really needed, but just once again, having more hands on deck, more people to help that are invested in other people and their welfare, is just what we need in healthcare. I think more personal connections like that and a system that can facilitate that’s really what we need. When it works out like that, that’s great.

Peter Panageas (22:26):

Dr. McCormick, what I normally do with all of our guests is, at the end, I’ll ask if there’s any one or two or three things that you’d like to share with our listeners, what would they be?

Dr. Ryan McCormick (22:35):

All right. Excellent. Well, thank you again for having me. I would just summarize and say that this has been a great opportunity for me to reassess primary care and my relationship to it. We just kind of get our nose down and get to work, and sometimes we don’t take us step back and reflect a little bit. It really gave me the opportunity to question why I went into this field, and I really did it to know my patients from a place of continuity, and to build trust and be able to really listen to their stories. I really find that fulfilling, and I really value that sacred doctor-patient relationship that I’ve had as a patient and that I hope to extend as a doctor. That’s been amazing to develop that over time with people.

Dr. Ryan McCormick (23:13):

I’ve been doing this in Marlton for 18 years now, so I’ve seen people in different chapters of their lives, and that’s really I think what we’re all here for, to help each other through the struggles that we all know are common, and be there in the good times as well. I think I would just tell your listeners, just try to get a family doc if you don’t have one, or a primary care practice or a physician. We try to really look at people through a biological and a psychological and a social lens. Lenses that really are the underpinning of people’s health. It’s not just about data and who you see when you have a cold. It’s a lot more meaningful and hopefully beneficial to people to build that relationship over time. Like you said, just to bring it back to the home base idea, I think having a home base has been shown to be a valuable thing to have in healthcare. So thanks for the opportunity today to talk about that.

Peter Panageas (24:04):

Dr. McCormick, thank you so much for being with us today. It’s been such a pleasure chatting with you, and look, for all of our listeners a couple points I think are important to tease out here today. February is obviously National Cancer Prevention Month. Please take all the necessary and appropriate steps to making sure that you’re doing all the preventative things, to making sure that you stay ahead of cancer too. Critically important, and Dr. McCormick certainly talked about the importance, if you don’t have one, the incredibly important role of having a primary care physician as that home base, and Dr. McCormick, I think it’s a great analogy, right? Having that home base is so critically important, and that journey that one goes on, is always important to have that individual.

Peter Panageas (24:44):

The role of the PA and the NP, obviously the impact that it made to Melinda and her family, and I’m sure the numerous stories that are out there with all the PAs and NPs that are out there. I would close by saying, Dr. McCormick, on behalf of all of our listeners and to all the healthcare professionals that are out there, specialists, primaries, NPs, PAs, et cetera, we collectively thank you. You’re on the front lines, you’re working hard, you’re doing things above and beyond in a really, really crazy time right now. And if it’s not for you, many of us aren’t on this healthy journey. And so from all of us to you and your peers and colleagues, thank you. Thank you for everything that you do every day for us.

Dr. Ryan McCormick (25:29):

Well, thank you so much too. I really agree with everything you said there, and I really want to commend you on this amazing podcast. It’s one of my new favorites and I really look forward to the new episodes dropping. And just personally, I really commend you on the strength, and once again, the determination and resilience that you showed, and just being a part of that journey with you has been great. And the stories that you shared in a previous podcast about your parents and how you helped them. It’s just a very human experience that we all go through together here with healthcare, and so I want to thank you for your trust and for your confidence in me, and I hope to serve you well in the future.

Peter Panageas (26:02):

Dr. McCormick, thanks so much for joining us today and for sharing informative information with each of us on the importance of primary care. And to all of our listeners, thank you. I hope you’ve enjoyed our discussion and learned something new today.

Peter Panageas (26:14):

For more information on Dr. McCormick’s newsletter and some of the topics we covered today, please check out the show notes insights.ibx.com. That’s insights.ibx.com. Also, hope share this episode with a friend or to family to encourage others to start seeing a primary care provider. Just like me, it could save one’s life. Thanks again for joining us today and look forward to seeing you again next month. Bye, everybody.