Can Exercise Help?

One of the questions I like to ask patients about at most visits is their exercise habits. I know a lot of times patients feel frustrated about questions pertaining to weight, diet, and exercise from their doctor, especially when it doesn’t feel relevant:

I’m here for my anxiety, why is she asking about exercise?

I know I’m overweight, but can we focus on my trouble sleeping? That’s why I came!

What does asking me about my exercise have to do with my memory issues?

And to be fair, doctors do often ask questions that are irrelevant to the reason a patient is there, in an effort to check off all of the boxes required to get reimbursement from insurance companies. So while I won’t need to worry about jumping through those hoops in a direct access primary care model, I will continue to discuss exercise often and here’s why.

Exercise is good for SO MANY THINGS! When I am helping a patient with their mental health concerns like anxiety and depression, I discuss how exercise helps to release those feel good brain chemicals that help you reduce stress and improve mood. In terms of sleep, trials have shown that exercise helps you fall asleep faster and improve sleep quality, with better next day results compared to sleep medications. Observational studies also show that higher rates of physical exercise are associated with lower rates of dementia, so when a patient talks to me about memory or concentration deficits, or just concerns about family history of dementia, exercise is always a part of the conversation. And those are just a few of the benefits of exercise, not to mention the reduction in cardiovascular disease, diabetes prevention, lower rates of cancer, improved bone health, lower fall risks in older adults etc etc etc.

I encourage all of my patients to exercise, but starting a routine or trying to figure out if your level of activity is enough can be overwhelming. As part of primary care at SFP, I am happy to help you create an individualized exercise regimen to start reaping the health benefits of exercise today!

Is Direct Primary Care Affordable?

Before I started Slack Family Practice, I worked for a large healthcare system. By the time I left, my patient panel was over 2000 and counting. If that sounds like a lot - it is. If that sounds uncommon for primary care - it’s not at all. Having such a large number of patients to care for was a direct and significant contributor to my burn out and ultimate decision to leave. I found there was not enough time in the day to provide patients with the level of care they deserve on such a large scale, not to mention leaving time for my kids, my family, myself etc. So this led me to direct access primary care - a model that allows physicians the time and mental space to really get to know their patients, and become a more integral partner in their healthcare and well being.

But can patients afford this? Is it something only available to the wealthy?

I acknowledge that paying an annual fee for primary care is not an expense that everyone can manage. A membership with SFP is not low cost - but I do believe it is high value. And when the membership fee is broken down and really considered, I don’t believe it to be an unreasonable investment. For a monthly cost similar to your cell phone bill, you have direct access to your doctor. A doctor who knows you, your situation, your health, your values. You have someone with credentials who you can ask for advice on over the counter medication and vitamins, whether or not that mole should get looked at, or if it’s normal for a knee to make that sound, rather than asking Dr. Google. For the cost of my kid’s monthly taekwondo membership, or a dog grooming appointment (Doodle’s are bougie!) or LESS than the cost of smoking a pack a day, you could avoid a trip to urgent care vs a 3 month long wait for an appointment when you are having symptoms now.

You can continue to use insurance to cover costs of things like labs, images, specialty visits, or hospital stays. And if you have private (non-Medicare) insurance, or a health savings account, you may be able to get at least partial reimbursement for your membership fee or in office visits. So don’t wait for the next time you find yourself feeling abandoned by the healthcare system, needing care but at a loss for how to get it or where to go. Instead, consider joining the SFP family now!

Weight Loss

In addition to direct access primary care, SFP offers medical weight loss management. I have gained a lot of experience over the past couple of years prescribing and managing GLP-1 medications like semaglutide and tirzepatide. I have seen first hand how successful these medications are at helping patients lose weight, and the data backs this up! Weight loss medication is generally considered successful with 5% of baseline weight lost after 3 months of use (so a person that weighs 200lbs is able to lose 10lbs in 3 months). However, studies of GLP-1 medications have shown up to 20% or higher of baseline weight loss!! And even better, a study showed that this weight loss was sustained years later.

These medications work in two basic ways, one physically and one mentally:

Physically, they slow down the movement of food in the GI tract. This helps you feel full for longer, thus reducing appetite. This mechanism of action is what is underlying the most common side effects when taking GLP-1s - nausea, constipation, bloating, and other GI upset. Starting the medication at a low dose and increasing over several months, along with learning how to change your eating patterns, will help reduce side effects.

Mentally, these medications work on the area of the brain that tells you “eat that!” A lot of patients describe this sensation to me as quieting down the food noise. They are no longer constantly thinking about food, and find themselves able to easily walk by something tasty in the break room that they previously couldn’t help themselves from devouring.

This combination of feeling mentally and physically full is what leads to such successful weight loss outcomes. If you have struggled with being over weight or obese, reach out to SFP to schedule a consultation to see if these weight loss medications might be right for you!

Slack Family Practice, Coming Soon!

Welcome to Slack Family Practice!

Exciting updates to share - While the practice is open and accepting new patients, I am currently offering telehealth services only since my office is under construction. This week, I was able to move forward with some of the more fun aspects of building a new space - picking out floors, cabinets, countertops etc. The office is going to be beautiful! My goal is to create a space that is warm and inviting, and aligns with the more personal and familiar relationship direct access primary care allows. There will be a comfortable waiting room, custom built reception desk, two offices and two exam rooms. Stay tuned for details on an open house once the office is complete!