Oswego doctor: ‘One of the best things you can do as a patient is work with your primary care physician to control your risk factors’
By Chris Motola
Q: How long have you been with Oswego Health?
A: I’ve been practicing since 2006. This is my ninth year with Oswego Health. I’ve been with them since 2013.
Q: Our focus this month is on heart health. As a primary care physician, what role do you play in maintaining the heart health of your patients and in screening for any problems that may arise?
A: One of the big things we do is monitor blood pressure. We take readings routinely when patients come into to see us pre-examination. We also monitor overall health and ask questions about the patient’s lifestyle, are they very active, are they eating a healthy diet. We also monitor risk factors. Age is a risk factor. Family history is a risk factor. Smoking, alcohol, recreational drugs. And when we have this information in combination with symptoms, then we’ll look into diagnostics to confirm our suspicions. So there are a lot of things that go into primary care considerations when we’re looking for coronary artery disease.
Q: What kinds of interventions can you do at the primary care level if you detect a problem with a patient’s heart health?
A: A lot of it is monitoring changes and progress, trying to help patients reduce their body mass index (BMI). One of the best things you can do as a patient is work with your primary care physician to control your risk factors. This is where having a regular primary care physician can help, because they can get to know you better, which will help them to detect symptoms that are irregular for you, whether that’s unusual chest pains, elevated heart rate, palpitations, or difficulty with physical activities. Then we can move on to the relevant testing based on the symptoms you have. That’s how we make a diagnosis. So my recommendation is to have a regular primary care physician.
Q: Has it been harder to maintain that kind of continuity of care during the pandemic?
A: We did have some problems in the beginning. We were relying on telemedicine for the first few months, but quickly realized that it was not enough. I think we were one of the first in the area to start seeing patients in the office again. So we’ve been seeing our sick patients almost all along, as well as doing video appointments. We’re even now seeing patients in the office who are COVID-positive. So things have gotten better. Initially it was tough when the pandemic started.
Q: What are you able to do effectively with telemedicine at this point?
A: Telemedicine can mean both phone and video appointments. A lot of people prefer the video appointments because they at least allow the physician to see them. It’s a bit more helpful for the physician, too. If a patient is complaining about having a shortness of breath and I can both see and hear that they’re struggling to complete their sentences, that’s very helpful to me. Unfortunately we do have patients who don’t have a smart phone or computer app. So for them we have to just do a phone call.
Q: How have you gone about alleviating patient concerns about COVID-19 so that you’re able to see them in person more often?
A: One thing we’ve done is try to limit the amount of time patients spend in the building. We have patients call when they’ve arrived and we have them wait out in the parking lot until the nurse is ready to put them into the examination room. So this limits exposure of healthy patients to sick patients. They’re waiting in their cars instead of the waiting room.
Q: For patients who have had their active lifestyles disrupted, particularly this time of year, but still want to keep active, what kind of advice do you have?
A: It’s been hard for a lot of patients who aren’t able to go the gym to get their exercise. I usually suggest floor exercises. There are a lot of routines and exercises you can find on YouTube that you can do at home. For my elderly patients I’ve been recommending that, every hour, they walk around for five minutes, holding the dining room chair if they need to. And they would do that for eight hours out of the day. So that’s about 40 minutes of walking for the day even though they’re only doing five minutes at a time. If you have a pet, walking your dog can be a good excuse to go outside for 15-20 minutes in the morning and evening. Shoveling snow is a very strenuous physical activity, so if you need exercise you may want to use a shovel instead of a snowblower. And if you’re healthy enough to handle the cold, taking a walk outside bundled up, even if it’s slow can be good exercise. Even if you don’t want to be outside for very long, you can do 15-20 minutes twice a day.
Q: Do you have a favorite home workout?
A: I usually use YouTube to find some. I personally like Jillian Michaels. Another thing people can do is take advantage of local programs. I had a patient who was doing a free exercise program in the local municipal building three times a week. Some patients may want to ask their local church if there are any activities going on. Even with social distancing there are still a lot of these programs going on. A lot of them are free of charge. And some of them will even host training videos on their websites. They had a video training program for tai chi on their website. But for me, personally, I use YouTube.
Lifelines
Name: Vandana Patil, M.D.
Position: Primary care physician with Oswego Health
Hometown: Mumbai, India
Education: NDMVPS Medical College, Nasik, India
Affiliations: Oswego Health
Organizations: American Academy of Family Physicians
Family: Husband, two sons, 14 and 10
Hobbies: Community gardening; reading