As Kinwell’s Chief Medical Officer, Dr. Mia Wise has taken a fresh approach to primary care. With over 15 years in practice as a family medicine physician, Dr. Wise knows what works in healthcare and how the experience can be improved for patients and clinicians alike. The National Institutes of Health note that numerous studies show how incorporating behavioral health into primary care results in improved health outcomes.
Why take a fresh approach to primary care?
Dr. Mia Wise (MW): One the biggest challenges in primary care is that it has become a transaction. Instead of taking care of patients and focusing on outcomes, physicians must push through a whole set of patients each day. Managing that volume becomes the focus instead of patient health and well-being. That diminishes what drove most of us to go into medicine—the desire to help people and make a connection. At Kinwell, we want to create the space and the time needed for patients to feel seen and heard and for clinicians to stay engaged and curious.
What do you mean by staying curious?
MW: In recruiting clinicians, one of the qualities I look for is curiosity. By that I mean the desire to dig a bit deeper into a patient’s condition and develop helpful therapies. For example, if a patient is having problems with knee pain, a clinician could either refer them to an orthopedist, or research the problem, order labs or imaging, and develop a plan of physical therapy or medication. At Kinwell, our clinicians have the time to go that extra mile.
What is a team approach to primary care?
MW: The team comes into play in a couple of different ways. We’ve moved away from the physician being the be-all and end-all in healthcare and are leveraging different levels of expertise in how we take care of patients. Our team of clinicians—doctors, nurse practitioners, physician assistants—rely on each other. If a physician in Lynnwood is unfamiliar with a unique condition, they can reach out to a nurse-practitioner in Pasco who may have experience with it. These virtual quick chats go on every day, and we’re great at using video conferencing for this. This culture of continuous learning is another foundational element of my recruiting and shows up in how we ask questions as peers and strive for input from a diverse set of clinicians.
We’re also building the team around the clinicians. A patient care coordinator or medical assistant can help with appointments and accessing records. They are some of the first people to introduce Kinwell to a patient and are a key component of planting the first seeds of trust and confidence. A behavioral health clinician can consult on a patient’s mental health in a holistic way that is not achievable when we work in silos. And a health coach can help address lifestyle habits that can improve well-being. Caring for each patient isn’t just the primary care clinician’s job anymore.
Was behavioral health always part of Kinwell’s plan?
MW: It was critical to me that we have behavioral health as a foundational part of primary care. So much of what we see walking through our doors, whether it is a rash or high blood pressure, may have an element of behavioral health. This may not be a serious case of depression, but it could be a case of the blahs—something that impacts the patient’s ability to engage in their health. There is mental illness of course, but there are also events in our life—maybe the loss of a family member or a problem at work—that contribute to a short-term disability. Such events can impact how much exercise a person is getting and what they’re eating, and that can impact the medical side in terms of diabetes, heart disease, migraines, and so on. Primary care clinicians can manage a lot of that, but it’s great to have behavioral health specialists right on staff to provide therapeutic interventions when the patient is asking for our guidance and support.
The other reason it’s important to offer behavioral health care is because it gives our clinicians additional tools to keep patient care centered in primary care. They have confidence that a diagnosis has been confirmed and that we can treat it appropriately. They don’t have to refer that patient to a specialist as often with the additional training and expertise in our own behavioral health care team. And if a patient with a serious mental illness needs an outside provider, they know Kinwell can be their holistic medical home where we can monitor their treatment as part of their overall health care journey. As human beings, physical and behavioral health are integrated, and it just makes sense they are both part of the primary care team.
To learn more about the importance of personalized care, read From Transactional Tasks to Personalized Care: A New Vision of Physicians’ Roles. To access Kinwell’s behavioral health services, reach your clinician through MyChart, or call 833-411-5469 to schedule an appointment.
