AHRS 492 Medical Provider Interview PDF

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Nicole Herbst Medical Provider Interview Northern Illinois University

I interviewed Dr. Tracy Quinn, a family doctor through Advocate Health. She has been my doctor, as well as my family members doctor, for a few years now. She works at the Advocate in Wauconda, IL. I have always had a very pleasant experience with her. She is very good about building rapport. She knows who I am and how I live and the things I like to do, even though she has tons of patients that she sees every day. I was really interested to see what she would have to say to these questions and what the main medical conditions she sees every day are. Her answers made a lot of sense though, considering the town she works in and the people she sees regularly. Interview Dr. Quinn told me she mainly treats diabetes and obesity. She said that this includes all populations, such as age, gender, etc. This makes sense because she is a small-town family doctor. Obesity and Diabetes are very prevalent, as well. A lot of diabetes is caused from obesity. The procedures she uses to diagnose patients with obesity and diabetes are ones she does often. These include taking vital signs and doing blood work. A very important thing she does with her patients, especially those with diabetes and obesity, is discuss their lifestyle. This is so incredibly important for people with any medical condition because how someone lives can ultimately make their conditions worse or better. Lifestyle changes usually have to made with any condition. Exercise and proper nutrition would be major lifestyle habits that someone with diabetes or obesity would need to learn about. Dr. Quinn provides tons of treatments to her patients. For obesity and diabetes, these treatments include lifestyle changes, nutrition and diabetes education consults, medications, and surgery referrals. The lifestyle changes are discussing exercise, diet, decreasing salt, etc. The surgeries may be a gastric bypass or a gastric sleeve surgery.

Dr. Quinn found it very interesting to look at the psychological, social and vocational aspects of the population with diabetes and obesity that she treats. For the psychological aspects of these diseases, she talked about how depression, anxiety and sleep disturbances often cooccur with obesity and diabetes. Depression and anxiety can be self-treated with food, which leads to other problems and increases the cycle with obesity. The social portion interested her the most. The people who are depressed, usually isolate themselves and eat many bad foods alone. She says that nowadays, obesity stems from overindulgence in bad foods because that is the typical "American" way. When bad choices to over-indulge constantly keep occurring, this is how people become obese. Dr. Quinn was kind of confused about the vocational issues. She talked about the patients she works with who have obesity, as well as intellectual disabilities and they work in day programs or our local Jewel. She said other patients do not discuss their issues they have at their place of work if they have obesity or diabetes. She does give her patients information that includes help for when they need to take care of themselves and be eating. Comparison to the Textbook The textbook talks about obesity kind of sporadically throughout it. It mostly talks about the complications with obesity in the diabetes chapter. This is convenient because diabetes and obesity are the two main medical conditions that Dr. Quinn treats. The book says "a major risk factor in development of type 2 diabetes is obesity" (Falvo, pg. 377). This tells me that Dr. Quinn is mostly treating type 2 diabetes. This also makes sense because 90% of people with diabetes have type 2 (Falvo, pg. 377). When identifying whether or not someone has diabetes, most is "identified through fasting blood glucose, a test in which blood is drawn after the individual has not eaten for a number of hours of a Hemoglobin A1C. The FBG test compares the level of glucose in the

individual's blood with the level of expected in persons without diabetes mellitus under similar circumstances. The A1C test measures the amount of sugar stuck (adhering) to the hemoglobin in red blood cells" (Falvo, pg. 377). This is similar to what Dr. Quinn had told me. She said the first thing she would do would get blood work done and check vital signs. She also said she would talk about lifestyle modifications and changes which the book also states is very important. People with diabetes need to learn how to manage their disease since there is no cure for it. People who are obese can learn to change their situation over time. Dr. Quinn may have to explain management for insulin for people who have type 1 diabetes. One thing that Dr. Quinn did not discuss with me is specific medications for diabetes. "Although some individuals with type 2 diabetes may be able to control their blood glucose levels with exercise and weight loss or diet alone, in other instances oral antidiabetic agents (oral medications that are effective in lowering blood glucose or preventing the blood sugar rising) may be needed...some enhance insulin secretion, whereas others reduce glucose production by the liver" (Falvo, pg. 379). Lifestyle modifications included in the book are diet, physical activity, self-management and monitoring. "Individuals with type 2 diabetes may be able to manage blood glucose levels with diet alone or with a combination of diet and oral agents" (Falvo, pg. 380). Dr. Quinn says she always discusses diet and exercise change, as well as decreasing salt intake. She also said that she tells them about getting consultations on nutrition for diabetes. This is exactly what the book says and it discusses that "diets for management of diabetes are individualized and based on many personal factors, such as weight, age, and type of daily activity (e.g., sedentary,

moderately active, very active)" Falvo, pg.380). I like how the book talked about the importance of a diet and exercise plan that is specific to the person. This is what will ultimately help someone with diabetes or someone who is obese. It's very important that a personal trainer or dietician takes into account everything about a person before writing up a specific plan. This is what will ultimately make them successful in their weight management journey. For someone who has diabetes, they discussed how it is important for them to be eating as many calories as they are burning. Which means they cannot be in a caloric deficit because this can "result in hypoglycemia (insulin shock)" (Falvo, pg. 381). Dr. Quinn did not mention any physical complications that come with diabetes and obesity. She focused more on the mental health issues that people may obtain like depression and anxiety. The book talks about some of the physical complications that can come with diabetes like complications with the eye, complications with the kidneys, complications involving the nerves like peripheral neuropathy, complications with the cardiovascular system, and possible amputation. Anxiety makes sense for someone with diabetes to get, because it becomes a lifelong condition that they are constantly having to think and potentially worry about. They really have to make it a point to schedule their time every day and their meals always need to be scheduled around any sort of activities they do. I thought it was interesting that Dr. Quinn brought up that she will tell her patients about surgery referrals for gastric bypass surgery or a gastric sleeve. The book does not really mention these surgeries because they are more for treating obesity. It would have been interesting to see what the book had to say about these surgeries. These surgeries can be very beneficial for someone who is obese. It can help out those with type 2 diabetes if they are obese. Student Critique

I thought that Dr. Quinn's answers were very similar to what the book said. She talked about the procedures and treatments that she would take and explain to her patients and it is exactly what the book says. She focuses a lot more on treating her patients for mental health issues like depression and anxiety when they are faced with medical conditions like obesity and diabetes. This makes sense since she is a family doctor and she will generally see many of the average issues in the general population like people who are obese and have diabetes. The only thing she discussed that was not in the book, was the surgeries to help manage obesity. These surgeries, like I said before, are the gastric bypass and the gastric sleeve. These surgeries would be good to discuss in the book because they are pretty common surgeries. I was surprised that the book did not have its own section on obesity, discussing all of the complications that can come from it. I was surprised that Dr. Quinn did not have more to say about the vocational issues with obesity and diabetes. She may not have been thinking that diabetes can have some vocational issues. The biggest issue would be that the person is able to take small breaks to get meals in. Their food schedule is important for them. If they have certain complications like peripheral neuropathy, "exposure to cold temperatures for long periods of time should be avoided to prevent possible complications such as frostbite" (Falvo, pg. 388). Most of the vocational issues will come from the complications from diabetes or obesity, such as amputation or the peripheral neuropathy. Conclusion I really enjoyed this project because it opened my eyes to how a medical provider thinks and acts towards their patients. I liked that I chose my doctor because it was interesting to see her

viewpoints medically. I also was not sure what the main medical conditions were that she treated, but as soon as she said obesity and diabetes it made complete sense. I liked that she said a lot of things that the book also said. It definitely made me feel better about what my doctor is telling me because I feel like I can rely on her to know what she's talking about.

References Falvo, D.; Holland, B.; (2018). Medical and Psychosocial Aspects of Chronic Disability: Sixth

Edition. Jones & Bartlett Learning, LLC. Quinn, Tracy. Wauconda, Illinois. (2018, March 13th)....