What is "Primary Care" & what is a "Family Medicine Physician"?
"Primary Care" refers to the medical specialties that are on the front lines of taking care of patients. Primary care physicians or PCPs act as the patient's "medical home." The specialties that make up "primary care" are:
Pediatrics - Pediatricians take care of babies, children, and teenagers
Internal Medicine - Internists aka Internal Medicine physicians take care of adults
Family Medicine - Family Medicine physicians take care of people of all ages
Obstetrics & Gynecology - OB-GYNs specialize in women's health and some also serve as primary care providers while others act more like sub-specialists
In the past Family Medicine physicians were called "generalists," "general practitioners" or GPs because they are the "renaissance men" of medicine receiving training in multiple areas of medicine. They provide ongoing comprehensive care for people of any age or gender, dealing with all diseases and parts of the body. Because they become familiar with the patient's medical history as well as family history and social history and have the potential to know and treat multiple generations in a single family, this medical specialty was renamed "Family Practice" and then switched to "Family Medicine."
As the practice of medicine becomes more and more fragmented with specialists, people are learning the value of continuity of care. Patients who go to a Family Medicine physician have the potential to have their doctor know them "from cradle to grave." Should a patient develop a problem that is beyond the scope of a Family Medicine physician's practice then the patient is referred to a specialist that focuses on that type of problem. Family Medicine physicians specialize in seeing the big picture, coordinating care and helping to prevent illness and injury, giving credence to the saying “A jack of all trades is a master of none, but oftentimes better than a master of one.”
What is a D.O.?
You may have noticed that our physician has the letters "D.O." at the end of her name instead of "M.D."
M.D. = allopathic physician
D.O. = osteopathic physician
Staff of the Greek Messenger god
Staff of the Greek god of Medicine & Healing
Both complete four-year bachelor's degrees with an emphasis on scientific courses then go to medical school for four years. They then obtain graduate medical education through internships, residencies, and fellowships. This typically lasts three to eight years depending on the type of medical or surgical specialty chosen. Both M.D.s and D.O.s are fully qualified physicians licensed to prescribe medication and perform surgery throughout the USA.
So what's the difference?
In an osteopathic physician's training, they are taught to practice a "whole person" approach to medicine with emphasis on comprehensive care, prevention, and the philosophy of treating people, not just symptoms.
Osteopathic physicians believe in the Osteopathic Tenets:
The body is a unit; the person is a unit of body, mind, and spirit.
The body is capable of self-regulation, self-healing, and health maintenance.
Structure and function are reciprocally interrelated.
Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.
Osteopathic physicians also undergo additional training in the musculoskeletal system, allowing them to use their hands to diagnose illness and injury, and are trained in how to perform Osteopathic Manipulative Treatment (OMT) to encourage your body's natural tendency toward good health.
What is Osteopathic Manipulative Treatment (OMT)?
Osteopathic manipulative treatment, or OMT, is hands-on care. It involves using the hands to diagnose, treat, and prevent illness or injury. Using OMT, your osteopathic physician will move your muscles and joints using techniques including stretching, gentle pressure, and resistance.
OMT can potentially help people of all ages and backgrounds. The treatment can be used to ease pain, promote healing, and increase overall mobility. OMT is often used to treat muscle pain, but it can also help patients with a number of other health problems. For example: asthma, carpal tunnel syndrome, headaches, menstrual pain, and plagiocephaly.
When appropriate, OMT can complement, and even replace, drugs or surgery. For example, research has shown OMT to reduce hospital stays and IV medication when used to treat pneumonia, decrease the likelihood of surgery for kids with recurrent middle ear infections, improve quality of life for chronic pain patients, and provide other health benefits.
What is your position on alternative and complementary medicine?
They have their time and place, however, if the best option for a situation is a prescription medication or surgery then that is what Dr. Weeks will recommend.
We at Apple Tree Medicine do our best to practice evidence based medicine and all treatments have risks and benefits. Dr. Weeks will work with you to weigh these risks and benefits to determine which of the options available are the best fit for you.
"Alternative medicine" means you are picking a nontraditional treatment instead of the traditional one. This is appropriate when the alternative treatment has equal or greater benefit and lower risk than the traditional treatment. For example, if you've tried acupuncture and know that it provides you with significant pain relief while a medication for pain results in intolerable side effects; choosing the acupuncture instead of the drug is completely reasonable. If an alternative treatment is more dangerous, is unproven to achieve the traditional treatment's result, or is not as helpful then Dr. Weeks will recommend against it. For example, eating strawberries instead of seeking traditional treatments for colon cancer. Strawberries have not been proven to cure colon cancer and choosing them instead of traditional treatment risks the cancer getting worse and potentially killing you.
"Complementary medicine" means you are using a traditional treatment option and adding on an additional type of treatment. Complementary treatments are appropriate when they can be SAFELY used in combination with another treatment and result in greater benefit. For example, OMT performed to help with sinus pressure won’t interfere with medication being used to treat the same condition and may provide additional symptom relief.
Just know that if anyone claims that any particular treatment has no risks or can treat/cure any ailment then that person is either uninformed or not being honest with you. Dr. Weeks will readily admit that OMT is not appropriate or helpful in many circumstances.
What if I love my current primary care doctor and don't want to switch, but would like to get OMT from you?
Everyone should have a "medical home," an office where you have a primary care physician who knows you and is in charge of coordinating your care. Patients should not bounce between primary care doctors because this leads to errors which can endanger a patient.
Normally when a patient comes to Apple Tree Medicine it is to establish this office as their medical home. If your primary care physician does not offer OMT and you would like to keep them as your medical home but you think you could potentially benefit from OMT or you wish to learn more, than you can make an appointment at Apple Tree Medicine for a consultation visit. In this scenario Dr. Weeks would act as a specialist. The history and exam would be limited and she would potentially provide the service of OMT but would not provide other services like prescriptions or labs as those would be issues that should be handled by your primary care physician.
What is your position on vaccines?
Every year the CDC publishes immunization schedules based on research data and with the approval of the Advisory Committee on Immunization Practices, American College of Physicians, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Nurse-Midwives.
We require that all children follow the CDC guidelines and we strongly recommend all adults be up to date on their immunizations as well. If you or your child have missed shots and are behind on immunization, we will help you get caught up per the CDC's recommendations. All staff at Apple Tree Medicine maintain their immunization status per CDC guidelines for your protection as well as their own.
But what if I don't want my child to be vaccinated?
Vaccines are one of the most heavily studied subjects and are constantly under evaluation, which is why the CDC publishes new guidelines every year in order to stay on top of the most current knowledge. Dr. Weeks follows the CDC guidelines, which include stipulations AGAINST VACCINATION in certain medical situations. If it would be unsafe for your child to receive a vaccine due to such a medical condition then Dr. Weeks would absolutely recommend AGAINST getting that vaccine as per the guidelines.
If you do not wish for your child to receive vaccinations for other reasons, then he/she will not be accepted as a patient at Apple Tree Medicine. The physician-patient relationship is based on trust. You cannot have that relationship if Dr. Weeks recommends vaccination but you think she is trying to hurt or endanger your child. If this is your position then you should seek care for your child elsewhere.
Do you administer vaccines at this office?
Not at this time because one of our goals is to save you money. Currently the most inexpensive option for everyone is to go to your local health department where they offer cheap or potentially free vaccines and will process your insurance if you have any. Should Apple Tree Medicine reach the point that we can offer comparable prices then we will carry vaccines. In the meantime, the health department serving vaccines for Newport News, Poquoson, Williamsburg, James City County, & York County is the Peninsula Health Center located at 416 J. Clyde Morris Blvd., Newport News, VA. Their phone number is (757) 594-7305
Are there any other particular services you don't offer?
We do not do Disability physicals, Workmen's Compensation physicals, or DOT (Department of Transportation) physicals.
We do not deliver babies or see patients in the hospital. We do not perform operating room procedures or surgeries.
We also do not do facial or head wound repair or prescribe opioids for the treatment of chronic pain.
Why did Dr. Weeks decide to do things differently?
The short answer is that she was sick of being abused by the medical system and refused to comply when it tried to prevent her from serving her patients. She got into medicine because she wanted to one-by-one improve people's quality of life and to be a healer. By doing things "old school" Dr. Weeks can practice for the sake of the patient and not "production." This gives her the chance to honor the patient-physician relationship and practice what she preaches.
The usual way of doing things can't be that bad, right?
Are YOU satisfied when your doctor rushes through your visit, doesn't listen, and you only see them for five minutes?
From the physician-side of things, because of how bad things are now:
>90% of physicians will actively discourage anyone from becoming a doctor, especially their loved ones
Most medical school students pursue the highest income specialties (i.e. NOT primary care) so they can retire early
Physicians are choosing to leave patient care for alternative careers
Approximately 400 physicians kill themselves every year
Can you explain how someone becomes a physician?
The process of medical education and associated terminology can be confusing. To become a physician, one must first maintain a high GPA at a four year undergraduate program and graduate with a bachelor's degree. They must meet many scientific course requirements, either included in their time at college or supplemented by post-baccalaureate classes afterward, and score well on the MCAT exam in order to qualify for applying to medical school. Many schools require an applicant to already have many hours of experience in the medical field through employment, volunteer work, and/or physician observation called "shadowing".
When someone is accepted and becomes a student at an accredited medical school they may be referred to as "student-doctor". This is because they are a student still in training to become a physician but have not yet received their doctorate degree in this field.
Traditionally, medical school lasts four years. The first two years are primarily spent learning from books and going to classes and labs. The hours devoted to class and study are typically the equivalent of working two and a half jobs. If they pass their classes, they then take their first national medical licensing exam which they are required to pass. If they do not pass, they either get another chance or they are kicked out of medical school.
Years three and four of medical school are composed of "rotations." Usually a rotation lasts four weeks, though occasionally two or eight week rotations occur. During this time period the medical school student spends their days with a physician of a particular specialty, working in hospitals and/or clinics. With each new rotation the student is with a new physician of a different specialty. This typically means that the student has to move multiple times over the course of these two years. During this time, they also take two more national medical licensing exams in addition to the exams required by their school.
Upon successful completion of their licensing exams and passing their rotations they then graduate from medical school. At graduation they receive their doctorate degree and are now called "Doctor" though they are not yet legally permitted to practice medicine.
If they wish to practice medicine and treat patients in the future then during years three and four of medical school they decide which specialty they wish to go into and apply to internship and/or residency programs. They travel for interviews and are then potentially "matched" with a graduate medical education program. "The match" occurs only once per year. If they do not successfully "match" with a program in their chosen specialty then they can "scramble" to enter a graduate medical education program for a different type of specialty. If they choose not to switch specialties and scramble, or graduate medical education programs do not accept them, then they will not continue this career path for at least a year.
All medical school graduates, aka doctors, who wish to practice medicine, and were matched with a graduate medical education program, first enter internship. Internship is the first year of residency so their status is referred to as either "intern" or "resident" but regardless they are a doctor. Some specialties have internship and the remaining years of residency occur at the same location with a single graduate medical education program. Other specialties will have the doctor do internship one place and then enter "the match" for residency with another program.
During internship and residency the doctor works as a physician but under the supervision and guidance of "preceptors" or "attendings" who are fully licensed practicing physicians. Typically at the end of internship the doctor takes their final national medical licensing exam. The number of years it takes to complete residency varies between specialties. If their program follows the law, they work an average of 80 hours per week and are frequently required to forgo sleep, food, and using the toilet. If they pass their last licensing exam and successfully complete their residency they are then allowed to practice medicine independently.
Fully licensed physicians have the option of becoming board certified. This is not a requirement to practice medicine. To be board certified they are required to pass exams and undergo continuing medical education through study, lectures, membership fees, and conferences. A physician must continue this process in order to maintain their board certification or it will expire. Some physicians opt not to maintain their certification due to the financial cost which can be up to five figures.