Building Better Health Together
January 2, 2023GBMC Health Partners Primary Care is built on the idea that physician-led, personalized care coordination teams manage your health alongside you. There is no one-size-fits-all approach to healthcare and the journey is much easier to navigate with a support system.
Here to give practical advice for taking control of your health in the new year and starting 2023 off right are GBMC leaders and 2022 Baltimore magazine Top Docs—Gregory Small, MD, Director of Primary Care Medicine at GBMC HealthCare and Internal Medicine Physician at GBMC Health Partners Primary Care, Texas Station, and Theresa Nguyen, MD, Interim Chair of Pediatrics and Pediatrician with GBMC Pediatric Group.
Primary Care for Adults with Dr. Gregory Small
There are a host of things adults need to check off their health to-do lists. From vaccinations and screenings to labs and behavioral health evaluations, the list can get long and confusing. Working with a primary care provider (PCP) can help create a plan with age- and gender-specific recommendations that make sense for you.
“For too long, too many patients have engaged in the act of healthcare as episodic: a symptom arises, we run to an urgent care or we run to an Emergency Department or we rush to a specialist,” Dr. Small said. “We are chasing a symptom, but we don’t have one person who’s looking at the big picture, tying everything together or who has been doing certain screenings up front to give us an awareness of what to expect in the future.”
Even younger individuals or those without chronic illness can still benefit from having a PCP.
“This is where primary care doesn’t need to be one size fits all. Maybe that healthy person doesn’t have to come in every year on the day. But a lot of times it becomes meaningful when you engage them in their history and family history and what to look out for,” Dr. Small said.
Care plans include timely checks like vaccinations and screenings as well as long-term goal planning such as weight loss or nutrition improvement. Dr. Small views tackling these larger intentions with “prescriptions.”
“What is your exercise prescription? How do you approach this?” Dr. Small said. “Too often it’s ‘I’m going to try and fit this in’ versus ‘I’m going to make this a priority.’”
Mental health also needs to become a priority, especially for teens and young adults. According to the CDC’s Adolescent Behaviors and Experiences Survey (ABES), a third of high school students categorized their mental health as poor during the pandemic and nearly half felt persistently sad or hopeless. Having a PCP at GBMC gives these individuals the opportunity to take advantage of the Collaborative Care Model.
The aim of the Collaborative Care Model is to provide brief and timely interventions for mild to moderate mental health issues, in the convenience of a PCP office, while referring out those with more serious illness. It is designed to efficiently use psychiatric expertise to help the maximum number of people without delaying treatment.
Dr. Small and his team are there to help you make yourself a priority.
General Pediatric Care with Dr. Theresa Nguyen
Parents today have enough to worry about. Dr. Nguyen takes the guesswork out of how to set your child up for success with her trifecta of health. Three simple focus points that will serve as the foundation for your child’s health are sleep, nutrition, and movement.
Sleep—The recommended amount of sleep is 9 to 11 hours for elementary and middle school children and 7 to 9 hours for high schoolers. Dr. Nguyen said the way to determine the amount of sleep your child actually needs is by evaluating their sleep on the weekends.
“I ask kids, ‘What time are you going to sleep and what time are you getting up on the weekend?’ Then, we get a better idea of how much sleep their body would like to have," Dr. Nguyen said.
Consider good sleep hygiene to assist with bedtime resistance and establishing good habits. No screens at least one hour before bed and ideally not in the room at all. Reading or relaxation exercises can help the body calm down as well. For anxious kids or those with racing thoughts, Dr. Nguyen suggested journaling or drawing to mimic the act of “throwing away” thoughts as well as more tactical suggestions like finger tracing and deep breathing.
Nutrition—When considering meals and snacks, choose as many foods that grow in the ground as possible. Whole, unprocessed foods are the most beneficial nutritionally, but Dr. Nguyen also recommended not limiting snacks and “treat” foods because heavy restrictions tend to breed unhealthy habits long term. Her rule of thumb is eating at least one plateful of vegetables daily, either divided across meals or at once, with as many colors of the rainbow as possible.
Movement—Dr. Nguyen prefers the term movement to exercise. Movement expands the options. It could be running or playing soccer but could also be dance or yoga. A healthy amount of movement could include walking the dog as a family or hitting the trails. Also, aim to get as much of your movement outdoors
as possible.
Building confident, resilient kids requires routine and consistency with this trifecta, as well as a parent’s ability to model the behaviors. Everyone—parents, teens, and young kids—is experiencing extra stress right now, and parents can model the behaviors they want their children to pick up while maintaining their own health along the way.
“If you want to grow something, you have to plant and nurture the seed for it to grow in you and your child,” Dr. Nguyen said. “Start with yourself because you can’t teach anything that you’re not embodying.”
Perfectionism is not the aim. If stress causes you to have a less than ideal response in front of your kids, it’s OK to show them it happens, and then give them an opportunity to see what repair looks like by taking accountability and explaining how you will react differently next time.
Raising resilient, confident kids requires building resilient and confident families. Participating in developing healthy habits together will help them last a lifetime.