Richard Kravitz, MD, pediatric pulmonologist, sleep physician, and division chief at the University of Virginia, shares why staying connected with primary care is essential in SMA health teamwork.

The question is, “Where’s your primary care person involved? What do they do?” Well, I talked earlier about the team approach with — what do you call it — pediatric pulmonologists, neurologists, gastroenterologists, cardiologists, all the -ists. We have lots in the team. I didn’t mention primary care because I was talking in the universe or within the center.

The primary care doctor is the gateway. They are key because the patients can’t come and see us all the time. Sometimes we’re two, three hours away from where our family lives. So working with our primary care docs is key. I view their role as more than just health maintenance, more than just immunizations, more than just ear infections for a pediatric.

I want them to feel as actively engaged as they can. So I want them to troubleshoot problems. I want them to see the patients first.

I want them to be able to look at my notes and say, “OK, this is what Dr. Kravitz recommended with Coles. I think I can handle this for now, but if this is not gonna work in the next day or so, I’m gonna reach out to him.” I want these docs to reach out to us. I want these nurse practitioners and physicians to feel comfortable reaching out.

And I’d work with them too, because if I can’t see a family, I’ll tell a family, “Here’s the deal. I want you to go to your primary care doctor. Here’s my number. When you’re seen there, if they have questions or concerns, I want you to have them call me. They’re gonna be my eyes and ears and my hands. And I’ll work with them to help.”

And once you really get to know some of the primary care providers, they’re a wonderful resource. They’ll call me up: “Rich, I have one of your patients here. This is what’s going on. This is what I think it is. I’m not sure where else to go. What’s the next step? What can we do before I have to send them to see you?”

And again, I try and keep everything in the community as much as possible because it’s hard to get in the car and drive three hours, especially when your child is sick.

So I view them as a valuable member of the team. They should always feel part of it, and if they don’t feel they’re getting the information they need, I want them to reach out and say, “Hey, I need this from you. How can you help me so I can better provide care for our mutual patients?