Primary Care versus Nutritional Care

Here at Be Well Clinic we offer a variety of different ways to support you. We separate everything we offer into two buckets: Primary Care and Nutritional Care. While this flexibility is helpful to provide you the best care possible to fit your individual needs, we understand that it can create confusion at times. In order to make things more clear, we will be outlining the different options you have for receiving support from Be Well Clinic, so you can understand and choose what’s best for your situation.

First, a brief history of Be Well Clinic. When I (Amy) first started practicing in 2013, I actually started two separate businesses. The nutritional business was called Wholly Guts, and focused on people doing the GAPS Protocol, and the primary care clinic was called Be Well Clinic. I did this to try to avoid confusion, but there were a couple problems! First, nutritional support is the foundation of both! And second, because of that, many people overlapped both businesses, so tracking and separating time for appointment billing under two different businesses was difficult. So I closed Wholly Guts, and everything came under the Be Well Clinic umbrella. This overall has made things more simple, but there can be confusion at times, which we hope to clear up in this article. 

Currently, there are two practitioners within Be Well Clinic. Amy Mihaly is a Family Nurse Practitioner, Board Certified, and a Certified GAPS Practitioner. Hollie Bigham is a Registered Nurse (with extensive Emergency Department experience), a Functional Nutritional Therapy Practitioner, and a Certified GAPS Practitioner.

Let’s talk about the two categories we use at Be Well Clinic: Primary Care and Nutritional Care

Primary Care:

Primary care falls under the umbrella of the way our modern medical model is set up. In the model, a patient finds a primary care provider (medical doctor, doctor of osteopathy, nurse practitioner, or physician’s assistant) within a practice, and that provider (also called a diagnosing provider or independent licensed practitioner) becomes the practitioner and care coordinator for that patient. In our practice, currently, I (Amy) am that provider. And if you are a primary care patient at our practice you get all of these same benefits (with the current exception of medication prescribing). All the benefits you get as a primary care patient are delineated in the table below.

There are a few guidelines that have to be followed for us to be able to be a primary care practice. First off, there are “boxes” that have to be checked during appointments. These are things like taking vital signs, reviewing allergies, doing a health history, performing an in-person physical exam, and discussing current symptoms. Additionally, our appointments are longer than in a typical medical practice because we prioritize having enough time to explore symptoms and their connections, provide education, and discuss the best plan of action. 

Second, it is typical for each primary care practice to dictate how often their patients need to be seen to be considered “current patients.” This protects the patient as well as the practice. For example, if we made medical recommendations for someone who we haven’t seen for 5 years, it could result in an unsafe recommendation, as their health history could have significantly changed during that time. We have determined what we feel is the best frequency of appointments to provide safe care to our patients. The frequency varies based on the age of the patient, and can be seen in the table below. 

*Incidentally, sometimes situations arise where having a primary care provider for your child can be very helpful, as attendance to regular well child visits is seen as responsible parenting in the state of Colorado.

Primary care if outside the state of Colorado:

If you are living outside of Colorado, there are some additional things that factor into whether or not you are able to be a primary care patient of Be Well Clinic. As Amy is our current diagnosing provider, her ability to practice is dependent on where her nursing license allows her to practice. Colorado is part of what is called Nurse Licensure Compact, which allows a nurse with a Colorado license to practice in the other states within the state compact agreement. You can check out the map to see if you are living in (or moving to) one of these states. 

If you are moving to another state, we do recommend you seek out primary care in your area. It’s important to know the healthcare system where you are, so you can use it as needed. We also understand that we are unique, or your area may not have exactly what you are looking for. If you want to continue using Be Well Clinic for your primary care, or use us for a year as you transition to another area, you need to make sure you are located in a “compact state,” and continue to have in-person well physicals as needed to remain a “current patient.” The appointments for these physicals cannot be via telehealth. As long as you continue to meet these criteria, you may continue using Be Well Clinic as your primary care provider. And even if you do not continue to meet these criteria, you may continue scheduling appointments under our Nutritional Care umbrella. Let’s talk about that next!

***Please be advised that our primary care schedule is booking out about three months in advance. Please plan accordingly.***

Nutritional Care:

You can be under the nutritional care umbrella whether or not you are a primary care patient. While all of our appointments are centered around nutrition, these appointments are focused on supporting your body nutritionally and holistically, and do not have to be focused on checking the boxes necessary for primary care. Some of the patients of Be Well Clinic are only nutritional patients, while many fall under the categories of both.

If you are a current primary care patient of Be Well Clinic, you don’t need to worry about the delineation of appointments. All appointment types (including the sick line) are available to you. If you have not seen Amy for a primary care physical, or are not current in your physical (according to the patient’s age) then you are still able to make nutritional care appointments. Nutritional care appointments are currently only available with Hollie, as Amy’s primary care schedule is too full to allow for her availability for these types of appointments. 

As stated above, nutritional care appointments are able to be completely focused on what you or your child needs to support the body to heal. These appointments include a discussion between you and the practitioner, and recommendations are based largely on your observations about your (or your child’s) symptoms. Therefore, there is not a need for an in-person physical assessment. This is very helpful, as many people who seek nutritional care from us (for example, people who want to do the GAPS Protocol) are out of state. This allows them to receive nutritional care from us. However, because of the lack of an in-person physical, these patients are not primary care patients and do not have access to the primary care patient benefits (see table below).

Another time nutritional care visits are utilized is if the support need is outside the requirements of primary care. For example, if you have a primary care appointment with Amy, and you discuss needing additional appointments to provide the necessary support for the symptoms or diagnosis, any follow up appointments will most likely be made with Hollie. Amy and Hollie work closely together with all of these “shared” patients, ensuring a continuity in the recommendations and support you receive, no matter which provider you see. This setup is beneficial to you as the patient, as it allows you to get the support you need in a timely manner.

What appointment should I make?

For new patients:

If you are looking for in-person primary care, we recommend you make an Initial Well Physical (Adult or Child) to establish yourself or your child as a primary care patient. If you do not need a new primary care provider, but are looking to heal specific acute or chronic symptoms, we recommend you make a New Patient Nutritional Consultation Package appointment. If you are unsure, you can schedule a Free 15 Minute Inquiry Call with one of our practitioners to discuss the best option for your situation.

For current primary care patients:

As a current patient, we want to support you as much as you need! In general, primary care appointments are with Amy for a well physical (frequency based on age). Any appointments in addition to your well physical should be made with Hollie. There are some exceptions, such as heart sound recording appointments, or other situations where in-person assessment is needed. If you feel you need additional support, you can call the sick line (for acute, non-emergent symptoms), schedule online, or call the office to make an appointment with Hollie.

For current nutritional care patients:

In general, your appointments should be scheduled with Hollie, with a frequency based on your needs. There are some occasions where in-person appointments are advised based on your discussion with Hollie. Should this be the case, you will make a plan together to ensure you get the additional care you need. These could be in-person with Amy, or elsewhere, as the situation dictates.

Hopefully this article has helped clear up any confusion you may have had about primary care and nutritional care, and how we use these terms at Be Well Clinic. If you are not sure which category you fall into, please ask! We can let you know if you are a primary care patient, nutritional patient, or both! Then we can help you understand what steps you can take if you want to use additional services that we offer. 

Onward,
Amy

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