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This week’s Making Rounds spotlights Luis Castro, a family medicine physician at Beebe Healthcare in Lewes, Delaware. Castro, who also runs Beebe’s family medicine residency program, talked about the most fulfilling part of his job, the importance of telemedicine for healthcare access, and the downfalls of quality performance measures in healthcare.
This interview has been lightly edited for length and clarity.
How would you describe your specific job to someone who doesn’t work in healthcare?
I see patients in our walk-in clinics, which are basically urgent care centers. We see them for most of their acute primary care problems, like cough, cold, fractures, or lacerations. I also provide obstetrical care. I do low-risk, natural deliveries. Beebe Healthcare also just started a new family medicine residency program, and they were looking for a family doctor with experience in obstetrics to teach residents the ob-gyn aspects of family medicine. That’s now my other role outside of being a walk-in provider.
What’s the most fulfilling aspect of your job?
Helping heal people at the most stressful and scary moment in their life. When I counsel young people who are considering going into healthcare, I often say, “Are you prepared to be with somebody at, potentially, the most stressful or most painful or most difficult time of their life?” Because that’s what happens in healthcare. If you’re not ready to say yes to that question, then you probably shouldn’t go into healthcare.
What healthcare trend are you most optimistic about and why?
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Telemedicine as a way to provide access to care for certain people who wouldn’t have access to a healthcare provider otherwise. We offer telemedicine visits in our walk-in setting, and this was something that came out of Covid-19. When patients were staying at home, they weren’t able to go out to see their providers in their offices or were afraid to go to a walk-in or emergency room. We just built on that. Telemedicine is here to stay. The potential for telemedicine to really reach patients and get them access to care—that’s really the issue. Access to care is a problem for many patients.
What healthcare trend are you least optimistic about and why?
Quality performance measures. The trend now in healthcare for most insurers is that they measure certain quality metrics and basically reimburse providers, clinics, and hospitals based on those. The problem with the actual metrics is they’re often things that we don’t have a lot of control over, like high blood pressure or high cholesterol. Quality measures don’t necessarily reflect the type of care patients are getting. If insurers really wanted to pay for quality, they should review my charts. Am I doing the right type of care, as far as the medications I’m prescribing, the advice I’m giving to the patient, the testing I’m doing, the screening I’m doing? That’s really more a reflection of quality than these metrics they’re using now. Paying for quality is the right idea, but how insurers measure quality is the problem right now.