ISSUE 22: FINDING A PRIMARY CARE PROVIDER SUCKS
I tried Tia, the holistic primary care home for women.
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AN APPLE A DAY DOESN’T HELP YOU FIND A GOOD DOCTOR
I’m a simple girl. If there’s one thing I look for in a primary care provider, it’s not gaslighting.
My health challenges over the years have led me to appreciate an approach to medicine that is more holistic and comprehensive. And that means that for more chronic health issues, you could say I’m raising an eyebrow if a practitioner whips out a prescription pad faster than I can say IBS.
Some of the biggest health challenges I have overcome have been from practitioners who ordered gut, blood, and allergy/food sensitivity tests and found the root cause of an issue that way. Once the root cause was identified, that could be treated. Not the symptom.
As a quick example, I used to have this crazy eczema rash on my neck that came out of nowhere and would NOT go away. I had healthcare practitioners tell me to put cortisone cream on it and call it a day. I knew it it was something more systemic, so I kind of ignored the advice (plus, coconut oil worked better). I also tried acupuncture which helped, but only to temporarily calm the inflammation.
At last, I started working with a functional medicine practitioner to address some health concerns, and she ordered me a specific food sensitivity test that you send in by pricking your finger and dabbing a little card with your blood. Reader, from this test, I discovered that at the time of this rash, I had a severe food sensitivity to chia seeds and zucchini. Excuse me?
I was downing zoodles and Purely Elizabeth’s granola (which is stacked with chia) like there was no tomorrow. Once I cut those out (and some other things that came up at a lower level on the test) my rash went away. Wow.
I won’t go too far into it, as even food sensitivities can come and go depending on your gut health and other factors, but at that particular time, I was eating foods that my body was nottt very pleased with. In my experience, a traditional Western doctor alone would not have solved this. I mean, can you imagine in I went into a traditional doctor’s office and said, “hey doc, can you run a food sensitivity test for chia seeds?”
The doctor would’ve literally slammed me into a locker and given me a swirly. And stolen my lunch money (co-pay).
Anyway, finding the right doctor for things is hard, which is why I have been putting off finding a primary care doctor for years. Until now.
PRIMARY SCARE PROVIDER
I was sad when I turned 18 and could no longer go to my childhood pediatrician. I’m pretty sure I still went to their office when I was in college, meaning this was basically me at 19 in the doctor’s office:
Not literally, but now I appreciate this scene from Forgetting Sarah Marshall even more. Feels relatable.
When my health issues (ok, I’ll tell you—BAD IBS!) came to a head in college, I ended up discovering a primary care provider who in hindsight was an incredible find. Not only was he an integrative primary care provider, but he was also an acupuncturist and worked with a naturopath in the same office (who I also ended up seeing). He could explain health stuff I was dealing with in a way that made me say “wow that literally makes so much sense.” Don’t you love when people make sense?
Like for instance, when I had shoulder pain and it ended up being an h.pylori infection which I discovered by a gut test aka putting my poop into a box and sending it away to a science saint. (Btw, H.pylori is the bacteria that causes stomach ulcers and potential stomach cancer lol. Why did I write lol. I’m a Millennial lol. Anything uncomfortable must be bookended by lol, lol.)
Anyway, he is still practicing in DC if anyone there wants a rec!
That doctor was my last primary care provider (PCP) since I moved to a new city and then back to my hometown because of the pandemic. Remember her? So many plans derailed, and yet here we are back to life….*whimsical harp*
And so finally, on the year of our Lord 2024, I decided that I simply must find a new PCP.
And how do you find out about any new product or service these days?
That’s right, Instagram ads!
FINDING TIA THE NEW-FASHIONED WAY
I first discovered Tia, “a modern medical home for women, offering integrated primary care, gynecology, mental health and wellness care in a welcoming, thoughtfully designed space” through Instagram. Showing the offices’ beautiful spaces, pretty patient robes, and a promise for integrative care, the video ads piqued my interest.
I remembered one of my friends mentioned trying it at one point and texted her to confirm. Yes! She loved it.
I figured why not, I literally don’t have a PCP and have barely used my health insurance this year, so I signed up for Tia and not tía, which means aunt in Spanish.
Because of that, I imagine this was their pitch to investors: “So, you know how you go to your aunt for Pap smear?”
That’s exactly how it went!
TRYING OUT TIA
Tia has a membership model which means you pay a monthly fee on top of whatever co-pay and insurance you have. While it may seem extra, the monthly fee gets you access to easy appointment booking, unlimited messaging with your care team, easy Rx refills, and probably whatever things allow them to have this more comprehensive, holistic service. Also, their nice offices.
The monthly fee isn’t too bad, just $20 for the first month and $15/month after that. Or, you can do an annual plan for $150. I actually found a code on my account for you to get $50 off an annual plan, which means the annual fee would end up breaking down to about $8 which is totally reasonable in my mind. Here’s the code if you want to do that: leah-53075
So what’s the catch? The only real catch right now is that Tia is (right now) only offered in California (SF + LA), Phoenix, and NYC, and you have to have a PPO health insurance policy. And before you tell me there’s another catch, I just discovered Tia is also open to men, and well, everyone! Though it clearly caters to da ladies. But men, idk, be bold, sign up, go to the pretty pink office!!!
APPOINTMENT’S BOOKED, ANXIETY BEGINS
I don’t really like doctor’s appointments. Or rather, I don’t really like the lead-up to them. The anticipation of explaining my health history or the fear of “uh oh I hope I’m actually ok as I feel” can be paralyzing for me.
Tia has an interesting 3-step appointment as your intake, which is essentially an annual exam/physical. Step 1 is a video appointment which is meant to discuss your health history and anything you submitted within your extensive intake forms (done online). I have to say, those forms were some of the most thorough I’ve ever filled out, touching on mental health, physical health, and more.
To be honest, because why else am I writing this newsletter, the first appointment experience for me didn’t wow me. It didn’t seem like the practitioner really reviewed my intake too thoroughly (which I thought was the whole point of this initial meeting), so it ended up being me reiterating key things I wanted to look at. I know healthcare professionals are busy AF so I get it, but you know, they are marketing themselves as ~different~ so that’s where my assessment is coming from.
I saw some reviews on Google saying that people’s insurance handled this first appointment weirdly, but so far I haven’t seen anything like that. I think they may have refined the system so the 1st video visit and the 2nd visit in-person are considered one visit total (your annual exam) and so it gets billed as one. Don’t quote me, but that’s what I can tell so far? You can always check with their team if you sign up.
Anyway, I made an appointment for my in-person appointment—still optimistic.
WOWWWWWWWWWW
One of the worst parts of a doctor’s visit is the office itself. You’re going in there to work on your health, and the musty florescent ambience is giving “illness.”
Tia, however, is quite different. Their offices are frankly beautiful, and this is both a genius marketing tool and also an incredible psychological way to make patients feel calm and comfortable in an otherwise “meh” situation.
I loved all the design elements and of course, the little silky spaces robes that you get to wear instead of a paper hospital gown. Also, I got to keep the socks! HELL YA!
My appointment began, and the medical assistant came in to go over things with me. I took the opportunity to ask if she liked working there and she said she loved it. She’d never worked anywhere quite like it and appreciated the holistic approach (especially mental health offerings). Nice!
I saw a nurse practitioner for my main appointment. At least in LA, I will say that most of the practitioners who are on staff are either NPs or PAs (versus MD). I was a little concerned about this initially, but also people in these roles know just as much as true doctors in a lot of cases—especially for the everyday checkup stuff. I don’t remember the last time I actually saw an MD, and that’s the healthcare system for you! But everyone has done great. No complaints. If you work in healthcare and want to demolish this paragraph, lmk!!! My family is full of nurses and PAs so I tried my best. Ok anyway, back to my appointment.
I passed! Lol.
Isn’t that what it feels like sometimes? But yes, everything looked good and my practitioner was very cool and chill. I was so relaxed I think I swore multiple times in conversation and then was like OMG I AM SPEAKING TO A HEALTHCARE PRACTITIONER, NOT A BESTIE.
I felt like everyone I talked to actually listened to me and didn’t act like they were about to launch a witch hunt when I mentioned more alternative, holistic health modalities I tried in the past for certain things or other things that Western medicine might consider taboo or irrelevant.
Also, FYI, the visit also includes a gynecological exam so you don’t have to go to a separate GYN for a checkup. This is part of the all-in-one-ness of Tia. Love that.
One thing that is a little bit disjointed to me is that for each of these three appointments, which are essentially a set, you are likely talking to a different practitioners every single time. They’re obviously tracking your info along the way so everyone knows what’s going on, but personally I like to build a relationship with one practitioner so that I feel like they are really getting to know me. However, having multiple practitioners be able to jump in probably makes it way easier to schedule appointments only a few days to a week out.
As part of your annual exam, they also order bloodwork for you to do when you’re there. I realized ahead of time that I’d only done bloodwork in the past while fasting, to get a more accurate read on things like blood sugar. I brought this up and at first they were like “ummm that’s ok you don’t need to be fasting.” And then eventually they were like “jk that actually makes sense, you should be fasting.”
Always advocate for yourself!!!!!!
I then booked a follow-up appointment to go back in and do my bloodwork where the phlebotomist (who was SO nice, omg) confirmed it was good that I was doing it while fasting. So there you go.
If you’re going in for a first-time appointment, I’d suggested booking an AM appointment so you can be fasting and do your bloodwork while you’re there.
They also give you little snacks after bloodwork, and this healed my inner child.
Ok this might also be TMI, but the first time I came for an appointment, I noticed there was a little cabinet in the bathroom that said “You can put that cup right here.” Initially, I was like OMG that’s so smart, I never have anywhere to put my drink if I’m holding a coffee or something when I stop in the bathroom.
Well, let’s just say that after my bloodwork, the phlebotomist said “oh by the way you need to do a urine sample. Just put the cup in that little cabinet in the bathroom when you’re done.”
Can you literally imagine if I’d put an iced americano in the urine sample cabinet?
THE AFTERMATH (INSURANCE)
Ok, so where I’m at currently in the process with Tia is that I have all my test results back, and I have the option to schedule my third and final appointment in the series.
They’ve reviewed my bloodwork and messaged me through the system with anything I need to know, including action steps I can take to address things that came up, so the third appointment is technically optional. I appreciate that things they recommended so far were lifestyle, exercise, and diet adjustments instead “take this drug.”
So far, the claims that have been processed by my insurance have me owing not too much money! I think the main visit was billed for like $300+ and I owe $40, which I’m pretty sure is just my co-pay.
Interesting enough, it says the provider on the claim is Cedars Sinai, which is like the it-girl of Los Angeles hospitals. I’m guessing that means Tia has some kind of back-end partnership with them, which is super interesting and honestly makes me feel even better about Tia’s quality and integrity if Cedars is co-signing them in some way.
I was about to say I just gave you insider information, but a quick Google proves that I am just late to the party here: Tia and Cedars-Sinai Come Together to Expand and Enhance Comprehensive Care for Women Across Los Angeles.
Well, there you have it. I didn’t know that (clearly) and now you more than I did when I signed up.
I haven’t tried any of the other offerings yet (mental health, acupuncture, and additional offerings listed here), but I’m excited to check them out at some point. I’m also excited to have the direct messaging to providers so that I don’t WebMD into a hell spiral next time something comes up.
IN SUMMARY
All in all, I’m so happy I decided to try Tia out. It turns out auntie gives a gentle Pap smear. (Sorry.) Also, it’s nice knowing I have a good first destination if any health concerns come up. The fact that it’s been a relatively smooth and pleasant process so far is worth the monthly membership fee’s weight in gorgeous design and friendly staff who’re there to help you actually get healthier and stay healthier. For a PCP, I can’t think of a better option right now.
And yeah, bitch, I got to keep the socks. (Which literally helped my anxiety ok bye).
Was this issue relatable? Inspiring? Unhinged? Please let me know in the comments and share with your friends who might be interested!
See you next week,
LJ