IVN Contributing Writer
Dr. Ben Allison is one of four new providers at Siskiyou Community Health Center. From St. John’s College where he studied the Great Books of Western literature, to Brown Brothers Harriman, where he worked for a while as an investment banker, Dr. Allison’s route to becoming an MD was a circuitous one.
“I was more interested in literature in college than science. And I didn’t find finance to be very interesting. It’s not very people oriented.”
For a time, Allison was interested in psychology. But he ended up in primary care practice.
“As it turns out,” said Allison, “I get more than my fair share of psychology as a family practitioner.”
After going to Harvard to get the science prerequisites under his belt, he went through a four year stint in medical school, a three year medical residency and then started at Siskiyou Community six months ago.
Allison said that what he loves about family practice is the variety.
“As a PCP you can to some extent chose your scope of practice. For example: People with heart failure you can refer to a cardiologist or you can manage them yourself.”
Allison added that PCPs treat a lot of psychiatric conditions. The bulk of psychiatric medications are prescribed by PCPs. Plus, even with physical complaints there’s often a psychiatric component.
Most challenging in Allison’s practice is the lack of resources in the Illinois Valley. He has a number of patients who don’t have transportation, or for whom the idea of traveling to Grants Pass is an overwhelming concept. For instance, he has some patients whom he would love to be seen by neurology. But there are just too many barriers to get there.
There’s also an issue of insurance, according to Allison. Every insurance has different formularies of medications that they will cover.
“If you want to order an MRI you have to jump through a bunch of different hoops depending on the insurance.”
Treating psychiatric patients is another challenging component of Allison’s practice. He explained that the bulk of psychiatric medications are prescribed by primary care physicians. One of the things he doesn’t like about psychiatry is that many of those patients are so sick that his interaction with them is not as important as the medications he prescribes. So it ends up being just about medication management.
“I would actually prefer to partner with patients by building a relationship of trust where there’s a therapeutic alliance involving health lifestyle changes. For example, there are really bad diabetics who just won’t take medication or change their diet and are losing limbs and who need dialysis. I have several patients in that situation. So that’s where the therapeutic alliance comes into play.”
Opiates are another issue. Allison has a lot of patients who either have been on opiates or who are demanding opiates. And that’s a difficult conversation. He pointed out that taking pain medication can actually lead to more sensitivity to pain. So it’s a slippery slope.
“But I enjoy interacting with patients,” he said. “I find it really rewarding.”