Sarah Taylor, MD, a primary care physician at Westford Internal Medicine, is a Massachusetts native who knew she wanted to remain in the state to practice. During 11 years at Westford, she has a panel of patients that includes many couples, as well as mothers and daughters. Dr. Taylor has roles within the Emerson Physician-Hospital Organization (PHO), as well as the Massachusetts Medical Society — activities that provide a “bird’s-eye view” of medical practice locally and statewide.
What attracted you to primary care?
I developed a strong interest in biology as an undergraduate. I wasn’t sure whether to go into the lab or into medicine. Once I was in medical school, I considered doing a residency in prevention. Public health and prevention are interests of mine, and they contributed to my going into primary care. As much as I am a physician, I consider myself to be a teacher — someone who digests medical knowledge and re-conveys it to patients at exactly their level.
Because I develop a relationship with my patients and know what that level is, we can discuss the medical information they need to make good decisions for themselves.
How has primary care practice changed since you started?
People have become more savvy about their health. The population in the Westford area is well educated, so they come in with requests for a specific drug or a diagnosis they’ve given themselves based on an internet search. I don’t have a problem with that; I just hope that they’re open to a conversation. We increasingly emphasize preventive care, but there is a wide variety of tolerance for risk in the population. A lot of patients hold beliefs about their health, including that they are not at risk for a health problem, even though they are.
Is there a skill you need to assure a successful appointment given the time pressure?
I come into the room with an agenda, and I expect the patient to have one, too. I always say “we’ll start with your list.” Some patients don’t have anything; some have ten items. We might have to negotiate each of our agendas and make a plan for another day. If there is a problem we need to focus on, I find a way to discuss it without saying “you need to do this.” For example, if I’m worried about someone’s liver, I will say so and also explain what their liver does, describe end-stage liver disease and note that their current behavior is damaging their liver.
Does having the right support staff make a difference in your ability to care for your patients?
Yes. We have an awesome staff at Westford Internal Medicine that includes our nurse practitioners. They are an excellent resource for the physicians and patients. Our medical assistants prep every chart prior to a patient’s appointment, checking for screenings, vaccines and labs they might need. I do my own chart review, but I appreciate having two sets of eyes involved. Through some of the programs we have due to our affiliation with Partners, we have case managers doing follow-up, mostly over the phone, about home diagnostic services. In addition, we have a mental health coordinator who calls patients to make sure they are taking their medications and see if they need refills or an office visit. Patients love it, and it saves us time.
You are involved in medical staff issues at Emerson and at the state level.
I’m on the IPA board and attend PHO meetings as a member of the Executive Advisory Committee. I currently hold the primary care seat, so I’m often asked how my colleagues in the IPA might feel about a certain primary care issue related to Emerson or to Partners. Also, I am on the Massachusetts Medical Society’s (MMS) Board of Trustees and a member of various committees. It connects me with a community of physicians who I wouldn’t otherwise know because I’m out in Westford. One of the things the MMS is looking at is physician burnout. I find that my involvement with the organization prevents me from feeling a sense of burnout.
