F A Q

What is internal Medicine? 

Internal medicine physicians take care of adults. "Internists", as we are sometimes called, are experts in complexity. We see connections throughout the human body, applying scientific knowledge and clinical expertise when caring for patients. We are especially well trained in the diagnosis of puzzling medical problems and the ongoing care of chronic conditions. Internists also specialize in disease prevention and health promotion.

Audrey Young, MD, has been a board-certified internal medicine physician since 2002.

What is Concierge Medicine?   

Concierge medicine is a new practice model based on an old style of patient care. The model prioritizes a physician knowing you well and being available during important moments. 

In many years of clinical experience, Dr. Young has seen that even patients with tremendous resources can receive fragmented health care. She knows communication can be more challenging within large systems. Insurance companies can further complicate the forward momentum of patient care.  

One major reason Dr. Young chose the concierge model is it allows her to spend as much time as needed with each patient. She does not have to see a certain number of patients each day to meet targets dictated by insurance reimbursement. She believes adequate time and space is crucial to thoroughly addressing a patient's concerns.

In a concierge practice, patients may notice the care is not only more time-efficient for them, but there is also more opportunity for completeness that can lead to better outcomes.    

What does “Comprehensive primary care focused on exercise and eating well” actually mean? 

Hundreds of studies have shown that exercise is highly effective against many medical conditions. Exercise is probably the most effective health intervention available to adults. For the prevention and mitigation of common diseases, the combination of regular Zone 2 exercise and resistance training can be as effective or more effective than many prescription medications. 

Maintaining physical fitness over the long run greatly improves your odds against problems like high blood pressure, heart disease, stroke, diabetes, cancer, depression, weight gain, and dementia. No single medication comes close to providing these results. Eating a healthy diet and addressing energy balance has also been shown to offer significant benefits with overweight and obesity, as well as prevention of cardiovascular disease and cancer.  

Are exercise and healthy eating all you need to live a long, healthy life? For some, the answer is yes. Are you one of these people? No doctor can know this for certain. We can improve your chances by thoroughly assessing your health and addressing early issues. Routine preventive care can further improve your odds. 

Many precursor conditions remain silent for years before "suddenly" manifesting as full-blown disease, whether as a heart attack, stroke, or even advanced diabetes. Dr. Young practices medicine grounded in scientific evidence and recommends medical treatment when it is indicated to improve your health and disease markers. She will also guide you towards greater physical fitness, healthy eating, and better sleep, with a goal of needing fewer medical interventions. Like other concierge physicians, she is able to spend as much time focusing on health as on disease, and as a result may be better able to minimize the use of pharmaceutical drugs and other medical interventions. 

Some people feel that “medical” and “natural” health care are mutually exclusive. Sometimes these are treated like two different "sides" and get labelled "good" or "bad". Dr. Young uses every proven tool available to guide patients towards better health. Exercise and healthy eating are extremely powerful tools, as is medical treatment when appropriate.

I've been told to take a statin, but I don’t want to. Can you help me avoid this medication?    

Broadly speaking, statins reduce cholesterol levels, which lower your chance of developing blocked arteries, which are the most common cause of heart attacks, strokes, and other major cardiovascular problems. 

Many individuals may not realize they are developing blocked arteries because there often aren’t warning signs until the situation is quite advanced. Statins have saved many lives and have relatively few side effects. 

You may be able to reduce your cholesterol levels by choosing specific foods. You can affect how you burn fat with targeted exercise strategies. You may have genes that put you at higher risk, or you may be blessed with naturally low cholesterol levels. Every individual person’s risk of cardiovascular disease is regulated by multiple factors. Have a conversation with your doctor to determine your own personal risk level and the best management plan.  

What if I prefer to take medication and skip the lifestyle stuff?  

In some instances, medical intervention and pharmaceutical drugs truly save lives. An internal medicine physician is trained to identify clinical situations where aggressive medical treatment is the best option and there may not be good alternatives.

There are also many cases in which a disease may respond to medication and also to lifestyle change. In these instances, Dr. Young is inclined to push heavily on lifestyle modification. She knows that changing lifestyle habits is not always easy but asks her patients to commit to developing healthier practices because these are more sustainable and are very often more effective for the long run.   

In two decades as a hospital physician, Dr. Young has cared for many patients experiencing medication side effects and interactions so severe they required hospitalization. Medications can interact in ways we don’t (and may never) fully understand. Medications can cause unwanted side effects that may be as bad as the condition they were intended to treat. Medications can disrupt healthy gut bacteria, stomach pH, and affect other body systems. Using medication always carries some risk.    

How will I know if the Sequoia Project is a good fit? 

Prospective patients can call the office with any questions at 206.339.3360, and can come in for a free meet-and-greet appointment to help decide if we're a good match.