Fall 2012
PMH STORY by Allan Kelly MD FACP
A PMH subscriber had a visitor. His family was hosting a teacher from China. Unfortunately, on the day prior to leaving Fort Worth, there was an accident. The host family’s automobile was hit by another car. The car was drivable, and no one complained of injury. Initially, the teacher felt fine. On the way home, he said perhaps he should see a doctor.
Due to leave the next day, there was little time to make an appointment. The obvious alternative was to go to the emergency room, with expected long delays and high bills.
The subscriber called Dr. Kelly. After talking, Dr. Kelly offered to come to the subscriber’s home and assist with evaluating and giving recommendations for care.
The visitor, now a patient, was seen and examined. The history was relatively benign, suggesting a whiplash like discomfort in the neck. Physical exam was normal. The medical options were straightforward and outlined to the patient. Symptomatic care was provided. Then the patient said he would need a certificate to give to his physicians in China.
Inquiring into more details, it was determined that a certificate could be quickly provided in longhand writing to satisfy the young man’s needs. He returned to China the next day, “certificate” in hand!
The total time involved in this service was less than an hour, as opposed to the many hours that would have been required for an emergency room visit. The availability of medical evaluation and treatment access, which respects the individual’s schedule, needs, and pocketbook, is one of the features and benefits of a PMH subscription.
PROVIDING CARE: THE WORK NO ONE SEES by Allan R. Kelly MD FACP
Though the United States continues to have good medical care for its citizens, there are issues that we need to address to improve quality of care and service. We hear people complain about short doctor visits and impersonal care. On the other hand, people are generally confident that the doctor is doing a good job.
RETHINKING THE ASSOCIATION OF HIGH BLOOD PRESSURE AND MORTALITY IN ELDERLY ADULTS by Allan R. Kelly MD FACP
Identifying and treating hypertension is a cornerstone of care for many adults. Over the past 20 years, mortality rates from cardiovascular disease have declined in part because of the power of antihypertensive therapy.
But later in life, the meaning of hypertension becomes more complicatd.
GERIATRIC CARE by Robert H. Kelly MD FACP
Geriatric medicine involves the treatment and care of adult patients with chronic illnesses and functional decline. Fifty percent of older adults have three or more chronic medical problems such as diabetes, arthritis, heart disease, and malignancy. Illness and treatment, combined with advancing years, are associated with decline in a person’s function. It is the balance of medications, illness and function that concerns the geriatrician.
ORGANIC FOODS by Robert H. Kelly MD FACP
Some interesting findings about organic food have been reported recently. Research published regarding organic food came in the September 2012 Annals of Internal Medicine. Some of the key findings were:
1. Pesticide levels in urine were lower in children on diets with organic food, although in both regular food and organic food, pesticide levels were well below limits of toxicity.
PRAVACHOL, STATINS, AND MEMORY IMPAIRMENT by Robert H. Kelly MD FACP
Statin drugs are effective at preventing recurrent myocardial infarction. Regular use of statins by those with cholesterol elevation leads to reduced death rates.
Earlier this year the FDA warned about reported memory impairment in statin users: “Cognitive brain related impairment, such as memory loss, forgetfulness, and confusion, has been reported by some statin drug users.” The FDA’s concern began when several persons taking statin medication wrote the agency about problems with memory that occurred during their treatment.
PMH QUOTATIONS Fall 2012
“In this work against sickness we begin not with genetic or cellular interactions, but with human ones.
” – Atul Gawande, M.D., BUMCP, Volume 25, No. 1, January 2012, Pg. 60
“We miss more by not seeing than we do by not knowing.”
– William Osler, M.D. 1926