Spring 2012
PMH STORY by Robert H. Kelly MD FACP
The call was not ordinary. A grandmother was requesting help for a visiting, out-of-town family member: her 10-year-old granddaughter. She had traveled here from out of state to join a family vacation. Unfortunately, she had become ill with fever and sore throat. The grandmother was worried, both about her and about others on the trip. Dr. Kelly offered referral to a pediatrician, but she said that she would like his help, so the grandmother and the granddaughter came to the office.
The child was not particularly ill. Dr. Kelly spoke with her mother on the phone and requested a release for treatment. This was provided via e-mail. She could be treated in the office or the child could be referred to a Pediatrician’s office. Well aware of her options, she requested that Dr. Kelly proceed and take care of her daughter.
A culture was obtained and treatment initiated. The culture came back: there was no Streptococcus or other pathogen. This was likely a viral illness. As there was no fever by this time, the child posed little risk to others, and the vacation went along as planned.
The grandmother called at around 9 o’clock. The patient was seen at around 10:30 and was out of the office before 11:30. As a Premium Medical Home subscriber she was able to get direct and immediate access to her physician for her family member.
This is one of the advantages of a Premium Medical Home. When a family member or a visitor from out of town needs medical help, a host always has options. Emergency rooms are open 24/7. Urgent care clinics are available. Some family medical offices have walk-in clinics. As a Premium Medical Home subscriber, you have an option: call your physician directly for help, even when the patient would be new to the doctor’s practice.
BREAST CANCER SCREENING: IT’S COMPLICATED by Allan R. Kelly MD FACP
A recent study from Norway looked at the question of mammography and the over-diagnosis of breast cancer. There has long been interest in whether annual mammography poses any risk to patients.In the past, there was study and recognition of the effect of x-rays on women with annual mammography. The risk of x-ray was straightforward and the dose has been greatly reduced. More challenging is the concept of “over-diagnosis” of invasive breast cancer.
NEXIUM, PRILOSEC, AND THEIR RELATIVES by Allan R. Kelly MD FACP
As medications come into widespread use, we learn more about their risks and benefits. This does not mean a medication becomes more dangerous, but that we know better how to use it, what to look for, and we learn about rare side effects or complications.
STATIN DRUGS: WARNINGS AND REASSURANCE by Allan R. Kelly MD FACP
Statin drugs like Lipitor, Simvastatin, and Crestor are known to reduce the risk of heart attack and stroke in many groups of patients. These drugs save lives.
When initially introduced, the risk of liver disease from statins was highlighted and there was an FDA warning that all patients on statin drugs should have liver testing done. This year the FDA has removed that warning.
MEDICARE WELLNESS VISIT by Robert H. Kelly MD FACP
Beginning in 2011, Medicare has directed doctors to offer an Annual Wellness Visit (AWV) to its beneficiaries. This concept of an annual check-up applies to all health conscious persons. In the past, such a visit was often referred to as an annual physical, but that name does not well describe the goals of an Annual Wellness Visit.
NEW FEES
Two years ago we launched Premium Medical Home to expand communication and enhance the relationship between you and your doctor. In order to maintain this high level of service and communication, we are adjusting the annual subscription to Premium Medical Home. The new rates will become effective July 1, 2012 and will be reflected on your statement as you reach your anniversary date for renewal.
PMH QUOTATIONS SPRING 2012
“While the convenience of electronic storage and retrieval of medical tests is undeniable, I am concerned about the likelihood of having to pay attention to the laptop to the detriment of the patient. The foundation of medical care starts with the patient-doctor interaction. That something so fundamental be disrupted by EMR’s may be one of the reasons for their slow adoption .
” – Corey Krueger, MD, FACP, 2012
“The glory in medicine is that it is constantly moving forward and there is always more to learn.”
– William Mayo, MD