MY PATIENT HANDBOOK

Your Family Doctor

2012-01-06T16:16:00.004-05:00

Patient Handbook to Medical Care is the best doctor visit you can have anytime! When you read this book you will feel healthier, wealthier and wiser!

Are you getting the medical care you deserve? Are you getting the right tests? Patient Handbook to Medical Care: Your Personal Health Guide by J. L. Richardson, M.D. lets you know! This book is written for patients by a medical doctor "to inform and educate patients about medical care".

ABOUT THE BOOK

This Writer's Digest International Self-Published Book Award winner informs patients about
basic medical care. By reading this reference book you will learn:

how to keep a medical diary
getting your medical records
your complete medical history
what the physical exam should include
about preventive tests and when to get them
about tests your doctor orders
about specialists and other medical providers
about health care plans and coverage
how to seek quality health services.

This 112-page easy-to-read. large print paperback handbook will help patients stay in charge of their health maintenance and overall care. "Patient Handbook to Medical Care: Your Personal Health Guide" is a concise, informative overview of health care basics. It provides patients with a doctor's perspective on professional healthcare, and allows them to become their own best advocates.

It also includes "My Health Notes", blank pages for you to write your own health notes! This is a great way to keep track of your health concerns, and start your medical diary.This book will tell you how to take care of your most important asset- YOU!

ABOUT THE AUTHOR

Dr. Richardson is a family medicine doctor with over 25 years of experience in the medical field. Dr. Richardson's undergraduate and medical degrees were received from the University of North Carolina at Chapel Hill, and residency training was done at Georgetown University and Providence Hospital in
Washington, D.C. Dr. Richardson is a member of the American Academy of Family Practice (AAFP), the Florida Academy of Family Practice (FAFP) as well as University of North Carolina Alumni
Association.

Past affiliations include: Managed Care Ombudsman Committee for the Florida Agency for Healthcare
Administration (AHCA); National Association of Managed Care Physicians; Dade County Medical
Association; American Medical Women's Association; Board Member fof McLamore Children's Center of Children's Home Society of South Florida; Grove Outreach Physician Volunteer; 1999 Special Olympics Physician Volunteer; Cedars Hospital (Miami, Florida) Medical Staff and Utilization Review Committee; and American Board of Quality Assurance and Utilization Review Physicians. Dr. Richardson has experience with independent medical record review and patient advocacy issues.

Bend of the River Books is proud to announce that Patient Handbook to Medical Care is now in 59 libraries throughout the United States. Our goal is to ensure that everyone has free public access to read and learn the importance of health maintenance, prevention, and wellness. This expert's guide to personal health care is the ideal book "to inform and educate patients about medical care".

Best health!

Making the Most of Your Doctor Visit

2011-11-12T03:16:00.005-05:00

When you go to your doctor or health care provider, you should be prepared. This is one way you can be sure that your doctor visit focuses on your most important health issues. The following suggestions will help you get the most out of your doctor vist.

Be on time.
Make a list of things you want to talk to your doctor about. Update the list before each visit. This way you will be able to keep track of what has been discussed, and what needs to be discussed. Try to talk about the most important things first especially those that need immediate attention. Each time you go for your visit, you can refer to your list and take up where you left off. Be sure to express your immediate concerns first. We all know how short a doctor visit can be.
Make a written or typed medical history* to take with you, especially if this is your first visit to a new doctor. Make a copy for you and your doctor. You both will be able to refer to it as needed. This will save valuable time, and give you and your doctor more time to talk instead of flipping through your medical record. It can be difficult trying to "remember" what test or procedure you had 10 years ago.
Get copies of your medical records from all your doctors. "The medical record is the cornerstone of keeping track of everything pertaining to your health." You will be able to check the accuracy of your records, and bring any errors or absent information to your doctor's attention. Let your doctor know about anything you do not understand, or if there is something you are unable to read due to legibility. It is surprising to see how many doctors are often unable to read their own handwriting.
Take advantage of the time your doctor takes looking through your medical chart during your visit by taking your own notes especially questions. As much as 1/3 of your visit time can be consumed by this alone.
Allow each other to talk without interruption.
Bring a trustwothy companion.

Click on "Comments" below to add your tips or ask questions.

*medical history form http://www.mypatienthandbook.com/

Violent TV Movie Syndrome: Public Health Crisis in Vivo

2011-08-18T21:26:00.003-05:00

Did you know that Violent TV Movie Syndrome (VTMS) is a major cause of many health and social problems? Single and repeated images of young children (or anyone) shot laying dead in pools of blood is horrific and unhealthy. As a medical professional familiar with death first hand as part of my job, I can only hope and pray someone will be responsible and speak up. This is child abuse. This is mental abuse. This is public health abuse. Hollywood makes movies with less violence and bloodshed. Any educated person knows that repeated violence harms people in so many ways. It is so unnecessary to show these images to tell a news story or any other type of story. Images such as these depict what is seen in the coroner's office., and should be kept there.

Suicide, homicide, and post traumatic disorder are just a few medical maladies that occur from watching violence. Surely you can choose to watch something else; however, the curious child with a TV remote may choose otherwise. Protect yourself and your children. This type of programming is hard to grasp and confuse with something else - real life! They become real life. Doctors and health care providers have much more serious conditions to care for instead of illness and death induced by "Violent TV/Movie Syndrome" which can be prevented. For the doctors who take an oath to "do no harm", let us hope our media will do likewise. Until then we can only counsel our patients to turn it off.

See this reference for more details http://www.parent.net/article/tv-kids-violence.shtml

Is the Doctor Really "In"?

2011-08-13T11:42:00.002-05:00

Dear Patient,

It has indeed been a privilege and wonder to take care of you and your family. Due to unforeseen circumstances, we must vacation indefinitely so we can find the best solutions for cost effective health care. Our budgets are lean as well and get leaner as more patients drop out to do self care or go to emergency rooms, public health clinics, or stand in "lotto" lines to get get health care from traveling clinics.

We must campaign for your healthcare and our salary. Routine sequential cuts for reimbursement by Medicare and Medicaid are taking its toll. Insurance companies demand more time with less pay as well. Now that the healthcare bill requiring each and every one of you to have insurance has been repealed. Self pay is an option, but you must have food and shelter first. Less money in, more money out.

Due to lack of campaign funds and time for raising necessary monies to do so, we are using and pooling our resources. We wish to provide you with continuity of care, but we must also find ways to keep a roof over our heads and food on the table. Many of my fellowess and fellow physicians are supplementing our income as well through other occupations.

Thank you for allowing me to care for you and the family. We are true believers that great health is true wealth; however, you must have money to keep it.

Best health,
Dr. Feelgood

P. S. Check out Patient Handbook to Medical Care: Your Personal Health Guide via links in the right column. Get a heads up and start checking yourself and your family.

Nootropic Neurological Nonsense - Limitless?

2011-08-06T10:46:00.004-05:00

Are you looking for mind bending treatment that will make you smarter as well as more mentally and physically efficient? The neurochemical nootropics, the so-called "smart drugs", are finally getting the recognition they deserve. Though medical evidence is inconclusive, these drugs supposedly improve every aspect of mental cognition including memory, concentration, acuity allowing for smarter, quicker human function. It sounds like a sure bet for anyone with Alzheimer's disease, ADD, and just pure laziness. They are commonly taken to keep one alert, increase energy, improve memory, and to decrease mental decline in aging.

So why is your doctor failing to offer you such a great "pick-me-up" medication? Considered both a natruceutical dietary herbal supplement and recreational drug may make it difficult for your doctor to prescribe it for you. But who needs a prescription? Premium prices for bulk amounts are available for the consumer patient to buy on line, and in specialty stores. For instance $25 will buy you 120 of Piracetam's mega 800 mg capsules, or 60 tablets of BrainAlert with it's 24 "natural" ingredients (far too many for one pill, some toxic). Designer versions of nootropics are available also. These are usually more recreationally formulated with less exact ingredients.

Side effects and adverse reactions including drug addiction may occur especially if the drug is withdrawn after long term use. For this reason alone, doctors may be hesitant to prescribe it; however, it is easily available elsewhere. The off-label recreational use of nootropics can be especially dangerous if addiction occurs. You may be and feel "superpowered" until the drug wears off and withdrawal sets in if you lack more pills.

Upgrading your body and mind with smart pills can be productive or destructive. Can this nootropic neurological nonsense be "limitless"?

NOTE: For more context and perspective watch the brilliant film Limitless which shows how a writer achieves success and riches using nootropics.

Ovarian Cancer: Early Detection

2011-07-30T15:09:00.001-05:00

Ovarian cancer kills many women quickly and silently. It is one of the cancers that is hard to detect. The treatment is pure hell and the vague symptoms become unbearably painful. Ladies, there is something we can do! The pelvic and transvaginal sonogram (also called ultrasound) is a simple test that every woman should have just because you are a woman. Like the mammogram, this medical test is inexpensive and non-invasive (unless vaginal insertion is considered so) as far as no IVs or contrast dye. Consuming mass amounts of water until you have to urinate (but must hold) is the least discomfort you should experience.

Talk to your doctor about pelvic sonogram screening. Most gynecologists have them in their office which is excellent standard of care and convenient for the patient. It can be done and read the same day by your gynecologist, possibly by the time you sit down to talk after the exam. The pelvic and/or transvaginal sonogram becomes part of your medical record for easy reference as needed thus providing consistency and, if necessary, for future comparison. These tests are also becoming more readily available for direct consumer purchase without prescription at diagnostic centers and through health fairs.

The CA-125 blood test may be useful; however, it is nonspecific and may be seen with other conditions like endometriosis, pregnancy, fibroid tumors, diverticulitis, and liver cirrhosis. It has been proven to be a reliable tumor marker once ovarian cancer is diagnosed. CA-125 tests, like the pelvic songram , is not recommended for women at average risk of ovarian cancer. High risk patients like those with a family history of the disease, mutations in BRCA1 or BRCA2 genes, or suggestive symptoms are encouraged to get tested.

Early detection of ovarian cancer saves lives as well as fertility especially for women of childbearing age. For these reasons alone sonograms should become part of every woman's prevention schedule on a routine basis like the mammogram. The patient's quality of life can be saved in a cost effective manner. The nonspecific symptoms of pelvic pain, low back pain, abdominal pain (bloating, fullness, distension), changes in bowel or bladder habits are surely worth looking into, but can lead your doctor into a quandry with many other diagnostic tests before ovarian cancer is suspected. The time this takes can definitely delay diagnosis.

Speak up before the silence of ovarian cancer quiets your life. Though unpreventable there are things you can do to lower your risk. This includes oral contraceptives, genetic counseling, and removal of ovaries (oophorectomy). Seek care and advice from experts in these areas via your gynecologist. The National Ovarian Cancer Helpline is very good for locating local resources. http://www.ovarian.org/local_chapters.php

Without a bonafide early detection test for ovarian cancer, we still must do all we can to detect early and prevent the rampage of this deadly disease. The pelvic and transvaginal ultrasound along with a thorough pelvic exam can reduce the sounds of suffering that ovarian cancer shouts out in silence.

Letter to the President: Code Blue! Get Crash Cart STAT!

2011-07-28T11:29:00.006-05:00

Dear Mr. President,

Please be aware that the doctors of this great nation are finding it near impossible to care for our patients, your people. Our patients are literally dying as the debt crisis looms in limbo for way too long. We are trying to avoid our patients demise, but with almost 1/2 of our population, especially seniors and kids, on Medicare and Medicaid this is already a major problem. Further cuts would be detrimental to us and our patients, your constituents.

Quality of care and proper treatment is near impossible especially with the physician shortage. Medicare and Medicaid should be increases to help us provide, instead of being cut again and again. Payment delays are unacceptable. This statement from the American Academy of Family Practice (Payment Delays Resulting From Debt Ceiling Impasse Are Possible, AAFP Warns http://ow.ly/1dZzY0 ) details the problems as does the letter sent to you and in June by AAFP Board Chair Lori Heim, M.D., who said, "If any budget proposal is to restrain the growth in health care spending, it must also support programs that build the family physician and primary care workforce, pay for quality and outcomes of medical care, and ensure that everyone has access to that care." http://bit.ly/pFjeE7 This is a code blue! Can you imagine not getting paid for your hard work? Or getting sued because you lacked?

The worriation of this debt disease is infecting our people in many obvious ways. I see those on limited incomes with no less than five chronic conditions struggle to keep food on the table and a roof over their heads as their health expenses become obliviously unaffordable. We all know what happens then. Chronic medical care that could have been avoided incurs, and we all pay, especially the patient and doctor.

As we strive for a Healthy People 2020, it is looking bleak. Though Congress has the purse strings, the buck stops with you. Eliminate this unnecessary worriation that has gone too far and too long causing more anxiety, suicide, and worsening of overall health for many.

As family physicians on the forefront of patient care, the burden rests with us to do our best. The most you and Congress can do is resolve the present debt crisis. If this was was your doctor treating you and your family, such delay would be unacceptable most likely leading to adverse outcomes. Everyone must do their job as if someone's life depended on it. Much too often it does, especially for patients and doctors.

Thank you, Mr. Obama.

Best regards,
Dr. Richardson

Spill the Pills, Take a Knife Slice: Surgery vs. Conservative RX

2011-07-26T10:10:00.003-05:00

Conservative treatment is the mainstay for many chronic diseases. This means that your healthcare team will most likely encourage you to avoid surgery unless it is life threatening issue. Why is the stigma of surgery avoidance associated with poor outcomes? This day in time savvy surgery techniques and fewer post operative complications complications are more likely to restore your quality of life to a livable level. In other words three years or more of taking pills with or without complimentary treatment can be more costly in the long run with a poor quality of life.

How will you know if surgery sooner rather than later is best for you? Talk with your doctors and healthcare providers. If you find there is disagreement, seek out more opinions until you find what is best for you. Surgery is preventive and can improve one's quality of life in months especially if conservative treatment fails. Conservative treatment may help, but after many years it is less likely and becomes more costly in every way primarily in worsening of symptoms.

Spare yourself countless years of needless suffering. Do your homework. See what treatments work best for you. Talk with your healthcare providers about new treatments, and look for doctors (specialists) who have experience in the area. If you've been getting around with the same nagging symptoms and watching your years pass you by without improvement or feeling good on the same treatment year after year, get on with it! Consider surgery if it is an option.

Great health is true wealth!

Health News Anemic on Mainstream TV Media

2011-07-25T04:10:00.005-05:00

Have you noticed that there is a media health news deficiency on your TV? In 24 hours of TV observance, mostly redundant repetition, health news rarely got repeated or even mentioned. In addition, health stories seemed to stem from some person's misfortune rather than their health challenge. As many times as the story is repeated, rarely, if ever, is there a clue about what you could do if it happened to you.

Within a 24 hour period health commercials comprised more health information than actual broadcasts. Most of these are via big pharma, heavily sedated with drug enticement for profit. If you wanted to know about the daily health news like the current blood shortage or the new measles outbreak, you can read about it on line before it becomes old news on TV, if at all.

Of course there are newsworthy things going on in health medicine - everyday. Drug recalls, disease outbreaks, new disease research, and public health hazards infect our communities daily. Local news may mention it, and is more likely to carry health news you can actually use as well as local resources to help you out.

Medical information on TV is limited and stagnating. Sixty seconds on the news. Two minutes on the talk show after commercials on prescription medication. Outdated show on this channel, and outdated repeat on that channel in between the new show. Watch some on this channel then click and click to different channels to connect your medical news for today. Channel surfing can become quite cumbersome with a low yield within 24 hours. Excluding taped health shows the daily intermittent health news infusion averages less than one hour.

Solution: health channel. The TV box is probably the most used medium by which folks get their news and information. It is certainly a way to get information to people. The most used information source is one of the least used by the cutting edge medical field.

Health and medical coverage on TV is surely lacking in this consumer driven health conscious society. We can watch as much sports, cartoons, movies, news as we want, but we still have to piece together our medical information and supplement it with the written word, or health care providers’ spoken word.

Great health is true wealth. Dedicated health channels and more daily health news would make us even healthier and richer. Transfuse, please.

Your Physical Exam: Below the Waist

2011-07-07T00:44:00.004-05:00

After the physical exam above the waist is completed, the rest of the exam follows. For females, the pelvic exam and rectal exam are done next. The pelvic exam can also be done by a gynecologist, a doctor who specializes in female medicine. This depends on your preference and/or if your primary care doctor chooses to refer you. It is an examination of the female external(outer) genitalia (parts) and internal (inside)reproductive sexual parts. The first female exam should be done at any age if there are any symptoms. Routinely, the first pelvic exam is done once the female is sexually active (having sex) or 18 years of age. It is recommended that a third person or chaperone who is an authorized health professional should be in the room for this exam. Every health care setting should have chaperone policies in place for gynecology exams. This should always be presented as an option, if there is no policy or law. Furthermore, it should be offered to a patient for the full physical examination, especially if the physician is the opposite sex of the patient.

The assistant will help you get in position. Your legs will be placed in stirrups (foot holders) that are at the end of the table. You will then slide your hips down until the buttocks touch the edge of the table. Your legs will then be able to relax
apart. (Some doctors have more comfortable exam chairs.) For those who might not be able to do this, there is the frog-leg position. The heels are brought together while the legs are bent: the heels are, thus, brought as close as possible to the
buttocks, like frog legs. For persons not able to assume either of these positions, referral to a gynecologist is necessary. Please note also that you should not be put in this position until the doctor is ready to examine you. That’s just good manners on the doctor’s part. Once the exam begins, the doctor will instruct you when to lie down. You should also be informed when and where you will be touched during each part of the exam. The doctor will be wearing latex gloves to do this part of the exam. You may also request that a mirror be placed so that you can watch the exam.

There are five basic parts of the pelvic exam. The first part is the exam of the external genital area where the doctor inspects and palpates for any abnormalities. The second part of the exam is done using a tool called a speculum. This is for looking into the vagina and at the cervix. It resembles a fancy pair of tongs (or a pelican beak) and is either plastic or metal. Most doctors
will and should warm the speculum with water before use. This allows for easier passage of the speculum. In the closed position the speculum is then placed gently in the vagina and opened to keep the vagina walls apart. When this is done,the doctor is able to see the cervix. The third part of the exam involves doing a Pap smear, which is a screening test for cancer of the cervix. A thin wooden stick about the size of a popsicle stick(called a spatula) and a stick with a tiny (about quarter-inch) brush on the end are used to do the test. When gently rubbed against the cervix, they are able to pick up cells. The cell samples are then placed on a glass side or in a test tube, which is then sent to the lab. The speculum is then removed.
Part four is the bimanual exam, which includes palpation of the internal female organs. One or two fingers that have been lubricated are placed in the vagina, while the other hand presses
over the pelvic (lower abdomen) area. The uterus(womb) and ovaries (eggs)can be felt for any tenderness or masses. The last part of the exam is the rectovaginal exam. Using a clean lubricated glove, one finger is inserted into the vagina and a
second finger into the rectum. This is an important part of the exam for two reasons: to check the rectum for bleeding and masses, and to further palpate the female organs. A complete
pelvic exam includes a rectal exam. The stool is checked for blood by placing a sample of stool from the gloved finger in the rectum onto a special card (commonly called guaiac or Hemoccult cards). If there is no stool for the specimen, your doctor will give you cards with instructions on how to collect samples at home. Once completed, the cards are returned to the doctor to be checked for blood. This is a very important test. Small amounts of blood in the stool cannot be seen with the naked eye but can
be detected with this test.

The male genital exam is the equivalent of the female pelvic. The doctor inspects first. With gloved hands, the penis glans (tip) and shaft are checked. If the male is not circumcised, the
foreskin (extra skin) should be pulled back. Then each scrotal sac is palpated to check the testicles for any abnormal lumps or bumps. This is a good time for the doctor to show you how to do your own monthly scrotal exam. Next the famous “cough” test is done in standing position. This is to check for hernias and is done with the insertion of the examining finger into the scrotal
and inguinal (groin) area while the patient coughs. It is done on the right and left side. The rectal exam follows and is usually done with the doctor’s lubricated gloved index finger inserted into the rectum. In addition to checking the stool
for blood, the prostate gland (which makes male fluids) is also checked for size, tenderness, and masses. This is an important cancer screening test for men and should be done routinely after age 40.

Examination of the musculoskeletal system(arms, legs, back), nervous system (including mental health), and skin mark the end of the complete physical. The extremities (arms and legs)are checked for symmetry (the same on both sides, and were being checked as you got on and off the exam table, to see if you required assistance or were using an assistive device such as a wheelchair,walker, or cane. Following instructions and answering the doctor’s questions during the exam allows for an indirect check of the nervous system. The skin can be inspected as each of the previous parts of the physical is done. Be sure to
have the doctor show you how to do your own self skin exam.

The inspection of the extremities continues as the doctor looks for scars, skin color change,edema (swelling), and effusions (joint swelling). The joints of the arms and legs are then tested for range of motion (actual movement) actively (movements done by patient) and passively (extremities are moved by the doctor). They are also checked for any tenderness, swelling, and
warmth or coolness. The strength, reflexes, and sensation(feeling)in the extremities are usually tested at this time or can be included in the neurologic(nervous system) exam. Strength is tested by resisting the doctor’s strength. Pushing the hand against the doctor’s hand, kicking the leg out, and gripping a finger with your hand are all relative tests of strength. The reflexes are checked with a reflex hammer at several places on
the arm (front and back of the elbow, above the wrist) and leg (below front of knee, back of ankle on Achilles’ tendon). Sensation can be checked using different items but is usually checked by light touch on the same parts of the arm or leg at
the same time. A sterile pin touched lightly on the area to be checked can also be used. Different areas of the body are touched while the patient’s eyes are closed and the doctor asks whether the touch feels the same on both sides or if a sharp or
dull feeling is experienced with the pin. Position sense is checked by being able to tell if your finger or toe is being held up or down with eyes closed. Vibration sense is tested on a finger or toe joint with a tool called a tuning fork (a six-inch
or so steel piece that vibrates when tapped lightly). Your job is to tell the doctor if it’s vibrating and when it stops. Finally, the extremities are checked for the pulses(circulation) in the arm and leg and for any vein abnormalities.

The rest of the neurological exam involves checking the way you walk, talk, and answer a few questions designed to check the mental state(such as where you are, the date, ability to identify a simple object). The cranial nerves(nerves involving the face and neck area) can also be checked now, if they were not included in the head and neck exam. During the back exam the doctor first looks at your posture. The shoulders and hips are checked for symmetry and deformities. The muscles of the neck, posterior thorax (chest), and lower back are palpated to check for any tenderness or spasm. Likewise, the bones of the spinal column are also checked. Movement of the neck and lower back is
done actively and passively in all directions of movement.

Please be reminded that the way the physical exam is done may vary from doctor to doctor. This is unimportant as long as a complete physical exam is done. Please note that the above
description of the CPE is quite generalized and does not include every specific detail. Book references for more detail include: "Bates Pocket Guide to Physical Examination and History Taking" by Barbara Bates, M.D., et al. (also available on CDROM
and VHS tape), and "Bedside Diagnostic Examination" by Drs. Elmer and Richard DeGowan. Many medical school curricula use
these references.

Once the physical exam is complete, the doctor and assistant will leave the room so you can get dressed. If an EKG (electrocardiogram — heart tracing) and X-ray are going to be done, you may be asked to get partially dressed (bottoms only) and keep the gown on. If blood has not been taken, that can be done at this time, too. Following these tests you will be able to get fully dressed. The doctor will then sit down with you in the office or exam room and discuss your symptoms,the physical findings (normal vs. abnormal), diagnosis, and whether any further tests or treatments are needed.

This is also the time for obtaining any prescriptions and to be told about any further tests or specialists whose expertise will be required. The doctor may also counsel you with information about your diagnosis and treatment, as well as any number of preventive healthcare topics. You may also be given handouts and booklets. Doctors may refer you to pertinent medical and patient education websites such as www.webmd.com. Email is becoming another way to talk with your doctor, in addition to phone calls, regular mail, and faxes. Prescriptions for medication are usually given to the patient at the end of the visit. Prescriptions are written orders for medicine that the doctor
has chosen for you. The patient should take these to the drugstore as soon as possible to stay well or to hasten recovery. Prescription medication must be dispensed by a licensed pharmacist. Some doctors fax or call the prescription in to your drugstore. Asking the doctor to do this for you will ensure you receive your medication promptly and will save you a trip to the drugstore. Some doctors are now using e-prescriptions
over the computer to send in patient prescriptions. By giving your doctor the number for the druggist you use, you will be able
to get a prescription filled in less time. You may also get prescriptions for medicine that can be bought over the counter—that is, without a pharmacist. Your pharmacist is the best person to help you with obtaining your medicine,discussing side effects and interactions, what the medicine is for, and so on. Be sure to discuss this with your doctor, too.

Best health!

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Your Physical Exam: Above the Waist

2011-03-20T02:07:00.003-05:00

After your doctor has taken a thorough medical history, a complete physical exam (CPE) is performed. The doctor started your physical exam from the time you were greeted just by looking at you. Are you able to get up and shake hands? Are you able to sit back down? Is there a cane or walker lying beside you? Are you speaking clearly? Are you tearful? This and many other observations can tell the doctor a lot. So the physical has begun before the doctor puts a healing hand on you.

The head, eyes, ears, nose, and throat (HEENT) are usually inspected first. The doctor looks at the scalp for any hair loss or other abnormalities. Your head is palpated (touched and felt) to check for any lumps, swelling, or sore spots. The eyes are next. You will be asked to follow the doctor’s finger with your eyes up, down, left, right. This tests your eye muscles. Pulling down the lower eyelid and pulling up on the upper eyelid allows for inspection of the white of the eye and the eyelids. The eye reflex is checked by shining a light on the colored part of the eye and is done with the lights dimmed (or light off and door cracked). The doctor uses the ophthalmoscope (an instrument) to look inside the eye. The blood vessels and nerve to the eye can be seen. Certain abnormal findings in the eye indicate diabetes, high blood pressure, and other maladies. For any findings that are abnormal with the eye, you will be sent (“referred” is the
up-to-date term) to an ophthalmologist (eye specialist). Routine eye exams by the ophthalmologist may also detect some diseases that are known to progress toward blindness or other complications. Looking at and reading from an eye chart tests the vision.

Can you hear a whisper? How about a watch ticking? Faint noises close to the ears allow a doctor to check to see how well you can hear. Formal hearing tests (like audiometry) are done by an otolaryngology doctor, also known as the ENT (short for ear, nose, and throat) doctor. Hearing tests may also be done by hearing aid centers. The doctor uses the otoscope (the same instrument used for the eyes with an attachment made for looking in the ears) to look in the ear canal and at the eardrum. Using the same tool, each nostril and the mouth are inspected. A stick called a tongue blade is used to hold the tongue down when the doctor asks you to say “aaaaahhhhh.” This is done so that the throat and the rest of the mouth can be checked. This procedure also tests the nerve for the gagging reflex (part of the nervous system exam). A gloved finger may be used to palpate (touch) the inside of the mouth. Any problems here will earn you a referral to the ENT doctor or dentist. Now may be a good time to ask any questions about the exam thus far. Please wait for the doctor to remove the gloved hand first.

The neck exam is next. At this time the thyroid gland is palpated. This is best done while the doctor stands behind the patient and places the right hand around the right side of the neck and the left hand on the left side of the neck. If any swelling or lumps are noted, further blood tests and a thyroid and/or neck scan may be ordered by the doctor. The lymph node glands can also be checked at this time. They are located in the front, back, and sides of the neck. They are also in the armpit and groin and are checked with those parts of the body. The lymph nodes should not normally be enlarged. More blood tests and Xrays may be ordered if they are enlarged.

Inspection, palpation, and percussion (lightly tapping) as well as listening to the chest give the doctor a chance to check the lungs. The doctor listens with a tool called a stethoscope, which makes the sounds louder. It is placed on the bare skin (beware of the doctor who tries to listen on top of your clothes) starting at the top of your upper back moving from the left to right, or right to left, from the top to the bottom of the chest
while you take deep breaths. The same will be done on the chest.

Then the stethoscope will be placed over the heart on the left and right sides of the breastbone. These areas are where the heart valve sounds are heard best. You may also be
asked to do certain things like holding your breath or bearing down (as when having a bowel movement). This makes some murmurs easier to hear. Certain positions may also be better for hearing some heart sounds. Your doctor has been trained to listen for certain things. If any abnormal sounds are heard, more tests may be ordered. These may include an X-ray of the chest(CXR, for short) and heart tracing(electrocardiogram—EKG, for short). Usually these can be done in the office after completion of the exam. Depending on your complaints, symptoms, and the results of the CXR and EKG, you could require more tests that are not done in the primary care physician office.

The breast exam is also done at this time. The doctor will let you know exactly what is to be done. For female patients, it is recommended that a third person or chaperone be present when this exam is done. After the gown is lowered to the waist, the doctor looks at the breasts with the patient sitting up on the exam table. The breasts should look the same size (sometimes one can normally be a tad larger or smaller than the other) and shape with the nipple positioned centrally. The breast is also checked to make sure there is no abnormal swelling, lumps, skin discoloration, or skin changes. Next you will be asked to put your hands on your hips and then raise your arms above your head much like doing your own breast inspection in front of the mirror. The doctor will again look and examine for any abnormal places. While you lie down on the exam table, the doctor will palpate each breast up and down vertically from right to left or vice versa. Palpation in a circle from out to in is another technique used. Breast tissue under the arm is also checked. The nipples are then squeezed gently to check for any discharge. Deeper palpation of the axilla (armpit) is then performed to check the lymph node glands. These steps are then repeated on the opposite breast. Any abnormalities may warrant a
mammogram and/or sonogram and possibly a surgeon’s evaluation. Men should also receive a breast exam. This is a good time for the doctor to teach to do your own self breast exam (SBE).

Now it’s time to look, listen, tap, and feel the abdomen, the area many people refer to as the stomach. This is where the liver, spleen, kidneys, bowels, and female reproductive organs are located. With this lineup of important organs the doctor has a lot to check. This part of the exam is done in the supine (lying on your back) position. Looking at the abdomen for scars tells about anysurgery you may have had. Listening with the stethoscope for overactive or underactive bowel sounds and/or bruits (sounds made by abnormal blood flow through arteries when there is blockage) is next. By tapping and feeling, a doctor is able to check for enlargement of the vital organs listed and to make sure that there are no abnormal internal masses or swelling. At this time the groin is also checked for any enlarged lymph nodes. If there are any abnormalities, further tests will be ordered by the doctor.

By J. L. Richardson, M.D.

http://www.mypatienthandbook.com/

www.twitter.com/MD4U

Free Health Advice - Would You Dare?

2011-01-27T03:07:00.000-05:00

In these days of rising costs on everything, health care may be seen as "optional" unless free or discounted. Many healthcare providers are often asked (especially at parties!) for free advice on and off the Internet.

Would you use free health advice from a doctor, nurse, or other medical provider? http://twtpoll.com/r/s16vcz

Healthy, Wealthy and Wise

2010-12-22T01:02:00.000-05:00

Prevention and wellness.
Transform America to a wellness society.

Wellness and prevention are missing...make them a centerpiece of healthcare reform.

Promote wellness and prevent disease.

Transition from sick care to a true health care system.

Preventing illness and staying well are as important as curing illness.

Wellness and disease prevention are as important to your health as early detection and treatment. If we incoporate this into our healthy lifestyle agenda, we will stay on the right path to Healthy People 2020, the nation's health promotion and disease prevention program. Wellness, health maintenance, prevention and early detection will make you healthier, wealthier, and wiser!

by J. L. Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide, a premiere health guide that helps you and your health care team take the best care of you.

Tweet with Dr. Richardson

Patient Handbook Website

Hangover Help

2010-12-12T00:43:00.004-05:00

Drinking too much alcohol at one time can make you feel like you have a new disease for which there is no cure. There are things you can do to pre-empt this show.

Refrain from drinking on a an empty stomach. This is a sure recipe for hangover hell.
Eat during the day instead of fasting for the party.
Stay well hydrated with water before and after the party. Alcohol dehydrates.
Drink responsibly, i.e. abstain from getting ataxic, speech impaired. Limit: 1-2 drinks/hr.
Avoid mixing different types of drinks.

If a hangover does occur, try these remedies:

Acetaminophen and ice pack for headache.
Avoid alcohol for at least 24 hours.
Drink lots of water.
Rest.

Drinking heavily and often are risk factors for hangover frequency, alcohol dependence, and multiple bad health problems (cirrhosis, dementia, delirium tremors, etc.). Drink wisely to reap the health benefits.

by J. L. Richardson, M.D., family medicine doctor and author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

Health Books: Must Read Healing, Part 2

2010-11-14T16:41:00.004-05:00

Flu IQ & Precautions

2010-11-09T03:00:00.005-05:00

Flu IQ Widget.
Flash Player 9 is required.

Incidentaloma Incidents

2010-11-05T14:28:00.009-05:00

When I had my initial body scan 10 years ago unexpected findings were discovered. These incidental incidentalomas had failed to cause any symptoms. An incidentaloma is the medical term for incidental findings that you may have been born with or acquired which are usually benign. Harmless and benign as they may be, further investigation is warranted, This may involve direct testing with a biopsy and possibly surgical excision.

Though most inidentalomas are benign, they may continue to grow inside the body. This may endanger other organs and become life threatening. Routine scans done at one, two, three, six months then annually is an accepted standard of care for following incidentalomas. In addition, periodic blood tests that correlate with it will help show any changes from the incidentaloma.

Of the five abnormal findings on my body scan, one proved life threatening. The ginormous kidney stone stuck in my kidney had caused no symptoms. Had it remained undetected, kidney failure and/or loss of a kidney surely could have occurred. Another incidentolama required biopsy and proved to be benign (was initially found on a cardiac stress test!). The others continue to be unchanged and asymptomatic. Followup with routine scans is the way they have been followed and they remain stable.

If you are concerned about cost and/or whether your health insurance will cover it, you may want to consider self pay. This test was worth each penny of my $750. Plus no prescription or referral is needed unless it is covered by Medicare. My insurance company now covers scans of each area with incidentolomas. Though not a body scan, the results are the same.

Incidental incidentolomas affect all of us. Once found they should be checked. Be sure to see any specialists that may be necessary to decide if biopsy, surgery, or simply following routine scans is enough.

Best health!

Health Books: Must Read Healing, Part 1

2010-10-30T21:24:00.006-05:00

Health literacy is the sure way to help you and your health care team make the best medical decisions for you. Making healthy lifestyles permanent is one of the keys to good health. The following books are recommended primarily because they teach you things you can do for yourself that you can incorporate in your lifestyle to make it healthier.

The Healing Power Of Prayer: The Surprising Connection Betweeen Prayer & Your Health
by Chester L. Tolson, Ph.D. and Harold G. Koenig, M.D.

Food as Medicine: How to Use Diet, Vitamins, Juices and Herbs for a Healthier, Happier and Longer Life
by Dharma Singh Khalsa, M.D.

Prescription for Herbal Healing
by Phyllis A. Balch, CNC

Spontaneous Healing
by Andrew Weil, M.D.

The Doctor and the Word
by Reginald Cherry, M.D.

Healing Words: The Power of Prayer & the Practice of Medicine
by Larry Dossey, M.D.

20 Minute Yoga Workouts
by America Yoga Foundation & Alice Christensen (founder)

Home Health Massage
by Wendy Kavanagh

Take Charge of Your Hospital Stay: A Start Smart Guide for Patients & Caregivers
by Karen Keating McCann

Power Healing: The Four Keys To Energizing Your Body, Mind, & Spirit
by Dr. Zhi Gang Sha

Patient Handbook to Medical Care: Your Personal Health Guide
by J. L. Richardson, M.D.

Best health!

What Internet Does For You & Your Health

2010-10-30T19:42:00.006-05:00

Prior to any medical diagnosis you or doctor visit, you are able to check things out for yourself. Textbooks in your personal home library and the public library along with information your health care providers may have given you is initial information most patients are exposed to initially. The Internet is now the primary source for health information for patients and health care providers all over the world. This is the only place you can find valid, up-to-date medical information from all over the world. In a few hours you know as much if not more than any new medical school graduate about your health conditions.

A survey done by the CDC (Center for Disease Control) reports that over 50% of Americans look up health information on line in 2009. Women were more likely than men to research health information on the Internet. Direct patient-doctor interactions like email, prescription refills, and appointments were used infrequently (5%). Disease specific information is the most searched health information followed by medication. nutrition and fitness.* Most of the patients discussed their findings with their doctors. Key word search using the search engine, Google, was the primary way information was located. Specific websites were second. Over 98% reported the material was reliable and easy to understand.

Information like this helps you and your medical care team help you get the best care possible. Wellness, prevention, early detection and treatment are a few hours and a few clicks away - free. The Internet is a valuable resource that does the following:

provide you with information that will keep you healthy and well
help you find the latest research, clinical trials, treatments, doctors for any illness
allow you to communicate with your health care providers directly (email, telemedicine)
find and share research thereby promoting your health literacy i.e learning and teaching for every one involved
help you find virtual and real communities that provide support for your conditions and diseases as well as social interaction
search and shop for insurance and other medical aid, supplies, etc.

Use the Internet to help you stay in touch with your health and keep it in your hands. Best health!

by J.L. Richardson, M.D., family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U

*study from Dept. of Family Medicine, Wayne State University School of Medicine, Journal of American Board of Family Medicine, 2006

Body Scan for Early Detection

2010-09-28T09:30:00.003-05:00

No prescription is needed for a body scan.. This is one of the most efficient health assessment tools that appears to be under utilized by the medical profession (fear of finding stuff they are unable to answer?). It is rather affordable, however, results yielded may pave the way for more expensive tests.

Reasons you should have a body scan:
_early detection of disease
_baseline exam for future reference & comparison
_follow chronic disease & abnormal findings like incidentalomas
more on these incidental findings here: http://bit.ly/9ANS09

Physical exams fail to pick up disease at the earliest possible stage. Total body scanning in conjunction with a physical exam and blood tests increase the likelihood that health issues will be detected earlier.

Best health!

by J.L. Richardson, M.D., family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide"

http://www.mypatienthandbook.com/
www.twitter.com/MD4U

Lose Your Wealth for Health...or Die Trying

2010-09-23T12:09:00.006-05:00

Lose your wealth, lose your health? Is draining your finances the way to live a healthy life? Medication can cost thousands of dollars especially new non-generics and injectables. Recent news reports a new one at $30,000 for treatment for one person. This was a preliminary guesstimate, mind you. It was unclear how long the treatment would take or how many shots is a cure. Perhaps this is part of the pre-debut gimmick that medicine companies produce time and again. Regardless of this scene, it is up to you and your health care basic instinct to determine how much money your health is really worth.

Is it really worth debt? Should you have to suffer health loss and financial loss? Is $30,000 a year the magic number for health care expenses? Oh wait..."I don't even make $30,000!" That's near the poverty line. Government assistance like Medicaid usually requires more. For instance, to qualify for nursing home placement you must lower your net worth by decreasing your assets to $2000. Does that qualify one for a $30,000 drug?

Great health is true wealth, but how much are you willing to pay? Death and taxes are sure bets, and so is your health.

Quality of Medical Care

2010-09-15T04:15:00.005-05:00

Quality medical care can be described as the best medical care. The goal is to keep a person well and healthy and to manage acute and chronic illnesses to help a person maintain optimum health. According to a 1996 national survey, “Americans As Health Care Consumers: The Role of Quality Information,” the major concern in choosing a health plan was quality of care (42% of 2,006 adults). This is more important than low cost, choice of doctors, and range of benefits. Employers provide some information on the quality of health plans. Most people choose health providers and health plans based on recommendations from doctors, family,
and friends.

There are independent organizations such as the National Committee for Quality Assurance(NCQA) and the Agency for Healthcare Research and Quality (AHRQ) that monitor and provide information about the quality of healthcare. They develop and report their findings based on research. The AHRQ (www.ahrq.gov) is a government agency that supplies research and guidelines for use by health providers and patients to help determine what care is available and which should be preferred. The NCQA (www.ncqa.org) assesses, monitors, and reports on quality of care. It is a private, nonprofit organization whose diversified board of directors includes employers, health plans, and most importantly, patients, the consumers of managed
healthcare. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) evaluates hospitals, clinics, nursing homes, home health agencies, and laboratories. For community, home health, and hospice programs there is the Community Health Accreditation Program (CHAP). Outpatient healthcare settings like student health services, diagnostic radiology centers, and ambulatory surgical centers are evaluated by the Accreditation Association for Ambulatory Health Care (AAAHC).

In addition, most managed healthcare plans have their own internal quality assurance plans. Once a plan has been reviewed and evaluated by NCQA or other review agencies, the plan is assigned a “grade.” If the plan meets the required standards, it is then given accreditation. This means that the plan met the required guidelines for providing high-quality medical care. The NCQA uses this information to develop a report card on each plan it reviews. The NCQA measures quality using its own Health Plan Employer Data and Information Set (HEDIS) for performance measurement. This data is used for the report card. The report card includes data on the plan’s actual medical services, such as doctor availability, specialist referrals, preventive care, and emergency and hospital coverage. It also reviews charts focusing on the physician’s medical competence and performance. The physician’s licensing, certification, and other credentials are also checked. The physical setting of the office is evaluated to be sure that all quality standards are met.

In evaluating healthcare quality NCQA accreditation and HEDIS provide a comprehensive, standardized, and uniform method that is used for the HMOs it reviews.
About 75% of the nation’s HMOs are accredited by NCQA or are in the process of becoming accredited. The following areas are the primary focus of the health plan review, weighted according to the percentages indicated:
• Access and service (patient satisfaction and
easy, timely access to providers and
treatments), 40%
• Qualified providers (trained, licensed,
credentialed), 20%
• Staying healthy (wellness and prevention),
15%
• Living with illness (proper diagnosis and
treatment of acute and chronic medical
problems), 15%
• Getting better (quality of care), 10%
Meeting the accreditation standards in each
area accounts for 75% of the grade.

The HEDIS (Health Plan Employer Data and Information Set) results make up the remaining 25%. Overall, HEDIS results look primarily at quality in the clinic and patient satisfaction. The results from each plan review are then compared to certain target goals for each category reviewed, and the plan is graded. These grades are compiled and compared to other health plan report cards. The collected information is then reported in a comprehensible format for patient use in selecting a quality health plan.

Information like this is becoming more readily available. It will become, increasingly, one of the ways patients look for and find quality health plans. The Accreditation Status List (ASL) is available to anyone by calling (1-888-275-7585), by writing , or by going to the NCQA website, which provides a list of the accreditation status of participating health plans. Accreditation Summary Reports (ASR) are also available and contain more detailed information than the ASL.
Individual private doctors and group practices that use these managed healthcare plans are usually under contract with the health plan to allow for periodic quality assurance checkups and monitoring.

Health insurance that is not part of a managed healthcare plan and private fee-forservice healthcare are also being included in assessments of quality. Uniformity of quality assessment and reporting among all healthcare providers is a major issue being addressed by the government and other independent agencies that specialize in quality measurement. Soon all providers of all types of health services will have routine quality assessment and reviews, and even more information will be available for the patient to review.

Even with the researched, scientific-quality databases provided by independent organizations, patients usually select a health plan and providers recommended by family or friends rather than one that rates much higher based on a formal quality assessment and review. This trend is also reflected in the choice of doctors. Patients are more concerned about the way a doctor communicates with and cares about them than about whether the doctor has been given a high rating by a quality assurance organization. If the doctor has board certification in her or his specialty, this is also given a higher ranking by patients than quality accreditation from an independent organization.

Many people are beginning to see that quality is important, since one of the goals of managed care is to contain costs, sometimes at the patient’s expense. In order to see that this does not become an issue, quality monitoring, assessment, and reporting are vital to the healthcare system. Making it available to the patient is also important. Information is a powerful tool. It allows patients to learn and to make decisions that are best for them. Looking for quality healthcare in today’s healthcare maze can be a challenging experience. Reading information from the medical provider is a good place to start. Many managed health plans provide patient
manuals and patient representatives that are available to talk with you in person or by phone.

For more detailed information you can contact your state’s insurance commission. Health insurance plans are regulated by state insurance commissions. The AHRQ is a federal government agency under the Department of Health and Human Services (DHHS). It does research on the quality and costs of healthcare. Some of the specific areas it covers are patient safety, quality improvement, clinical outcomes, assessment of medical practices, preventive and primary care services, and funding for medical research.

AHRQ states, "Health services research examines how people get access to health care, how much health care costs,and what happens to patients as a result of this care". The main goals of health services research are to identify the most effective ways to organize, finance, and deliver high quality care; reduce medical errors; and improve patient safety. The AHRQ has maintained a database of medical care guidelines based on medical research. The research is “translated into practices and policies that have been proven to provide the best care, diagnosis, treatment, and follow-up for specific conditions. The guidelines are available free of
charge at The National Guideline Clearing House (www.guidelines.gov ).

More information on choosing the right health plan for your medical needs can be found in the following patient information brochures available on the Internet or by contacting the agency via phone or mail:
• “Choosing and Using a Health Plan” and “Checkup on Health Insurances” from AHRQ www.AHRQ.gov
• “Choosing Quality: Finding the Health Plan That’s Right for You” from NCQA
• “Which Plan Is Right for Me?” from NCQA www.NCQA.org
• http://www.healthchoices.org/ website by NCQA
• “It’s Your Health—How to Get the Most Out of Your HMO” from Consumer Action,
http://www.consumer-action.org/ a consumer advocacy group

Best health!

Prevention Checkups: Is It Time for You?

2010-09-02T16:22:00.010-05:00

Staying healthy and disease-free is what prevention is about. The complete physical is the beginning of prevention. The breast exam checks for cancer, as do the Pap smear and rectal examination. Depending on your age and sex, there are guidelines for when to have certain tests. These guidelines are recommended by health organizations such as the U.S. Preventive Services Task Force, American College of Physicians, American Cancer Society, and American Heart Association. These guidelines are by no means laws, but they serve as useful suggestions for you and your doctor to use in your prevention and treatment program.

So how often should you have a complete physical? When is it time for your next tetanus shot? I have reviewed guidelines from the various health organizations mentioned above and compiled a summary of adult preventive care standards. These are also based on my own clinical experiences and on the number of lives saved by doing tests, regardless of whether the time frame of the guidelines was observed.

ADULT PREVENTIVE STANDARDS
AGE:------------18–25----26–40 ----41–60----60+
Physical Exam 1–3 years 1–3 years 1–2 years yearly
Height/Weight 1–3 years 1–3 years 1–2 years biannual
Blood Pressure 1–3 years 1–3 years every year biannual
Eyes and Ears 1–3 years 1–3 years 1–2 years every year
Mouth 1–3 years 1–3 years 1–2 years every year
Breast Exam every year every year every year every year
Pap Smear* 1–2 years every year every year 1–3 years
Prostate Exam if needed if needed every year every year
Scrotal Exam every year every year every year every year
Rectal Exam if needed if needed every year every year
Stool Blood if needed if needed every year every year

COMPLETE BLOOD PANEL
AGE:---------18–25----26–40 ----41–60----60+
Lipid Panel 5 years 5 years every year every year
Liver Panel 5 years 5 years every year every year
Hepatitis 5 years 5 years every year every year
Kidney 5 years 5 years every year every year
Blood Count 5 years 5 years every year every year
Thyroid 5 years 5 years every year every year
Urine 5 years 5 years every year every year
Electrolytes 5 years 5 years every year every year
Glucose 5 years 5 years every year every year
Prostate (PSA) if needed if needed every year every year
HIV — test if any risk factors or exposure —

IMMUNIZATIONS**
AGE:----------------18–25----26–40 ----41–60----60+
Tetanusdiphtheria 10 years 10 years 10 years 10 years
Pneumococcal — as needed for persons at risk — once after 65
Influenza (flu) — as needed for persons at risk — every year
Hepatitis — — — — as needed for persons at risk — — — —
Measles-Mumps-Rubella — — if no antibodies, get 2nd dose — —

TESTS / PROCEDURES
AGE:---------18–25----26–40 ----41–60--------60+
Mammogram if needed 2–3 years every year every year
Chest X-ray baseline if needed if needed if needed
Electrocardiogram — — baseline — — every year every year
Colonoscopy if needed if needed 3–5 years 1–3 years
Body Scan baseline 1–3 years 1–3 years 1–3 years
DENTAL — — — — — — every year — — — — — —
MENTAL — — — — — — as needed — — — — — —

For any abnormalities, repeat screening and follow-up should be done sooner or more frequently depending on the individual person. For example, if your cholesterol is found to be increased when you are 18 years old or younger, you would want to have that checked at least every year instead of every five years. For people with a family history of breast cancer, yearly mammograms may start as early as the twenties.

Persons with a history of chronic illness (diabetes, hypertension, cancer, etc.) should have a yearly physical regardless of age. Frequent routine visits during the year are also in order for those with any chronic illness. In addition to preventive health screening tests, preventive health counseling is also very important. In addition to the doctor’s verbal counseling, ask for patient education references. Reading and knowing as much as you can about staying healthy also helps improve your quality of life and can make you feel better!

*Some sources recommend that after two normal PAP smears, repeat every 1–3 years.

**For further details, refer to the “Recommended Adult Immunization Schedule” published by The Advisory Committee on Immunization Practices (ACIP) from the Centers for Disease Control and Prevention (CDC).

Prevention & Early Detection with Your Personal Health Guide

2010-08-02T02:35:00.008-05:00

Prevention and early disease detection are important for your health and wellness. Patient Handbook to Medical Care: Your Personal Health Guide is the perfect book to inform you about the proper tests and exams every patient needs.

Use this quick link http://bit.ly/dpEGyA with Google Books to read actual book excerpts, and to locate libraries and book stores where the title is available.

Great health is true wealth - YOU are your most important asset.

Patient Handbook to Medical Care is now in the Kindle library. You can find this great health reference book at the Kindle Store http://amzn.to/9wjMXn on Amazon. Also available at many libraries and on line book stores.

www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

What You Would Like to Hear From Your Doctor Parody

2010-07-30T22:19:00.004-05:00

It's so good to read the truth at last! Would you like to hear your doctor tell you these things?

Q: I've heard that cardiovascular exercise can prolong life; is this true?
A: Your heart is only good for so many beats, and that's it.. Don't waste them on exercise. Everything wears out eventually. Speeding up your heart will not make you live longer; that's like saying you can extend the life of your car by driving it faster. Want to live longer? Take a nap.

Q: Should I cut down on meat and eat more fruits and vegetables?
A: You must grasp logistical efficiencies. What does a cow eat? Hay and corn. And what are these? Vegetables. So a steak is nothing more than an efficient mechanism of delivering vegetables to your system Need grain? Eat chicken. Beef is also a good source of field grass (green leafy vegetable). And a pork chop can give you 100% of your recommended daily allowance of vegetable products.

Q:Should I reduce my alcohol intake?
A: No, not at all.. Wine is made from fruit.
Brandy is distilled wine, that means they take the water out of the fruity bit so you get even more of the goodness that way. Beer is also made out of grain.
Bottoms up!

Q:How can I calculate my body/fat ratio?
A: Well, if you have a body and you have fat, your ratio is one to one. If you have two bodies your ratio is two to one, etc.

Q:What are some of the advantages of participating in a regular exercise program?
A: Can't think of a single one, sorry. My philosophy is : No Pain..Good!

Q:Aren't fried foods bad for you?
A: YOU'RE NOT LISTENING!!!
.... Foods are fried these days in vegetable oil. In fact, they're permeated in it. How could getting more vegetables be bad for you?

Q: Will sit-ups help prevent me from getting a little soft around the middle?
A: Definitely not! When you exercise a muscle, it gets bigger. You should only be doing sit-ups if you want a bigger stomach.

Q: Is chocolate bad for me?
A: Are you crazy?
HELLO
Cocoa beans! Another vegetable!!! It's the best feel-good food around!

Q: Is swimming good for your figure?
A: If swimming is good for your figure, explain whales to me.

Q: Is getting in-shape important for my lifestyle?
A: Hey! 'Round' is a shape!

Well, I hope this has cleared up any misconceptions you may have had about food and diets. And remember:

'Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body, but rather to skid in sideways - Chardonnay in one hand - chocolate in the other - body thoroughly used up, totally worn out and screaming 'WOO HOO, What a Ride' AND....

For those of you who watch what you eat , here's the final word on nutrition and health. It's a relief to know the truth after all those conflicting nutritional studies.

1. The Japanese eat very little fat and suffer fewer heart attacks than Americans.
2. The Mexicans eat a lot of fat and suffer fewer heart attacks than Americans.
3. The Chinese drink very little red wine and suffer fewer heart attacks than Americans.
4. The Italians drink a lot of red wine and suffer fewer heart attacks than Americans.
5. The Germans drink a lot of beers and eat lots of sausages and fats and suffer fewer heart attacks than Americans.

CONCLUSION:
Eat and drink what you like. Speaking English is apparently what kills you.

Patient Handbook to Medical Care: Introduction

2010-07-28T22:26:00.006-05:00

To ensure that you receive the best and even proper medical care, you must know the basics. This book focuses on things that are important when you go to the doctor, and it will help you to obtain the quality medical care you deserve. If you don’t know what you’re supposed to be getting, you might well not be getting it. I have had many people—family, friends, and patients—tell me that their annual checkup was okay. Then, they describe it. Most of them say their doctor did not ask them the usual questions about their health history and did not do a complete physical examination of their body. They are told that they are okay, yet they commonly receive prescriptions and orders for more tests without knowing why. They may be given an appointment to come back, or they may not.

The goal of this book is to inform and educate patients about medical care. The book is written in an order that corresponds with the basic steps of medical care. The medical records kept by your doctor are the cornerstone of keeping track of everything pertaining to your health. This is one reason why patients should also get copies of their medical records from their doctors. In addition, I suggest that patients keep their own medical records in the form of a diary. Chapter 1 discusses keeping a medical diary and obtaining medical records from your doctors. Chapter 2
outlines what a proper physical exam should include. Preventive medicine guidelines are presented in Chapter 3. Chapter 4 discusses medical tests and what they mean. Chapter 5 describes physician specialists and when they may be necessary. The final chapter discusses types of health insurance and the quality of medical care.

It is very important for patients to learn as much as possible about wellness, disease prevention, and disease management for themselves. In our society we are accustomed to taking a doctor’s word on the state of our medical condition and treatment whether or not we understand it and either without asking any questions or without getting adequate answers to the questions we might pose. Today that might not be a healthy situation. It is necessary to be informed to get the most from your health plan and to get the best medical care from the medical resources available in the healthcare system.

By reading this book, you will find out how to take charge of your most important asset — you. This book is written to inform patients about the facts. It is by no means a substitute for your personal physician’s care and advice or for that of
any of your healthcare providers. Instead, it is a supplement. Use it in good health!

Healthy Recipe: Blueberry Batter Cake

2010-07-22T22:39:00.005-05:00

Blueberries are very healthy and have lots of antioxidants. This easy, tasty recipe is a cake pudding that tastes like a pie. Try it, you will like it! Best health!

Use 11 X 8 inch pan for 6 to 8 servings.

Ingredients:

2 cups fresh or frozen blueberries
3/4 cup sugar or sugar substitute
1 cup flour
3 tbsp. butter
1/2 cup milk
1 tbsp. cornstarch
1 cup boiling water

Butter baking dish. Sprinkle blueberries over bottom. In bowl combine sugar, flour, and butter. Add the milk. Mix until blended. Spread the mixture over the blueberries evenly. Sprinkle cornstarch over top. Pour boiling water over the batter. Bake at 350 degrees for 45 - 60 minutes. Serve warm with whip cream.

Variant---Substitute other fruit like strawberries or rhubarb for blackberries.

Doctors & Specialists

2010-07-20T02:05:00.012-05:00

For many people, the most familiar doctor is their personal or primary care physician (PCP). This is the doctor that coordinates all of your medical care routinely and continuously. Usually this doctor is a medical doctor (MD) who is a family practitioner, an internal medicine doctor (internist, for short), or a doctor of osteopathic medicine (DO). There may be times when your doctor or you feel an “expert” opinion is needed in a certain area. Then your doctor will refer you to a specialist. These doctors help the primary care physician with proper diagnosis and treatment.

After completion of undergraduate and medical school in the United States (which usually takes from six to eight years), the physician enters an internship (first professional year) followed by a residency program (two years or more) at an accredited university program in the specialty chosen. The choice of specialty determines how long the doctor is in residency training. Family practitioners and general osteopathic doctors must complete three years of medical training in all areas of medicine. D.O.’s receive additional training in osteopathic manipulative medicine (OMT), which adds a holistic approach. Surgeons have three years of general surgery, including some general medicine. General internists train for three years. If a doctor chooses to specialize further, in a sub-specialty, there may be an additional two years or more of training.

Once training is complete, the doctor may take a test to become certified in the chosen specialty. This is an indication that the doctor has excelled in a particular field and is ready to provide the best, most up-to-date medical care. The doctor must possess a license to practice medicine for the state(s) in which she or he practices. This comes from the state licensing board, which also monitors physician conduct and competence. Doctors who do not follow the law are sanctioned by this board. The mission of the board of medicine is to protect the patient.

Patients are able to contact the state boards to determine if doctors are licensed and if any disciplinary action has been taken against the physician for wrongdoing of any kind. In addition to providing information about physicians, the state boards handle patient complaints about doctors. This can lead to hearings where doctors are “tried” as in court and may lead to discipline and loss of license. The public information collected by state boards can be found on some state health agency websites.

Choosing your PCP and specialists is crucial to your health care. Word of mouth is the best and most common way good doctors are found. The internet is also a great resource.

Best health!

Your Health & Medical History

2010-07-02T02:01:00.008-05:00

One of the first things your doctors and healthcare providers want to know is why you made your appointment. Once you answer this question (hopefully before interruption) there will be questions about your general health and wellness, as well as more information about your reason for the visit. For specific concerns you may be asked:

How long has this been going on?
What have you done for it?
Have you had it before?
Where does it bother you?
How often does it occur?
What makes it better or worse?
Are there any other symptoms?

You will be asked about how the other parts of the body are working, such as your eyes, ears, heart, breathing, and so on. This is called the “review of systems” (ROS). If there are any problems not related to your main problem, now is the time to let the doctor know.
This will be followed by your past medical history (PMH), which includes:

Diseases you have (high blood pressure, sugar diabetes, arthritis, cancer, depression,
etc.), or have had that are better or gone (including childhood diseases such as
measles, mumps, and inherited disease)
Operations and times you were in the hospital (including accidents)
Medication, including prescription, over-the counter (don’t forget about vitamins),
natural (garlic, aloe), and herbal
Allergies and reactions to anything and what it did to you (for example: breaking out in a
rash, swelling, itching, upset stomach, etc.)
Smoking, alcohol, drug use (how much,
how often)
Shots (childhood, flu, last tetanus, etc.)
Sexual (active, using protection, number of partners, diseases)—in females this will also
include menstrual period, pregnancy, last mammogram, and Pap test
Family history (conditions that run in family
such as cancer, high blood pressure, etc.)
Social history—your job or jobs; family; marital status; living arrangement (house,
apartment, alone, etc.); transportation (drive self, public transport, walk); ambulation
(use walker, wheelchair); disability (deaf, blind, amputee, etc.) Religion, ethnic customs, and traditions

If there is anything left out or that you feel the doctor should know, now is the time to speak up. It is sometimes hard to get someone’s full attention, so take advantage of it while you have it. Some doctors’ offices will have you fill out forms asking the above questions or will ask you the questions and fill out the form for you. This is not a substitute for the doctor’s personalinterview and questions.

Writing or typing this information is a sure way to keep all of your PMH. Make a copy for your doctor. While talking you both can refer to this vital source of health information. This is part of your medical record.

Best health!

Use this handy form to get you started http://bit.ly/bEvHk6

How to Get Your Medical Records: Your Life on File

2010-06-30T15:30:00.006-05:00

Communicating with your health care team is vital. To be sure nothing is missed, take the time to collect your medical records from all the doctors you see. This includes notes from your primary care doctor and specialists, tests, and surgery reports. You may want to start with your primary care doctor, the doctor who sees you the most.

To obtain your records, you should submit a medical record release form. This form gives your doctors and other health providers permission to release your records to you. This can be done at the doctor’s office, by mail, or by fax. You can get a record release form at doctors’ offices or at other medical facilities such as hospitals and clinics.

The medical record is your life and health on paper. Once you get your records, it is important to review them for accuracy. If any information is inaccurate or any reports are missing, bring it to your doctor’s attention. You might find some
things your doctor did not tell you about or things you simply do not understand. If your doctor is unable to get the missing information, contact the source directly for copies of your reports.

Gather this information into a folder or notebook. Add a cover sheet with your name, address, phone number, email, and date of birth. On this page make a list of your medical conditions, all the medicines you take, your allergies (and any other reactions to medication), operations you’ve had, and a history of diseases that run in your family. You will be able to make copies to take to any doctor you go to. This also prevents the delay that occurs when records are sent from doctor to doctor, which can take from weeks to months to years.

Best health!

by J.L, Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.

Patient Handbook to Medical Care provides 112 pages (large print) of health information that will tell you what your doctor should be asking you, telling you, and doing for you - as taught in medical school and used since Hippocrates.

www.mypatienthandbook.com/

www.twitter.com/MD4U

www.blogtalkradio.com/drjfpmd

Eleven Effective Rules of Communication

2010-06-26T14:40:00.004-05:00

Listen a lot.
Be specific.
Ask for a reasonable change that will relieve the gripe.
Make sure your partner understands what you want and you understand what she or he wants.
Deal with only ONE issue at a time.
ALWAYS consider compromise.
Never assume you know what the other is thinking. Check it out. Don't assume or predict reactions, rejections, or acceptance.
Accept what the other feels. Don't tell your partner what he or she should or should not be feeling.
Don't name call or label.
Sarcasm is dirty fighting - call each other on it.
Stay in the present. Grievances should be dealt with at the earliest possible moment. Don't save them up to use as weapons.

Great health relies on effective communication by everyone - patient, family, and health care team. Best health!

Praying for Health - No Insurance Required

2010-06-13T19:58:00.010-05:00

Pray for me. This often forgotten yet basic request is often deferred until times of severe health duress. How effective is prayer in helping heal your illnesses or that of someone else? Combining this with other forms of treatment has proven effective in managing illness, especially chronic disease.

Prayer is considered an alternative health treatment; however, faith healing is the only way to many. Man made medical treatments like drugs and surgery combined with modern technology have overshadowed prayer. Prayer, like many other alternative "natural" treatments, is usually left off the intern and resident training in medical school. Research has shown that many patients pray for their health regardless of religious background, and that is does indeed have healing health benefits.

Praying for oneself as well as being prayed for are effective in staying healthy as well as in healing. The beautiful thing is that you can do it anywhere, anytime without paying any money. No health insurance is required.

Best health!

by J.L, Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.

This book provides 112 pages (large print) of health information that will tell you what your doctor should be asking you, telling you, and doing for you - as taught in medical school and used since Hippocrates.

www.mypatienthandbook.com/

www.twitter.com/MD4U

www.blogtalkradio.com/drjfpmd

How To Make Your Doctor Appointment

2010-06-12T00:03:00.002-05:00

The doctor in charge of your overall care is
called a primary care physician (PCP). Your first
office visit with a new doctor is the most
important one. This is when you get to know
your doctor and supply information about your
medical background. This visit may be for a
specific problem or for a complete checkup (that
is, a complete physical exam—CPE).

For a specific problem, you might only get an
examination of your complaints, symptoms
(what is bothering you), and of other areas that
the doctor knows to check depending on your
symptoms. In this case, you are usually given a
later appointment (typically in two to six weeks)
for the CPE, but ideally you would have the CPE
on your first visit. It is a good idea to make an
appointment with your doctor while you are
well. This will help you and your physician focus
on your total healthcare more clearly and without
distraction.

Schedules usually have 15-, 30-, and 60-
minute time slots. The longer times are usually
for patients who need a CPE. When you call for
your first appointment, let the doctor’s office
know if that is what you want. That way you will
not be put in a 15-minute slot, the time usually
allowed for a routine visit. Doctors’ schedules can
be very frustrating for patients, doctors, and staff.
This can lead to longer waits and shorter visits.
Being on time is important for both patients and
doctors.

Unless an emergency arises, the wait to see the
doctor should be no longer than thirty minutes.
If there is an emergency, waiting patients should
be given the option of continuing to wait,
rescheduling, or going elsewhere for treatment. If
you really have to see the doctor, just be prepared
to wait, and pray that the magazines are up-todate.
You can bring your own items to read, your
laptop, a CD or tape player with earphones, or
you can strike up conversation with other
patients. Listening and talking with others in the
waiting room is a great way to gather and share
information. Also, take the time to observe. Take
a look around the doctor’s office and watch how
things take place.

Some of the many reasons for a doctor’s
“tardiness” include overbooking patients, double
booking (scheduling two patients at the same
time), “pre-booking” (scheduling appointments
before the doctor gets in), and emergencies. If
you belong to a managed healthcare plan like an
HMO (Health Maintenance Organization), the
doctor usually has little, if any, say over the
schedule because success is equated with seeing
as many patients as possible. Also, the doctor
may be an employee. The doctor who works for
someone else cannot be solely blamed because
the staff also works for someone else.

Before managed care most doctors ran their offices and
hired employees themselves. This means that the
doctor was responsible for the whole office and
the way it was managed. If your doctor is an
employee and waiting is an issue, please let the
doctor, office supervisor, and health plan know
what has happened. The doctor will then be in a
position to let the employer know there is a
scheduling problem. This should help improve
wait time and any related problems.

Best health!

by J.L. Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

For Men Only: Checkup Checklist

2010-06-11T23:05:00.006-05:00

"If I had known I was going to live this long, I would have taken better care of myself." — Mickey Mantle

Statistics show that men are less likely than women to get routine health checkups and physical exams. Men are more likely to seek medical attention when there is an acute problem, and once that has resolved not until another acute problem. Part of the reason for this is lack of health education. Men are also more prone to the "this can't be happening to me" syndrome. Is ignorance truly bliss? Short term, maybe. Long term, no.

So what is a fella to do? Make a yearly checkup routine. Do it around your birthday or holiday like Father's Day or Christmas as a gift to yourself (your most important asset!). In addition to a complete medical history (be sure to take your notes and questions) and physical exam, there are other things your doctor should do. This includes:

complete blood panel including a PSA (prostate specific antigen) if over 40 or have a history of prostate cancer in your family - please note that PSA screening is very controversial as to if it should be done and should be discussed at length with your doctor as this test does save lives
EKG, baseline at first physical then every 2-3 years - yearly if over 50, have risk factors such as smoking, obesity, hypertension, diabetes, increased cholesterol, family history of heart disease
cardiac screening by a cardiologist if any signs or symptoms of heart disease especially if there is a family history of heart attack, angina
colon cancer screening with stool guaiac cards - stool samples are placed on these and returned to your doctor who checks for blood (this should be done when a rectal exam is performed, but if for some reason it is not, be sure to get these cards)
colonoscopy, baseline at 50, sooner if stool positive for occult blood or gross rectal bleeding, weight loss, stomach symptoms

Be sure to include regular visits to the dentist, and optometrist or ophthalmologist (eye doctor).

Best health, guys!

by J.L. Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/

www.twitter.com/MD4U

www.blogtalkradio.com/drjfpmd

How Safe Is Your Seafood with Oil Spill?

2010-06-11T01:30:00.006-05:00

The big oil spill has caused great concern about the safety of the seafood we eat. Much of the nation's shrimp, oysters, and crabs are from the Gulf coast. Restaurants are still serving Gulf coast seafood and grocers are still selling it. How can you be sure it is safe for consumption?

The smell of oil is a sure sign that seafood should not be eaten. Trainers at federal fishery labs sniff for tainted seafood. The inspection is done after the catch before it is sent to market. NOAA and the FDA do actual chemical testing. The large number of fishermen. fisheries and processors makes it impossible to inspect and test all the seafood. Smelling your food before you cook or eat it is a way to avoid food poisoning.

If you do suspect food poisoning after ingesting seafood, you may have the following symptoms:

stomach cramps
nausea and vomiting
fever and chills
diarrhea
bloody stools
weakness

These symptoms usually occur from 30 minutes to several hours after eating the tainted food. If suspected call your doctor or visit your emergency room as soon as possible. To avoid severe illness take in as much clear liquids as possible to prevent dehydration. It is best to avoid solid foods for 24 hours, and then slowly advance from a soft, bland diet to regular food.

Clear liquids include water, ginger ale, tea. An easy soft diet to remember is BRAT - bananas, rice, applesauce, toast. Avoid dairy products, greasy food, alcohol and raw foods for 48 hours as this may worsen the symptoms. Soft diet may be started after 24 hours without nausea, vomiting, or diarrhea. If symptoms persist or worsen in any way call 911 or go to the nearest emergency room.

by J.L, Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.

This book provides 112 pages (large print) of health information that will tell you what your doctor should be asking you, telling you, and doing for you - as taught in medical school and used since Hippocrates

http://www.mypatienthandbook.com/

www.twitter.com/MD4U

www.blogtalkradio.com/drjfpmd

Medicare & You: Will It Be There When You Need It

2010-06-01T18:42:00.007-05:00

If you are in your near retirement years, I am sure you are getting ready for Medicare to take over your health care. Will it be there? By 2030 there will be about 100 million persons receiving Medicare. This is twice as many as 2008. This comes at a time when the growing demand for doctors is at a critical point. Their numbers are dwindling, especially those that accept Medicare payments for services.

Medicare is a health program that is publicly funded by the government to care for persons over 65 who have been legal residents for five years.It is a single payor program. Medicare eligibility starts at 65 years of age. If you are a person with disability, end stage kidney disease (i.e. requiring dialysis or kidney transplant), or Lou Gehrig's disease you will get benefits before age 65.

For the past few years Medicare payments to doctors have been cut by as much as 21% in 2010, while Medicare premium payments by patients have risen (along with the cost of health care!)an average of 10% per year. In addition, Medicare taxes are being prepaid through every working persons' paycheck - 2.9% of your wages to be exact (more if you make over $200,000). It would make sense that doctors and health care providers would receive increases instead of sharp cuts (pun intended). Instead doctors are quitting and looking for second careers unrelated to clinical medicine. Hospitals are closing (the small reserves for hospitals may exhausted by 2017). Clinics are downsizing and closing.

Predictions abound that Medicare will be bankrupt by 2020 to 2030, . "The latest report on the solvency of the Social Security and Medicare trust funds reveals that these entitlement programs will likely run out of money sooner than expected." (reference: Brookings Institute, 2009) Medicare alone was 13% of the federal budget (almost $400 billion) in 2009. It is projected to be near the same in 2010 with a higher cost near $500 billion! The amount spent on Medicare is likely to exceed the payroll taxes collected from your hard earned wages. Astounding data! In spite of the fact that doctors must now accept what Medicare pays them versus what they charge (traditional from 1960 to 1980), this program will be in the red.

Health care rationing may become part of the plan to cut costs and be sure all get health care. Those over 60 and those with multiple chronic conditions many of which occur just because you get old like arthritis, high blood pressure, decreased vision with cataracts, decreased hearing will be put in the long line near the end. As we live longer more health care is needed especially if we inherited the family genes for certain things like diabetes, cancer, and heart disease. Add this to the "old age" diseases and you have the equation of a Medicare patient. Of course old age is much kinder to some than others, but it happens to everyone.

Where will you go for health and medical needs when you reach 65? Medicare was supposed to be there. You worked and paid for it. So you must look after it. First and foremost, you must realize that your health is everything. Loss of function of an arm or leg, your speech or vision almost renders you dependent until you "overcome" it, if you do.

Health maintenance and wellness are vital. You must be your best health advocate by taking the time to prevent as much as possible. Routine checkups by you and your healthcare providers are very important. Early detection will prove a lifesaver if some illness is discovered. This will help you get through the Medicare years. You will be able to see your premium payments and hard work pay off, just with less Medicare and more of your money out of your pocket.

Bottom line: cut Medicare benefits or increase payroll taxes? This is truly a "beast and burden" that needs taming.

by J. L. Richardson, M.D.

Dr. Richardson is a family medicine physician, independent medical record reviewer, and author of Patient Handbook to Medical Care: Your Personal Health Guide. This book provides 112 pages (large print) of health information that will tell you what your doctor should be asking you, telling you, and doing for you - as taught in medical school and used since Hippocrates.

http://www.mypatienthandbook.com/
www.blogtalkradio.com/MD4U - Dr. Richardson reads from Patient Handbook
www.twitter.com/MD4U - health info in 140 or less

GREAT HEALTH IS TRUE WEALTH!

Women's Health Checkup

2010-05-16T22:36:00.003-05:00

Ladies, schedule your routine screenings and appointments to include:

mammogram/ MRI for breast cancer
PAP smear & HPV test for cervical cancer
stool check for blood (fecal occult blood test, FOBT) for colorectal cancer
cardiology doctor for cardiovascular prevention(get EKG, ECHO, and thallium stress test if indicated)
bone density scan to check for osteoporsis
counseling for smoking cessation, alcohol/drug dependence, and domestic violence
evaluation for depression and other mental disorders if necessary
complete physical exam, and routine blood tests.

Get in 5 to 10 minutes of exercise a day at least and eat healthy! Laugh a lot and love a lot!

by J. L. Richardson, MD, family practice doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/

www.twitter.com/MD4U

www.blogtalkradio.com/drjfpmd

Health Insurance Update

2010-05-10T00:32:00.004-05:00

Health insurance companies are overcharging again! Treatment for medical illness that helps patients is consistently ignored and unapproved. Paying an additional $360 per month to get what you need in addition to your $1000 monthly premium is obtusely extreme. Many drugs used have potential for serious life threatening complications, yet health care providers continue to be pill pushers ignoring reports of better results with alternative treatments. The cost of the medicine may be one-fourth the price in dollars and more deadly, but it is the approved standard of care.

Earnings for the health insurers poured in recently revealing huge profits, earnings, and executive compensation packages. A good chunk of patients' health insurance premiums surely helped this cause as well as that of the lobbyists and uninsured. Health care reform measures that may help patients insurance costs will not kick in for who knows how long - anywhere from one year to four years or more. The patient will be unable to dodge the bullet shooting another increase because it was a fact before health care reform was more than radar blip on the national agenda.

How much longer will patients be ignored and treated so casually by the very people who are supposed to be helping them, healing them, taking them from cradle to grave in a dignified manner?

How much longer will patients be forced to suffer in silence and pain from their diseases while drug companies and health insurance entities continue to prosper in such an adverse environment?

How much longer will patients have to choose between a meal or a pill?

by J.L. Richardson, M.D

Author of Patient Handbook to Medical Care: Your Personal Health Guide
www.mypatienthandbook.com/

Read excerpts on google Books www.bit.ly/aTBrEN

Disability Insurance & You

2010-04-11T02:01:00.004-05:00

Have you thought about what you would do financially if you were were unable to work? If you were disabled short term or long term, where would the money come from? Disability insurance is one of the best lifetime investments you can make. Hopefully you will not have to use it, but you may need it.

It is important because anyone can have a devastating health challenge that could wipe them out physically and financially. Medical costs are one of the top reasons people end up in the poor house. Disability insurance payments allow you to have money for health needs as well as for everyday necessities. This is a very sensible thing to do.

Disability insurance is seldom talked about when it comes to insurance you need. Your house is insured. So is your car. So you should be insured, too. Life insurance is good, but pays off after you die.

Disability coverage is available as "own occupation" coverage. This type covers you for being unable to work at the occupation for which you have been explicitly educated, trained, and employed like doctor, lawyer, broadcast media, president, etc.
It is usually more expensive than basic generic coverage like Social Security, and pays more. The going rate is two-thirds of your salary.

If you pay for your own policy instead of allowing your employer to do so, your money is tax free. If you withdraw IRA monies early and provide proof of disability you are exempt from the penalty.

Protect yourself financially from medical disability and potential financial free fall. Disability insurance like health insurance protects your most important asset - YOU.

by J.L. Richardson, MD, family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

Home Health Clinic

2010-03-22T23:31:00.004-05:00

Monitoring your health at home is easier than you think. You must stay involved and up to date with medical history and needs for every family member.

1) Be sure you have a copy of your medical records from all of your doctors. Check them for accuracy. If legibility is a problem ask your doctor to decipher for you. You should be able to read yor medical record like a book.

2) Become familiar with all of the medical conditions listed. Research the details to be sure you are being checked regularly. Bring any discrepancies to your doctors' and healthcare providers' attention.

3) Keep the medical files and research in a file cabinet for easy reference. Storage with other important documents is optimal.

4) Equip your bathroom or other designated area of your home with medical equipment and supplies. This should include a blood pressure monitor, thermomemter, glucometer, glucometer strips, alcohol, stethoscope, and nebulizer. These items can be used by almost anyone with proper instruction. Keeping these items together with medication and other medical supplies ensures easy central access as well as portability in case of emergency.

5) Important phone numbers should be posted in several places in your home. Be sure to include direct numbers to all healthcare providers and local hospitals.

Take care of your most important asset - YOU! Invest in your health for your home.

by J.L. Richardson,MD, family medicine doctor, patient advocate and author of "Patient Handbook to Medical Care: Your Personal Guide".

Further health tips http://www.twitter.com/MD4U

Health Insurance Costs

2010-02-25T22:09:00.004-05:00

Written a year ago, this blog post is still relevant. For more posts on healthcare reform, click on in index to the right.

Health care costs are up at least 5% from last year. Health insurance is up from 6% to 40% or more! This means that health insurance company profits are up. Check the earnings. Their profit is up even with decreased net income and higher medical costs. Almost 100 million people are paying off medical debt while insurers rake in piles of profit.

Hopefully President Obama will allow exemptions from medical debt, and allow capped prices on insurance premiums without regard to pre-existing conditions. Health insurance companies should discontinue lifetime limits on health coverage. At an $100,000 lifetime coverage limit, one or two major surgeries or a chronic disease with complications your coverage could evaporate in a year or two or less.

More consumer protection is needed. Protection with lifelong health membership would be optimal. The national health plan, National Health Insurance Exchange, will likely make this a reality giving all the privilege of being insured as securely as our President and Congress.
With a premium of $1000 month, your payment for one year is $12,000. This should be enough to guarantee lifetime coverage. After all, your insurance premiums are giving insurance companies lifetime profits.

by J. lL. Richardson, MD, family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U

Medical TV: Where is the Health News Channel?

2010-02-24T18:38:00.007-05:00

This was written three years ago, but is still relevant.

Medical information on TV is limited and stagnating. Sixty seconds on the news. Two minutes on the talk show after commercials on prescription medication. Outdated show on this channel, and outdated repeat on that channel in between the new show. Watch some on this channel then click and click to different channels to connect your medical news for today.

Remember the crawler at the bottom of the screen. Oh, you missed that there was a bird flu outbreak in Pakistan today, and that HPV vaccines will be required for teen women and men. These are the ways we learn about some of the most important news we should know. It concerns our health and public safety.

If only we had a dedicated medical TV CNN (instead of just Dr. Sanjay Gupta’s excellent show on early weekend mornings, or his occasional special). You know, like the sports channels by sport, the cartoon channels by age (and now one for the boomers!), the movie channels, government channels, and on and on. Where is the “MTV” of medical channels? Discovery Health has been carrying the TV health media for years. There should be more!

The TV box is probably the most used medium by which folks get their news and information. It is certainly a way to get information to people. The most used information source is one of the least used by the cutting edge medical field. This was noted in my research paper, “Building an American Health System”, in 2002. This is 2007, and it’s pretty much the same, maybe even less.

A medical TV channel (actually several would be optimal) would be great! A daily health news show would be a great start towards 24-7 medical TV. Envision yourself clicking to the heart channel, or to programs with content about specific diseases. You could learn more about that high blood pressure you are trying to control, and how you can monitor it at home. Topics on maintaining good health, and prevention of disease would be a click away. And if you missed a show, it would be shown again and again.

Health and medical coverage on TV is surely lacking in this consumer driven health conscious society. We can watch as much sports, cartoons, movies, news as we want, but we still have to piece together our medical news and supplement it with the written word, or health care providers’ spoken word. And radio.

Great health is true wealth. Medical TV would make us even richer.

by J.L. Richardson, MD, family medicine physician, patient advocate and caregiver, and author of Patient Handbook to Medical Care: Your Personal Health Guide,

http://www.mypatienthandbook.com/

www.twitter.com/MD4U

Doctor Search On Internet

2010-02-23T01:47:00.003-05:00

Have you looked your doctors up on the Internet? When you do, you may find incomplete inconsistencies. Many web sites had no listing for several doctors I was looking up. So I looked at some others.

I went to the state medical board pages. I found that some doctors listed on the other web pages were not listed on the state board pages. Another doctor is listed with an active and an inactive license (several are listed like this). This doctor’s medical education and training have been done overseas. Some doctors have no residency training listed. This doctor has been in practice for 45 years, and is licensed in two countries and two other states. The doctor’s address is listed as a PO Box.

The type of information listed was different amongst the states. For instance, one state listed one line of information – license number, status of license, present location, disciplinary action (yes or no, not what), date of issue and expiration. Another state gives this plus the doctor’s education and training information, details of disciplinary legal action, other states/ countries where licensed, and board certification status. There were inactive licenses that were listed as active in another state’s information.

These incomplete inconsistencies are rather consistent. Do you know about your doctor’s background? Is your doctor properly trained and licensed? Which information is correct?

The American Medical Association (AMA) has a page with links to the state boards for licensing. Check your doctor at http://www.ama-assn.org/ama/pub/category/2645.html. Compare it to the information at “doctor finder” sites. Incomplete inconsistency.

J.L. Richardson, MD is a family medicine doctor and author of "Patient Handbook to Medical Care: Your Personal Health Guide".

http://www.mypatienthandbook.com/
www.twitter.com/MD4U

Heart Screening Checklist

2010-02-22T02:41:00.004-05:00

Check your heart list:
___Heart and vascular exam by health care provider
___Blood pressure, pulse, weight, height
___EKG

For further evaluation, especially if symptoms are present, and/ or if there is a strong family history of heart and vascular disease see a cardiologist.

Tests may include:
___Doppler echocardiogram (checks heart valves, size, etc.)
___Stress test - nuclear, doppler or exercise (heart function)
___Heart MRI scan (artery disease)
___Interventional studies like cardiac catherization, angiogram (checks artery blockage, valve function)

Heart health habits:

Maintain a healthy weight.
Eat healthy small portions.
Exercise regularly - every little bit counts! Just do it regularly.
Keep blood pressure under control.
Keep stress level low.
Get adequate sleep.
Take an aspirin a day if in a high risk group. Check with your health care provider.
Love, laugh, and let go!

Have a happy, healthy heart!

J.L. Richardson, MD, family medicine, is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com

www.twitter.com/MD4U

www.twitter.com/drjfpmd

Doctor Visit Tips

2010-01-06T15:17:00.004-05:00

Going to the doctor can be quite a challenge. These tips will help you make the most of your doctor visit.

One of the first things you want to do is make a written or typed medical history* to take with you, especially if this is your first visit to a new doctor. Make a copy for you and your doctor. You both will be able to refer to it as needed. This will save valuable time, and give you and your doctor more time to talk instead of flipping through your medical record. It can be difficult trying to "remember" what test or procedure you had 10 years ago.

Start keeping a list of things you want to talk to your doctor about. Update the list before each visit. This way you will be able to keep track of what has been discussed, and what needs to be discussed. Try to talk about the most important things first especially those that need immediate attention. Each time you go for your visit, you can refer to your list and take up where you left off. Be sure to express your immediate concerns first. We all know how short a doctor visit can be.

Request copies of your medical records from all your doctors. "The medical record is the cornerstone of keeping track of everything pertaining to your health." You will be able to check the accuracy of your records, and bring any errors or absent information to your doctor's attention. Let your doctor know about anything you do not understand, or if there is something you are unable to read due to legibility. It is surprising to see how many doctors are often unable to read their own handwriting.

Stay on top of your health care with these tips. After all, great health is true wealth!

Click on "Comments" below to add your tips and questions.

by J. L. Richardson, MD, family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide, the perfect tool for helping you make your medical visits the best.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

More tools to help you with your doctor visits:

http://www.mypatienthandbook.com/ - *medical history form on website.

Medical record release form - http://office.microsoft.com/en-us/templates/TC010234611033.aspx?CategoryID=CT101433201033

Medical tests A to Z - http://www.medicinenet.com/procedures_and_tests/article.htm

Specialists A to Z - http://www.healthadvantage.org/body.cfm?id=85

Flu Prevention

2009-12-10T21:32:00.006-05:00

Flu season is in full swing. Remember the basics: wash hands, cover mouth when cough, and stay home if you have the flu. Consider the vaccine if you are at high risk - pregnancy, children, over 65, multiple chronic illnesses, healthcare workers.

Preventing the Flu http://short.to/q651

H1N1 map of cases around the world http://is.gd/1Kxtj

J. L. Richardson, MD family medicine doctor, and author Patient Handbook to Medical Care: Your Personal Health Guide .

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

Patient Handbook to Medical Care: Your Personal Health Guide is available at:
Amazon http://short.to/wi5l
Barnes & Noble http://short.to/wi5m
Borders http://cli.gs/5VX9n (excerpts here, courtesy of Google books)

Some Doctors Miss the Mark

2009-12-02T16:32:00.004-05:00

For the past few years I have seen pain management specialists for chronic pain. Seeking relief after many, many years has indeed been a challenge. Each time I was referred to a pain management specialist for the neck and back pain (from arthritis and herniated discs), treatments offered were medicine (especially samples of new stuff), and invasive procedures like epidural spinals and trigger point injections. Alternative treatment was rarely offered, and if so was limited to 20-30 minutes physical therapy sessions for about six weeks every few years, upon my request.

Fortunately, my neurosurgeons saw the light. In efforts to achieve pain control and maintain function without surgery, other treatments such as massage and acupuncture were recommended. Sadly enough, these choices are not covered by my insurance. I am still waiting for over a year now for approval and payment for long term treatment (which works) instead of six weeks.

Even though some doctors miss the mark, there are others who are on the mark. As a savvy patient you must always recognize this. You have choices even if you must pay for medical services you need out of your pocket. It is a tough choice, but the best for your health. If there is something you need that is not covered by your insurance, you have choices. Make the one best for you, especially if your doctor misses the mark.

by J. L. Richardson, MD, family medicine doctor, patient advocate and author of Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com
www.twitter.com/MD4U

Read excerpts at Google Books http://books.google.com/books?id=kPmXiNrg1pYC&printsec=frontcover&dq=patient+handbook+to+medical+care

Routine Checkups Work, Ask Kareem

2009-11-10T19:27:00.007-05:00

After disclosing his diagnosis with myeloid cancer, Kareem Abdul Jabbar, told journalists how routine checkups (for him every two years) help find his cancer early. His confidence in telling his medical story was utterly genuine. What a smart patient! He revealed that his symptoms were clues that something was awry with his health. His complete blood count (CBC) helped his doctor find the cancer. He further expressed his savvy by discussing his family history and that cancer was present. This is valuable knowledge for every patient.

Prevention and early detection in addition to education are key for great health. You must help your health care team with your health plan. Information like family history, your present medical and past medical history are the basic building blocks for your individual health maintenance plan. Take the time to put this down on paper and share with your present doctor and each new doctor you see. As you go along research your findings from medical records you have, and be sure they are accurate, correct and yours.

Routine checkups work. Ask Kareem.

by J.L. Richardson, MD, family medicine doctor and patient advocate, author of Patient Handbook to Medical Care: Your Personal Health Guide, recipient of Writer's Digest International Self Publishers award in reference books.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd - readings by author
http://short.to/vb5e - excerpts & bookstores on Google Books

Marijuana for Pain: Up Close & Personal

2009-11-01T21:41:00.006-05:00

Such a timely question, medical cannabis. I live in a state that has all but decriminalized possession of small amounts of marijuana for personal use. Police may write tickets and confiscate, but even that minimal enforcement is rarely performed.

While I empathize with my cohorts with a variety of pain issues, I can only speak from my own experiences, so here's my first person perspective.

I was in the music business in Nashville when it became known as the "Third Coast" in the early-mid 1980s. Drugs were everywhere. The same people who smoked dope were into exotic highs like mushrooms, and then cocaine swept over us like a wave. Not wanting to raise my daughters in that environment, I left - the business, and the state.

Having been in the environment, I am one who unfailingly believes that marijuana is indeed often a "gateway drug" to more hard core substances - but for a different reason. The people I saw moving on to harder substances were a personality type - those who pushed the envelope. Perhaps for some it is the thrill of living dangerously, i.e. breaking a law, rather than the effect of the drug. I honestly
don't think I ever met anyone who suffered withdrawal symptoms from either being without a supply of pot, or from discontinuing it cold turkey.

Alcohol and tobacco are legal, controlled and taxed. There is an expectation that the ingredients (including the toxic ones) are of a consistent strength and character. Not so with illegal cannabis, which may be laced with angel dust or rat poison for that matter. No two highs are the same, or so I'm told.

The fact that there is no guarantee of safety or consistency, nor a legal way for me to try cannabis medicinally (and that I obey the speed limit when no one is watching) prevents me from experimenting. But some nights the painful systemic neuropathy drives me to the very brink of sanity.

With liver function tests consistently out of normal range, I'm in a terrible place for pain control: I have none. Neuroleptic drugs like gabapentin are notoriously hepatotoxic. Hydrocodone/apap or stronger narcotic/acetaminophen combinations are not only not effective for neuropathic pain, the acetaminophen is contraindicated in the presence of suspected or confirmed liver disease. So is alcohol.

I'm not aware of any research indicating cannabis in liver disease.

Medical cannabis can be delivered through smokeless methods, important to folks with respiratory disease. I've read that atomized cannabis is particularly effective and I'd love to try it, prescribed and monitored by my physician. Surely it would be safer pain control than the corticosteroid that only helps a little.

I've been a good Doo-Bee. I passed up the pipe, the rolled dollar bill, the magic mushrooms, and the Jack Daniels bottle under significant peer pressure. I'm so careful with my prescribed pain medications that I'm considered "narcotic naive". I've had surgical pain interventions, but there is no rhizotomy for systemic neuropathy.

Would it be too much to ask my government to permit me compassionate use of a natural substance to alleviate the pain that prevents me from being the person I can be?

Rachel Rosenfeld
http://www.twitter.com/NanaRCR

Thanks to guest blogger Rachel Rosenfeld for this great post on medical marijauna as it relates to her personal health issues. Medical research by doctors has shown it to be effective for safe treatment of pain and many other medical conditions that have been failed by traditional medication (including Marinol pills). Legalizing marijuana will have a great positive impact on patient comfort and quality of life.

Side Effects of Flu Vaccines

2009-10-06T00:35:00.007-05:00

The flu vaccine may mimic symptoms of the flu. Check with your health care provider for any side effects from vaccination. Some side effects encountered are:

Allergy reaction with rash, shortness of breath/asthma, swelling

Fever, chills. malaise

Sore arm with redness, swelling, bruising at injection site

Muscle aches and headache

Nausea, vomiting

Guillain-Barré syndrome (GBS) muscle weakness and sometimes paralysis

There have been no reports of the more serious side effects in the small studies conducted. Which poses the greatest risk - the flu or the vaccine? It is up to you and your health care provider. Be informed so you can make the best decision for you.

Best health!

by J. L. Richardson, MD family physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide, the book that tells you how to be your best advocate from medical records to medical exams to medical tests and more.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U

Doctor-Patient Communication Suboptimal, Part 2

2009-09-25T13:21:00.005-05:00

When you go to see the doctor you expect compassion, kindness and time! Doctors are walking out the door while you speak. There is little time for much more. Unprofessional hurried behavior is the norm amongst many physicians, while their health care extenders - nurses, physician assistants, nurse assistants - are reported as having much more bedside manner that shows true compassion. Is it really okay to be an unprofessional professional?

Is is okay for your doctor to come in and say, "How you doing dawg?" ? Meanwhile you look around to see if you are in the veterinarian's office by mistake...without your dog. All of a sudden this middle-aged man has finally joined the hip hop now generation. A "How u doin'?" a la Wendy Williams would have been really nice.

Is eight minutes really long enough for a doctor visit? This includes only the conversation without an exam. After repeatedly interrupting you and being interrupted this decreases to three to four minutes. The doctor has just enough time to meet the objective of writing that medical note about you that you may never get to see yet it determines your destiny.

Is it okay for your doctor to admit that she is a "bad doctor" because she admits that she is not keeping a list of all the medicine samples she has given you over the years? There is no documentation in your medical records of all the current medication you are taking. "Bad doctor" by self admission raises a red flag for sure. It seems "bad medicine" is more like it.

As has been said many times, many ways...YOU are your best advocate. It is up to you to be sure that you know all the medicines you are taking and to know your complete medical history. It is up to you to be informed and educated about all of this. Waiting for your doctor may be very hazardous to your health.

by J. L. Richardson, MD family physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide, the book that tells you how to be your best advocate from medical records to medical exams to medical tests and more.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

H1N1 Update

2009-09-15T03:01:00.004-05:00

The US Center for Disease Control (CDC) has reported 593 deaths to date (compare to 170 at the end of June increasing from 17 at the end of May). All 50 states have been affected. Mass vaccination is planned starting some time in October. Over 2,800 have participated in vacccine clinical trials http://is.gd/3cVSf . Though reported to give immunity in over 90%, many are already reluctant to get the vaccine.

Thank God, H1N1 is not chicken little and the sky is not falling. Best health!

More references:

Preventing the Flu http://short.to/q651 wash hands, cover mouth when cough, consider vaccine
H1N1 map of cases around the world http://is.gd/1Kxtj

by J. L. Richardson, MD family medicine doctor, and author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

Know Your Medication Names - Brand & Generic

2009-09-07T00:36:00.004-05:00

Please welcome, guest blogger, Ellen Richter for this post. Know your medication!

If you take a brand-name drug, you should learn all the other names for the drug. I cared for a patient last month who had been taking Plavix for a mini-stroke since 2001. He knew that he should never stop taking the drug, so when he was hospitalized, he asked his nurse what medications his doctor ordered. She told him baby aspirin and clopidogrel. He never heard of clopidogrel so he called his wife & had her bring in his Plavix. He thought the hospital wasn't giving it to him! Every day, he silently took his own Plavix without telling the staff and then was given the daily dose, in generic form, by the nurses! If only he knew the different names for his drugs! He assumed the generic clopidogrel was a new pill the doctor had started him on!

Ellen Richter, RN, CLNC is a legal nurse consultant and founder of South Florida Legal Nurse Consultant Service, specializing in medical record review.
http://www.findlegalnurse.com/index.html

5 Medical Money Savers

2009-08-27T17:38:00.005-05:00

Here are five medical money savers to help you spend your health dollars wisely.

Keep weight stable. It is the healthy thing to do. This will save on grocery and clothing expenses. Long term savings on medical expenses.
Get prescription meds in bulk quantity of 100 versus thirty day supply especially if you are paying for your meds.Buy nonprescription medical items in bulk when on sale. You will be amazed at your savings when you buy a six to twelve month supply on sale. This tip is also effective for emergency preparedness.
Check with your state provisions for health care. Many states have low cost insurance plans available. Check what your state has to offer by contacting the state health agency.
Talk with your doctor by phone, fax, and email to save on the cost of an office visit payment. Just think about the number of office visits you have been to where all you did was talk (after waiting for a long while). Save your time and money.
For blood pressure checks, get yourself a home blood pressure monitor. Call in your readings. Many doctors will discover that your blood pressure is actually stable when the stress of the doctor's white coat is absent. For diabetics, a home glucometer is very useful for monitoring blood sugar.

Invest in your most important asset - YOU.
Great health is true wealth!

J.L.Richardson, MD, family medicine expert, is the author of the award winning, Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

Doctor-Patient Communication Suboptimal

2009-08-20T02:48:00.008-05:00

This email reply is in regards to my poll question on preferred way patients wish to be contacted by their doctors for their test results (http://twtpoll.com/mn9yin), if they are contacted at all.

Of course, "if you don't hear anything that means all is okay" is definitely not the answer. Many patients have been wrongly diagnosed, diagnosed too late, or died with this mantra. Lack of followup by patients and doctors is one of the top reasons for adverse outcomes and wrong diagnosis that lead to malpractice suits, delay in diagnosis, etc.

Make it your decision to contact your doctor if you don't hear about your test results in a timely manner. How you wish to contact your doctor is up to you. Make sure you followup if your doctor fails to do so.

Much thanks to Rachel Rosenfeld for allowing me to share this insightful information.

Dear Dr. Richardson,

Thanks for the DM regarding how to contact patients about test results.

In various roles as patient, family member, friend, caretaker and advocate, and in being in late 50s and having seen medicine (when did it become healthcare) change over a half century, here's my take:

40 years ago, medicine was less rushed, docs had time to pore over test results and a call from the nurse "everything came back ok" was the norm . Why did patients need specifics, they knew their doctor-god would watch over them.

Fast forward to the present with informed, educated patients as consumers, overworked physicians providing assembly-line medicine and yes, occasionally forgetting Mrs. Cardwell's first name. We know our numbers these days, or we know about our chronic conditions, we know when our hypothyroidism is not quite under control for example and "normal" won't cut it when that number is outside our personal normal limits. My cholesterol is "a little high but ok" - but what's the
change since last year? My lymphocytes are high but total count is normal - and you didn't bother to call me and I have sarcoidosis and almost died from that untreated infection that lingered for six months....

We patients watch our numbers, or our conditions ... in my case, let's watch my CA and my BUN and creatinine and the white blood cells, I'm not too worried about anything else. For my brother, it would be trends in glucose and cholesterol ...

And we know where to find the results from last month, last year, we know how we feel compared to those lab results and we know how to adjust behaviors for something trending negatively (e.g. cholesterol), or how to get hold of our specialist for something outside normal limits (e.g., elevated CA or lymphocytes as in my sarcoidosis).

But we have to be told, whether it's by direct access (hospitals in Northwest FL have been doing this for years), email, fax or phone.

"Everything's normal" is no longer the accepted norm.

Shalom
Rachel Rosenfeld

Healthcare Reform Changes Due Date?

2009-08-14T15:44:00.006-05:00

When will the health care changes occur? Why have we ceased hearing about everyone having access to the same health plan as the President and Congress as promised during their campaigns?

My insurance premium has risen over $100 per year in the past 5 years and is now almost $900 per month! I have COBRA. The President says those with COBRA will get lower premiums. Will this be retroactive as well?

Should I consider dropping my insurance vs. seeking a new insurance? Unavoidable pre-existing conditions pose a problem no matter what. The President says this will cease.

By the time a health care bill is approved, I fear my insurance premium will have skyrocketed beyond my ability to pay. Mind you this does not include any other medical costs like prescriptions, treatments prescribed by my doctor that the insurance company does not cover, co payments, over the counter medication/ supplies, etc.

P.S. As a doctor, please let me dispel the myth that we (and nurses) are "paid too much". Today doctors finishing medical school entering residency are in debt at least $50,000 to $100,000 or more. Residency training barely pays enough to cover monthly living expenses.

by J.L. Richardson, MD, family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide, the book that helps you take care of your most important asset - YOU!

www.mypatienthandbook.com
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

Medical TV: Where is the Health News Channel?

2009-08-07T23:10:00.005-05:00

Medical information on TV is limited and stagnating. Sixty seconds on the news. Two minutes on the talk show after commercials on prescription medication. Outdated show on this channel, and outdated repeat on that channel in between the new show. Watch some on this channel then click and click to different channels to connect your medical news for today.

Remember the crawler at the bottom of the screen. Oh, you missed that there was a bird flu outbreak in Pakistan today, and that HPV vaccines will be required for teen women and men. These are the ways we learn about some of the most important news we should know. It concerns our health and public safety.

If only we had a dedicated medical TV CNN (instead of just Dr. Sanjay Gupta’s excellent show on early weekend mornings, or his occasional special). You know, like the sports channels by sport, the cartoon channels by age (and now one for the boomers!), the movie channels, government channels, and on and on. Where is the “MTV” of medical channels? Discovery Health has been carrying the TV health media for years. There should be more!

The TV box is probably the most used medium by which folks get their news and information. It is certainly a way to get information to people. The most used information source is one of the least used by the cutting edge medical field. This was noted in my research paper, “Building an American Health System”, in 2002. This is 2007, and it’s pretty much the same, maybe even less.

A medical TV channel (actually several would be optimal) would be great! A daily health news show would be a great start towards 24-7 medical TV. Envision yourself clicking to the heart channel, or to programs with content about specific diseases. You could learn more about that high blood pressure you are trying to control, and how you can monitor it at home. Topics on maintaining good health, and prevention of disease would be a click away. And if you missed a show, it would be shown again and again.

Health and medical coverage on TV is surely lacking in this consumer driven health conscious society. We can watch as much sports, cartoons, movies, news as we want, but we still have to piece together our medical news and supplement it with the written word, or health care providers’ spoken word. And radio.

Great health is true wealth. Medical TV would make us even richer.

by J.L. Richardson, MD, family medicine physician, patient advocate and caregiver, and author of Patient Handbook to Medical Care: Your Personal Health Guide.
www.mypatienthandbook.com
www.blogtalkradio.com/drjfpmd (book reading by author)
www.twitter.com/drjfpmd

Save Your Life

2009-08-05T13:33:00.004-05:00

"Save your life!" is the title for this blog on Patient Handbook to Medical Care: Your Personal Health Guide. It was written by Sue Leonard of Cornerstone Fulfillment Service on her blog All Things Fulfilling.

It is so nice to know that this book is helping to save lives. Health maintenance, wellness, prevention, and early detection/treatment are the keys to unlocking your best health.

http://allthingsfulfilling.wordpress.com/2009/08/03/save-your-life/

Thank you Sue for this powerful message that is one of all things fulfilling!

Potential Pandemic Pandemonium: Swine Flu Who's Who

2009-07-28T23:48:00.007-05:00

I wrote this comment to post on a blog post entitled,"Get Ready for Pandemic" in May. At this time there was evidence that people will be left out of treatment. Now with the new swine flu vaccine, the designated list of who gets it first has been made known. That alone may be enough to fuel pandemic pandemonium as new cases and deaths erupt daily. (** Thanks to the AC 360 blog for moderating on my comment. Posting it on this blog may reach more people.)

Dr. Flynn & Dr. Redlener, this is a great assessment and all so true. After seeing the actual response, and reading the “unfinished” (states Stage 3 is in progress) 336 page HHS Pandemic Flu Guide, The Pandemic Toolkit from Roche (makers of Tamiflu), pandemicflu.gov, and much more, we have so much more to do.

It would be nice to know that the national stockpile has more than the 50 million doses* for a 300 million plus population, many who are not able to afford it.
Add to the pandemic flu all the other natural disasters occurring daily, and it is easy to see that the health system and all systems will have a tough challenge to keep all safe. As you say, individuals must take responsibility and communication must be ongoing.

Thanks for this great article.

My footnotes added here:*Doctrine of HHS Pandemic Influenza Plan circa 2005, page 6,"
4. Quantities of antiviral drugs sufficient to treat 25% of the US population should be stockpiled." (how did they get this number?) and "8. At the onset of the pandemic, antiviral drugs from public stockpiles will be distributed to health care providers for administration to pre-determined priority groups." (who exactly is this?)

Are we ready for a pandemic? Or pandemic pandemonium?

by J.L. Richardson, MD family medicine doctor, and author of Patient Handbook to Medical Care: Your Personal Health Guide, http://mypatienthandbook.com/ .

More emergency information at Emergency Exchange, http://emergencyexchange.blogspot.com/ .

**http://ac360.blogs.cnn.com/2009/05/05/still-unprepared-for-a-lethal-pandemic/

Tips for Your Doctor Visit

2009-07-26T01:25:00.004-05:00

Going to the doctor can be quite a challenge. "Patient Handbook to Medical Care: Your Personal Health Guide" is the perfect tool for patients to make their visits worthwhile.

One of the first things you want to do is make a written or typed medical history to take with you, especially if this is your first visit to a new doctor. Make a copy for you and your doctor. You both will be able to refer to it as needed. This will save valuable time, and give you and your doctor more time to talk instead of flipping through your medical record. It can be difficult trying to "remember" what test or procedure you had 10 years ago.

Start keeping a list of things you want to talk to your doctor about. Update the list before each visit. This way you will be able to keep track of what has been discussed, and what needs to be discussed. Try to talk about the most important things first especially those that need immediate attention. Each time you go for your visit, you can refer to your list and take up where you left off. Be sure to express your immediate concerns first. We all know how short a doctor visit can be.

Request copies of your medical records from all your doctors. "The medical record is the cornerstone of keeping track of everything pertaining to your health." You will be able to check the accuracy of your records, and bring any errors or absent information to your doctor's attention. Let your doctor know about anything you do not understand, or if there is something you are unable to read due to legibility. It is surprising to see how many doctors are often unable to read their own handwriting.

Stay on top of your health care with these tips. After all, great health is true wealth!

P.S. What tips do you have for doctor visits? Share your tips for doctor visits. Click on "comments".

http://www.mypatienthandbook.com/

Disability & Illness

2009-07-23T14:47:00.003-05:00

Blog talk radio show tonight July 23 - 7PM - topic #Disability & #Illness

Patient Handbook to Medical Care - show by Drjfpmd & MD4U on #BlogTalkRadio - www.blogtalkradio.com/drjfpmd

Patient Handbook in Your Library

2009-07-22T00:15:00.004-05:00

Dear Librarians,

A FREE copy of Patient Handbook to Medical Care: Your Personal Health Guide will be donated to your library upon request until Labor Day.

Bend of the River Books is proud to announce that Patient Handbook to Medical Care is now in 60 libraries throughout the United States. Our goal is to ensure that everyone has free public access to read and learn the importance of health maintenance, prevention, and wellness. This expert's guide to personal health care is the ideal book "to inform and educate patients about medical care".

Thank you for all your support. It is so appreciated.

Best,
Dr. Richardson

http://www.mypatienthandbook.com/
info@mypatienthandbook.com

read excerpts from Google Books http://short.to/kbv1

High Blood Pressure - Home Checks

2009-07-16T01:05:00.006-05:00

High blood pressure, also called hypertension affects 1 in 4 adults. Do you know your numbers? do you what a normal reading is? A good normal reading is 120/80 with borderline at 130/85 to 140/90.

For more accurate measures of your blood pressure and what affects it consider home blood pressure monitoring. Buy a blood pressure monitor for home use. Wrist and arm monitors are available at Target, Walgreen's, CVS, Wal-Mart, and local medical supply stores. Shop on line by doing a search for "blood pressure monitor".

Record your blood pressure readings daily starting with morning, midday, and night. Make a note of your activity and how you are feeling. You may notice that extreme anxiety makes it go up. The correlation to your pressure will help you manage the things that make it go up. Share your results with your doctor so medication and lifestyle changes can be made if necessary.

You may find that while your blood pressure is high in the doctor's office, it may be normal in everyday activity. Remember, the doctor's result is a one time reading every one to four or more months. With normal home results, and high results at your doctor visits you may have "white coat" hypertension. There is much controversy over whether this should be treated. Check with your cardiologist.

If your blood pressure is borderline at 130/85, you want o start a low salt diet. The best is the DASH diet (http://bit.ly/hnbsL). Exercise, weight control, and stress reduction are other things to include in your treatment plan. For higher blood pressure readings over 140/90, medication may be necessary. Take your home blood pressure results in to your doctor. This will help in deciding on the best treatment for you.

Check out the American Heart Association http://hearthub.org/ for more information.

by J.L. Richardson, MD, author of the Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U

Medication Mimics Disease

2009-07-15T10:07:00.005-05:00

Medication mimics disease. Medication mimics disease. Medication mimics disease. This is one of the first medical pearls I learned in medical school. Tried an true. Time and again I have found it to be truer than I would like to believe.

I first wrote about this last year as my father was recovering from heart bypass surgery. Click the following link to read the blog on this after you finish reading this one, http://bit.ly/Dsr8H. I have experienced this myself and this time I know it is the medication that caused my recent asthma attacks.

When you are on more than one medication, it is hard to tell if it is the medication or another illness. In an effort to treat one problem, you develop another that makes you feel worse than what you have been treated for.

I was so pleased to see my blood pressure responding to about the fifth medicine my doctors had tried without success. Finally, the "magic" medication was working! After a few daily doses of this 24 hour, long acting, slow release pill, I started getting short of breath and wheezing. The asthma flareup was not responding to regular use of inhalers.

I could see no other cause for my asthma, so I decided to stop the blood pressure med. After two days the asthma attacks became less frequent, but remained. I went back to my medicine cabinet, and figured it must be another new med. I decided to read the drug information for side effects. Quite naturally, I trusted my doctors would know this was a side effect, and not give it to me since I have asthma (or not?). I read up on the side effects of yet another muscle relaxant "sample" my doctor had issued me. All my doctors missed this, and instead chose to give more med for the asthma.

I took matters into my own hands again, and stopped the other medication. After two days these 24 hour, long acting, "magic" meds were out of my system the asthma was gone, and I started feeling a lot better!

Medication mimics disease. Yes, it does. This was only one lesson learned. As I blogged before (http://bit.ly/r1snG), you should be reading the same information as your doctor on your medication and side effects. Well, if your doctor is not reading it, what are you going to do? Read it yourself, or get someone to read it to you!

You would like to think your doctor knows, but they don't especially if they are giving out new medication samples routinely. Second lesson, doctors are so eager to try new meds and to satisfy the drug reps that give them. This means they may get a financial incentive or some other "prize", and they will get more free samples.

Third lesson, we as patients are so eager to see results and feel better that we do as prescribed. We would like to know our doctor would "do no harm". Doctors hardly have or take the time to read about new medication. They just give it out, and if they pray, pray for the best.

Finally, once daily long acting medication sounds convenient. it is, but once you take it it lingers in your body longer. The side effects are continuous. When you have more than one medication, and more than one long acting, you can get a new disease or severe exacerbation of another.

Look out for yourself. Read up on your medicines before you take them. Check with your pharmacist who may be of some help (my pharmacist was unaware like my docs). Talk with others who may take the same. I would say call the drug company, but am hesitant to say if they would own up to whatever side effects you may be having.

Medication mimics disease. When in doubt, start with medication adjustment. Discuss it with your doctor, if you are able to get them before you succumb to another disease caused by medication.

Best, safe health to all!

By J.L. Richardson, MD, family medicine doctor, patient, patient advocate, and author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com/
www.blogtalkradio.com/drjfpmd
www.twitter.com/MD4U

You Are A Preferred Patient If You Are....?

2009-07-12T20:36:00.009-05:00

There is little room for "theirs" and "ours" medicine, and there is very little of it. The myth that doctors, nurses, and health care workers get better or preferential treatment is absolutely preposterous. It' s more like rich patient, poor patient and healthy patient, sick patient. There is more health discrimination than ever amongst people based on sex, money, ethnic, and religious background. This is what we should be concerned about and be doing more to prevent any type of discrimination!

Think as you like; however, many documented experiences of health disparity occur amongst health care professionals by their own health care providers. How pathetic is that? If you are female, you will be more likely to get some "attempted" lack of health care by a doctor who may feel as every woman's symptom is "in her mind", and if you're over 65 the feeling is "who cares". Disabled patients especially those with communication challenges like hearing impairment, are underserved too often. If you are too sick, or they don't know what to do for you, you will be kicked to the curb. Oh, yes! When that happens, you must continue to seek and find the best for you and those you advocate.

Before your health care provider's options "run out", you better run...to you! It is in your best interest to know what illnesses affect you, and to know all about them. With the credible information on the Internet, from books, media, and from real people, you are able to know as much or more than your doctor about what ails you and what works best. The health care providers are there to coach, but it is your game.

Many patients come to me with more information than I already knew on conditions they have. It is good to see they want me to know and learn, too. In return, I read and research what they bring, and talk about what matters to them, what is best for them It would be really nice if more of my personal doctors did that. Doctors that failed to do so have been replaced (or should I say "kicked to the curb") with those that do best by me as a patient. There are good doctors, and there are bad doctors for everyone. It's your choice to take it...or leave it and move on. Someone will give you non discriminatory, preferential treatment as a patient, not by what you do or by by some other limiting parameter like age, sex, etc.

For many doctors I see as a patient, or advocate for someone else, there is no talk of Dr. Richardson. This actually can make it harder for me and them to get the best, most timely, and most cost effective health care. I am J. Richardson Patient. If I have to become Dr. Richardson, my appointment is not made sooner, my co payments remain the same, my health insurance premium goes up, and on and on. My peers, other health workers, and patients have similar stories.

Patients of this great nation, you must see that American health care doesn't care! There are no special favors like great care, and low cost unless you are "proven" 100% healthy, and/ or wealthy, i.e you have no pre-existing condition. Is a national health plan the only way we may see equal care for all? Maybe if we had health coverage like our President and lawmakers, things would be better, and would be in existence by now. After all we were promised that by them while they were campaigning for our trust and official appointment. Instead we are fed almost daily press conferences on healthcare for all repeating the same things in a different way on a different day.

It's your game - coach it, referee it, and play it so that you are the winner, my patients. You are a preferred patient if you are...getting good medical care.

Your Personal #Health Guide on Google Books

2009-07-12T16:34:00.008-05:00

Read excerpts at Google Books http://books.google.com/books?id=kPmXiNrg1pYC&printsec=frontcover&dq=patient+handbook+to+medical+care

Patient Handbook to Medical Care: Your Personal Health Guide is written for patients by a medical doctor "to inform and educate patients about medical care". Health maintenance, prevention, early detection, and early treatment are the foundation for great health.

This Writer's Digest International Self-Published Book Award winner informs patients about
basic medical care. By reading this how-to reference book you will learn:

how to keep a medical diary
how to get your medical records
how to document your complete medical history
what the physical exam should include
about preventive tests and when to get them
about tests your doctor orders
about specialists and other medical providers
about health care plans and coverage
how to seek quality health services.

Also featured are "My Health Notes", blank pages for you to write your medical history, questions, and things to discuss with your health care team!

Great health is true wealth!

Health Insurers Sell Funeral Plans

2009-07-03T19:53:00.004-05:00

"You may have already planned ahead for funeral expenses." This is the opening line in a brochure found in a doctor's waiting room. The brochure from Emphesys, further states "call me today for a free quote or a personal consultation in the convenience of your home your home" (so they can assess how to get you to the grave sooner?).

Does this sound like the type of reading material you want to see when you go to your doctor's office? This is absolutely appalling! Insurance companies have no shame, and little respect when it comes to advertising and selling their products. It's all about the bottom line, the profits. Life and death. We will give you limited covered health care, as much generic medicine as you need, increase your insurance premiums every year by 25%, and pay for your funeral, too. How thoughtful.

There is a big conflict of interest here - going to doctor's office to stay well and walk out with a brochure on funeral expenses. The biggest conflict is that the company appears to be part of the health insurance group. The Internet search for this company led to this link http://www.manta.com/company/mm8g6r0 listing the web address as http://www.humana.com/ .

Even sadder is the fact that the doctor did not know this brochure was in his office.

Physicians & Celebrity Medicine

2009-06-26T12:07:00.011-05:00

What happened to Michael Jackson's personal physician? He was with him at the time of death. Today news reports are that he is nowhere to be found as police search for him. You would think he would be talking with the coroner's office.

Celebrity medicine is a different medicine. Those physicians that we hear about from media reports provide personalized health care to their famous patients. By the time we hear about this sensitive, personal, private informaton something has gone wrong. Even when a personal physician is not involved, medical errors that lead to death are common.

Do these physicians lurk in the shadows waiting to pounce on the rich and famous? For money? For fame? How could someone trained to heal bring harm? It is surely puzzling to me. Even more puzzling is the fact that celebrities like many people fail to practice preventive medicine. Given the means to pay for health expenses and more (like home defibrillators or home clinic) there is a sense that this is not a priority. Then along comes a quack, or unexpected death.

No one is immune to bad medicine.

by J. L. Richardson, MD, family medicine physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/

Summer Skin Care

2009-06-16T08:55:00.007-05:00

It's summertime! Remember to practice good skin care by keeping your skin safe from those damaging UVA and UVB rays that cause serious, irreparable sun damage. Follow these steps:

1. Limit sun exposure – avoid 10AM to 3PM, spend less than one hour in direct sun - less or none if fair complexion, burn easily, prone to skin cancer.

2. Wear protective clothing – wide brim hats, long sleeves, long pants, skirts and/ or clothes made with sun protection fabric.

3. Umbrella and shade.

4. Use sunscreen SPF 15 or greater. Put on every hour if sweating or swimming. Put on every area exposed to sun, and be sure to remember behind those ears and on the neck.

5. See your family doctor and/or dermatologist for sunburn, or any suspicious skin spots.

Keep yourself well hydrated by drinking lots of water. Have a fun, safe summer!

by J. L. Richardson, MD, family practice physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com/

www.twitter.com/MD4U

www.blogtalkradio.com/drjfpmd

President Obama's Health Care Reform Plan

2009-06-11T12:26:00.008-05:00

Did the President sell us a health care overhaul today? Or is it more of the same talk phrased differently in a town hall setting set before the media? SSDD - same stuff, different day.

He discussed the National Health Insurance Exchange that helped fuel his campaign. It is nice to hear a promise that if you like your doctor and health care plan, you will be able to keep them. What other choice do you have with pre-existing conditions? A promise for lower cost would be nice, especially since "health insurance premiums have grown three times faster than wages". Actually, it is more like five times.

This "patchwork system" needs tweaking. Big time. The public option gives people a choice especially if they don't have health insurance. Does it really?

"Every plan should have incentives for preventive care." Incentives are attractive, but is it enough? Do incentives work? What types of incentives are you talking about? Will everybody have access to them, or just those with employer-based health insurance?

It will take "a couple of years" to get it all done. That will be a true miracle from the holy waters of Lourdes. Oh, then the President changes that...it may take four or five years or so. Or longer.

"The more tests I perform the more I get paid" is the "business mentality" of physicians. The more tests doctors perform, the better chance you will get an accurate, timely diagnosis. Those tests that aren't done, are a primary reason for malpractice. Doctors sure could use help with malpractice insurance, especially if medical testing is limited by big business "gatekeepers".

Prevention and wellness is key. The example of obesity and weight loss is a good one, but how realistic is this for the low income 70 year old morbidly obese hypertensive diabetic who is in a wheelchair?

The last question on wellness and prevention covered an incentive example. If you stop smoking, you will see your premium drop. Does this apply to the uninsured? Will you get health insurance if you practice wellness and prevention?

Finally, trillions of dollars in Medicare and Medicaid is still not enough. If "we can bend the cost curve down....we're going to be okay". Let's hope so.

Please, "steal my ideas", Mr. President.

See the previous blogs here for a real plan. It is time to act. It is time to stop talking.

by J. L. Richardson, MD, family medicine doctor, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide.
http://www.mypatienthandbook.com/

ABC's of Healthcare Reform

2009-06-10T16:18:00.005-05:00

The link below on the ABC's of healthcare reform is from my friend, Kathleen O'Connor. Her organization, CodeBlueNow! (http://www.codebluenow.org/ ), is dedicated to health care reform. Her effort is one of the best around. Ms. O'Connor started this after challenging the American public in a contest to write about their thoughts on how America's health care system could be fixed. Out of the 2003 entrants CodeBlueNow! was born.

Thank you Ms. O'Connor for the opportunity to submit my action plan, Building An American Health System. I was one of the ten finalists.

As we look forward to the President's national health care plan being passed soon, let us all speak up for the best health care we deserve. It is time for successful CPR.

http://www.codebluenow.org/ABCs%20of%20Reform--The%20Alphabet%20of%20Health%20Care.final.4-27.1doc.pdf

by J.L. Richardson, MD, family physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide.
http://www.mypatienthandbook.com/

Building An American Health System

2009-06-09T01:42:00.004-05:00

These are the notes from my Power Point presentation of my 2003 research paper, Building an American Health System. The medical budget and financing was based on a federal deficit. This was about $400 billion dollars which was greater than the HHS budget alone. In 6 years the only thing that has changed is the exorbitant price we all pay.

Slide 1 Building an American Health System = the best health care for everyone by bringing
best of all medical systems together.

FOCUS of my paper is to bring best of all medical systems together = government, private, international – much of infrastructure in place especially with government = agencies, IT, monies

Slide 2 Information technology = CIA = Communication Information Automation
Communication = medical record creation, maintenance, transmission
Information = education + wellness, prevention, diagnosis, treatment
Automation = Internet wired wireless medicine

One of the first things to get the BEST is to maximize IT, info tech

uses CIA…which connects patient to doctor to health providers – thus creating uniformity w/ easy accessibility

Communication based on most important document, the medical record = it’s creation, maintenance and transmission

Information primary for health education

Automation brings it all together seamlessly and efficiently

Slide 3 System Update = uniform with continutiy of care; timely and easy acces to health care;
eduation on wellness, prevention. and treatment based on prevalence of disease and
proven preventive measures; provide more information to patient; serve everyone

In view of the rise in elder and chronic medical illness a uniform system allows access anywhere, anytime i.e healthcare obtained from every state, doctors licensed in every state – this allows timely, quality care – the best –

USPTF and Healthy People 2010 exists for prevention – HHS has many programs from community to federal level and its systems which have shown to have the best care - more efficient care and lower cost than the private sector

Slide 4 To DO List - use government + private "bests" = merger; extend IT infrastructure,
data base

This will create uniform and easily accessible system for everyone from patient to doctor and in between

there is a ways to go when look at federal deficit at an all time high! As is health spending at over $1 trillion!

suggestions for financing are outlined in my paper as are resources already in place

Slide 5 GOALS - Uniform continuous qualitymedical care to everyone regardless of cost of
of pre-existing condition; educate and inform; practice wellness and prevention to
have a Healthy America.

the goals are ...

As the cartoon in depicts the doctor telling the patient “your HMO won’t cover any illness contracted in the 20th century” = that was in 2000 – if American health system continues the way it is this is a dilemma we all potentially face and are beginning to experience.

twtpoll :: How do you prefer your doctor contact you with your test results? (via )

2009-06-02T07:24:00.002-05:00

twtpoll :: How do you prefer your doctor contact you with your test results? (via )

Posted using ShareThis

Sicker from Med or Illness

2009-05-30T11:54:00.004-05:00

You just had that coronary heart bypass, and you have been prescribed several new medication pertaining to that and other conditions that popped up during your hospitalization for the surgery. You go to see specialists for these new diagnoses, and you get more medication. So you have over ten different medications to take now. You thought you would be getting along much better by now, but something is just not right. Are your conditions getting worse?

You may think that you are getting worse from the illness, but could it be the medicine? You decide to get out the Physician's Desk Reference (PDR) and the Internet to research the medication you are taking. Upon discharge from the hospital you received information sheets about each medicine, but the information seems so scanty. Sure enough, you are right.

The PDR and Internet gives details about side effects and drug interactions you had no idea could occur. You wonder why the doctor didn't tell you one of the drugs could cause blindness, fatal lung disease, hepatitis, hyper- and hypothyroidism, loss of appetite, anorexia, constipation, worsening of the condition for which it has been given, etc., etc. As you read further you find this drug should not be used with two other medications you have been prescribed.

You no longer have to wonder why your recovery has been slower than expected, and why you feel so bad. You have been overmedicated! Here you were thinking you were getting sicker from your diagnoses and surgery.

Take the time to read about medicines you are prescribed. You may find that you are not as sick as you thought you were. Overmedication can easily mimic as well as bring on symptoms of many disease conditions, and make you feel worse than that for which you are being treated.

by J.L. Richardson, MD, family practice doctor, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide, a Writers Digest International Self- Published Book Award winner.

www.mypatienthandbook.com/
www.blogtalkradio.com/drjfpmd
www.twitter.com/MD4U

Medical Specialists & Economic Stimulus

2009-05-28T16:25:00.002-05:00

From the email bag for today's healthy belly laugh:

Apparently the American Medical Association has weighed in on the new
economic stimulus package....

The Allergists voted to scratch it, but the Dermatologists advised not
to make any rash moves.

The Gastroenterologists had sort of a gut feeling about it, but the
Neurologists thought the Administration had a lot of nerve.

The Obstetricians felt they were all laboring under a misconception.
Ophthalmologists considered the idea shortsighted.

Pathologists yelled, "Over my dead body!" while the Pediatricians said,
'Oh, Grow up!'

The Psychiatrists thought the whole idea was madness, while the
Radiologists could see right through it.

Surgeons decided to wash their hands of the whole thing. The Internists
thought it was a bitter pill to swallow, and the Plastic Surgeons said,
"This puts a whole new face on the matter."

The Podiatrists thought it was a step forward, but the Urologists were
pissed off at the whole idea.

The Anesthesiologists thought the whole idea was a gas, and the
Cardiologists didn't have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to
the assholes in Washington.

MEDICAL HISTORY FORM

2009-05-27T15:27:00.002-05:00

Your medical history is the cornerstone of your medical record.

Print, fill out, and use it to keep up with your health.

Share it with your healthcare providers, and take a copy with

you when traveling.

MEDICAL HISTORY FORM

NAME__________________________________________

DATE OF BIRTH______________________

SOCIAL SECURITY NUMBER_____________

INSURANCE COMPANY__________________

INSURANCE ID #_______________________

PHONE_____________ FAX___________

ADDRESS__________________________

CITY_________________STATE______

ZIP_______COUNTRY_______________

EMAIL______________________________________________

PAST MEDICAL HISTORY

ALLERGIES______________________________________________________________________________________

_______________________________________________________________________________________________

DRUGREACTIONS________________________________________________________________________________

_______________________________________________________________________________________________

DIAGNOSES & MEDICAL CONDITIONS (include year diagnosed)

SURGERY/ OPERATIONS (include year done)

MEDICATIONS (list prescription, over-the-counter, foods, herbs

also write dosage and how often taken)

PAST MEDICATIONS (list anything you have taken and stopped – note why it was stopped)

FAMILY HISTORY (list medical conditions in family members – list ages, list if deceased and reason)

MOTHER____AGE________

LIVING: YES___NO____

FATHER____AGE_________

LIVING: YES___NO____

______________________________________________________________________________________________

SISTERS_____AGES_________

LIVING: YES___NO____
_______________________________________________________________________________________________

BROTHERS __AGES_________

LIVING: YES___NO___

_______________________________________________________________________________________________

GRANDMOTHER (Mother's mother) AGE__________LIVING: YES___NO___

_______________________________________________________________________________________________

GRANDMOTHER (Father's mother) AGE__________LIVING: YES__ NO___

_______________________________________________________________________________________________

GRANDFATHER (Mother's father) AGE__________LIVING: YES___NO___

GRANDFATHER (Father's father) AGE___________LIVING: YES___NO___
______________________________________________________________________________________________

SOCIAL HISTORY

Home: lives alone___

lives with family___

lives with friend____

lives in facility_____facility name, address____________________year moved in____________

Marital: Single___Married____Divorced___Widow/Widower_____

Use of cane___ walker___ wheelchair___prosthetic_____

Other___________________________________________

Alcohol consumption:

How many times per day/week/year?________________

How much per drink?____________________________

Cigarette use: Yes___ No___

How many per day?________

At what age did you start?_______

Sexual: Are you active? Yes___No___

Drug use: Yes___ No___

OCCUPATIONS/ JOBS/SCHOOLING

______________________________________________________________________________________________________________

MY MEDICAL NOTES

Use this page to list any other medical history

Treatment - Alternative & Conventional

2009-05-25T11:36:00.003-05:00

With all the controversy surrounding whether a child with cancer should have conventional chemotherapy or alternative treatment, it can be hard to know what to do. Prayer and meditation are tops in alternative treatments patients use. It works. So why aren't more doctors recommending it along with all the other treatments? Why does conventional treatment get first choice?

Massage, acupuncture and other alternative modalities can be just as effective with better results, less side effects. Treatments and medicines used over 2000 years ago on Eastern medicine are dismissed and discouraged as fist line treatments. Evidence based studies is the buzzword for medical treatments that works best today. Drug trials over a few months to years take precedence over tried and true alternative treatments.

One size does not fit all. Treatments must be customized to each patient. This takes careful history taking, physical exam, in conjunction with other tests - conventional and alternative. All aspects of medical treatment must be respected and offered to patients so they can make a fully informed medical decision.

Even more discouraging is that health insurance rarely covers any alternative treatments. For a person with a chronic pain conditions like fibromyalgia and arthritis, insurance will cover addictive potent pain medications when routine massages and/or acupuncture and/or routine conventional physical therapy offer better pain control, and ongoing daily function. Drug addiction is covered by insurance over non addicting complimentary treatment even knowing that rehabilitation for addiction will incur extra cost and suffering for the patient.

What do you choose? Are you willing to pay extra for treatments that your insurance does not cover?

by J.L. Richardson, MD, author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienhandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

Medical Marijuana

2009-05-20T18:44:00.002-05:00

Medicinal uses of marijuana prove beneficial to patients especially those with cancer, pain, AIDS, MS, glaucoma, and many more chronic non terminal illnesses. Like so many forms of alternative and complimentary medical treatments, it has been viewed with lots of controversy and skepticism because studies have also shown it to be harmful. Is this unlike any other medicine that is legal? Really, no.

As controversial as it may be, it is legal in some states for medicinal use. How can this be fair? Who gets to decide who gets a cannabis prescription to "take as directed whenever for whatever"? The state of Ohio is currently considering the Ohio Medical Compassion Act which would legalize marijuana for medicinal purposes. The title of the act itself is a testament.

Other things to consider in making marijuana legal: decrease drug related crimes; decrease money spent on drug crimes; give farmers a moneymaking crop (as pot and hemp).

If it were legal and taxed, it would be a high healing crime reduction money maker.

Women's Health Week Checkup

2009-05-10T21:04:00.005-05:00

Ladies, it's time to schedule your routine screenings and appointments to include:

mammogram/ MRI for breast cancer
PAP smear & HPV test for cervical cancer
stool check for blood (fecal occult blood test, FOBT) for colorectal cancer
cardiology doctor for cardiovascular prevention(get EKG, ECHO, and thallium stress test if indicated)
bone density scan to check for osteoporsis
counseling for smoking cessation, alcohol/drug dependence, and domestic violence
evaluation for depression and other mental disorders if necessary
complete physical exam, and routine blood tests.

Get in 5 to 10 minutes of exercise a day at least and eat healthy! Laugh a lot and love a lot!

by J. L. Richardson, MD, family practice, author of Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com

Pandemic Pandemonium?

2009-05-06T00:45:00.010-05:00

I wrote this comment to post on a blog post entitled,"Get Ready for Pandemic". ** Thanks to the blog for moderating on my comment. Posting it on this blog may reach more people.

Dr. Flynn & Dr. Redlener, this is a great assessment and all so true. After seeing the actual response, and reading the “unfinished” (states Stage 3 is in progress) 336 page HHS Pandemic Flu Guide, The Pandemic Toolkit from Roche (makers of Tamiflu), pandemicflu.gov, and much more, we have so much more to do.

It would be nice to know that the national stockpile has more than the 50 million doses* for a 300 million plus population, many who are not able to afford it.

Add to the pandemic flu all the other natural disasters occurring daily, and it is easy to see that the health system and all systems will have a tough challenge to keep all safe. As you say, individuals must take responsibility and communication must be ongoing.

Thanks for this great article.

My footnotes added here:
*Doctrine of HHS Pandemic Influenza Plan circa 2005, page 6,
"4. Quantities of antiviral drugs sufficient to treat 25% of the US population should be stockpiled." (how did they get this number?) and "8. At the onset of the pandemic, antiviral drugs from public stockpiles will be distributed to health care providers for administration to pre-determined priority groups." (who exactly is this?)

Are we ready for a pandemic? Or pandemic pandemonium?

by J.L. Richardson, MD family medicine doctor, and author of Patient Handbook to Medical Care: Your Personal Health Guide, http://mypatienthandbook.com/ .

More emergency information at Emergency Exchange, http://emergencyexchange.blogspot.com/ .

**http://ac360.blogs.cnn.com/2009/05/05/still-unprepared-for-a-lethal-pandemic/

Medication Information for Patients

2009-05-03T22:54:00.004-05:00

Should patients receive the same information about medication that doctors get? YES!

The information from the drug company that comes with the medication should be given to the patient. After all the patient is the one taking the medicine. The benefits and the risks should be readily available; however, this is very seldom the case. Most of the time the doctor has not read this information, and does not give it to the patient. There is usually a lot to read. There is so much to read that most drug companies use extremely small print on a 10 foot long sliver of paper to tell about the drug. Fortunately, this information is now available on the Internet drug company web sites.

How many doctors or pharmacists even get to the last page of "patient counseling information"? If there is specific patient information, why is it at the end? Why is there information "for doctors only"? Why is the patient information so different from the doctor information?

Medication errors occur far too frequently to leave the patient out. Medication awareness for patients should be as important as diagnosis and treatment. Full disclosure of the good, bad and ugly effects of medication should be available to anyone who wants to know about it - especially the one taking it.

By J.L. Richardson, MD, family medicine doctor, patient, patient advocate, and author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com
www.blogtalkradio.com/drjfpmd - book excerpts read by author.
www.twitter.com/drjfpmd

Missed Diagnosis - Oooops!

2009-04-28T11:19:00.002-05:00

Doctors are missing diagnoses especially with cancer - OVER 50%!!

Are you getting the right treatment? A 2006 study* of 307 closed malpractice claims revealed that many missed or delayed diagnoses in outpatients lead to serious harm, some fatal. In this study, 30% resulted in death! Adverse outcomes occurred in 59%.

The most missed diagnoses were cancer (breast and colorectal primarily), infections, fracture, and heart attacks. Fifty-nine percent of errors were associated with cancer diagnosis - or should I say misdiagnosis? Most of these malpractice claims (59% again) showed that diagnostic errors were significant.

The most common reason for failure to diagnose was failure to order the right test (55%). The other reasons were:
-failure to follow up (45%)
-failure to obtain a complete thorough medical history and physical
exam (42%)
-wrong interpretation of medical tests (37%)
Some cases were cited where the doctor failed to check the test results, or to tell the patient the results.

This data is truly mind blowing! Though a small study, it carries a lot of weight. The percentages are phenomenally high! How can this be happening in the most medically advanced country in the world? The fact is, it's happening. It is more common than we think - hidden, not talked about. What can you do to keep it from happening to you?

Has your doctor discussed preventive tests for cancer detection? Of course, you should have a routine complete medical history and physical exam first. Using this information your doctor will know what tests you may need. If cancer runs in your family, you really want to consider preventive cancer screening.

The medical history and physical exam give your medical facts. Findings on physical exam may suggest cancer for which testing is needed. Some tests considered for routine cancer screening are:
-mammogram, MRI - breast cancer
-PSA (prostate specific antigen) - prostate
cancer
-colonoscopy - colon cancer
-stool blood check - colon cancer
-PAP smear - cervical cancer
-complete blood count - blood cancer
-CT or MRI scan - lung cancer, brain cancer
-pelvic sonogram - ovarian cancer
-body scan (neck to buttocks and in between) - body (this scan shows other things ,
too).

Screening tests save lives. Talk to your doctor. Be sure your doctor goes over the test results with you and explains EVERYTHING! Leave with your questions answered! Be sure to follow up with your doctor, too, to prevent any delays.

Get a copy of your test results. That way you will know if you were told everything and that the information is accurate. Research your results and diagnosis. Things you don't understand, ask again. Getting a second (and sometimes tiebreaker third because you were told different things by each doctor!)opinion is a reasonable research tool, also.

Patients must be their own advocate and take charge of their health. Health maintenance and prevention are so important to one's quality of life. Make it an important part of yours!

Remember to do your own monthly breast exams for both sexes, and monthly scrotal check for the males.

Great health is true wealth!

(*from AHRQ, Agency for Healthcare Research and Quality, publication "Research Activities" February 2007 from study in Annals of Internal Medicine, 10/3/06)

J.L. Richardson, M.D., is a family medicine doctor, patient advocate, and author of "Patient Handbook to Medical Care: Your Personal Health Guide".
http://www.mypatienthandbook.com

Swine Flu Resources

2009-04-26T17:26:00.005-05:00

Swine flu information can be found at the sites below. If you have symptoms or have been exposed, seek medical attention.

Today the number of KNOWN identified cases of swine flu in the US is at 20. "CDC has NOT recommended that people avoid travel at this time."

Follow RSS feed link for current CDC updates.

Center for Disease Control (CDC)
http://www.cdc.gov/swineflu/

CDC RSS Feed
http://www2a.cdc.gov/podcasts/createrss.asp?t=r&c=252&showall=1

US Dept of Health & Human Services (HHS)
http://hhs.gov/

Follow CDC on Twitter http://www.twitter.com/CDCemergency

Your local health department is another good resource. Find your local health department at
http://www.healthguideusa.org/local_health_departments.htm

Stay safe. Wash your hands and maintain good hygiene.

by J.L. Richardson, MD is a family medicine doctor, patient advocate, and author of "Patient Handbook to Medical Care: Your Personal Health Guide".
www.mypatienthandbook.com

NOTE: The links are now working with a click. you can also Copy and Paste, or type web address into your browser. I finally figured this out. Thank you.

Doctor Search on the Internet - Healthy Thing to Do?

2009-04-20T20:46:00.005-05:00

TEST YOURSELF?

2009-04-16T20:09:00.003-05:00

Many doctors are concerned that some tests like the body scan will lead to unnecessary procedures that could harm patients. Often these tests may show abnormal things that are “normal” meaning that the abnormal finding is something that is just there. It is benign, and not life threatening.

What does the doctor do when a patient comes in with a test that they have done on their own? The patient has decided that I may need this test because heart disease, and /or cancer runs in my family, plus heart disease is the number one killer. Should I have a heart scan, body scan or a virtual colonoscopy? My doctor has told me that tests like these may find things that are benign, but something serious may show up. It could be something that would turn up in a few years and possibly be life threatening, but if I check now maybe I can do something about it.

What does the doctor do when a patient comes in with abnormal test results from a test they orders and paid for themselves?
1. Repeat the test
2. Refer the patient to a specialist
3. Do more tests to check it out
4. Scold the patient and say “It’s okay. There’s nothing to worry about.

What does the patient do?

J.L. Richardson, MD is a family practice doctor, and author of the award winning "Patient Handbook to Medical Care: Your Personal Health Guide".

http://mypatienthandbook.com

Patient Advocate Vital Signs

2009-04-13T20:31:00.002-05:00

The “Vital Signs” of patient advocacy are important. We look for these in all our health care providers.

TRUST
CARING
COMMUNICATION
COMPASSION
EDUCATION
INFORMATION
KNOWLEDGE

A patient advocate is someone who cares for and helps monitor patient's medical care. You should be your own patient advocate as well as an advocate for loved ones, friends. Doctors should act as their patients’ advocates. This seals the patient-doctor bond and assures them that they will get everything they need in a timely manner.

My health care providers are trusting communicators with caring compassion that provide education, information, and knowledge.

J.L. Richardson, MD is a family practice doctor, patient, patient advocate and the author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://mypatienthandbook.com

Preventive Medical Screening

2009-04-07T20:00:00.007-05:00

Doctors and organizations may rant and rave about some preventive medical tests as "out of date". Think about the people you know who found a breast liump or had a high blood PSA test and later found out it was cancer. Today, in one day, I talked to three friends who told me how preventive tests saved their lives. They are all long term survivors.

Early detection and treatment as well as prevention can save your life. The tests are out there. You must know about them and decide for your self. Every life counts.

J.L. Richardson, MD, family medicine doctor, and patient advocate is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

www.mypatienthandbook.com
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd - features book reading by author

www.books.google.com - for book excerpts to read

Colonscopy for Colon Cancer Screening

2009-04-05T20:46:00.001-05:00

Have you had your colonoscopy?

baseline if 50 years of age
history of colon cancer in family
personal history of colon polyps, cancer
rectal bleeding
have a disease that is a risk like Crohn's disease

Check with your primary care physician. You will then be directed to your gastroenterologist (GI doctor, for short) for a complete evaluation. Ask your PCP for occult blood stool cards to take home to check for blood in the stools.

The Hemoccult test checks for blood that is not detected by the human eye. After you complete your stool sample cards, return to your PCP by mail or in person. They will be checked by your doctor. Any GI exam without this test and/or a rectal is incomplete.

J.L. Richardson, MD is a family medicine doctor, patient, patient advocate and author of Patient Handbook to Medical Care: Your Personal Health Guide".

www.mypatienthandbook.com

Deaf Health - Can You Hear Me?

2009-04-01T19:59:00.002-05:00

I ran into a 43 year old gentleman at a local place of business. He asked me for money for food. I started talking to him and saw that he was reading my lips. He read lips very well. He failed to understand sign language. We were able to communicate enough to exchange names, and find that he was deaf from an early age possibly from birth. He was unsure. He was looking for work. We discussed how it is hard for many deaf people to get jobs because they are deaf.

I tipped him for his pleasant conversation and recognized the sadness of it all.
After this encounter with fate, I reflected on yet another deaf person that had been failed by the American health system. How this system is able to allow a hearing impaired young man get well into adulthood without proper medical attention to assist with his deafness. He should know how to sign. He should have money. He should have work. He should have health care. He should have been covered since birth.

I know this scenario all to well. I have a brother who was born deaf. The system is still failing him all around, too. He and most of his deaf community are at “poverty level”. Rather than the system continuing all assistance beyond 18 years of age, they encourage working versus working plus government assistance. How does the government expect him to pay money he supposedly owes them over a 10-year debt? Does he really owe them? Without steady employment and government assistance, it is impossible. Each time he applies for government help like Medicaid, Social Security Disability Income, etc., he is cast aside with uncertainty.

It is truly devastating to the human spirit. He has struggled with part-time jobs at minimum wage with no benefits. I have helped him find the medical care he needs. The whole family chips in to help him in all ways. It is a family affair. Many of his doctors give generous discounts when he “tells” them he is uninsured. This has really helped him get the medical care he needs. Over the years I have collected his records and taught him to work his way through the medical system.

His medical record is his basic communication tool along with reading lips, and writing things down. He is a master at sign language (and so many things), but none of his doctors know sign language. He requires an interpreter, but it is difficult to arrange when you are deaf and no one knows your language or how to use the TDD (telecommunication device for the deaf) phone devices or operator services. You can even do it on line. How do you get a doctor appointment? Often the emergency room becomes the primary care clinic.

If you are not heard, you are ignored or misunderstood. We must open our ears to the deaf and all people with disabilities. To be born deaf is not ever hearing anything. It makes us realize the importance of communication, another vital sign.

J.L. Richardson, MD, family medicine doctor and patient advocate, is the author of PatientHandbook to Medical Care: Your Personal Health Guide.

http://mypatienthandbook.com

Emergency Preparedness - Do Your Part

2009-03-27T00:00:00.007-05:00

It is always time to be sure you are prepared for any emergency. Safety and health are more important than ever during an emergency situation. Being prepared is a real-time, year round activity.

Though September is official National Preparedness Month, which is sponsored by the Department of Homeland Security (DHS), it is time to prepare now. This program helps us prepare for emergencies. It encourages us to "get a kit, make a plan, be informed, get involved".

While it is important to prepare yourself, it is also important to help prepare your community. The Citizens Corp, "uniting communities, preparing the nation", encourages you to start with personal preparedness as well as volunteering to help in community preparedness.

Citizens Corps programs include the Medical Reserve Corps (MRC), Community Emergency Response Team (CERT), Fire Corps, Volunteers in Police Service (VIPS), and USA on Watch (National Neighborhood on Watch).

Learn more about these programs at http://www.citizencorps.gov/ . Get involved. If you are already involved, call on others to do their part.

Preparedness begins at home. Be ready, stay ready. Be informed and check out National Preparedness Month at http://www.ready.gov/ .

In US 80% Happy with Health Care

2009-03-26T13:35:00.001-05:00

Poll on healthy health care. Are you satisfied with yours?
http://www.healthcarebs.com/2009/03/24/80-happy-with-their-health-care/

Tests YOU Pay to Get

2009-03-25T22:35:00.003-05:00

Many doctors are concerned that some tests like the body scan and other preventive medical test will lead to unnecessary procedures that could harm patients. Often these tests may show abnormal things that are “normal” meaning that the abnormal finding is something that is just there. It is benign, and not life threatening.

What does the doctor do when a patient comes in with a test that they have done on their own? The patient has decided that I may need this test because heart disease, and /or cancer runs in my family, plus heart disease is the number one killer. Should I have a heart scan, body scan or a virtual colonoscopy? My doctor has told me that tests like these may find things that are benign, but something serious may show up. It could be something that would turn up in a few years and possibly be life threatening, but if I check now maybe I can do something about it.

What does the doctor do when a patient comes in with abnormal test results from a test they order and pay for themselves?
1. Repeat the test
2. Refer the patient to a specialist
3. Do more tests to check it out
4. Scold the patient and say “It’s okay. There’s nothing to worry about.”

What does the patient do?

J.L.Richardson, MD, family medicine, is the author of Patient Handbook to Medical Care: Your Personal Health Guide.

http://mypatienthandbook.com/

Self Check You

2009-03-25T17:39:00.001-05:00

We the people of this mighty fine country vow to take the absolute best care of our most important asset - US. A nation is as great as its assets. We have so many. As long as us Americans stay healthy, we will stay wealthy.

True wealth is great health. It is time for you to take responsibility for your health. It is time for you to know what your health numbers are. It is time for you to know your medical conditions, risk factors, and family medical history.

Give yourself a medical checkup. Start by writing or typing or recording your medical history - medical conditions, surgery, treatments, family history. Add your medication. Save it. Update it. Add to it. Correct it. Keep it current. Keep a copy in a secure place.

Examine as much of yourself as you can. Look at your skin, hair, nails, eyes, teeth, and every part of your body that is visible to you. Make note of any abnormalities. Make note of any symptoms you have - new, old and ongoing. Go through each body system. Add this information to your medical history. Add to this your doctors' and health care providers' names, phone number, land address, and email address.

Call your doctor for an appointment for a comprehensive CPE (complete physical exam). Take your information and notes with you on your appointment. Review everything with your doctor. Take notes.

Sign a medical record release to obtain a copy of your medical record from each doctor you see at the time of the visit.

Be sure to schedule a follow-up appointment within a month or less to go over everything with your doctor. Get copies of your information including blood tests, and any other tests as well as medical notes.

Take charge. Be the healthiest you can be - as a person, as a nation.

Great health is true wealth!

J. L. Richardson, M.D., family physician patient advocate, is author of Patient Handbook to Medical Care: Your Personal Health Guide.
http://www.mypatienthandbook.com/

The website offers a FREE excerpt from the book about the information for your medical history. Check it out.

Free Medical Advice

2009-03-25T12:52:00.004-05:00

Today's Twitter question at http://twitter.com/drjfpmd : Doctors free medical advice on or off line - would you? Is free medical advice as good as paying for it?

5 More Medical Moneysavers

2009-03-23T17:41:00.001-05:00

Thanks for your responses to the first ten medical money savers. So you want more? Here are five medical money savers to help you spend your health dollars wisely.

Keep weight stable. It is the healthy thing to do. This will save on grocery and clothing expenses. Long term savings on medical expenses.
Get prescription meds in bulk quantity of 100 versus thirty day supply especially if you are paying for your meds.Buy nonprescription medical items in bulk when on sale. You will be amazed at your savings when you buy a six to twelve month supply on sale. This tip is also effective for emergency preparedness.
Check with your state provisions for health care. Many states have low cost insurance plans available. For instance, in Florida the program is Cover Florida, http://www.coverfloridahealthcare.com/. Check what your state has to offer by contacting the state health agency.
Talk with your doctor by phone, fax, and email to save on the cost of an office visit payment. Just think about the number of office visits you have been to where all you did was talk (after waiting for a long while). Save your time and money.
For blood pressure checks, get yourself a home blood pressure monitor. Call in your readings. Many doctors will discover that your blood pressure is actually stable when the stress of the doctor's white coat is absent. For diabetics, a home glucometer is very useful for monitoring blood sugar.

Invest in your most important asset - YOU.

Great health is true wealth!

J.L.Richardson, MD, family medicine expert, is the author of the award winning, Patient Handbook to Medical Care: Your Personal Health Guide.

http://www.mypatienthandbook.com/

Self Breast Exam Beats Breast Cancer

2009-03-23T10:11:00.004-05:00

Here is a video from Healthination.com that shows how to do a self breast exam. Monthly exams could save your life.

http://healthination.com/Videos/Breast-Self-Exam

10 Money Saving Medical Tips

2009-03-23T05:33:00.003-05:00

You are your most important asset. Here are some money saving medical tips to help you during these tough financial times.

1) Keep your health insurance coverage. This is as important as your home and food. Cut expenses elsewhere to keep it in your budget. Let your doctor know if you do not have insurance coverage. Many offer discounts to the uninsured as do other health providers like hospitals and diagnostic centers. Pay for what you need instead of relying on insurance.

2) If you lose your job, get COBRA through your employer. You will have at least 18 months of coverage. You will have to pay for it. It is worth it.

3) Be sure you are up to date on your health maintenance. Get in now for your physical and preventive tests (mammogram, blood tests, eye exam, shots, etc.).

4) Check your medication, prescription and non-prescription. Review these with your doctor to discontinue any you really do not need, and/or can't afford. Let your doctor know if you are unable to afford any of your medication, so other options can be discussed such as drug assistance programs. Research them yourself on the Internet, and by calling or writing the drug company that makes your medication. Remember to include your non prescription medicine in your budget (like cough medicine, stool enhancers, pain relievers, etc.). Talk with your pharmacist.

5) Discontinue unhealthy habits like smoking and excessive drinking. These items cost money and your health.

6) If you are disabled, you can withdraw money from your IRA without paying the penalty and taxes. You may need this money to pay for present or future health costs. It may benefit you more while you are well enough to enjoy it. By the time retirement rolls around, you may not be around.

7) Eat healthy small servings. Smaller portions of healthy food save your money and your health. Remember this when you eat out.

8) Exercise at home. Save your money and time on that gym membership. You can reap the same and better benefits with a home exercise program with or without expensive exercise equipment. Turn on the TV and participate in the fitness shows that are best for you. Exercise DVDs and tapes are a one time expense that can be used again and again. Ride your bicycle, take a walk or jog in your neighborhood. It all counts.

9) Continue your home exams like self breast exams, and self scrotal exams. You may detect something early. There is much controversy about the self breast exam, and it is no longer recommended by some. Common sense tells you that self detection is a smart thing to do.

10) Save money for your health bank. As insurance companies and plans cover less, you will be paying for more for services and premiums. Keep a nest egg for health expenses.

Remember that YOU are your most important asset. Great health is true wealth.

Dr. Richardson is the author of the award winning, Patient Handbook to Medical Care: Your Personal Health
Guide.http://www.mypatienthandbook.com/

FREE Health Brochures

2009-03-23T05:25:00.001-05:00

FREE BROCHURES ON TOPICS LIKE HIGH BLOOD PRESSURE, HEART DISEASE, ASTHMA, LUNG DISEASE AND MORE ARE AVAILABLE AT NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI), http://www.emall.nhlbi.hin.net/.

THE PHONE NUMBER IS 301-592-8573. YOU ARE ABLE TO LOOK AT THE CATALOG ON LINE, AND YOU CAN ORDER IT.

ENJOY SHOPPING FOR YOUR HEALTH!

Cap Insurance Premiums, Mr. President

2009-03-22T23:38:00.005-05:00

Dear President Obama,

As part of your spending cuts, put a scalpel to insurance premiums. Cut and cap. It is preposterous to think that someone on a limited income (like seniors, retirees, disabled folks), or those whose salaries have flat lined can continue to afford increases of 25% or more per year. With the average annual cost of living increase of 3 to 5% it is simply unaffordable. For many this can be as much as 10%or more of their income.

For the past three years many insurance premiums have risen as much as total of 25% or more per year for the past few years! Meanwhile insurance rates in Congress were recently reported as an 8% increase last year to 12% this year. Give us the same. After all, Congress works for us. Everybody keeps saying we should have the same health insurance opportunities as Congress. Act on it and stop the private insurance sector from hemorrhaging us to code blue.

Start by putting a cap on insurance premiums. Make this retroactive for the unfair cost increases over the past five years. Let the insurance companies apply this instead of a tax credit to our insurance. It is time that patients instead of shareholders and company executives reap the benefits of decent health care. Shift the focus on preventive care to preserve your health and save your life as opposed to waiting until you get sick and die.

Do the right thing and the best thing for your country. Keep insurance premiums affordable. Keep your country's health from failing. Invest in prevention, health maintenance, wellness, and health preservation. Make the insurance companies accountable for this, too. Disease management is good, but if it is prevented or detected early it's even better.

Information technology such as electronic medical records are great, too. Be realistic. We are behind here and trying to catch up. Take care of patients first and do this as you go. Most doctors' office are still trying to figure out how they are going to afford it.

Consolidate some of the government health agencies that overlap. As I waded through the Health and Human Services department, I drowned in an alphabet soup of agencies that do similar things. It looks like a lot of money being spent for those most in need; however, the disparities in health care continue in despair.

Keep our country's vital signs stable. Resuscitate. Perform CPR STAT. Open the airway, breathe in fresh air, and circulate the proper health care to all Americans. It is our birth right. It is our privilege. Make it our asset.

Best regards,
Dr. Richardson

P.S. On a personal note - my insurance company increased my premium another 25% this year from $700 to $882. Pre-existing conditions have prevented me from getting affordable continuous coverage elsewhere, or from getting into less expensive plans in the company.

J.L. Richardson, MD, family medicine doctor, is author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.
http://mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd

DASH Diet for High Blood Pressure

2009-03-22T19:27:00.004-05:00

The link below is the best information I have seen on DASH (Dietary Approaches to Stop Hypertension). It is from the NIH National Heart Lung Blood Institute. There is more to managing hypertension with diet than avoiding salt. Diet and salt restriction (2400 mg/ day about 1 tsp.) is the initial treatment step along with exercise. Medication may be required if blood pressure remains high after a 6-8 week trial with diet and healthy lifestyle changes.

Click link for DASH diet.
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf