High Blood Pressure Accuracy

If your blood pressure is higher than 120/80 repeatedly, you have high blood pressure also known as hypertension. Three consecutive visits to the doctor's office with high readings can be all it takes to be diagnosed with high blood pressure. It is called the silent killer because there are often no symptoms until a heart attack or stroke occurs. 

Even when your blood pressure is normal at home, it is the readings at your doctor's office that determine the diagnosis and treatment.  Ambulatory blood pressure monitoring (ABPM) is changing the way to accurate diagnosis.  More doctors are becoming aware of this and ordering it to check for twenty-four hours. In addition, checks by patients with blood pressure devices are being recommended.  This allows for checks in everyday life situations versus the few high anxiety visits to the doctor.

ABPM can help with treatment as well.  You can see what makes it go up and avoid these things.  Some medication can make it go too low, and the dosage adjustment or type of medication may need adjustment.  These situations usually occur at home after doctors' office hours.

When blood pressure monitoring is done by your schedule, it may be more accurate. ABPM can be a healthy way to keep it stable for you and your family. Best health!  

MY PATIENT HANDBOOK: Ambulatory Blood Pressure Monitoring

MY PATIENT HANDBOOK: high blood pressure

Healthy Life Line: Make Medical Test Screen Part of Healthy Routine

Today patients have a big advantage with prevention screening.  Mammograms and colonoscopy are recommended routinely for those with high risks as well as those without.  These along with blood tests like the PSA (prostate specific antigen) are important prevention and early detection tools.  Why wait for symptoms occur or for something potentially life threating to happen? It is important to avoid when it can be prevented or detected early.

Many lives have been saved by medical prevention screening.  When diagnosed early, it can lead to a better quality of life.  False positives and incidentalomas may also show up.  These can be further evaluated and followed as deemed necessary with and without surgical intervention.  It is important for patients to educate themselves and ask questions about medical prevention and screening tests.

Be prepared to pay something for some tests even with health insurance.  Your car insurance fails to cover maintenance, but you must maintain the insurance coverage plus pay for maintenance and repairs.  Do likewise for your good health.  Pay extra and reap the extra benefits of good health amd saving money.  After all, true wealth is good health.  Best health!

Doctor Shortage Delays Medical Care

Physician demand in all specialties is greater than the supply.  As the population grows the number of doctors is decreasing.  The 2036 projected shortage in the United States is 86,000 according to the 2023 study by AAMC (Association of American Medical Colleges).

The Covid pandemic worsened the crisis as more doctors left physician life primarily due to money.  During this time Medicare continued to decrease doctors' reimbursement for medical services rendered to elderly and disabled patients.  Basic costs like office rental or purchase, malpractice insurance, employee salaries were the main sources of money outflow.  All of these were increasing as were costs for an aging population most of whom had at least five chronic medical conditions.

As a potential physician shortage may be approaching, it has become more difficult to get timely appointments.  If you have insurance, they must be in network to avoid extra cost beyond your insurance coverage.  This usually means longer wait time primarily due to smaller listing of doctors.  Many physicians also have limited visiting hours unlike days of old when they made themselves more available to patients than two days a week.

In addition, doctors are more specialized and selective in their choices.  One choice is cash only payment instead of insurance, Medicare, or Medicaid.  Another choice is the specialty or subspecialty chosen.  The more specialized are usually more expensive and highest paid. Some have gender and age preferences. Burnout due to overworking has led to limits in the number of new patients for some doctors, or just quitting.

Patients should try to find doctors they feel are best for them and their family.  Even if it means consulting several in the same specialty until you get the right one.  Doctor shopping is becoming more popular as the healthcare landscape keeps rapidly changing.  The Internet makes it easier to do, but the telephone makes it more personable.  Talking to someone can give you more informatiom and add to your research.  Word of mouth is still a good way to find doctors.  Seek out the best doctors and you will find trustworthy personalized precision health care for you.  Best health!

Medical Money Malady

Medical money spent for your basic healthcare is expensive. The new medication will cost you $1000 full pay. The cardiac test will cost you $1000 for your portion of the $15,000 full price.  Your portion of the physical therapy evaluation with a provider out of your insurance network will cost $500. In or out of your insurance network is expensive.  If you lack health insurance, it is more expensive.  How do you choose what medication, treatment, or procedure to get? Is treatment more important than prevention?  If it was prevented treatment may be unnecessary.  

Medical care today is expensive and complicated.  More unhealthy chronic conditions make medical treatment complex and costly.  Many average household budgets are barely able to get proper nutrition and housing.  Health insurance is less affordable.  This leads to less prevention care, lifestyle maintenance care, and more treatment care. The cost of prevention is most likely less that treatment for chronic disease. As health insurance costs rises, personal deductibles and co-pays increase.  Being unable to pay for basic health insurance usually means less medical care including health maintenance! 

Chronic disease will become more chronic and more expensive to treat!  The rising cost of healthcare including health insurance leads to more money spent by the patient.  Along with the overall economic inflation (especially food), certain expenses are liable to be dropped.  Health insurance and medication are likely to be discontinued or decreased so one can afford housing, food, gas, clothes, and more basic needs.

More prevention care, lifestyle maintenance care, and less treatment care is critical care.  One of the best things a patient can do is to continue with a healthy lifestyle for you and your family.  When you eat nutritious food, your grocery bill can be healthier as well. Exercise keeps you moving and with less pain.  It also helps decrease stress creating mental health clarity and good mood.  Add daily meditation and prayer for more mental health benefits.  Healthy is less stressful for your medical care with less doctor visits, tests, and medication. Healthy lifestyle in itself is a lifesaver and money saver.  Best health!

More medical money information: MY PATIENT HANDBOOK: money

  

Men's Health Month Means Checkup Time

 "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 http://bit.ly/122ZEeF) 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
• genetic testing should be included for family inherited conditions 

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.

Listen to What Your History and Physical Should Include http://bit.ly/2MC0r5c