Body Scan for Early Detection

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

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

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?

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).