The state legislature in Florida decided it is legal and appropriate for pharmacists and pharmacies to begin administering vaccines against multiple diseases. Their list of adult vaccines includes seasonal flu shots, Pneumovax (pneumonia vaccine) and Zostavax (vaccine to prevent shingles). The rationale of the legislature is that access to doctors to receive these preventive vaccines is limited and difficult.
By refusing to administer vaccines in their office because it is time …
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As school bells ring out announcing a new school year and pigskins fly through the air announcing the arrival of a new football season, the Center for Disease Control and Prevention (“CDC”) begins its annual influenza vaccine campaign. “Flu” or influenza is a viral illness associated with fever, severe muscle aches, general malaise and respiratory symptoms. Most healthy children and adults can run a fever for 5 – 7 days …
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The Center for Disease Control and Prevention (CDC) has requested that all individuals born between 1945 and 1965 be tested for the presence of the hepatitis C virus. This is a clear cut change in their policy which had previously asked that only high risk patients be tested.
Hepatitis C is a viral infection usually transmitted by blood to blood transmission. High risk patients include intravenous drug users who share needles, …
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Research radiologists at the Massachusetts General Hospital in Boston evaluated the accuracy and detail of imaging the colon (a virtual colonoscopy or colonography) with no laxatives as preparation and comparing it with traditional colonoscopy. There are clear evidence based guidelines suggesting that all low-risk men and women have a screening for colon cancer with a colonoscopy at age 50. If that study is normal they are directed to repeat it …
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An investigative newspaper article published in the Milwaukee Journal Sentinel, in cooperation with online periodical MedPage Today, chronicles the increased use of narcotics for chronic pain relief in the elderly.
The article highlights how in 2009 the American Geriatrics Society put together a panel of geriatric pain specialists who published geriatric narcotic pain relief guidelines that have led to the dramatic increase in use of narcotics in the elderly. There is apparently …
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As a geriatrician who believes strongly in prevention, my perspective is that the recent high volume of research on healthy aging, chronic disease and its association with vitamin D and calcium supplementation has done nothing but confuse the picture for us all. I have always been an advocate of healthy eating – a balanced diet that is prepared in a manner that retains and promotes the absorption of the foods …
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Ralph Coates, PhD of the Center for Disease Control (CDC) described in the June 15, 2012 issue of Morbidity and Mortality Weekly Report that by looking back at a U.S. study done between 2007-2010 called “Use of Selected Clinical Preventive Services among Adults,” health providers need to do a more comprehensive job of offering preventive services.
According to the report, only 47% of patients with documented heart and vascular disease were …
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For various reasons our nation’s public health programs have been decimated. This comes at a time when the number of unemployed and health uninsured are at a record high number. Additionally, we are seeing individuals live longer and experience more chronic debilitating illnesses and conditions that stretch the resources of an already under manned and under funded health system. Emphasizing prevention and healthy living should be a lifetime necessity for …
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An article and editorial have appeared in the Annals of Internal Medicine demonstrating that primary care physicians do not understand simple statistical data presented to them regarding screening tests for cancer. The consequences, as outlined in an editorial written by a former chairperson of the much maligned Institute of Medicine, is that primary care doctors are over-using cancer screening tests because they do not understand the statistical ramifications and conclusions …
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To meet Federal patient satisfaction goals, our hospital administration is requiring community based physicians to give patient admission orders before we have a chance to see the patient. Patients who self-refer themselves to the emergency department, are evaluated by the emergency room staff, and who are determined to require admission must be admitted by their community physician within 20 minutes of receiving a call from the ER staff advising the …
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As a geriatrician in a locale with many elderly retirees, I am frequently asked how long mom or dad (or both) can stay in their home and live safely and successfully. It is clearly a complicated issue even if the individuals involved are cognitively and mentally intact, physically capable and financially able to pay for support and help.
There is much to consider. Are the patients physically able to maneuver within …
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A response to Concierge Practice: Unjust for Patients and Doctors Alike.
Like the shots fired at Concord and Lexington in 1776, concierge medicine and direct pay practices are the initial shots fired by concerned primary care physicians in the revolution against health care systems which limit access to physicians and destroy the doctor / patient relationship. Concierge medicine arose as a result of government, private insurance, and employer intrusion into …
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I have listened to health economists debate the value of an annual physical exam. Is it cost effective? Does it prevent disease? It doesn’t matter. It is an essential part of the development and continuation of the doctor patient relationship.
The annual physical exam is a form of benchmarking. It allows the doctor and patient to review all the pertinent aspects of your health history …
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Recently, while jogging through my community, I had the pleasure of bumping into a former colleague and his brother who were out for their daily five mile walk.
Dr. G. had attended a local medical school, finished near the top of his class, and had gone on to do his internship and residency at the premier private hospital in Miami Beach, Florida. After completing his residency …
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I received a phone call from the Broward Sheriff’s Office Police Athletic League Youth Boxing Program asking if I would help them out and be the fight physician at their upcoming youth boxing tournament.
Their usual physician, a member of the Boxing Hall of Fame, had another commitment. However, he was willing to train me in advance and show me the ropes on the day of the event.
State law and the …
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Last weekend I had the privilege of supervising University of Miami Miller School of Medicine students at a free public health screening in Pompano Beach, Florida. The screening was sponsored by the medical school, with the assistance of community leaders, and held in a local public school. The program organization, recruitment of student and faculty volunteers and management of the program was undertaken and implemented by the students. It is …
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An active 61 year female, who has been in my practice for 30 years, developed strange aches and pains and abdominal symptoms. My evaluation turned up nothing.
I then asked for help at the University of Miami rheumatology and gastroenterology divisions. With the help of a brilliant local gastroenterologist and rheumatologist, and after a trip to Johns Hopkins Medical Center and the Mayo Clinic, collagenous …
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Five years ago my associate and I invested sixty thousand dollars to purchase and set up an electronic health record system and eliminate extensive paper use.
We researched all available systems and decided upon MediNotes because it was a large company with an excellent record of service and their system met all the national requirements for certification. We worked through our local computer vendor’s family …
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