Top Docs Radio

  Patient Engagement This week I caught up with our friend, Frank Martin, of The Medical Consultants Group.  We talked about how his consulting firm can help a wide range of medical practices, from solo offices to multi-site large groups.  Frank talked about the variety of facets of a business that is a medical practice […]

 

Patient Engagement

This week I caught up with our friend, Frank Martin, of The Medical Consultants Group.  We talked about how his consulting firm can help a wide range of medical practices, from solo offices to multi-site large groups.  Frank talked about the variety of facets of a business that is a medical practice improve operations.

Frank talked about strategies for helping patients related to managing their out-of-pocket obligation, including deductible and co-payment.  We also discussed how the ACA has placed new emphasis on patient satisfaction and outcomes relating to how the practice (or isn’t) reimbursed.  Another requirement is to provide an electronic portal that allows remote access to patient data BY the patient, coupled with a means to transmit/receive relevant information to/from patients.

We discussed the difference between legacy EMR systems (where software was installed on hardware in the office) and cloud-based applications where data and the software exist on a remote cloud-computing-based architecture.  The decision-making capability of the cloud-based applications, coupled with security and rapid access to important data, make modern cloud-based EMR applications the wise choice for practices to convert to today.  These modern applications do not require on-site updates of the application on every device.  Now, the application is updated where it lives, meaning the user’s experience is not interrupted or inconvenienced.

Frank places great emphasis on helping his client practices become better-running businesses.  To that end he works with the group to be able to change processes, or software, business plan, and/or other key facets such as office location and office space leasing to operate more efficiently and profitably.

Special Guest

Frank Martin / Medical Consultants Group  

* Past recipient, “Volunteer of the Year, Big Brothers Big Sisters”

* Published author

* Successful entrepreneur in the healthcare sector

The 4 R’s of Gut Health Did you know that as much as 80% of your body’s immune capacity comes from your gut?  Neither did we.  That’s why we’re glad Dr. Ellie Campbell of Campbell Family Medicine came by to blow our minds(again) with information (The 4 R’s of Gut Health) about ways we can […]

The 4 R’s of Gut Health

Did you know that as much as 80% of your body’s immune capacity comes from your gut?  Neither did we.  That’s why we’re glad Dr. Ellie Campbell of Campbell Family Medicine came by to blow our minds(again) with information (The 4 R’s of Gut Health) about ways we can dramatically improve our health.  She shared how she progressed from her traditional primary care practice to a Direct Pay model to get away from the pressure to see more patients, faster, in order to make a respectable physician’s income.  In her office she doesn’t work with insurance companies.  Instead, her patients simply pay a monthly membership fee to have access to her 24 hours a day, 7 days per week (sometimes even when on vacation!).  She also wanted to be able to provide care to her patients that is based on best practices and evidence rather than being simply limited to what an insurance company will or won’t pay for.

https://d2g3ugptlasun4.cloudfront.net/wp-content/uploads/sites/114/2015/02/DR-AVAIL-24-7.mp3

We talked about the fact that, with limited time per patient, prescribing a medication and moving on to the next patient is often the way physicians must conduct their practice.  She shared how allergic responses to foods and other environmental sources are behind many of our illnesses (or mirror many illnesses).  We also talked about how important what we eat and drink is in our overall health.  Dr. Campbell described how food and beverages have such dramatic impacts on our hormone levels and cellular health that we need to look at what we consume much like drugs one can take in a pill.

Dr. Campbell discussed The 4 R’s of Gut Health, going over foods we should eliminate (or at a minimum significantly reduce) from our diets because they cause inflammatory responses in the gut and vascular system (and elsewhere).  Things like wheat and plants from the nightshade family such as tomatoes, peppers, potatoes, and eggplant can, for many, create allergic reactions.  The challenge is, many of these allergic responses don’t manifest in immediately-recognizable ways.  It could be a general feeling of malaise, skin problems, GI problems that can emulate reflux, and more.

The 4 R’s of Gut Health (Explained in greater detail in the interview):

* Remove offending substances from the diet.

* Replace digestive enzymes, bile salts, immunoglobulins, DAO, and stomach acid where necessary

* Re-inoculate the bowel with pre- and probiotics

* Repair gastroentestinal mucosa through proper nutritional support

Special Guests:

Dr. Ellie Campbell, DO, Family Practice & Integrative Medicine at Campbell Family Medicine      

* Doctor of Osteopathic Medicine, Kirksville College of Osteopathic Medicine

* Family Medicine Residency, Medical College of Georgia

* Board Certified Family Medicine

  Correctional Medicine This week we continued our monthly series with Medical Association of Georgia.  I sat down with MAG CEO/Executive Director, Donald Palmisano, Jr., and Director of Correctional Medicine, Clyde Maxwell.  We talked about how MAG became involved with accreditation of numerous correctional medicine facilities in the state of Georgia. MAG created its […]

 

 

Correctional Medicine

This week we continued our monthly series with Medical Association of Georgia.  I sat down with MAG CEO/Executive Director, Donald Palmisano, Jr., and Director of Correctional Medicine, Clyde Maxwell.  We talked about how MAG became involved with accreditation of numerous correctional medicine facilities in the state of Georgia.

MAG created its Correctional Medicine Committee in 1975 – following the prison riots in Attica, New York, and just before Georgia State Prison was placed under the jurisdiction of the federal courts for maintaining health care facilities that violated a constitutional prohibition on cruel and unusual punishment. The committee was charged with “studying and recommending ways to improve the delivery of health care in non-federal prisons in Georgia.”

MAG developed standards for evaluating health care in jails and prisons in the state as part of a national initiative; these evolved into the standards that are now used by the National Commission on Correctional Health Care.

In 1982, MAG developed legislation to establish an accreditation program for health care for correctional facilities in Georgia. The state began funding the program in 1983, and MAG subsequently started charging application fees for site accreditation visits.

The Medical College of Georgia assumed responsibility for the health services contract for state prisons in the 1990s.

MAG currently surveys eight county jails and 33 state prisons.

A number of major deficiencies have been corrected at jails and prisons in the state as a result of MAG’s site accreditation visits, including some that were related to…

* Physician and nurse licensure

* Physician and nurse CPR/ACLS certification

* Expired pharmaceuticals

* Needle and narcotics security

* Nurse call systems

* Inmate physicals

* Mandatory CQI and infection control meetings

Special Guests:

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia     

* JD Law, Loyola School of Law

* Board of Directors, Physician Advocacy Institute

* Medical Payment Subcommitte Member, State Board of Workers’ Compensation

* Treasurer, Board of Directors, Physicians’ Institute for Excellence in Medicine

* Former Director, Government Relations/General Counsel/Director, GAMPAC

Clyde Maxwell, Director of Correctional Medicine of Medical Association of Georgia

* Masters, Hospital Administration, Baylor University

* Certified Correctional Health Professional

* Active duty in the Medical Service Corps for more than 20 years

* Designed the “Quick Reaction Hospital” that is used to respond to natural disasters through much of the world

  Georgia Prostate Cancer Coalition Statistics show that 1 in 6 men will develop prostate cancer in their lifetime.  The risk for developing the disease rises with age, being most prevalent among men over the age of 60.  However, the risk begins to rise after 40 and prevailing medical thought is men should get at […]

 

Georgia Prostate Cancer Coalition

Statistics show that 1 in 6 men will develop prostate cancer in their lifetime.  The risk for developing the disease rises with age, being most prevalent among men over the age of 60.  However, the risk begins to rise after 40 and prevailing medical thought is men should get at a minimum a PSA test (a blood test that can detect prostate cancer) or if possible a digital rectal exam as well around the age of 40.  This will provide an early warning if there are worrisome findings on either study that will afford the patient more options for treatment that are much less traumatic and much more likely to be successful than if the cancer is found at a more advanced stage.

Ken shared his own story about how he was found to have a lump on his prostate on an insurance exam but was not actually recommended to have a biopsy until roughly a year later.  At that point it was found he did, in fact, have prostate cancer and that it was a more advanced stage.  He ended up having a radical prostatectomy, followed by a recurrence of the cancer.  To fight the recurrence of the cancer he underwent radiation therapy and more surgeries.  After all of that it was found his PSA levels were rising yet again, prompting his physicians to recommend hormone therapy to slow the progress of the cancer.

After his challenging experiences he began to work to increase awareness of the value of early detection of the disease to help his male counterparts avoid having to undergo similar difficulties.  He interfaced with the American Cancer Society to lobby for increased information for men about the risks of prostate cancer and the benefits of early detection.  He spent some time as a spokesman for the American Cancer Society.  He ultimately co-founded the Georgia Prostate Cancer Coalition, a non-profit organization aimed at creating community awareness as well as raising funds to help provide screening (including some free PSA testing) for men in the community.  The organization also collaborates with community businesses to help them provide prostate cancer screening for their male employees.

In speaking with Ken it’s clear that we men can do ourselves a big favor and go to our primary care physician or one of the screening events held by the Georgia Prostate Cancer Coalition to get a PSA test done and ideally, couple that with a digital rectal exam.  If our lot in life is to be a prostate cancer patient, we can have a large impact on what our journey is like in dealing with it if we endeavor to catch it early.

Special Guest:

Ken Stevens, Co-founder of Georgia Prostate Cancer Coalition   

 

Mitochondrial Diseases and Hyperbaric Medicine This week I sat down with experts in the fields of mitochondrial diseases and hyperbaric medicine.  Each cell in our body has an “engine” where the nutrition we consume through eating is converted to the energy we need to function and survive.  These engines are known as “Mitochondria”.  These cellular […]

Mitochondrial Diseases and Hyperbaric Medicine

This week I sat down with experts in the fields of mitochondrial diseases and hyperbaric medicine.  Each cell in our body has an “engine” where the nutrition we consume through eating is converted to the energy we need to function and survive.  These engines are known as “Mitochondria”.  These cellular components use genetic code to function and on occasion there will be problems with the genetic code or with how it is decoded.  In these cases, a variety of health problems can reveal themselves, depending on what sort of tissue is made up by these cells in question.  These can range from challenges with learning, developmental problems, or disease states such as Alzheimer’s, Parkinson’s, Muscular Dystrophy, and others.  Dr. John Shoffner, neurologist and geneticist of Medical Neurogenetics came by with Laura Stanley of the Foundation for Mitochondrial Medicine.

 

We talked about the research Dr. Shoffner is doing in an effort to find medical therapies that could help patients who are dealing with the variety of disorders caused by mitochondrial dysfunction.  We talked about how challenging it can be to identify a health problem(s) that are caused by mitochondrial disease unless a patient’s family is fortunate enough to be seen by a physician familiar with the genetic tests that can be utilized to diagnose them.

As described by the Foundation for Mitochondrial Medicine, “Every aspect of our beings – seeing, breathing, thinking, moving – requires energy. Mitochondria, often called the cells’ “powerhouses,” supply that energy by turning raw materials found in the food we eat and in the air we breathe into a substance called ATP (adenosine triphosphate), which our cells can use as fuel. ATP is, quite simply, vital to life.  Without enough ATP, children cannot appropriately develop, grow, learn, move, or even sleep. Adults without enough ATP are unable to sustain brain, muscle, and other vital organ function. A deficit of ATP can also cause invisible damage in some disease states, leading to early failure or dysfunction of organs, or just a chronic state of inefficiency leading to pain, fatigue, changes or limitations in thinking and learning, and increased susceptibility to acquired diseases.”

Laura and Dr. Shoffner shared how they are working to improve awareness of mitochondrial diseases and through research, uncover treatments to halt or at  least slow the effects of these diseases.  The ultimate goal is to find a way to prevent or reverse these problems.

Dr. Helen Gelly joined us to talk about a recent article she co-authored with Dr. Caroline Fife in Today’s Wound Clinic, called, “Hyperbaric Oxygen Therapy in Wound Care: A Service Under True Pressure“.  In the article, Dr. Gelly and Dr. Fife talked about how numerous Medicare Administrative Contractors and Commercial insurers are making changes to indications they are willing to reimburse hyperbaric oxygen therapy for.  That means that patients with wounds that place them at risk for amputation or for degraded quality of life due to previous radiation therapy may not be able to receive this evidence-based, effective treatment.  We talked about how in some cases where the providers in a given MAC were asked for clinical documentation of their HBO treatments provided, as many as 30% failed to respond.  Dr. Gelly shared how this lack of response leads to suspicions of fraud.

It was clear from the Today’s Wound Clinic article and from our conversation that hyperbaric medicine specialists must begin to activate and collaborate to protect this evidence-proven treatment modality.