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The Doctors Roundtable

Month: June 2013

Concierge Medicine

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Where did the preferred old days of extended doctor –patient relationships go, in today’s healthcare system? Many are not only asking the question, but both physicians and patients are taking steps to get back to more of an extended knowledge and quality time relationship.  Both physicians and patients are meeting their needs by joining the ranks of over 4400 primary care physicians practicing concierge medicine. Concierge medicine or “direct care” is a growing trend whereby the patient pays the physician an additional  financial “retainer” (annually or by month) for enhanced benefits such as: 24/7 access, cell phone access, no wait times for appts, coordination of care and longer visit times.

Although there is controversy as to whether or not this delivery model promotes a two tiered health system, both patient and physician satisfaction levels are quite high.  Physicians typically have more time to spend with patients during in office appointments as they care for a much smaller patient population (about 300-1000) than the traditional practice (3000-4000 patients).  Typical services not included with a concierge physician: labs, ER visits, hospitalizations, medications, and consults outside of the practice.

Join concierge provider Dr. Ellie Campbell and Michael Tetreault, Editor-In-Chief of Concierge Medicine Today, as they discuss this growing trend from both a local medical practice and national trend perspective. Listeners can visit: www.campbellfamilymedicine.com and www.conciergemedicinetoday.com for more information on our great guests.

Dr. Eleanor Campbell

  • DO from Kirksville College of Osteopathic Medicine
  • Residency  in Family Medicine from Medical College of GA
  • Board certified in Family Medicine
  • Private practice in Cumming, GA since 2005

Michael Tetreault

  • Editor of  national publication, Concierge Medicine Today


Personalized Medicine and Pharmacogenetics

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Personalized medicine is an emerging  model that extends traditional approaches by using an individual’s genetic profile to guide medical decisions and treat illnesses.  Genetics gives us a more detailed understanding of how genetic variability between people can be used to better predict a patient’s response to medicine, titrate doses, and significantly reduce adverse drug reactions. “One size does NOT fit all” in drug therapy.  Low cost, easy to use gene testing is now available and moving closer to the mass market.

The FDA recently documented that genotyped patients receiving warfarin therapy are expected to have 31% fewer overall hospitalizations and 28% fewer bleeding incidents that may result in healthcare savings of $1.1B.  Over 2 million adverse drug reactions are documented in the US annually and an estimated 100,000 deaths per year are caused by ADR’s in hospitals across the US . Like knowing your blood type, knowing a genetic baseline /genetic variations can be quite valuable.  Patient profiles that benefit the most include: on 4+ medications, taking Warfarin (Coumadin) or Plavix, have unexplained symptoms, or where medications have not been effective.

Iverson Genetics, in Washington, is a leader in this exciting field. Today, on this segment, Dr. Christina Mailloux and Randy Satterlee will discuss “P4” medicine: predictive, personalized, preventive, and participatory new pharmacogenetic advances.   Listeners can visit www.iversongenetics.com and www.personalizedmedicine.com to learn more.

 

Dr. Christina Mailloux and Randy Satterlee

Iverson Genetics

 

Telemedicine and High Risk Pregnancy Management

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Telemedicine is the provision of medical services across distances. The technology has been around for over 50 years and recent advancements are allowing specialists to reach a larger number of new patients.  Although telemedicine had humble beginnings using audio and video technology, this field has moved from curiousity to mainstream acceptance. Last year, approximately 36 million Americans experienced telemedicine in some way.

Patients are often limited by distribution of doctors, their own disabilities, and distance. Recent telemedicine providers estimate that 80-90% of specialist care can be delivered remotely.  Telemedicine works by having a physician in one location, connect to a patient at a “presenting” site. Varying types of technology allow for complex exams to take place without the “human touch”. Telemedicine as proven that it is 1) feasible  2) able to generate comparable clinical outcomes as in person and 3) of value to patients as it provides access, convenient ,and is cost effective.  Challenges such as technology glitches, reimbursement and licensure issues are hindering adoption. However, health care reform is speeding up the implementation of telemedicine.

Listen to Dr. Patterson, a master’s degree engineer and double board certified physician, discuss telemedicine in general and how she applies it to her rare specialty of maternal fetal medicine.  She shares achievements with numerous outcomes on high risk obstetric patients and more on how she is working to achieve some new breakthroughs in rural obstetric populations.  Listeners can visit: www.americantelemed.org , www.gatelehealth.org and www.womenstelehealth.com for more information.

 

C. Anne Patterson, M.D.

Dr. Anne Patterson is a board-certified maternal fetal medicine specialist who received her medical training at Emory University after completing a masters engineering program at Georgia Tech. She has practiced at Northside Hospital, one of the largest OB delivering hospitals in the US for the past 25 years. Dr. Patterson is also an advisor to the Georgia OB/GYN Society.  Most recently, she moved from private clinical practice to telemedicine and now is one of the nation’s top leaders in her field. She has presented at the national American Telemedicine Association, been a 2013 nominee for the Atlanta Business Chronicle’s Health Care Hero awards, and been featured in numerous videos on this subject.

 

Osteoarthritis and Rheumatoid Arthritis: Overviews to Breakthroughs

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On the heels of National Arthritis month in the U.S., this segment of  The Doctors Roundtable focuses on osteoarthritis and rheumatoid arthritis.  These two illnesses, out of the over 100 musculoskeletal disorders,  affect millions of Americans and their ability to maintain high quality physical movement throughout their lives.   In the U.S., arthritis is the leading cause of disability and it is not just a disease caused by aging.  Osteoarthritis and rheumatoid arthritis are chronic conditions with no clearly known causes.  These diseases are progressive and degenerative , leading to the breakdown of cartilage, bones, muscles and membranes surrounding the joints.  The effects of this breakdown include: inflammation, pain, fatigue, joint stiffness and at times joint deformity and disability.  Imagine standing, sitting, lying down or coughing and all causing pain.  Many patients report there is never a day they can forget they have arthritis.

The Arthritis Foundation is the nation’s largest private funder of research, public health programs and advocacy on behalf of the 50 million Americans living with this painful disease.  With the aging of Baby Boomers, it has been estimated  that by 2030,  67 million Americans will have some form of arthritis.  Here, the Arthritis Foundation will discuss an overview of these two diseases and how they are working to fund research, change policies and educate to help arthritis patients today and tomorrow.

 

John H. Klippel, M.D.

John H. Klippel, M.D. is president and CEO of the Arthritis Foundation, the largest voluntary health organization serving the 50 million Americans living with the nation’s number one cause of disability. Dr. Klippel has held the position since October 2003.

Prior to joining the Arthritis Foundation, Dr. Klippel served as Clinical Director of the National Institutes of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). During his professional career at the National Institutes of Health, he authored or co-authored 190 peer-reviewed publications and textbook chapters related to arthritis.  He has served as editor of the Primer on the Rheumatic Diseases and the textbook Rheumatology.

 

Roberta Byrum

Roberta K. Byrum, CPA, is the chief operating officer of the Arthritis Foundation – the nation’s largest national, nonprofit health agency working on behalf of the 50 million Americans living with arthritis.

As COO, Ms. Byrum is accountable for all aspects of the daily operations of the Arthritis Foundation National Office, headquartered in Atlanta, Georgia. In addition to her operations leadership of the national office, Ms. Byrum works closely with the Foundation’s regional CEOs to ensure strategic alignment of nationwide operating activities.