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GASTROINTESTINAL topics
- Appendicitis
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INFECTIOUS DISEASES
- Antibiotic Resistance
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- CORONA VIRUS
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- Miscellaneous Articles
-
NUTRITION - EXERCISE - WEIGHT
- Cholesterol : New guidelines for treatment
- Advice to lower your cholesterol
- Cholesterol : Control
- Cholesterol : Raising your HDL Level
- Exercise
- Food : Making Smart Choices
- Food : Making Poor Choices
- Food : Grape Fruit and Drug Interaction
- Food : Vitamins, Minerals and Supplements
- Omega 3 fatty acids
- Vitamin B12 deficiency
- Vitamin D
- Weight Loss
- ORTHOPEDICS
- PAIN
- PATIENTS' RIGHTS
- SKIN
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- TREMOR
- Warfarin Anticoagulation
- OTHER STUFF FOLLOWS
- Fact or Opinion?
- Hippocratic Oath
- FREE ADVICE.......for what its worth!
- LAUGHTER.....is the best medicine
- Physicians Pet Peeves
- PHOTO ALBUM - its not all work!
- Cape Town, South Africa
- Tribute page
- The 100 Club
- Free Wi-Fi
PRIORITY CARE PRACTICE
Practicing medicine is and remains my passion.
It is hard to believe that I have done this for the past 40+ years and despite the stress of practicing as a primary care physician at this time, I would do it again in a heartbeat. It is a privilege and responsibility that I take very seriously.
Unfortunately there is a lot of dissatisfaction with the current state of the practice of medicine. There is an increase in the number of patients who now have insurance, which is a good thing, but a diminishing number of primary care doctors who are accepting new patients. This has resulted in an increase in the wait time to get an appointment. We have fewer doctors seeing more patients for shorter visits. The personal and meaningful connection with that one doctor, who has known patients and their families for years, is rapidly fading.
What saddens me is the frustration, that I sense in patients and physicians alike, about the feeling of having rushed appointments and not being able to receive and deliver the care we all deserve; of not having all our problems adequately addressed; and of not having enough time to spend on preventive medicine.
Years ago I twice seriously flirted with the idea of switching to a "true concierge type" practice, but always felt bad about doing this because it would have forced many patients to find a new doctor.
In 2013 I found a solution for those who chose to make a change.
For a small annual fee, my patients who chose this option were offered special services:
Everyone puts a different value on their personal health. Some may feel that spending less than $5 a day ($2.74 to $4.93 depending on age) is not worth it to themselves, but will spend this without thinking on Starbucks coffee, cigarettes, their car or their pet.
Over the years I have made myself available to my patients by email. I answer them after normal office hours, on weekends that I am not on call and even from South Africa. I have kept current both my personal website and that of Belmont Medical Associates, I try to keep my patients informed as to new developments in medicine by Twitter and Facebook*. I bend over backwards to help my patients. Most appreciate it. Some take it for granted. It is the kind of care that I want to continue. I have also learned during these 40+ years of private medical practice that I can't please everyone all the time. Some have short memories when it comes to the services they have received over the years.
I see patients who are overweight, have diabetes or high blood pressure that can be better controlled and think I wish I could spend more time with them or see them more frequently, so that they can be made to understand the importance of following a particular diet or taking a particular medicine. I want that time!
I feel very confident that some of you will find real value in the relatively small extra cost involved. Your health is important and I look forward to continuing our relationship for a long time. Take this journey with me.
For those of my patients who decide not to join, I respect your decision. I will continue to see you as I have always done, but I will not be taking on any new regular patients and the almost real time email exchanges that many of you now expect and may have experienced at night and on weekends that I am not on call will be curtailed because the sheer volume is not sustainable.
The annual fee for my PCP option "plan" is :
Remember that this is NOT an insurance plan. It is not a PPO or an HMO. Insurance companies have accepted the legality of this hybrid model of care because unlike true concierge practices, it does not disenfranchise existing patients.
Your insurance plan will continue be billed as usual for regular visits and services.
There are many of my patients who want more time to discuss issues at length and to go over and interpret internet research that they may have done. This is a perfect plan for them.
There are many of my patients who want more direct access to me and do not want to deal with an answering service or a covering physician. This is a perfect plan for them.
But........
...this is not for everybody. Patient's who enjoy good health and are seen infrequently; those who call or email rarely, may not find value in this option of care. There will be no "hard sell" on my part. There is no deadline for sign up and the 12 months begins when the contract is signed.
But......
...for those who do sign up, I know you will not be disappointed about your decision.
Final "but"......
...My Priority Care Practice option of care has been up and running for the past 10 years and I have reached the goal that I deemed manageable to successfully fulfill all the promises to the patients who have chosen this option.
Now that this target has been reached, this plan is no longer open to new patients.
It is hard to believe that I have done this for the past 40+ years and despite the stress of practicing as a primary care physician at this time, I would do it again in a heartbeat. It is a privilege and responsibility that I take very seriously.
Unfortunately there is a lot of dissatisfaction with the current state of the practice of medicine. There is an increase in the number of patients who now have insurance, which is a good thing, but a diminishing number of primary care doctors who are accepting new patients. This has resulted in an increase in the wait time to get an appointment. We have fewer doctors seeing more patients for shorter visits. The personal and meaningful connection with that one doctor, who has known patients and their families for years, is rapidly fading.
What saddens me is the frustration, that I sense in patients and physicians alike, about the feeling of having rushed appointments and not being able to receive and deliver the care we all deserve; of not having all our problems adequately addressed; and of not having enough time to spend on preventive medicine.
Years ago I twice seriously flirted with the idea of switching to a "true concierge type" practice, but always felt bad about doing this because it would have forced many patients to find a new doctor.
In 2013 I found a solution for those who chose to make a change.
For a small annual fee, my patients who chose this option were offered special services:
- Priority same day or guaranteed next day appointments for sick visits; extended visits when appropriate.
- Unhurried visits. Dedicated "first appointment" time slot between 8:00 am and 9:00 am for annual examinations.
- Comprehensive annual examinations of up to one hour in duration if necessary. Now you can go through your whole "list of questions" or discuss your internet research*.
- 24 hour dedicated, direct cell phone access to me unless of course I am on vacation. Calls after regular work hours should be for urgent or emergency issues and it is expected that routine non urgent issues be dealt with during work day hours whenever possible. I will give you adequate advance notice if I am not going to be accessible.
- For my "busy" patients, freedom to do more telephone, email and now even video consultations, if they cannot come into the office.
- Additional housecall option for qualifying patients.
- More time to spend on personalized preventive care; weight loss; nutrition; wellness advice, without feeling rushed and as though all your issues have not been fully addressed.
- I will continue to accept reimbursement from your health care plan for medical services rendered for "sick" or other visits. Please remember that the insurance co-payment is still your responsibility. Our agreement with your insurance company mandates that we collect it at each visit.
- On joining each patient will be given a unique PCP number that will identify them as having chosen this option and my direct cell phone number.
Everyone puts a different value on their personal health. Some may feel that spending less than $5 a day ($2.74 to $4.93 depending on age) is not worth it to themselves, but will spend this without thinking on Starbucks coffee, cigarettes, their car or their pet.
Over the years I have made myself available to my patients by email. I answer them after normal office hours, on weekends that I am not on call and even from South Africa. I have kept current both my personal website and that of Belmont Medical Associates, I try to keep my patients informed as to new developments in medicine by Twitter and Facebook*. I bend over backwards to help my patients. Most appreciate it. Some take it for granted. It is the kind of care that I want to continue. I have also learned during these 40+ years of private medical practice that I can't please everyone all the time. Some have short memories when it comes to the services they have received over the years.
I see patients who are overweight, have diabetes or high blood pressure that can be better controlled and think I wish I could spend more time with them or see them more frequently, so that they can be made to understand the importance of following a particular diet or taking a particular medicine. I want that time!
I feel very confident that some of you will find real value in the relatively small extra cost involved. Your health is important and I look forward to continuing our relationship for a long time. Take this journey with me.
For those of my patients who decide not to join, I respect your decision. I will continue to see you as I have always done, but I will not be taking on any new regular patients and the almost real time email exchanges that many of you now expect and may have experienced at night and on weekends that I am not on call will be curtailed because the sheer volume is not sustainable.
The annual fee for my PCP option "plan" is :
- $1,400 for patients over 40, but under the age of 50
- $1,600 for patients over 50, but under the age of 60
- $1,800 for patients over the age of 60
- $2,600 total for married couples/domestic partners
- $2,800 for married couples/domestic partners over age 60
- $3,600 total for families with three members (couple and a child; couple and a parent)
Remember that this is NOT an insurance plan. It is not a PPO or an HMO. Insurance companies have accepted the legality of this hybrid model of care because unlike true concierge practices, it does not disenfranchise existing patients.
Your insurance plan will continue be billed as usual for regular visits and services.
There are many of my patients who want more time to discuss issues at length and to go over and interpret internet research that they may have done. This is a perfect plan for them.
There are many of my patients who want more direct access to me and do not want to deal with an answering service or a covering physician. This is a perfect plan for them.
But........
...this is not for everybody. Patient's who enjoy good health and are seen infrequently; those who call or email rarely, may not find value in this option of care. There will be no "hard sell" on my part. There is no deadline for sign up and the 12 months begins when the contract is signed.
But......
...for those who do sign up, I know you will not be disappointed about your decision.
Final "but"......
...My Priority Care Practice option of care has been up and running for the past 10 years and I have reached the goal that I deemed manageable to successfully fulfill all the promises to the patients who have chosen this option.
Now that this target has been reached, this plan is no longer open to new patients.
Frequently asked questions:
- Do I have to pay the annual fee all at once? NO. This may be paid semi-annually or annually. There is no cut off and the 12 months of coverage only begins when you sign the contract and make the first payment. You may decide at anytime.
- Can I get a refund if I am not satisfied? YES, but only if you have not had your annual examination. You will then receive a prorated refund.
- Can an out of town family member or a visitor of mine be seen? YES. In the event that you have an out-of-town guest who may require services on an unexpected basis, they will be seen for urgent matters as if they were a member of the practice. Standard office fees apply.
- Is this concierge medicine? NO, as no one will be forced to make a choice about staying on as a patient. Your care will continue as usual. In addition, it is priced significantly less than concierge practices in this area.
- Will you be moving? NO, I will continue to practice at Belmont Medical and will continue to be part of their on call coverage for regular patients. Those on the PCP option plan will have 24 hour direct access to me by a dedicated cell phone.
- Does this impact my current insurance? NO, you continue to maintain your current insurance as before. All non-covered services will still be billed through your current insurance program
- Is there a family rate? YES, there is a significant saving for married couples/domestic partners and even more significant savings for families with three members.
- How will this impact me if I do NOT join? Other than not being able to book the 8:00 am to 9:00 am time slot on occasion, there will be no change in your actual medical care. You will still be seen as usual. Email access after regular work hours on nights and weekends that I am not on call will be dealt with the next work day.
- Is there a deadline for sign up? NO, you can sign up at anytime. The year begins on completion of the contract and the receipt of your check.
- Is your regular practice closed? YES, my practice is only open to those new patients who are interested in signing up for the PCP option of care.
You can choose to pay for a business class airline ticket and get priority boarding and a more comfortable seat on a plane.
You can choose to fly economy class without the "frills".
The plane will get you to the same destination with either choice.
Life is all about choices!
You can choose to fly economy class without the "frills".
The plane will get you to the same destination with either choice.
Life is all about choices!
If you needed your physician urgently right now. How would you reach them?
Could you....
Could you....
- email them....
- call them on their cell phone....
- video consult them....
- text them....
- see them that day or the next....
- even if it was the weekend or the middle of the night?
* Patients are big online research fans, with 61% saying they had turned to the internet for information on their medical care. Doctors on the other hand are not big fans of this kind of research, with nearly half saying it helps very little or not at all, and 8% saying it was very helpful.
With only 7 percent of doctors e-mailing their patients, let alone engaging them on blogs, Twitter or Facebook, the medical establishment needs to realize the influence of the Internet and social media on patients.
Guiding patients to better online sources of medical information should be a new physician responsibility for the digital age. Not only should doctors expect and be receptive to questions patients raise from Web research, they need to proactively engage patients online in order to dispel falsehoods and guide them to legitimate sites.
- Kevin Pho, MD
With only 7 percent of doctors e-mailing their patients, let alone engaging them on blogs, Twitter or Facebook, the medical establishment needs to realize the influence of the Internet and social media on patients.
Guiding patients to better online sources of medical information should be a new physician responsibility for the digital age. Not only should doctors expect and be receptive to questions patients raise from Web research, they need to proactively engage patients online in order to dispel falsehoods and guide them to legitimate sites.
- Kevin Pho, MD
How to Pick a Primary-Care Doctor
The best physicians are caring, competent and connected. Often patients choose and remain with a doctor because they are warm and engaging, an excellent diagnostician or highly accessible. The best PCPs are excellent in all three dimensions.
Choose a physician who is caring.
A caring physician:
Choose a physician who is competent.
A few ways for patients to evaluate a physician’s competency include:
Choose a physician who is connected.
With the significant changes in health-care markets, it’s important for patients to:
Picking a doctor is a very personal decision. Just because a doctor is recommended by someone or has an excellent rating on a website doesn’t mean he or she is right for you.
When picking a primary-care provider, in general, it’s important to have someone who you trust and who you feel listens to you, has up-to-date knowledge and expertise, and is accessible, whether by email or phone. Making sense of health-care information is an enormous challenge. Unfortunately, there’s not an owner’s manual that tells you when to get a tune up. While the Internet is a terrific resource, the information you find about health care, treatments and general wellness can be confusing and, at times, misleading. Having the right doctor to help you is key. But even choosing a doctor is tough. Patients say that they want a doctor with good bedside manner but they also want someone with up-to-date knowledge and expertise.
Many people ask for recommendations from friends or family when they are looking for a new doctor. Interpreting ratings you find online for doctors may be hard. For example, doctors with great ratings might get them more for being warm and friendly than for their expertise. In some cities, you can obtain information about which doctors are recommended most by other physicians, which may help you make a decision. Each state also has a medical board that lists physicians’ education and training, whether they are certified by the American Board of Medical Specialties, and any adverse actions that may have been taken against them.
It’s most important to know that as a patient, you have options and you should trust your gut. If you feel you have a physician who listens to you, explains your options and the rationale behind care, and makes sure you can get answers day or night when necessary, you’re probably on the right path.
The best physicians are caring, competent and connected. Often patients choose and remain with a doctor because they are warm and engaging, an excellent diagnostician or highly accessible. The best PCPs are excellent in all three dimensions.
Choose a physician who is caring.
A caring physician:
- Listens to patients’ concerns, makes eye contact, and asks and cares about patients’ personal stories.
- Discusses the plan for the visit and the future, offers a warm smile and empathizes.
- Avoids or explains unfamiliar medical terms.
Choose a physician who is competent.
A few ways for patients to evaluate a physician’s competency include:
- Look for information about the physician’s background and training online. For example, is he or she board-certified? You may also find patient reviews, which generally evaluate caring more than competency. It’s important to note that health care lacks standards for reporting physician or hospital performance, so the type and accuracy of information varies widely among sites.
- Ask the PCP what quality data they collect and how the data collection is performed. For example, how many of their patients with high blood pressure or diabetes has their disease controlled?
- Find out whether the physician—or more likely the practice—is part of a primary-care medical home, which provides coordinated care and monitors several measures of quality.
Choose a physician who is connected.
With the significant changes in health-care markets, it’s important for patients to:
- Ask and understand how the physician schedules urgent appointments, who covers when they are away, and whom to call and what to do if help is needed in the middle of the night.
- Find out whether the physician uses email or provides online access to your medical record, and how available they are by phone.
- Ask what network of specialists the primary-care physician works with and how they choose those networks. What is known about their quality? What hospitals are they associated with, and do they have access to an academic medical center? Do any financial conflicts of interest exist with any of the networks? The same questions apply for lab testing sites, imaging centers and hospitals.
Picking a doctor is a very personal decision. Just because a doctor is recommended by someone or has an excellent rating on a website doesn’t mean he or she is right for you.
When picking a primary-care provider, in general, it’s important to have someone who you trust and who you feel listens to you, has up-to-date knowledge and expertise, and is accessible, whether by email or phone. Making sense of health-care information is an enormous challenge. Unfortunately, there’s not an owner’s manual that tells you when to get a tune up. While the Internet is a terrific resource, the information you find about health care, treatments and general wellness can be confusing and, at times, misleading. Having the right doctor to help you is key. But even choosing a doctor is tough. Patients say that they want a doctor with good bedside manner but they also want someone with up-to-date knowledge and expertise.
Many people ask for recommendations from friends or family when they are looking for a new doctor. Interpreting ratings you find online for doctors may be hard. For example, doctors with great ratings might get them more for being warm and friendly than for their expertise. In some cities, you can obtain information about which doctors are recommended most by other physicians, which may help you make a decision. Each state also has a medical board that lists physicians’ education and training, whether they are certified by the American Board of Medical Specialties, and any adverse actions that may have been taken against them.
It’s most important to know that as a patient, you have options and you should trust your gut. If you feel you have a physician who listens to you, explains your options and the rationale behind care, and makes sure you can get answers day or night when necessary, you’re probably on the right path.