My practice philosophy

  ​I have always emphasized periodic health assessment and preventive health care, in accordance with the accepted national guidelines. My goal was to detect and modify "risk factors" before they lead to serious illnesses such as heart attack and stroke, emphasized early detection of potentially curable disease such as breast, colon and prostate cancer, and provided individualized instruction and guidance. With my specialty training in Internal Medicine, I had the expertise to promptly diagnose and treat most acute medical illnesses, as well as manage chronic and often co-existent problems such as high blood pressure, diabetes and elevated cholesterol levels. The evaluation and treatment of more complex conditions such as asthma, emphysema, coronary artery disease, congestive heart failure and peptic ulcer disease were also well within the scope of my training. If I diagnosed a problem for which consultation with a specialist or sub-specialist (e.g. surgeon, cardiologist, gastroenterologist, or dermatologist) was indicated, I coordinated your referral and recommend consultants who had earned my confidence and trust throughout the years. 
 
What represents good communication?

•  You should have things explained to you in a way that is easy to understand.
• You should be listened to carefully
• You should be given clear instructions about what to do to take care of the health problems or symptoms that were bothering you
• You should be given clear instructions about what to do if your symptoms worsen or come back. 
• I believe that your health management is a shared responsibility Research shows that patients who are more involved in their care tend to get better results. Prepare for every visit and be clear about the reason for the visit. You should have as much information as possible about your condition, so that you have the confidence to share in the decisions that affect your health. The better prepared you are to ask informed questions, the better are your chances of receiving optimal medical care. Speak up if you have questions or concerns. You need to be sure you understand what you are being told. If you don't understand, ask to have it explained again. Bring a second person to help, especially if you are feeling sick, worried or English is not your first language.

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:

• 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.

 

• You have the right to preventive medicine and I follow the American Cancer Society guidelines with regard to cancer screening.

• I try to keep abreast of the latest treatment protocols in the management of: osteoporosis, diabetes, hyperlipidemia, hypertension, coronary artery disease, congestive heart failure and chronic obstructive lung disease.         
  
  
• I believe in the value of getting an annual influenza vaccination in October or November and keeping up to date with appropriate immunizations ( e.g. tetanus boosters every 10 years; two doses of zoster vaccine (Shingrix) for adults >50 regardless of history of shingles; two doses of the pneumococcal pneumonia vaccines (Prevnar-13 and Pneumovax-23 at ages 64 and 65). It is advisable for college bound young people to receive the meningococcal meningitis vaccine. This is not part of the routine immunizations, so please ask about how to go about ordering this potentially life saving vaccine.  Three doses of the Gardasil vaccine are recommended for all adults aged <26 to protect against certain strains of  the human papillomavirus [HPV.] This virus is associated with a higher risk of cervical cancer, cervical dysplasia, genital warts, anal cancer and certain head and neck cancers.
•  In an attempt to reduce the development of resistant bacteria, I try my best to avoid the unnecessary and inappropriate use of antibiotics. Remember: antibiotics are ineffective against viral infections.  I have a link specifically devoted to this important problem.

Talking about tough topics:

• Give me a list of symptoms you’re experiencing. Do not be shy, ashamed or embarrassed about asking questions. Tell the truth. This is your health, and accuracy is important. List the most severe and most problematic symptoms first. Be specific. How long have you had them? When did they occur? What makes the symptoms better? Or worse?

• Menopausal symptoms, loss of libido, erectile dysfunction, concern about sexually transmitted infections [STI], depression, alcohol and drug abuse are some subjects that patients are embarrassed to raise as issues. I hope that you will feel comfortable enough to bring these problems to my attention, as excellent help is available.

• I strongly believe in smoking cessation, but understand how difficult it is for some people to kick the habit. Feel free to ask me about different approaches to dealing with this.                      
•  I believe in death with dignity and                                                   have found the Hospice organization to be most helpful and supportive. Ask me about the value of having a Health Care Proxy.

Staying on message:​  

• To gain the most out of your visits, it's always best to focus on the problem that is bothering you most and tell us about it first rather than leaving it to the end of the visit. Trying to squeeze multiple problems into one visit often leaves both the patient and physician feeling frustrated.
  • Be specific regarding what is wrong.
  • Prepare a handwritten list or copy of your concerns and give it to me at the beginning of your visit.
  • Be brief - mention your "major" issue first.
  • Tell me what you have done to help your problem (home remedies, medication etc).
  • Don't wait until the end to bring up a new topic or concern. Let me know all of your issues up front.
• "Patients are big online research fans, with 61% saying they had turned to the internet for information on their medical care. Many doctors are not big fans of this kind of research, with nearly half saying it helps very little or not at all, and only 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

 

• Annual examinations are encouraged, but remember: they are "well patient visits" or more like a "maintenance" visit when we review your history and see whether any studies or immunizations are due based on your age and updated family history. Please try not to cram in a year's worth of questions and expect them all to be answered, especially all the "orthopedic aches and pains".
• We make every effort to give same day service to any patient who needs, or feels they need to be seen. If my schedule cannot accommodate you, then you will be seen by one of my associates. Elective annual exams and non-urgent problems should be scheduled accordingly.  ​

Humor

• Even though I take my work seriously, I try not to take myself too seriously and believe in the value of a sense of humor. Laughter has been shown to be a marvelous stimulus to the immune system. So feel free to share a good joke, but PLEASE do not email me any jokes!

  My practice philosophy