31 Burst results for "Family Medicine"
"family medicine" Discussed on Outcomes Rocket
"And outdoors, the humidity is always pretty much always higher than it is inside One of the more interesting stories about this is ear infections in the Indigenous People in Alaska and Jerry my wife and I went there to talk to the native American people and see if we do anything about their problem with your infections. So we talked to the Indian health. Service and they weren't much help We talked to audio logistics in the audiologist told us that they go out to the communities and the elders in those communities. The really really old people saying, Oh, we didn't have any ear infection problems before we got civilized and they got civilized in the fifties when we gave them houses modular homes to live in with the central heater and took him off the ice. So they didn't have to live in Igloos an ice homes anymore and what that did was dropped the humidity and their wintertime and they live in a very cold environment. So there's not much humidity in the air anyway, but breathing cold air stimulate SISTEMI. Opens the doors to the vascular. So it gets more water in your nose automatically. So they took them out of this environment and put them in these homes that are by far more comfortable and more pleasant except the they made people made their kids sick with ear infections and they have the highest incidence probably in the whole world of ear infections, recurrent infections, and they're very common. If you can stay in this Green Zone, you wouldn't have. Those ear infection, and if you can increase the humidity where the Red Oval is, if you can increase community about fifty percent, you don't have respiratory infections cove. It is a respiratory infection and that's one of the reasons ayatollah works because it pulled water interior nose just like histamine opens the taps except you don't need open taps if you put Xylitol in your nose and it stays in your nose for about six hours, so you're getting A. Benefit that lasts for six hours and pulls water into your nose puts you in Greenville, and if you have respiratory infections like the Red Oval says, you won't have anymore and that's one reason it works because it optimizes your nasal defenses by keeping enough fluid in your nose to help those defenses weren't bets and the second way it works is like the study from the University of Tennessee showed and that is a little bit harder to. Explain but microbes hold on to our cells, the surface of those cells and almost always is tradition complexes that are on the surfaces of ourselves that they hold onto and they know what they're holding onto because sugar complexes are pretty stable in their configuration. Early studies looked at the E. coli bacteria that causes urinary tract infections. Manno is a sugar like glucose a little bit different configuration that man owes is the sugar that those bacteria hold on. And if you put Nanos in their diet since most women with urinary tract infections or self infected from their GI, try it shifts out the bacteria to those that do not hang onto mammals. The man was wonder washed out, and so he have less trouble with urinary infections. XYLITOL is not a six carbon sugar like our bodies are used to news. It's a five carbon sugar and it's flexible. It's like the pickpocket thing that you can stick in door and twist and turn in. And the fits because it's flexible, it can get into those binding sites.
"family medicine" Discussed on Outcomes Rocket
"Sorry. We're not interested. We need. We need a something we can control an atmosphere. So we've been selling those watch for Sir Twenty years and recently my son who took over the manufacturing and distribution and selling and marketing. All wanted to find out what it did for the virus and he's added other stuff to it. So make a little bit more complicated. Took it to the Laboratory at Utah State University, and they looked at it and said, Hey, this does something to the virus. So we had to take all the parts apart and found out that it was a rape fruit seed extract that they use it as a preservative that kills the virus. And so they started doing some research it and they're doing research in southern Florida on that nasal spray to see what it does for the virus and preliminary reports from that study a anecdotal so far. But when the study is completed, they'll. Be a a double blind placebo control study. So if it's all the bells and whistles, the FDA Wa the preliminary reports house to people anyway with the symptoms and positive tests that are symptom free and test Frey in seven days. So that's pretty good and then there's another study. From amp site pharmaceuticals, AMC y you can search. Pharmaceutical Company and covert and Xylitol, and they paid the byles. Laboratory. At the University of Tennessee to look at xylitol their study was a little bit different because it washed watch the mixture before they finally counted the virus virus on the in the end result and there were not so Xylitol in this case interferes with the adherence of the back of the virus in our noses hand. So you get a one two punch with with this nasal spray and it's simple safe twenty years of marketing without any complaints and a lot of success here can get it up.
Moderna's Work on a COVID-19 Vaccine
"Are in the final phase of their vaccine trials in the U. S. CBS News chief medical correspondent Dr Jon Lapook took a look inside and behind the scenes of what it's like to be part Of Fighters Cove in 19 vaccine trial. I wanted to be part of the solution for Dr Victoria Smith, who practices family medicine near New Orleans. Covert 19 is personal. She's lost three patients to the virus. I'm not an immunologist, but by being part of a trial. I could be part of that research front as well. In late July, Dr. Smith became one of the first of 30,000 participants needed for fighters Phase three vaccine trial she received her first dose at auction or medical center in Louisiana. It's a double blind study, meaning neither she nor the researchers know whether she received the vaccine or a placebo. Are you kind of hoping you got the vaccine? Yes. CBS News got an exclusive look at auction ER's Phase three trial site every week. Visor sends them packages of the vaccine and placebo vaccine is then stored in this freezer. At a temperature of at least minus 60 degrees Celsius to remain stable. This vaccine is new. Did that give you any pause? Not really. I trust the process. To be approved by the FDA. A covert 19 vaccine must prevent or decrease the severity of the disease in at least 50% of vaccinated people. There's no evidence that that the vaccine makes the disease worse at all. So that's really, really insured in very encouraging. Dr. Kathryn Edwards is on Visors Vaccine Safety board Once a week, the five members of the committee video chat to carefully look through data for adverse effects, especially serious ones, such as hospitalizations, So we're very, very cautious and how we look at the data. Certainly, if there were severe reaction, we wouldn't get that information right away. Dr Edwards says there is no evidence so far. The vaccine causes serious reactions, but that mild reactions are common and should not deter anyone from getting vaccinated. You may have a sore arm, or you may have a
"family medicine" Discussed on Outcomes Rocket
"Welcome back to the outcomes. Rocket saw Marquez is here and today have the privilege of hosting Paul Dow? He is the current e-health innovation strategist for the American Academy of Family. Physicians based in Lee would, Kansas with the advent of covid nineteen. The goal is focusing on practice tools that will be robust in the rapid transition that telehealth and virtual patient engagement during the emergency, and beyond policy and innovative thinker and a strategist than the space and I'm excited to be diving into what they're up to at the. American Academy of Family Physicians and for him to share his message around practice viability, and then and his him, and his organizations search for long-term solutions to help with cove in nineteen, and beyond a Paul, such a privilege to have you here if you can give us a little more insight into you and your bio, and and then we could dive into into the the interview. Sure. It's great to be here, Saul, thank you for having me. I. Am a helping petition and have worked for the Academy for about a year prior to that I was at the. Leading Cardiac Society Washington DC for about six years, and then prior to that. Were for medical device vendor for about ten in their clinical education space. Clinical Background is in radiology. Sea Tac X. Ray tech from back in the day but moved were into health it that really kind of seemed like the future and turns out he was so I'll have a variety of other predictions by the end of the podcast, and maybe a few lottery numbers. I love it. I got my plenty handy. Yeah insightful Paul. I definitely was the future, and it is the president now. Health it. The use of technologies like a I digital health. They're here with us and have been accelerated What what is it? That inspires your work in healthcare? I mean you've been in it for for a long time. What keeps you working within the bounds of healthcare? All to me that it's endlessly I guess endless curiosity. He's be interested There's there's so much to learn and file and. It. It feels like there's always a new development into new insights that come out of research or technology. Advancements and trying to apply those into a clinical space you know. How can we make this this thing? This taking care of people more efficient and more effective, not not in the sense of trying to make positions more efficient hamsters. But more, how do you? Leave them off. The monotonous tasks that their their skills are not suited for. Physicians you know floor five stenographers by one then to use their clinical expertise and their deep insight into the diagnostic process as well as also their deep empathy. They got into healthcare because they care about people and if we can have tools. Free up their time then they can focus on hearing for people and You know that that to me is really a huge motivator. A finding solutions that actually work aren't just cool. I'm doing air quotes now But, actually actually are productive and help them on a day to day basis. Love it yeah, it's it's a great great calling, and as as we dive further into into your organ, the organization Europe part of It'd be. It'd be great to to know how you guys see yourselves position to add value to family physicians but also to educate us on on what your community looks like in the breakdown of of physicians that you guys are are helping. Share, so we have about seventy five thousand members of ASAP. if you include residents and medical students that swells to about one hundred, but as far as practicing clinicians in the field, it's about seventy five thousand We have fifty thousand who are employed at a variety of locations, every qualified health centers Medical Centers and the other twenty five thousand are independent practices so basically these are small businesses that are run by clinicians. And we're trying to find solutions to help. Help all of them. You know certainly There is no one perfect technology that's going to fix everyone's issues, but if we are you know patch, some of these technologies together and then provide some insights on workflow your best practices. We share within within the House of Family Medicine. you know then we can start to build some trends and build some some improvements that can be sure to one day. That's great and so give us some examples PA. Love to hear you know some of the some of the resources that you guys are coming up with for for your members, and you know maybe some examples of how something has surfaced that has helped, and how it's helped a great story to share shares always good and miss part. Sure sure so we've been working with a company called. sukey s you KFI and they have a digital digital clinical assistants that works, so it's a little bit like a Alexa, but for you HR's so that they are able to interact with their ehr just with their voice patients reviewing results so that they aren't there and typing in in keyboarding quite as quite as much. You know we're seeing. We've heard stories from clinicians. WHO said that they have? Have about two to three hours per night of data entry basically that they had to do after clinic and then after using Sukey, they were able to leave the clinic on time, and actually leaving on time felt like vacation. Then I think it'd be able to have that. You know ten hours per week back into their back into the bay could choose they wanted to do. They could go to their kid's soccer game or exercise and show some self care. What do you can just? Talk to talk to their family and have dinner at the same time as opposed to bag around for a quick snack at ten o'clock at night, you know and then going to bed Sukey. Sukey data. Yes sukey? Just used them.
Navigating Innovation for Family Medicine with Paul Dow
"Welcome back to the outcomes. Rocket saw Marquez is here and today have the privilege of hosting Paul Dow? He is the current e-health innovation strategist for the American Academy of Family. Physicians based in Lee would, Kansas with the advent of covid nineteen. The goal is focusing on practice tools that will be robust in the rapid transition that telehealth and virtual patient engagement during the emergency, and beyond policy and innovative thinker and a strategist than the space and I'm excited to be diving into what they're up to at the. American Academy of Family Physicians and for him to share his message around practice viability, and then and his him, and his organizations search for long-term solutions to help with cove in nineteen, and beyond a Paul, such a privilege to have you here if you can give us a little more insight into you and your bio, and and then we could dive into into the the interview. Sure. It's great to be here, Saul, thank you for having me. I. Am a helping petition and have worked for the Academy for about a year prior to that I was at the. Leading Cardiac Society Washington DC for about six years, and then prior to that. Were for medical device vendor for about ten in their clinical education space. Clinical Background is in radiology. Sea Tac X. Ray tech from back in the day but moved were into health it that really kind of seemed like the future and turns out he was so I'll have a variety of other predictions by the end of the podcast, and maybe a few lottery numbers. I love it. I got my plenty handy. Yeah insightful Paul. I definitely was the future, and it is the president now. Health it. The use of technologies like a I digital health. They're here with us and have been accelerated What what is it? That inspires your work in healthcare? I mean you've been in it for for a long time. What keeps you working within the bounds of healthcare? All to me that it's endlessly I guess endless curiosity. He's be interested There's there's so much to learn and file and. It. It feels like there's always a new development into new insights that come out of research or technology. Advancements and trying to apply those into a clinical space you know. How can we make this this thing? This taking care of people more efficient and more effective, not not in the sense of trying to make positions more efficient hamsters. But more, how do you? Leave them off. The monotonous tasks that their their skills are not suited for. Physicians you know floor five stenographers by one then to use their clinical expertise and their deep insight into the diagnostic process as well as also their deep empathy. They got into healthcare because they care about people and if we can have tools. Free up their time then they can focus on hearing for people and You know that that to me is really a huge motivator. A finding solutions that actually work aren't just cool. I'm doing air quotes now But, actually actually are productive and help them on a day to day basis. Love it yeah, it's it's a great great calling, and as as we dive further into into your organ, the organization Europe part of It'd be. It'd be great to to know how you guys see yourselves position to add value to family physicians but also to educate us on on what your community looks like in the breakdown of of physicians that you guys are are helping. Share, so we have about seventy five thousand members of ASAP. if you include residents and medical students that swells to about one hundred, but as far as practicing clinicians in the field, it's about seventy five thousand We have fifty thousand who are employed at a variety of locations, every qualified health centers Medical Centers and the other twenty five thousand are independent practices so basically these are small businesses that are run by clinicians. And we're trying to find solutions to help. Help all of them. You know certainly There is no one perfect technology that's going to fix everyone's issues, but if we are you know patch, some of these technologies together and then provide some insights on workflow your best practices. We share within within the House of Family Medicine. you know then we can start to build some trends and build some some improvements that can be sure to one day.
"family medicine" Discussed on KOMO
"People employed at family medicine offices including the receptionist the assistants nurses doctors and the billing staff Carly Johnson come on news reports of doctors taking deep pay cuts in clinic staff being furloughed coming in from all over the country when orders came to stop performing elective procedures and put off routine doctor visits revenues to those offices drop fifty to seventy five percent the Oregon nurses association says hundreds of its members have been laid off at Oregon clinic locations in the Portland area for that same reason Rachel Gumpert is with the nurses union she tells KGW the stories are heart breaking she told us that she's afraid that she won't even be able to afford groceries alone the the other necessities of life in some cases those laid off healthcare workers are being redeployed to facilities treating covert nineteen patients are new patient overflow sites still ahead his community pulls together to support those out of work I'm Brian Calvert and it's amazing what you can come up with over a good beer first a channel for couple traffic we check it every ten minutes on the force with Kierra Jordan east Redman drivers were finding another day of drilling that's taking place on novelty hill road between two hundred and forty third in west no Kwame valley road and so that's causing some delays around the immediate area they also have another day of road work in Seattle eastbound I. ninety on the floating bridge that's blocking your right lane although pierced transit continues to operate on a modified Sunday schedule starting today they've actually added a couple of extra runs to ensure that drivers have enough space between them and this is mostly being added on our key morning in key afternoon routes taking a peek at a couple of travel times effort to Seattle at twenty four minutes of Bellevue to Seattle twelve minutes on either like bridge in Olympia to JBLM swing gate that's taking about eighteen minutes our next como shop I got ten fourteen now the global eagle river forecast with Kristen Clarke Seattle's dry stretch of weather may continue well into next week this could be the dry stretch that we have seen since late October and.
COVID-19 Q & A
"You guys. This is such a treat his. You'll know our all star. Washer hot a leak you know. He's like with us from the beginning. Right you guys know that. He's like contributing op ED writer. He's a CNN commentator. It's a big deal to have him calling us from his car. So welcome wash minivan respect and the Dad Boston okay. Here's the amazing thing dear listener. We are joined by his wife. She's a brilliant physician. Her name is Dr Sarah. She's a physician at Georgetown Family Medicine. And Hey you're married to watch you've done this for a while you're the euro. Welcome to the doctor. I thank you so much for having me and I'm calling from the cars. Yes so watches in the fan in our driveway. And I'm in the car in the driveway and they're watching the children from six feet away. This is about as social distancing as you can get this is the most socially responsible podcast in the world amazing amazing and I just love. What was just told me that he wants to do which is to wrap me up in bubble wrap so that. I stay healthy. Thank God I am healthy. In fact I just tweeted out today. I was just like how I'm going to be grateful for having a roof over my head husband. Who LOVES ME? My kids at home. home job. So we're GONNA start podcast on a note of gratitude and I'm just so thankful that was and Sarah are joining. Hulu me because this is a big deal. It's our first time to have a married couple. It's also our first time living through a pandemic so here we are. We're surviving there are now over three hundred thousand cases worldwide with over thirty five thousand Kovic in nineteen cases in the United States making this the country with the third most cases after China and Italy. We're actually just eleven days behind Italy in terms of trajectory. So keep that in. Mind as you guys know. It's putting such a strain on our healthcare system The CDC is telling healthcare workers to improvise when they have a shortage of masks. What we have several states multiple states that have you know basically placed some form of shelter in place or lockdown protocol. I have to say I'm surprised that not all fifty have done it so Sunday night. The president of the United States his name is president trump. You know he said this and it was really it was really It was a moment because he said that the National Guard is going to be deployed to New York California and Washington State. That made a lot of people of color really uncomfortable. Yeah and then also on Tuesday the Prime Minister of Japan. Avi Shinzo he said. The International Olympic Committee will postpone the Summer Olympics. They were supposed to be held in Tokyo this summer. Now they'll take place no later than summer of twenty twenty one so I just want to back up for a moment to understand. And we're we're laughing through this because we're we're releasing and because we're with people care about right now on this past but Every single day it's just like Oh my God. No joke like no joke. How serious diseases and why? We should have taken these measures back in February but Sarah Update us. What what we've learned so far about cove in nineteen you know. I just have to agree with you. I've just say we are already weeks late and doing everything. Normally when you're late to do things it's like. Oh the toll measured in something. That might not be that relevant right now. The the tragedies toes measured in lives loss. So every day that there's a misstep or delay it's going to be measured and more lives lost absolutely horrifying so where we're at right now. I mean at least in the US like you said we actually don't even know the two cases. Those are reported cases when you don't know the real official number because we've been under testing and we haven't been testing and we haven't been tracing and just like the World Health Organization said it took a think about sixty seventy s from the first reported case to reach the first one hundred thousand cases and then after that it took just eleven to reach the second one hundred thousand cases and then just four days to reach a third one hundred thousand cases so this is a horrible buyers exponentially affecting people all over. So this is scary and we are not overreacting or under reacting and as public health professionals. We always say if we do our job right then. People will say that we overreacted. And that's okay because then that means we're all okay but unfortunately that's not the case right now so sir one of the things that we did for this show because we have a real community of people who listen to us right so we're familiar even though we're not touching each other the ask our our listeners to send questions and one of our listeners on twitter reverberate wire asked if it is spreading through for example gas pumps and how long it lasts on surfaces. I mean sometimes when you're seeing this information it's its terrifying how long the virus can last on different surfaces. What do we know is is fact about this question? So we're always finding out new information. This is a new virus. Things are always changing but what we know as of now is it's highly effective so are not is the rate of infectivity of any virus and if it's greater than one then that means the virus is going to keep spreading and if it's less than one that means you're gonNA see decrease in number infections And when it's greater than one what that means is so far the SARS coronavirus two are not is. It's around three so for every one person infected you're likely in fact three other people And this is without without social distancing and all those measures so one of the reasons it's so infectious again. The flu is like one one point five so this is almost doubled infectivity rate of the flu. 'em Is because it does last on surfaces right now. What we're finding is akin lost on cardboard boxes or paper for anywhere up to twenty four hours and it can last on plastic or steel for two three days. Whoa WHOA Yikes. Yeah I want to say based on what I've been reading. The literature shows that that's not the highest rate of transmission can get transmitted that way but the highest rate is droplets through a person to person contact. And there's a small number fecal oral also ooh K. All right good to
Warming Up Before Your Workout
"Sure all of you will have heard this before. You need to adequately warm-up before going the full throttle into any workout will that be weight training running any sort of sports and so on and more often than not this advice this falls on deaf is so why is it so important to ensure your warm up properly before you exercise. A warm up is a period of time prior to being doing physical activity which consists quite often of light cardiovascular exercises and quite often stretches as well and a woman activties serves two major purposes ready to enhance performance when we first gets help to also prevent injury now. What is really interesting to notice that Mike? With many topics in the health and fitness world there is contradictory advice out there. Because I'm sure many of you will have heard that you should did stretch before warming up as stretching spores exercise helps you to increase flexibility. It helps increase the ability of joint to move for. Its Fru range range of motion. But I'm here to say today that there might be some clues lifting evidence on stretching before we start doing size but before we talk about this contradictory trade balls dot that I should say. There are different forms of stretching. There's static stretches which of those where you're standing or sitting or you're lying still and you hold a single who position for a long period of time and these differ to dynamic stretches while you're performing genital repetitive. Movements perhaps like leg swing weh Edwin gradually increases the range of motion of movement but it always remains in the normal range of movement. Another example might be doing like chocolate cake Jorgen between each each one. But you're doing an open and close. The Gates Foil in an outer thighs are looked at up. If you're not sure I mean there but it has more movement involved rather than just being static taking sedentary as you'll doing the stretch so all of heard in the past is that regular stretching is thought to increase flexibility by making all muscles more supple and by retraining the nervous system to tolerate stretching further however according to the National Strength Conditioning Association a growing body of research has shown that pre-workout workout or pre event static stretching may actually have a negative effect on force production POW performance strengthen durance reaction time time and running speed in fact. Several studies said stretching before a workout or an advantage the race or a weightlifting competition. Whatever it may be has been shown to reduce performance went up to three percent? Dr Ian Schrager. A sports medicine clinician researcher and associate professor at the Department of Family. Medicine at Montreal's McGill University. Christie said that research now suggesting that stretching before exercise actually makes your muscles weaker and slower but it does help to increase. You'll range of the notion professor. Robert Herbert is a senior principal. Research Fellow Wave Neuroscience Research. Australia found that most of the evidence strongly suggest adjusted static. Stretching before exercise does not reduce the risk of injury and even a little bit quite negligible I mean study called a pragmatic randomized trial of stretching before and physical activity to prevent injury and soreness found what they called to be. A hint of an effect on reducing injuries like Ligament Tasr has muscle strains and sprains. So where does this leave. As if we've been told allies to do stretches and static stretching before exercising what shall we actually do. What free exercise warm up should we do? If there's a point in doing one at all so according to Dr Sharia your decision to stretch not distract should be based on what you want to achieve deep if the objective is to reduce injury stretching before exercise is not helpful. Your time better spent by warming of your muscles with the light. Aerobic Nick Movement. We talked about light cardiovascular movements getting some light joining in for example and gradually increased their intensity whilst of your objective is increase your range of motion so you can more easily do the splits. For example this is more beneficial doing stretches then doing a cardiovascular joke for example the purpose solve warming up has to prepare mentally and physically for your chosen activity so typical warm up should take at least ten minutes and involve the light Arabic movements we talked. What about with dynamic stretching that mimics the movements of the activity? You're about to four form unless as we said you're about to perform a split for example or something like the way you might want to consider static stretching you should then gradually increase the range of motion of these movements during the warm up to prepare the body for more intense versions of those movements that occurred during the sport itself so by doing this. This process will raise your heart rate. Increase the blood your muscles thereby warming your muscles up. And when he formed to muscles up less stiff they work more efficiently than has more blood flow. That's enabling your muscles two or more oxygen to reach your muscles and produce is energy and the woman also activates the nurse signals to muscles which can increase your reaction time so what is better recommended then. It's a combination Asian. Really if you're going to do a sport or weight training all a run. For example of dynamic stretching where into being cooperating some lights cardiovascular activity tippety as well as some more movement and Joe stretches raw than holding them in a static position so this episode might be very contrary to what you've heard before about stretching but I hope it has helped shed some light on pre-exercise war ups and what we should be doing What we should consider depending on what our objective
For Her Head Cold, Insurer Coughed Up $25,865
"There's no question that medical bills are often higher in expensive neighborhoods and there's no question that this corner of New York City not far from grammar see park is one of the most expensive bits of real estate in the country but still you have to ask if you go to a doctor with a cold and a sore throat should you expect the last bill that tops twenty eight thousand dollars that's what a doctor at Manhattan specialty care just off Park Avenue south charge Alexa cast the I caught up with this forty year old public policy consultant at an office uptown I start getting a really sore throat and so I decided just to go the doctor to see if I had strep throat I was leaving on vacation that next week overseas and so I just wanted to like have some antibiotics in case it didn't go away the appointment with doctor Roy thought a lot he was quick she says a throat swab and blood draw and she was out the door with her prescription for cold went away pretty quickly and she enjoyed her vacation I get back about ten days later there's several messages on my phone and I have an email from the billing department at doctor Patel he's office the teller that BlueCross BlueShield this mailing her family a check for more than twenty five thousand dollars to cover some of the out of network lab tests the actual bill was over twenty eight thousand dollars but the doctor says they will collect the twenty five hundred dollar copay I thought it was a mistake I thought maybe they meant to hundred and fifty dollars I couldn't fathom in what universe I would go to the doctor for a strep throat culture and some antibiotics and I would end up with a twenty five thousand dollar bill this is perfectly normal the doctor's office kept assuring her and they sent a courier over to our house to pick up the check did the doctor tell you what test she was running now did you tell you that she was sending things to a clinician alright that lab that was out of network now definitely not yeah he went back and forth a little bit with the billing people right you were that you made it clear that you're unhappy about this yes I made it very clear that I wasn't happy about it in fact she told him she would report the doctor to the New York state medical board the test in question turned out to be DNA probes that were looking for a smorgasbord of viruses and bacteria Dr Renae majority professor of family medicine at the Georgetown University school of medicine sees no reason to run them in my twenty years of being a doctor I've never ordered any of these tests let alone seen anyone of my colleague students in other physicians order anything like that in the outpatient setting I have no idea why they were ordered maybe for a patient in the intensive care unit or with a difficult case of pneumonia there could be a reason to run these tests he says the ones for influenza are potentially useful but there's a cheap rapid test it could have been used instead there about two hundred and fifty viruses that cause the symptoms for the common cold and even if you did know that there was virus a versus virus to be it would make no difference because there's no treatment anyway so no reason to run these tests Alexa Kasdan also wondered whether running these tests and running up her insurance bill is even legal or show marking an attorney in overland park Kansas who specializes in medical billing says that depends on the details there are a lot of state law issues that can be involved and there's a lot of contractual issues that can be involved in this particular issue New York state has a surprise billing law patients need to be informed if they're in network doctor is referring a test to an out of network provider and to warn people that they could end up with a big bill state laws also limit cozy relationships between doctors and labs that could be at play here once companies also have contracts with doctors say making sure lab tests are done in network but billing expert marching says insurance companies aren't monitoring those claims as they come in most claims processing even for something a claim like this that you and I would read it after the fact and think gosh this just seems outrageous to pay this much money for these types of lab services are often completely automated there's never a human set of eyes that look at the bell and decide whether or not it gets paid the list prices in this case or about twenty times the going rate in that Manhattan zip code marking says and if the threats wanted been sent to lab core which is in network for Castin I'm courses that would have charged the insurer about six hundred and fifty dollars rather than the more than twenty eight thousand dollars for essentially the same tests Dr fought a lot he did not respond to requests for comment and even though a lexicon aspen didn't have to pay practices like this still cost us morning says she may not be paying anything on this particular claim but overall if the group's claims and costs rise everyone all the employees and and their spouses paying into the health plan may eventually BPP paying for the cost of this after we started asking questions about this cast and Kerrier Blue Cross blue shield of Minnesota launched an investigation they acknowledge that the review process failed to flag this extraordinary bill this at the doctor's office had not cash the check so they put a stop payment on it well they dig deeper morning says people can take issues like this to their insurance company or state regulators or do some of their own legwork before leaving the doctor's office I always ask where they're sending my labs or where they're sending my images so that I can make sure that that's in network with my health
Why Do People Still Use Fax Machines?
"In eighteen. Seventy eight Alexander. Graham Bell filed patent for a history altering device called the electronic telephone. But what you may not know. Is that the patent for another amazing communication tool. The simile machine or fax machine was filed by Scottish. clockmaker named Alexander Bain three decades earlier. That's right fax machines predate even rudimentary telephones and with a cockroach-like likes survivability that makes very little sense from an evolutionary standpoint. The fax machine lives on beeping and wheezing up sheets of paper. The world over for example vaccine is big in Japan even today about half of Japanese families use a fax machine in their homes. The question is why to understand. Dan Helps to know a bit about the facsimile machines place in history. Although the technology had been around for decades it wasn't until the nineteen thirty nine New York world's fair that fax machines. I seized mainstream recognition in the United States there attendees stood slack jawed in amazement as they viewed images and text arriving from around the the world at eighteen sheets permit. The machines were simply too expensive for everyday use though even by nine hundred eighty two one standalone fax machines sold for a whopping twenty thousand dollars far too pricey even for most businesses much less individual consumers. It wasn't until later in the nineteen eighties that the cost of the machines dropped to a point that businesses and offices found them useful notably documents that required legal signatures copied signatures. As you can probably guess were a source of controversy for years as legal professionals argued about the validity of documents that arrived via phone lines however as court after court confirmed armed the validity of faxed signatures doctors lawyers financial gurus and other professionals began to rely on faxes to transmit paperwork all over the place thus thus entrenched in the workflow and minds of countless millions of people the late nineteen eighties saw dramatic rise. In the number of fax machines. America had only around three hundred thousand contraptions in the middle of the eighties by nine hundred. Eighty nine there were more than four million. The Fax Machines Heyday was at hand. They even featured prominently in pop up culture. The one thousand nine thousand nine Scifi comedy back to the future part two explorers a future where the mic fly family had a fax machine in every room so the facts in process is one that billions of people have ingrained into their consciousness place assigned document in the machine punching the destination phone number. Hit the green button and minutes later. Your paperwork is in the hands of a colleague on the other side of town or on the other side of the world assuming that the fax machine has paper the cartridge is not out of ink and nothing has gotten stuck in the transmission transmission process but in the mid nineteen ninety s another history changing technology exploded and use the internet which provided people with ways aged instantly. Send text pictures and documents without these of paper with the coming of widespread e mail. It seemed that fax machines were doomed. Only they weren't aren't in two thousand seventeen study from market intelligence firm. IDC showed that the four major industries that are still using faxes Those industries being manufacturing factoring healthcare finance and government all predicted increased use of faxing over the next two years averaging twenty five percent increase. So why is that hat. Faxing is familiar technology that people trust the complexities of the Internet and its many offshoots technologies along with endless headlines about hackers spyware aware viruses and data breaches create in many people's minds. A sense that the web just isn't secure. In addition government policies still encouraged faxes and legal processes like discovery of evidence. Lean heavily on paper documents. Doctors backs prescriptions and private documents and patient records fax machines. are a habit and it's a habit that is hard because it's a simple low tech interoperable system that anyone can use just a few minutes of training also fax x machines like the aforementioned roaches are evolving with the times the people surveyed by. IDC said that the biggest reason for the increase in faxing was axing was now integrated. I graded with email as digital faxing and so was easier to use A. We spoke by email. Todd Johnson DR at Access Family Medicine in Lincoln Nebraska. Aska he said `I office notes prescriptions lab data orders and consultation requests affects anything else. It's requested I would email just as easily but I don't have a general email account to send the requested information to typically usually. I'm only provided with fax number to return requested information. Johnson Johnson says that the newest generation of digital faxing mixes workflow fairly easy quote. I don't use a feed and fax paper machine. I can facts from any of my computers tablet habit smartphone. I use them because I'm requested to use them by other facilities they're easy to use and now electronically configured into my phone system. I just drag and drop a pdf into the fax x Portal and away. It
Survey shows American kids have doubled their online video consumption in 4 years
"So about a fifth about third graders on smartphones and you got all my CAD third graders up fifty third graders own smart we're talking fifty three percent of eleven you don't have a smartphone my god what are we doing to these kids by the time their tweens which is a year later or teenagers three quarters of kids have smartphones which makes one go what's going on with the other that's three cars what what what's going on with the other court what's wrong with you people the average screen time is something like almost five hours a day for the average teen are for the average I'm Sir tween seven and a half hours for the average teenager and how it breaks down is a gaming is about twenty percent of that TV or videos another forty percent of that and the increase overall as you know has gone through the roof in the last number of years when it comes to consumption of online videos and what is the big demon known as screen time joining me on the queue hearing centers dot com hotline from family if he's a family a doctor practices family medicine damn physicians Dr Elizabeth Thomas Dhaka morning are you good morning thank you for having me on your show thanks to come I hope you're the voice of reason because I'm looking at the study doc I'm going all right the scientific pride the parent part because yeah okay screens but the other part of me goes what we've always had the boogie man out there looking at okay now it's screens right that that they said this about comic books back in the in the old old old days before me in you came along the comic books were going to destroy can rock kids minds they need to read the classics is that way from comics and there's always something it's this it's culture to music it's movies now it is screen time is the big nemesis should we be as afraid of screen time as are making it out to be well that's a great question and I I think what we're seeing in terms of research is the effects of early introduction to digital media is that we're seeing kids having a difficult time sleeping there have been academics a B. C. D. activity has decreased and because of that there seems to be a zoning and not how long should really be on social media digital media is it really affecting that and unfortunately we are seeing this alarming statistic where we are seeing effects and mood and sleep with their eyes their eyes and need to take a break okay but I I look at this and go let's look at how young people young adults what they're tempted by and what at the time of the year in which they grew up with they're attracted to self there wasn't a time long ago when we had to actually not taxed anyone or I am someone doc as you may recall maybe you don't I I in in you actually do use what's called a land line and in most houses had maybe one phone some had multiple phones but you only have one phone line and if your parents thought you tied up the phone line too much talking your girlfriends talk your friends whatever they would say get the hell off the phone I have to use it or go to bed it's time for bed same thing when it comes to television that parents should limit your screen time when it comes to television or video games most recently for that matter isn't yeah you could spend all your time on the phone or you can spend all your time in front of a book or in front of TV over what might be it's up to mom and dad a sense of okay take a break do some go outside blow the stink off that's exactly right and parents have the key essential part in all of it they need to be consistent with any task that time thank you you can use our digital media zone but real time read when everything should be turned off make sure the recharging and their their devices and a family room or kitchen overnight with the kids have no active so you're exactly right parents have to be consistently to Coldplay with their kids in terms of knowing what happened programs and you should be there watching and be able to interact with their kids and their old friend Hey what what kind of after your kids eating because more than likely their own children are using the same app very important that parents are Bob to help even send their what their children are watching because they can be exposed to the world and predators out there and we really want to keep him safe our doctor was the Thomas family practitioner the show this morning at seven hundred W. O. W. talking about this new study that's come out that says so many kids are online right now and it's it's it's I guess the take away without putting words in someone's mouth not your sister let that study but it's a it's like you're riding your brain it's a it's it's a digital hair when I heard the term digital hair one before I roll my eyes because once you dig down ago well what's doing is we do studies and we hook them up to very sophisticated machines that people like yourself not operate theirs dials and gauges and meet all these things and measurements and and they hook it up and the minute they start playing video games or watching TV all of a sudden we see what happens in the frontal cortex of the brain and all of a sudden that the brain chemistry starts changing and you just watch this thing you watch your brain become poisoned with neuro transmitters but I just yesterday had a good job on my show talking about the neural pathways in the brain and all these things and how to stop Alzheimer's before it happens after engaging in exercising your brain by learning their physical exercise and other things in neurotransmitters and a we know scientifically that our brains adapted the change based on the stimuli that they face so if I put a pizza down in front of someone or a TV show they want to watch this is a video game or a book for that matter movie what what the what in your brain change because it's the pleasure centers that that's what they're supposed to do they're supposed to react to something that you see is pleasurable so why is screen time so bad versus let's say I don't know reading the book it may be the same you may have the same reaction right it's more the exposure of what the kids are being exposed to that's fair in terms of like virtual violence I think that kids are more exposed to violence on these these new video and gaming you mentioned Jamie early on that production now you don't even know what's realistic and what's fantasy and so being able to sit with them and talk with them through those kinds of things I think the key here is the exposure and as you know the future videos which is really metric thirteen about what we have eight nine year old better on you he finished one video and it's going on they have no breaks in between and I think that could lead to some of that addiction to the digital media yeah but is it different than addiction to I mean my my brothers I sit for hours with our you'll baseball cards trading cards look in the back of cars and we've user self hours over the summer days doing that or if you're in it's always it's interesting you know you could send a kid but let's say the same kid goes and he watches you two videos for four hours which is a long time right is watch oh my god it's it's your poison his brain you said the same kid too I don't know practice the cello and we look at him and that individual as being all my gosh look how intelligent they are what's the difference great question you know it's the creative side of your brain that simulated when you're playing the cello or when you're doing something more that with a video game or some of these like mine craft for example where it's open ended in your you know you're coming your own conclusion about things I can make a case for that as well as I could about a piano lesson we're just sitting there you know hitting the same note over over to learn basically it's it it's developing your hand eye coordination I I think both things but maybe different doc but you know that the people who look at go out for example you sit around and watch TV is frowned upon but sit around and read I'm or three Harry potter books in a row you'd be patting the kid on the top of the head it's the same thing you're not moving well yeah but I think what we're seeing now though is that research has shown that when they are sitting in front of the screen for a long period of time that it's more negative effects birthdays hang up that instrument for doing something more productive like physical activity because what you're doing with digital media is you're dropping your levels on the amount of sleep because getting the collectivity even what they're eating and so I think that's where we're seeing that negative effect right completely see where you're coming from but I think it's important that the child has a variety of things to do and once you have an iPad you tend to not get up from it we're out there putting on yeah playing a cello you tend to play that for a couple hours then you go find something more productive to do but I think you make a great point however because the research shows thank you the facts we want to make sure kids are safe and not be exposed to things that are inappropriate and that they're not just to get to to that the screen but isn't that two different things out that the content I mean you could say some kid is addicted to reading and other nerdy kid it's it's all library all day and it's your pasty white skin and he's the other is because of the glass is the whole thing stereotype right I don't see there's any differently Candace it's in and and sits on the couch and and plays video games I mean they're exercising different parts of what I guess the thing is I just hate vilifying because we do that in societies you know doctor Thomas is anything new it's got to be a threat it's got to be endangering the children because while adults don't understand it we're we're not supposed to understand it but but your brain and dabs we adapted and I'm sure these kids all that the point is you just can't spend all your waking hours doing one thing right and you know fortunately we don't see much research and you know kids are reading too much in the negative effects of it or we are playing an instrument for too long in the negative effects of it but I think with social media it's more of effect on the brain affected by effect on their overall weight and because we're seeing all that that is why they come up with a recommendation in order to make sure families all generally healthy I guess to when you hear about screen time it just to me it doesn't seem like it seems like too broad a category because you're typically all too much screen time okay I'm watching you stupid you two videos about you know dog kiddies playing piano is another stuff and minecraft videos and maybe stuff I'm not supposed to watch but I think the problem here too is content reggae dog he gets all travel together so whether you're watching on a laptop or a phone or tablet it it doesn't matter the devices get jumbled together and I know is there a difference between watching like you know watching a football game on you to T. V. over your phone verses I don't know watching something I you know it it's it's like saying Hey everything that we look at that on paper it is a paper time is just as bad as screen time minutes if you say well paper time what is it is absurd to screen time because
Amazon launches Amazon Care, a virtual medical clinic for employees
"Amazon is launching a new health care clinic an app really for some of its employees of the test Amazon care it's called is a pilot for Seattle Amazon employees only and it'll allow them to video chat with doctors and more market places Merial segera has been following this how will it work let's say you're an Amazon employee in Seattle and you sign up for this program and then you get a sore throat you could open up the app and message or video chat with a health care provider like say a nurse practitioner. and if that providers is like well I really need to do a test for strep throat you could have a nurse come your house or meet with you in a room on Amazon's campus and then if you need a prescription for antibiotics Amazon can send that to your pharmacy or delivered to you obviously this is Amazon we're talking about and are these doctors and nurses where they're coming from a they on staff at Amazon they'll come from a family medicine clinic in Seattle called away says medical group Amazon's partnered with that clinic we don't know all the details though lake whether Amazon will have access to its employees healthcare records we do know that the program isn't required at this point it's often and this is another ever by Amazon the great disruptor to get into healthcare yeah Amazon does have ambitions in the health care space it bought the online pharmacy pill pack last year and C. N. B. C. just reported that Amazon's working on your buds that'll include health and fitness trackers this particular program though is just for employees you may remember last year Amazon partnered with JP Morgan and Berkshire Hathaway to start a nonprofit that would work on cutting healthcare costs for its workers and in
Study: Psychiatric Diagnoses Are 'Scientifically Meaningless' In Treating Mental Health
"Okay so this time I caught my eyes where psychiatric diagnoses are called a scientifically meaningless this is not something you usually see in headlines and the timing couldn't be any more worse cross my legs there could be any worse because we're trying to grapple with how we deal with our mental health and how to find the next shooter or the next you know Boston Marathon bomber you know or the next terrorist and you know we're we're trying to you know get a grip on how to diagnose and how to identify if we have a disgruntled employee and then we come in we find out that one of psychiatric diagnoses you might not have enough scientific merit and this study that was published in psychiatry research and it concluded that psychiatric diagnoses are scientifically quote worthless as tools to identify discrete mental health disorders this comes from the university of Liverpool so basically what they did a lot of the DSM an art diagnostic manual are are DSM four is kind of our Bible when it comes to psychiatric disorders that there really is our Bible when it comes to that and they look at that and they found that psychiatric diagnoses all use a different decision making roles that there was a huge amount of overlap in symptoms and that almost all diagnoses mask the role of trauma an adverse events and they say diagnoses tell us a little about the individual patient and what treatment they need now some of you may be like Hallelujah praise the lord it's about time somebody calls it like it is and I I know there's a lot of you out there many of you have emailed saying I got a diagnosis of depression or anxiety and I don't have that in so it is very subjective he I'm training that I got as a family medicine doctor we got a lot I it's not enough not enough for me to be confident doing psychiatry in my practice so I generally just like I treat I would diagnose mild anxiety mild depression I would diagnose I came up with this idea of you having low serotonin and that being a condition and maybe your low serotonin is making you here in a ball and causing insomnia and making you grumpy and giving you a bad day in giving you Val problems are causing your blood pressure to spike and so I would try some of the selective serotonin reuptake inhibitor medications and a lot of times we found great success but I was really reluctant to give you a diagnosis of major depressive disorder or anxiety disorder or adjustment disorder or you know another sort of of mental health diagnosis and it is subjective and unfortunately insurance companies have forced us doctors to give you a diagnosis because if I see you as a patient and you let's say we've talked about this on air a lot let's say you want to fall asleep on a plane and if you want some Xanax because it helps you fall asleep on a plane and then you can wake up and get out well when I was using an ex for insomnia and you don't really have insomnia you just want to fall asleep on a long flight so I don't wanna why so I have to choose okay well are you using a just a fall asleep insurance once a cult to pay for that visit and for us to write a medication like that I got to give them a call so then well do you have a little anxiety are you able to falsely but yeah I guess I don't see Paul on the plane may because of that so you get the diagnosis of anxiety but you really don't have anxiety that's not your diagnosis and so were forced to come up with diagnoses all the time maybe that's a pro with medicine maybe it's all about diagnoses well you have high blood pressure you have diabetes you have this person who's at risk for heart disease I don't know what it is eat like crap you're overweight you smoke you got a lot of family history of stuff why do I have to give you seven to ten different diagnoses we got the ICD ten code with millions of codes and you know these cold snow falling for life because we have electronic medical records so now we have you know more more patients one alive they don't want their diagnosis of anxiety to follow them because they may want to own a gun later and just because they wanted Sam axe to fall asleep on a flight they don't want that to prevent them from being able to exercise their second and the rights and so we're we're kind of in this Max and so psychiatry is there are certain diseases that afflicts people that are very very obvious that are very unpredictable we could very consistently diagnose such as like schizophrenia or major depressive disorder or an addictive personality or you know narcissism histrionic antisocial attention deficit but you know I come to learn that attention deficit is more of a symptom rather than a diagnosis you know people say yeah my kid as ADHD and so my second question is why why well does he have autism does he have as workers does he have hypoglycemia does he have a thyroid disorder these attention deficit could be a symptom of something else and so sometimes we get to the diagnosis of wood but we stop it there because well we got a right there by the hands of the concern of the medication well why isn't anybody asking why so what's good about this study is it makes this kind of re look at how we approach psychiatry and how we approach a patient that may have a mental health issue but do we really need to stigmatize do we really need to diagnose everybody you know if somebody can't sleep or somebody doesn't like the mother in law or somebody has a fight with their spouse or somebody doesn't want to be in Los for Christmas or if somebody you know is sick and tired of smelling dog crap in the house you know and they you know don't know how to deal does that really mean they have a mental condition you know so these are things that I think we do have to talk about I do not want anybody taking this headline to think that whatever they were diagnosed with this poppycock that's not the case okay you know if you were diagnosed with a mental health condition there's a very good chance you'll have that right there's a lot of overlap and when I hear people use the term bi polar all their bi polar all right where they diagnosed with bi polar I mean you didn't really have bipolar do they really have the press to do they really have anxiety I think we might need to re look at when we actually label and
Being 'pear-shaped' may protect even normal-weight women from heart disease, study suggests
"First let's start today show the way we do every week with our co host actor Jennifer Wessels doctor Wessels as a family medicine physician she's also the VP of medical affairs for the SSM health medical group Dr Wessels thanks for joining us again today thanks so much when you talk to you today about a whole bunch of different summer related health issues but before we get into that a couple new stories at the start of this week I wanted you to address the first one concerns where women collect body fat it may determine their health risk all those fifty something women looking in the mirror and bemoaning their pear shaped physics should instead be high fiving themselves a new study of postmenopausal women of normal weight has found that the fatter the belly and the skinny or the hips and thighs the higher a woman's risk of stroke or heart disease the researchers suggest so called apple shaped women should try to lose that belly fat and instead a spire to become more pear shaped Vicki Barker CBS news exploring apple shaping pear shaped well apple she prefers to at the shape of someone's body in where they hold their body fat so folks that have a larger abdomen are maybe wider in their mid section with skin your leg skin your hips that's considered an apple shape and that's compared to someone who we call pear shape or they may have a thinner smaller waste but may be larger in their bottom or their hips or thighs so what should women strive to be so typically we we note that in a lot of scientific studies women who are more pear shaped tend to have a lower risk of heart disease and stroke women who are more apple shaped tend to have a high your risk of heart disease and a higher risk of stroke does it matter what shape men are well we know that there is also a higher correlation of her disease in men who have more fat around their abdomens are who have a larger mid section so for for anyone in general keeping your weight in a healthy range eating healthy exercising regularly all of that will only do good things for you to lower your risk of heart attack and
Measles: 4th case reported in King County
"Less than a month after measles outbreak in Vancouver. Washington ended a fourth measles case was reported this month in King County come assume Romero has more. The latest cases women in her thirties. And she traveled around before, realizing she was sick, including the Hudson alcohol bakery, at the airport, and valley family medicine in Renton. Jeff do chin with Seattle. King County public health believes all the recent cases came from exposure to measles at the same place on the same day seatac airport on April twenty fifth so the waiting to see if any new cases developed from these four that should be something that would be happening beginning around now and could go on for a couple of weeks. So we have our fingers crossed that device is not going to spread further in our community. You can see a list of the potential measles exposure locations at KOMO news
How do physicians assistants and nurse practitioner come with physicians on meaningful outcomes?
"The number of medical students entering primary care specialties, like family medicine, pediatrics and general internal medicine has steadily declined to fill this void mid level providers like physician's assistants nurse practitioners have taken on a far larger role. This is Dr Michael Wilks with a second opinion. These providers spent about twenty five percent of the time training compared to that of physicians. The irony is that their patient outcomes are often just as good and on. Some variables like patient satisfaction. They're actually better than physicians despite about a third of Americans getting their primary care from a mid level provider. Most patients don't know much about these mid level providers how they're trained and what they can do. In a recent study half of the public did not recognize that mid level providers could prescribe medicines and diagnose illnesses in a study published in the. Annals of internal medicine. Researchers compared doctors nurse practitioners, and physicians associates caring for about three hundred and fifty thousand people with diabetes, of course, diabetes is a chronic disease and requires careful management there simply are not enough doctors in the United States to adequately treat all diabetics. But everyone does deserve to be managed with the best evidence based treatments. The researchers in this study assessed quality of care by looking at the appropriateness of medications prescribed for diabetes, hypertension, and cholesterol. And they used lab tests to show affective nece over a two year period, they found absolutely no meaningful difference between the three types of providers. Still many people would prefer to wait for physicians even for minor concerns. What they may not realize is that most mid level providers work in a team and consult with. Physicians when the complexity of the onus increases, I know what I'm about to say may not be popular. But it is long past time to rethink the entire of medical education, do physicians really need for years of undergraduate training four years of medical school and three to six years of residency at a cost of hundreds of thousands of dollars per student. Remember that this high cost only drives medical students into the highly paid specialties where they demand ridiculously high salaries it is time to look at eliminating a couple of years of college and shortening medical school by thirty percent. I feel strongly that this would have no impact on the quality of our doctors. Now, I'm not sure I would do much to change residency programs. Of course, they certainly need some quality improvement and an injection of humanity. But the time required for training and residency is probably. About right to train good doctors. But all of medical training needs a radical redesign with PA's and NP's playing a vital role in healthcare delivery. What stands in the way of such changes physicians who else this is Dr Michael Wilks? With a second opinion this podcast was made by public radio station. KCRW our status as a nonprofit enables us to make bold and unusual programs. But we need your support to keep it that way donate or become a member at KCRW dot com slash join. And thanks.
"family medicine" Discussed on Bulletproof Radio
"It for free right now. And I founded this outta pocket. Interviewed a dozen experts, including Dr Hyman not Haymond is on the show. But Dr Mark Hyman as well as Dr Ayman and a dozen people like me who just got taken out at the knees in different ways by mold. You would understand that a hundred million structures probably including your kid's school have toxic mold in them right now. And that breathing it is even worse than putting it in your food or drinking Darrow say in your coffee. Yes, bull. Improve coffee beans are carefully made in lab. Tested to be free of micro-toxins because they Jack you up. Well, I've got a guy with impeccable credentials who's been studying mold for years and look at when it does your hormones to your genes to your brain to making you tired, and we've had other people on the show who talk about how toxic mold as one of the big things contributing to Alzheimer's disease, and there are links to cancer, heart disease and everything else. So this is a big thing going on in your life. Whether you're specifically dealing with fibromyalgia, chronic fatigue. And if you've heard me talk about lime, I think Lyman moulder integral e connected, you never really get lime until you've had toxic mold exposure, I could be wrong. We're gonna find out in the interview today with Dr Andy Hayman, welcome to the show. Thanks day. Thanks for having me how to do in. That intro. You did great. Now, how long have you been studying mold? You know, I was forced into it in a sense. Not not unlike you and to me there were sort of two phases. The first was I spent sixteen years at university of Michigan where did my training. And then I was on faculty there in our department of family medicine in my mic spor- even back then was in integrative medicine. And I honestly thought I knew everything I needed to know at that point about treating complex patients using multi-modal therapies, I then decided around two thousand nine two thousand ten to move to Virginia and I bought a private practice there. And I started seeing patients that did not fit a profile that was used to sing they were far sicker. The the memory loss. The word finding difficulties brain fog fatigue, way, gains twenties. It's horrible. It's awful. They're a mess. And you know, I had a suspicion that maybe it was some sort of exposure. But I couldn't figure out what it was. So I started doing a little bit of research with George Mason University their local university in Virginia, and they developed a pretty good line test turned out a portion of those patients. Hadline and defended I definitely definitive had his definitive. And I said, okay. So now, we're onto something, but a portion of the patients didn't, but they had all the same symptoms and two thousand twelve and thirteen. You know, I started feeling like I was having some of those symptoms as well. Living Virginia the living in Virginia. And I did the task insure enough. I had line. So I treated myself and was getting better. But then two thousand fourteen I felt like I was hit by truck. Yes. I know that feeling so what happened? Total memory loss intense migraines. I would see a new patient in my practice in six weeks later would have no recollection of having met them. I mean, it was really scary. For me. What was going on frightening about disability insurance on the happened to me in my twenties? Yeah, awful. Okay. And I was not used to that. I mean, I trained for triathlons. I was always fit. I was pretty fled. I felt like I knew my body, but you wake up one day, and you realize you're not yourself anymore. But I couldn't get any good answers. It wasn't lime at that point. But it kind of felt like line so started collecting more data and began working a bit with Dr Richie shoemaker. And it turned out that I was sick for mold shoemakers, an interesting guy. He's a pioneer. I think the first clinician to figure out these fat, soluble toxins from environmental mold were were fighting you. There's a direct effect from cells. He spoke at a conference several years ago and has. As very rigid protocol for mold and there's been a lot of evolution from that original work. But you gotta give credit. He was a family doctor just noticed this and in like a bulldog in like, oh, that's right. And we continue to do re research together, the model has absolutely changed..
"family medicine" Discussed on Outcomes Rocket
"Health and family medicine residency at the university of Florida was recruited to come back to Asheville as the assistant medical director for primary care at mission medical associates as the ACO planning began in two thousand thirteen Mr. feels lead the quality steering committee. And how the initial planning of what was to become. Mission health partners. He's done a lot for that community. But also across his experience in healthcare to improve outcomes. And it's a pleasure to have him here on the podcast with us to discuss what's on top of his mind. So rob pleasure to have you on the podcast today. Thanks Thanks for for having having me. me. Tom. Tom is a pleasure. So what is it that got you into the medical sector? Rub. Yeah. I mean, honestly, my older, brother. I've brother who's ten years older. And at one point had wanted to go into medicine, and that's how the idea for that in my head, and then had some experiences in high school and volunteering and kinda got it. Then I was pretty sure I wanted to do primary care, even then I just kind of solidified, you know, you go through undergraduate have different thoughts. But really always came back to medicine something that was really met all my need. I need for service in a need for to be my love of science and relationships and all the though it interesting to combine all the things I love, and it's been a great career. That's outstanding man. Yeah. It's such a such a great place to get all those wonderful things mad, and then also help people in the process. And so as you've worked your your feel for technology as well, as you know. You know, caring for patients, tell us what a hot topic, you.
Michigan man charged in fatal-dumbbell bludgeoning of aunt
"Two. Troy man, accused of killing his aunt appears in court yesterday on the first degree murder charge. Newsradio nine fifty are Huber with more of your old now year Masroor was the focus of a short man hunt Tuesday afternoon near square lake and John are Troy police say Masroor hit his aunt in the head with. Fifteen pound dumbbell in the basement of a home on shoreline. He then went to another home where he jumped from a second story window and fled through the neighborhood. A lockdown was placed at four Troy schools until officers found the suspect hiding in a marshy area near the murder scene. The victim was Dr Rabab Huck who practiced emergency and family medicine in Troy was a well known member of the community a judge denied bond from us ROY
Researchers: Selfie-related deaths on the rise, call for 'no selfie zones'
"Arise in selfie related fatalities may lead to the creation of no selfie zones. In many cities a study in the journal of family medicine and primary care showing between twenty eleven and last year. There were two hundred fifty nine. Selfie related deaths in America that might not seem like a ton. But the authors of this study say the deaths are often categorized by law enforcement is accidents, which masks the real number
"family medicine" Discussed on WINT 1330 AM
"Right thinking My. Opinion is, all stars not life right the way, person thinks determines. Who they are and what they, become, so, your, thought, life, will, determine, your real life, just, remember, that, your thoughts become the life that you live. People think there's no, big deal. It's a huge deal that's how you, turn out you look, at, your thoughts and I'll. Tell you where he likes going to be the goals what you right now Every single day hopefully right your goals down on a regular basis Got to, put them in front of you all the time if you don't you'll end, up. Somewhere. Where you don't even want to be So you got to write those down goals. Are important what you think is important the way you do. Things every single, day that matters it's what lays out everything for your life It's a big. Deal because our thoughts determine every single. Thing that we. Do on this show we want to encourage you to get there let's get on. The phones and talk to Elizabeth high Lisbeth I would like to know About possible causes of. Horizontal lines in your fingernails Okay so the fingernail issue it depends okay the, horizontal lines lead tons can be an iron deficiency but it also could, be if you've got kind of their horizontal ridges then dimensions then that could be leaning toward a, heart related condition also would call clubbing the nails which will they kind of get rounded that is a. Usually indicator that something's going on with the heart it's amazing because there's a whole There's a? Whole kind. Of. Diagnostic set the the old school doctors family doctors way, back in the day like when I say way back in the day, it's kind of like little house on the prairie days I did some family medicine in medical school, in my clinicals and I wanted to I wanted to go out west and I went out west to. A training program for family medicine For period of time and it was. Really cool I mean it was it was I'm talking out in the middle of. Nowhere where you're the only doctor I wanted to see what it's like the only doctor in like Five hundred mile radius no hospitals I mean it was it was. Rural I mean big time like in. The sticks as we say It was amazing the reason. It was cool is because the diagnostic tools were so old school sometimes? That these, guys were using fingernails the tongue is. Looking inside the is not just for. The regular things will you do in medicine I. Mean they. Were finding all kinds. Of things I. Learned a, lot needless to say so the cool thing is About the fingernails is yeah it, tells you a lot so if you've got. Anything like that going on. Recommend a couple of things to you for sure so you wanna get your doctor and definitely get some, testing, dine blood test in further testing rights so even if they consider the heart a a potential they can. Do some simple testing right they. Can run. EKG internet go they can do whatever they need to do they can run some labs you want to get. All that done. Because it's sometimes it just takes like a fingernail to to say hey it's warning sign that something's coming down the. Pipeline in the one thing. Is you don't want to wait you don't wanna wait till things you're? Bad you, don't want to wait till things already. Broken down and you want to get. Way ahead of the game So you get ahead of the game and then you can build A good solid game plan around at that's we have. To, start the fingernail, issues iron or something to do with, heart typically like for example if you've got little. Puffy white spots you ever seen will, white spots, on, your, fingernails, zinc, deficiency, just, about, every single time, triple, eight, two, eight, three seven two seven two this triple eight two eight three seven. Two seven to give us a. Call or go to the website you go to inshapenetwork dot com That's inshapenetwork dot com we're here for each and every..
"family medicine" Discussed on NewsRadio 1080 KRLD
"KRLD inked up, today is national tattoo day they're more popular than ever, uh statistics show that roughly, half of millennials have one as to thirty, six percent of gen Xers and while the. Ink is considered Pretty cool of, course, the question is is it safe is it joining us live to discuss Dr one practices family. Medicine at Methodist Mansfield medical center Dr Govinda thanks for joining us Five pleasure good morning so the FDA actually, regulates the ink used in tattoos but it's the tattoo parlors themselves. That are regulated by? The state how can you be sure you're going to get a clean. Safe, place. To get it done well absolutely it is regulated by the state. So they do have some standards. There's no like u. s. standard but something you should actually try to search for is a tattoo, parlor that has a good reputation but also think. About it as a medical procedure so you wanted to be as clean as your dentist or your medical office and make sure that everything, they're using his new and sterilized and quick points. Of that is even the ink, so if you see. Big jars that's the warning sign you want small jars of ink that are open in front of. You and everything is brand new what's the? Most common thing that goes wrong is it taking care? Of. It after you get it, right so the most common. Things. The number one thing Pain period but after that it would be infections absolutely skin infections that can develop and that's why. It's super important to keep everything very clean? Have there been any any advances made in tattoo removal? Always. Heard that that was an, extremely painful procedures well Yes not only as a. Painful but extremely expensive I mean to get a tattoo. Off it takes around five to twenty sessions depending on the ink and the size and each session is. A couple of hundred dollars so, you're looking at almost ten times, the price of that tattoo there has been Inc that's basically called freedom to Inc it's been recently approved. By the. FDA and it makes the tattoos less permanent kinda. Inc inside the capsule so when the. Laser hits it if you imagine that Gatica game it would just lay. Them destroy has gone slow the capsule and in could be absorbed by. The body that's great a doctor give all the thank you. So much we appreciate your time on this Dr one Gavaldon Methodist Mansfield medical center talking about tattoos this. Morning David Johnson's got a big dollar sign tramp stamp by her Dental the. Lower back I know. That it's just a rumor sicker emerged seven hundred thousand five it's time to check. On your money and we say good morning to David Johnson you know? What I'm I'm thinking about what. Are those suckers look like let's say forty, years from now when you're sitting round the assisted living center gravity has taken exactly It's like oh my gosh the regular. The I just saw in that, goes just the stock market. Pointing a little bit lower Dow industrials average looks down seventeen Espy looks dad's six the, real racks gotta be over the NASDAQ was a double whammy, yesterday so around two o'clock with Amazon prime day started obviously we all. Know now it. Was a thud because the. The system froze up they got it. Working later on but glitches on and. Off so Amazon's been under some pressure and it looks to be opening down about. Nine dollars but then just after three o'clock right after the market closed Amazon came, with number net, flicks gave with. Numbers and on the service they're good eighty five. Cents six cents better. But subscriber growth was well below expectations the guiding still lower for this quarter and. Consequently networks looks down fifty one dollars a share on the opening right? Now and that would put the. NASDAQ of the whole by about fifty points, gold's up ninety cents Crudes up, dime ten, year rates two, point eight five percent that's a little bit lower and the daleks down sixteen David Johnson NewsRadio today. To KRLD David traffic and. Weather together on the agents. Coming up on KRLD a everyone's. Super excited for Amazon prime day and. Here's our pick for one of the hottest deals, up to forty percents off a blink video home security system we're talking as low..
"family medicine" Discussed on AFP: American Family Physician Podcast
"Doc it's and we are your student and resident chairs of the two thousand eighteen afp national conference a family medicine residents and medical students we are so excited to tell you about the conference initiators theme picture yourself in family medicine how could you picture yourself in family medicine a small town rural physician delivering babies an intercity doctor specializing in substance abuse in hiv care a global health physician addressing health disparities around the world what could your future look like your adventure starts here there will be ample opportunities at national conference to learn about what a career and family medicine could mean for you come network with hundreds of residency programs in our expo hall participate in our business sessions run for national positions and help shape the future of our specialty so come join us in kansas city august second through fourth to experience all national conference has to offer hashtag af nc register before july six at af dot org slash nc to say fifty dollars are you ready to picture yourself in family medicine see their next up we have the podcasts i whatever i d a poop tafelwein sponsored by lo para mine that's right this is a ten question event like no other based on the recently updated guidelines for the diagnosis and management of infectious diarrhea you guys ready i'm ready okay first up i want to introduce our contestants i we have michelle aka michigan gala hamilton after her we have joanna campy don akot and finally kelly wheeler.
"family medicine" Discussed on Liberty Talk FM
"Realized that i really didn't have enough background to be doing what i was doing i had become an mp in a in a state that has completely unsupervised independent practice and i really didn't have the knowledge base to be completely independent like that yeah and and i went to like i said well the top programs in the country and a pre self educated i've bought several text books that i read and it just but it's just yeah what you make of it so even in my own n p program the clinical i arranged by self as far as if i was interested in something so i went and shadowed someone in orthopedics and that went and shadowed a little bit radiology because i knew i'd like the emergency department and i might need some of those skill but there was nothing set as far as a standard curriculum other than a certain number of hours and then there had to be a certain number of hours that were family medicine it gets a little bit of time poll midwife as well that's kind of kind of how i became an mp isn't that show but when i when i realized that there wasn't enough information for me was also incidentally at the same time that the n p world was discussing in the journals and academic settings discussing creating a new degree to be called dr clinically and i had a real problem with this because i was really traditional nurse i really loved the role of being a nurse and i actually had pride nursing has its own sciences nursing sciences is real behavioral it's very much psychology and sociology and helping people cope and it is also very much you know following instructions carefully the deficient physicians ordered.
"family medicine" Discussed on WVNJ 1160 AM
"To this from you i thought that would catch your tastes and this is published this week in the annals of family medicine it's a new study reveals that eight weeks of mindfulness meditation will describe that in a moment may help to prevent major depressive disorder in people with sub clinical depression and it's amazing that about ten to twenty four percent that's almost a quarter of a population are estimated to be affected by sub clinical depression in their lifetime and sub clinical depressions the presence of depressive symptoms that are not yet severe persistent enough to warrant a diagnosis of major depressive disorder and depressive symptoms doug they include feelings like sadness hopelessness killed lack of energy fatigue problems sleeping difficulty concentrating and suicidal thoughts if such symptoms are present almost every day for a minimum of two weeks and this would usually warrant a diagnosis of major depression and previous research we talked about this few months ago ccs psychotherapy may be a benefit treatment strategy for sub clinical depression and that it could limit the progression to major depression where you need all the medication for a long time you're dealing with suicide possibilities but the news this week is that mindfulness meditation this is a psychological practice that focuses on being fully aware of experiences in the present moment rather than being distracted by what is happening around us and mindful.
"family medicine" Discussed on AFP: American Family Physician Podcast
"Um but the third and probably most important thing i'd like to do for afp is really further what j has done to make it more valuable for point of care use ius fp every single day at the point of care and i'd really like to find a way for others to be able to use it in that same way of course there are plenty of resources ius at the point of care but i find afp is written by family doctors four family doctors and it's very easy to read this is what can really help you in your senior patients you have it's great so people can right into a fp edit at a fp dot org if they have suggestions for dr sexton as as she takes over as editor in chief so what advice do you have for medical students considering a career in family medicine other than putting the journal under their bed yeah exactly put the journal in your bed listened to podcast commute i actually tell my students will not to put the journal in her bed but to listen to podcast i i think it's important even if somebody doesn't go into family medicine afp has so much to offer for somebody learning family medicine primary care but i tell students you know follow your heart don't be swayed like all i need to do this specialty year that specialty year or you know i understand there are financial considerations of course but i'm hopeful with the way medicine is changing the the primary care physicians can be rewarded for the good things that they do and i have learned so much from my patients and their families and being able to take care of the whole person and it's it's the other thing is there's a lot of responsibility you can be jackofalltrades but master of some you if you wanna do global medicine.
"family medicine" Discussed on AFP: American Family Physician Podcast
"Yeah it was neat to see i mean we certainly i think jumped on the abm bandwagon early on and uh the listeners may not realise this but one of the things we did was a got the then uh editors of family medicine journal's together at the at an stf mbd in and said let's let's develop a evidence reading system uh which is called the strength of recommendations taxonomy mark a bell was the one came up with that uh acronym and so we developed this evidence rating system that which uh all the family medicine journal's use and it really made us focus on what is the best evidence for making recommendations about diagnosis and treatment and and shape or journal with that in mind yeah so we're very fortunate to be welcoming dr sexton as our new editor in chief you've a j you've worked with sumi awhile tell us about how you've met her and what we can expect from her future work well a like they do on a on the circuit you knock you read my book or you could reapply had a toro read the editorial i wrote about sumi which i'll i'll give you a little bit of a bit of documents the the incredible journey she took to where she got two day which is the incoming editor of this great publication but the twenty three years ago uh she was a medical student at the university miami and dove.
"family medicine" Discussed on The Rich Roll Podcast
"Well when you like like what kind of nourish life star trek nerd or like physics textbooks i go i loved reading i would i was really really creative now is like with i devised things like i would rate tests eight or nine for my my younger brother and i would treat my own library my own lending library at home to think like that garrelts somewhere your stepdad would bring home books to you and he brought home weicker gastropod and you you're like devouring out over the summer ends thick book like the america guide to family medicine and and i was so enthralled by everything in that book i read it from cover to cover several times and if i could find it are probably be notes in the margins and and that sparked my interest for a possible career medicine and that's where i want it i thought that i wanted to be a gastroenterologist 'cause i i thought that that was the the kind of dr that dealt with diabetes and other endocrine issues and because that was becoming a problem in my family and so um but that idea was throwing it when i saw the movie gross anatomy beckham advisory and i didn't realize that you had to deal with cadavers in your medical training and it's out as part of the deal vows it mentions that i decided to become a musician and rights right and we're going to talk about that because that's interesting that does i don't think that gets talked about enough near story you're like an incredible talent that abducting backing little bit well you were singing in the choir right like church was a big deal like normal sunday was about.
"family medicine" Discussed on AFP: American Family Physician Podcast
"Main dartmouth family medicine residency your honor sir okay so first off let's get out of the way that there are some broad definitions for precision medicine right a lot of people just categorize it as genetic testing but dr fierro argues here that prevention screening and therapies are increasingly based on attributes of an individual patient but when we're talking about precision medicine we're talking about genomic medicine right it's the idea that you can test the patient find out their specific dna and pick a treatment specifically for them and we're just not there yet right that's what it's advertise that's what it's been build build as but it's really a crude version of that and we have no evidence that the does anything in the primary care setting yeah and i don't think we're there yet to do a full human genome and try to use it to predict response to medications but where we are is using individual characteristics of patients to allow for better risk stratification for screening tests to use physical correct characteristics and other biomarkers to help optimize care in therapies so just a couple of examples that are used here in this article first is pap smear screening so with hpv genetic markers for virus type sixteen and eighteen we can identify women at higher risk for developing cervical cancer therefore sparing a lot of women for more frequent invasive screening also breast cancer screening is now influenced by bracket testing and even lipid management is based on risk stratification determined by a patients individual characteristics so while it may not be using their genome it's still precision and that it's looking more at the individual i'm glad you out a breast cancer screening reich has brca one is a is the most common touted precision medicine to all right so women are able to test for this this gene raid and then can undergo profile.
"family medicine" Discussed on KDWN 720AM
"Any child was under the care of somebody who refuses to give the medical treatment that child needs to be taken away from them what they're sick or taken away from them in and you know indefinitely and it that's a tough thing for a doctor to come in and say but this is how i handled it with my patients quite a lot of patients who want to utilise took remedies i have no problem with that have yet and you know my practice was integrative family medicine so we had chiropractic we had acupuncture would homeopathy i was the more straight line medical uh you know family medicine physician but i had partners who did other things and so when i had a patient that would come in saying well if you know i don't want to give it to my child if he doesn't need them i i agree with you have your child doesn't need the antibiotic i agree don't fishermen human antibiotics down the kids throat but cold manage that with me if your kid gets sick make sure i'm i'm aware make sure i am at least you know make sure i'm aware of the situation bring 'em in because it terms he we have a medicine that we could use and we never had an issue are you know the the children that had viruses got better those that did it got an antibiotic and god treated and i you know we never had an issue so for those of you that are holistic that you know are questioning when to give a child of medication in mind you antibiotics of side effects i mean a lot of people were freaked out about that story with that little girl excuse me there was a little girl years ago i believe it was over the thanksgiving holiday who took children's mottram and she went into a stevens johnston's reaction where she lost most of her skin it was a horrible of reaction that happens because she reacted to children's moacher and as she had had a viral illness add rather than taking antibiotics too you know it was something that kids take all the time and she was the one in a million you've got a bad side effects so i.
"family medicine" Discussed on The Dave Ramsey Show
"Game better than i do there harry better than i deserve soii just actually graduated presidency answered the opposite of previous caller um yeah he and i have a huge debt have about 500000 from medical school in a little bit from god school com it's my only outside of my home and make question is we're would that fit in my baby steps given that it's too big how did you get a half a million dollars for men school and well i had 50000 in um from graduate school i haven't master's degree and then umi winter private medical school that was about 60000 a year and i wasn't married at the time so the and you don't allow you to work in medical schools soi w i didn't have any living expenses very very expensive med school is what you're saying a day double gonsalves in fortlauderdaleso it was you pay double what other people paid right good lord so you have a specialisation i'm sorry what what what field of medicine are you going in ohi'm not a family on family medicine doctor i'm just about to start my new um my new job in and then attending on as a resident no no noi'm finished with finnish i just he get very big night what is your income i'm right now my husband and i make together about 150000 often no on with a new job well we'll make about 400 okay then you don't do anything new claim this.