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Tag: Primary care doctor

  • Weight management tips for older adults

    Weight management tips for older adults

    Obesity is a high-risk health issue in the United States and is associated with intensifying the impacts of chronic disease in old age. And, more than three in ten older adults are obese. Despite the unique implications of the obesity paradox, it’s important for older adults to actively manage their weight. Below are good practices to follow. The best strategy may be to start by talking to a health care practitioner.

    The CDC reports that losing 5-10 percent of body weight can have benefits for individuals who have been prescribed weight loss. Blood pressure, cholesterol and sugar levels are likely to improve even for individuals who are still categorized as obese or overweight by a health care professional.

    Understand types of weight gain

    • Obesity is excess accumulation of body fat, either just below the skin or around organs. Healthy eating habits and regular physical activity can limit the excess fat, but obesity is often rooted in more complicated, chronic conditions like diabetes or physical impairment.
    • As adults retire from their jobs or become less mobile, they use their muscles less frequently, which leads to sarcopenic obesity. Sarcopenic obesity is common in older adults; muscle loss contributes to fat retention. Staying active, even minimally, can help mitigate this.

    Assess your weight at home

    • Calculate your body mass index: BMI is the most commonly known method of determining body composition. To calculate, divide your height by the square of your weight using this calculator from the National Heart, Lung, and Blood Institute. It helps to screen for weight categories that indicate high-risk circumstances.
    • Measure your waistline: This method may be more valuable than calculating BMI because it can yield a more accurate illustration of body composition. This is specific to older adults because the BMI often overestimates body fat as aging results in loss of height.

    Talk to a doctor or healthcare provider

    Find yourself a health care buddy

    Finally, ask a caregiver, family nurse practitioner or doctor if you suspect that you or a loved one needs help with addressing obesity risks. What works for one individual might not be right for another, so it’s important for adults to establish measures that enable best practices for their specific needs.

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  • September: Healthy Aging Month

    September: Healthy Aging Month

    Did you know that September is Healthy Aging Month? Here are a few reminders on healthy aging for adults of any age.

    1. Stay connected to friends and family. Social bonds are important for physical and mental health. In fact, frequent social interactions have been shown to promote longer life.
    2. Get moving! Be physically active on a regular basis. Work in at least 150 minutes of moderately vigorous activity each week.  “Moderately vigorous” can be brisk walking (at a pace of 4 miles per hour), heavy cleaning, gardening, light bicycling, or doubles tennis.  Remember that any amount is better than none at all!
    3. Get enough rest. Aim for at least 7 to 7.5 hours of sleep. Sleep promotes energy, alertness as well as physical and mental well-being.
    4. Have an annual appointment with your primary care doctor, even if you are feeling great, find out what health screenings you are due for Know your cholesterol, body mass index, blood pressure, glucose, and A1C.  Medicare considers an annual wellness visit so important for older adults that it covers the full cost. Here are some tips to prepare for your doctor’s visit.
    5. Get up to date on your siblings’ and parents’ medical history. Many of us are able to report major family history regarding major diseases like cancer, stroke and heart attacks. These are important to know about, including the age at which they were diagnosed. Also make sure you are informed on family history of other conditions, such as allergies, asthma, auto-immune diseases, arthritis, osteoporosis, fractures, bleeding or clotting disorders, liver or kidney problems, migraines, dementia, skin conditions, cholesterol, diabetes or pre-diabetes, mental health, and gastrointestinal problems. This webtool from the U.S. Surgeon General may help. Share this information with your doctor and your family.
    6. Watch your diet, for reasons beyond weight. Many conditions, such as blood pressure, diabetes, cholesterol, headaches, sleeping problems, mood, irritable bowel are substantially prevented, ameliorated and sometimes cured with dietary changes. Not sure what or how to change? Find a good nutritionist through your physician! Medicare covers nutrition counseling. A few basic points:  Get 4.5 cups of vegetables per day. Limit sugar intake. Eat lots of whole grains (What is a whole grain?) Avoid trans-fats entirely (“partially hydrogenated vegetable oils”).
    7. Here are some other great tips for healthy aging.
  • How to address the doctor shortage in the U.S.

    How to address the doctor shortage in the U.S.

    A new report by the Association of American Medical Colleges (AAMC) projects a doctor shortage over the next ten years of between 61,700 and 94,700, with a primary care doctor shortage of between 15,000 and 35,600.  To address the doctor shortage, AAMC recommends a multi-pronged approach, including federal support of 15,000 more residency positions over the next five years as well as support for new care-delivery models and technologies.

    The rise in demand for doctors stems largely from a projected 41 percent increase in the number of people over 65 in the next ten years. The projected shortfall in doctors results as well from the fact that more than one in three doctors will be over 65 in 2025 and many will retire. Today, about 37 percent of doctors are between 55 and 75. The impact of the Affordable Care Act and the higher number of insured Americans on the doctor shortage is less than expected at 1.2 percent.

    Currently, medical schools are expanding their classes to enroll more students, but these students often struggle to find residency programs. The federal government caps enrollment in residency positions, limiting access. Under the Balanced Budget Act of 1997, Medicare cannot spend more than $9.5 billion a year on residency programs, and it is the largest funder of these programs.

    In the last 20 years, there are 20 more medical schools–175 total–and hundreds more students graduating from them. Five hundred students could not secure residencies in 2013. Many residency programs and states are taking matters into their own hands, finding money to increase residency slots.  But, that is no small feat since each slot is estimated to cost $150,000.

    At the same time, there is a need to ensure that more doctors deliver primary care. Yet, the percentage of doctors going into primary care is lower than ever before.  The cost of medical schools and residency programs drives doctors into specialty care that helps ensure that they can pay off loans. Thousands of prospective doctors are drowning in debt. The National Health Service Corps and other loan repayment programs can encourage doctors to enter primary care medicine and to practice in underserved communities.

    To be sure, addressing doctor shortfalls in underserved communities presents a challenge; it likely means establishing more residency slots in these communities.  One study found that only 48 of more than 1,390 residency programs and training sites in family medicine (4 percent) and only 48 of 936 in internal medicine (5 percent) are in rural or community-based settings. Exposure to these settings is more likely to lead doctors to practice in these settings, so the researchers recommend more residency programs in these settings.

    Congressmen Joseph Crowley (D-NY) and Charles Boustany, Jr., M.D. (R-LA) have introduced H.R. 2124 the Resident Physician Shortage Reduction Act of 2015, which supports 3,000 more Medicare direct graduate medical education and indirect medical education residency positions each year for five years beginning in 2017.

    Stateline
    Stateline

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  • Watch your feet: Foot care is critical and pain is treatable

    Watch your feet: Foot care is critical and pain is treatable

    You’ve heard the expression, “watch your back.” When it comes to older adults, you might say “watch your feet.” Caring for an older adult means checking vision, gait, hearing and balance on a regular basis.  It also should mean checking feet.  Feet are a window into whether an older adult is able to care for himself or herself.

    When it comes to feet, older people have lots of issues. Your primary care doctor or geriatrician should be sure to check your feet regularly. Here are seven things to watch out for and talk to your doctor about:

    1. Foot pain: People are more likely to have foot pain in later life as the skin becomes thinner and less elastic. Painful feet can usually be treated.
    2. Fungal infections between the toes causing redness, blisters or itching: Use an over-the- counter fungal spray or cream. And, talk to your doctor. Make sure your feet, including the area between the toes, are dry to prevent infections.
    3. Corns and calluses: Make sure your shoes fit well, and your feet are not rubbing up against them. Use a pumice stone or foot file to remove hard or calloused skin. You also can rub the corns or calluses gently with a washcloth but do not shave them. Moisturize dry and rough skin on your feet to prevent cracks.
    4. Ingrown toenails: Cut toenails regularly to avoid ingrown toenails caused by the nail growing too long and cutting into the skin. Keep in mind that many older adults can’t bend down to cut their own toenails.
    5. Tissue build up in the ball of the foot or toes causing pain. This could make it harder to balance. Make sure your shoes are wide enough.
    6. Toes that are pulled back: This can affect balance. Make sure shoes have enough space in them.
    7. Swelling.  See a doctor if your feet are swollen.

    If you have diabetes, you may have poor blood flow in your feet. And, you are more prone to scrapes, bruises and infections. You should check your feet every day for red patches. If you have sores or blisters or cracks in your skin, see a foot doctor. You want to avoid getting infections.

    And, regardless of your health status, exercise your feet to increase blood flow and improve the health of your feet. You can also do foot exercises.  For more information, check out this pamphlet from the National Institute on Aging.

  • The benefits of shared doctor appointments

    The benefits of shared doctor appointments

    Many years ago, I heard a primary care doctor explain his solution to the minimal time he had to spend with each of his patients: He offered to see those with similar conditions collectively.  Instead of taking seven minutes with each diabetes patient, he spent 70 minutes with ten of them.  The sessions worked so well that when he needed to cancel one, the patients asked to meet without him.

    The American Academy of Family Physicians reports that shared medical appointments are becoming quite common.  In 2010, one in eight family doctors give their patients the option of having a shared appointment with other patients, twice as many as in 2005.  These appointments enable doctors to see more patients in a day and allow patients to learn from other patients with similar conditions.

    We’re all in this together: Research reveals the powerful and positive health effects spouses and friends can have on one another.  A Just Care post reports on research showing that if you exercise, you actually may be helping your spouse by encouraging your partner to exercise.  Similarly, if you quit smoking, it increases the likelihood that your spouse will quit by as much as 67 percent and that your friend will quit by 36 percent.

    Social supports can make a big difference.  Bringing a health buddy with you to the doctor or hospital can be critical to ensuring you hear and understand the doctors’ advice as well as get your questions answered.  Research on group medical visits similarly show the value to diabetes patients and patients with heart failure for retaining information they need to know. And married people have been shown to have lower risk of heart disease.  

    And, here’s advice from Just Care on how to talk to someone you love about changing an unhealthy behavior.

  • Wanted: More doctors

    Wanted: More doctors

    The population is aging and demand for doctors is increasing. At the same time, doctors are less satisfied with their work so fewer people are interested in becoming doctors. We need innovative ways, like Stanford Hospital’s time in the bank program, to ease the load on physicians and encourage more people to join their ranks.

    Research shows that doctors are more likely to experience burnout than other workers in the United States and more likely to be unhappy with work-life balance. Doctors typically work more hours a week than other professionals, and many are exhausted from their work. A recent survey of physicians from all specialties* shows that almost half of doctors, 45.8 percent, report at least one indication of burnout.

    Physicians who practice emergency medicine, neurology, internal medicine, family medicine have the highest risk of burnout. Many of these practitioners suffer from heavy workloads and loss of autonomy. But of those, only neurologists were unsatisfied with work-life balance.

    Physicians who practice dermatology, pathology, preventive medicine and general pediatrics have the lowest rates. Those doctors practicing general pediatrics, dermatology and preventive medicine also had the highest satisfaction levels with work-life balance.

    At the same time that physicians are experiencing decreasing job satisfaction, demand for physicians is increasing. The affordable care act has led to a 2 percent increase in the demand for physicians.  And, with the population is aging, demand for physicians is expected to grow  by 17 percent by 2025.

    The Association of American Medical Colleges projects a need for 12,500-31,100 more primary care doctors than we will have in 2025 and a need for between 28,200 and 64,700 more specialists.

    *Survey data is based on responses from more than 7,000 doctors in all practice specialties.

    Make sure you choose your doctors wisely. All doctors are not created equal, and you can now see data comparing surgeons.

  • Health caring for mom: Three ways to let your mom know you love her on Mother’s Day

    Health caring for mom: Three ways to let your mom know you love her on Mother’s Day

    Mother’s Day is the time to show your mom some serious love. But how? Most of us love flowers and chocolate. So, consider getting mom a little of both. What we really treasure, though, is the priceless gift of time together and conversation. And there are few things more important to talk about than your mom’s health.  So here are a few priceless gifts for mom on her special day:

    1. Make sure your mom is safe and healthy.  Talk to her about all of the drugs she’s taking, both over the counter drugs and painkiller prescriptions. If your mom has a chronic condition like asthma or diabetes, find out whether her primary care doctor is doing a good job of coordinating her care. Click here to learn how your mom’s primary care doctor can help her. And, if your mom wants to stop smoking, lose weight or change another unhealthy behavior, here are some tips for motivating her to do so.
    2. Talk to your mom about planning for her future health care needs. Who would she want to take care of her when she cannot take care of herself?  Would she like to remain at home as long as possible? What are the tradeoffs she would like to make? And, make sure your mother has a reliable health care proxy and a living will. (You should have those too!)  Click here for free help with these advance directives.
    3. Double check that your mom is getting the preventive care services she needs.  She should get regular pap tests, pelvic exams and breast exams. If she’s over 60, she should get a shingles vaccine.  Medicare and most insurance cover all these tests in full. Next time she’s headed to the doctor, consider tagging along. Mom, like all of us, could use a health care buddy to ask the questions she might not ask.

    These are important conversations. Most of us know we should talk to our mothers about their health, but we never quite get around to having the actual conversation. Why not use Mother’s Day as a reason to get serious about your mom’s health? Just talking to your mom about these issues can be healthy for her.

  • Do I need a primary care doctor?

    Do I need a primary care doctor?

    You should not underestimate the value of a good primary care doctor. According to the American College of Physicians, having a primary care doctor means better health outcomes at lower cost. Better outcomes mean fewer hospitalizations as well as better management of chronic disease. An emphasis on primary care increases the overall health of patients and leads to lower healthcare costs.
    The American College of Physicians report compiled more than 100 studies to show evidence of the benefit of primary care in the healthcare system. According to the report, to improve patient outcomes and decrease overall costs, primary care needs to be supported: there needs to be incentives for physicians to become general practitioners as well as a restructuring of the payment system and a physician-guided model of care.