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South Macomb Internal Medicine

Warren, MI

Improving The Patient Experience Series

Improving The Patient Experience: Part 6 – Assessing Medications

December 3rd, 2021

By Dr. Scot Goldberg, MD

Hello everyone!  This is part 6 of a series around how we work towards improving the patient experience!  Part 5 was on treating urinary incontinence, and today we will discuss performing an assessment of a patient’s medication compliance and ability to pay for medications, changing prescriptions as appropriate and letting them know about avenues to explore if they need financial help.

Medications

 

Assessing Medications, Compliance, and the right Prescriptions

Part of a routine medical visit is an assessment of a patient’s medications.  Medications can be very expensive and the newer better medications are often out of financial reach for most patients.  For example the newer diabetic medications are better than the old ones but they are pricier, so we are always evaluating them to try to strike that balance between cost and effectiveness in the best interests of our patients.  This also includes tracking potential efficacy and side effects of these medications.  In other words we want to make sure they work and that they won’t cause other problems.  We will typically call into the pharmacies to find out coverage to see what we can prescribe for different situations.  We also keep an electronic log and we keep up with the pharmacies to ensure that they are filling the prescriptions properly!

There are some specific avenues we frequently explore to help our patients get their prescriptions:

  • We have the good RX cards that the patient can use to price out prescriptions.
  • The Canadian Pharmacy is less expensive in many cases and sometimes we will help steer them in that direction.
  • Patients can check insurance guidelines where some insurances are less expensive for filling 90 day’s worth of a medication than 30 days.
  • We have copay cards available for some prescriptions.
We know medications can be expensive, we are aware they have side effects, and we are aware that they are being marketed to you at every turn, but rest assured we are here to help you navigate it and get the best care with the right medications for you!

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Improving The Patient Experience

A little background on this initiative and some highlights as outlined by Blue Cross Blue Shield of Michigan:

Medicare Star Ratings is a rating system developed by the Centers for Medicare & Medicaid Services to help consumers find the best Medicare Advantage plan for them. Blue Cross Blue Shield of Michigan has two MA plans – Medicare Plus Blue℠ for its PPO members and BCN Advantage℠ for its HMO members.

CMS assesses a member’s health plan experience through the Consumer Assessment of Healthcare Providers and Systems, or CAHPS, member survey. The survey asks patients to report on their experiences with a wide range of health care services. A large portion of the CAHPS survey is driven by the member’s experience with his or her physician’s team, including such things as follow-up on labs and imaging, and getting timely doctor appointments.

And, most importantly for patients, a positive patient experience results in better adherence to protocol, better relationships with health care providers and a feeling of mutual respect between them and their medical team.

***************************************************************************************************************************

South Macomb Internal Medicine

28401 Hoover Rd.  Warren, Michigan 48093

Phone: (586) 276-7530

South Macomb Internal Medicine has been designated a Patient Centered Medical Home by Blue Cross Blue Shield of Michigan.

Join us on Facebook at facebook.com/SMIMdoc!

Feel free to click on the categories and keywords below to find more content as we add more to the website!

Improving The Patient Experience: Part 5 – Treating Urinary Incontinence

November 19th, 2021

By Dr. Scot Goldberg, MD

Hello everyone!  This is part 5 of a series around how we work towards improving the patient experience!  Part 4 was on assessing physical activity and the risk of falling, and today we will discuss assessing if Medicare Advantage patients have urinary incontinence or urine leakage and review options for treatment!

Urinary Incontinence

Assessing Urinary Incontinence

Urinary evacuation is very important in the elderly and actually any kind of bodily evacuation can be difficult to discuss, but doctors routinely bring it up at every visit with the appropriate patients.  Today we’re specifically going to discuss urinary incontinence.

A very common problem in both males and females, in males it can be a problem due to prostate enlargements or bladder dysfunction among other reasons.  Doctors will ask about the quality and frequency of urinary flow and whether you need to get up at night to urinate.  Incontinence is a particularly important issue, especially for quality of life, and we have medications and other non-medical remedies available.  The newest treatment for incontinence involves medications that can help the bladder regulate the frequency of urination.

In females it’s usually due to a decrease in the muscle tone of the pelvic floor.  This can be a result of childbirth.  In females we also use vaginal creams that can soften the mucosa (dry mucosa can be responsible for painful recurring urinary tract infections).  In females we can also recommend kegel exercises which will help strengthen the pelvic floor and hopefully prevent urinary incontinence.  There are also medications we can use that would strengthen the bladder.

The bottom line is that we can help our patients who struggle with urinary issues.  Patients should not feel embarrassed to discuss it with their physician – it is a common issue that we deal with routinely so do not feel like there is “something wrong with you” if you are having trouble with this.  Let’s discuss it and treat it!  Let’s return you to a better quality of life.

***************************************************************************************************************************

Improving The Patient Experience

A little background on this initiative and some highlights as outlined by Blue Cross Blue Shield of Michigan:

Medicare Star Ratings is a rating system developed by the Centers for Medicare & Medicaid Services to help consumers find the best Medicare Advantage plan for them. Blue Cross Blue Shield of Michigan has two MA plans – Medicare Plus Blue℠ for its PPO members and BCN Advantage℠ for its HMO members.

CMS assesses a member’s health plan experience through the Consumer Assessment of Healthcare Providers and Systems, or CAHPS, member survey. The survey asks patients to report on their experiences with a wide range of health care services. A large portion of the CAHPS survey is driven by the member’s experience with his or her physician’s team, including such things as follow-up on labs and imaging, and getting timely doctor appointments.

And, most importantly for patients, a positive patient experience results in better adherence to protocol, better relationships with health care providers and a feeling of mutual respect between them and their medical team.

***************************************************************************************************************************

South Macomb Internal Medicine

28401 Hoover Rd.  Warren, Michigan 48093

Phone: (586) 276-7530

South Macomb Internal Medicine has been designated a Patient Centered Medical Home by Blue Cross Blue Shield of Michigan.

Join us on Facebook at facebook.com/SMIMdoc!

Feel free to click on the categories and keywords below to find more content as we add more to the website!

Improving The Patient Experience: Part 4 – Assessing Physical Activity!

November 5th, 2021

By Dr. Scot Goldberg, MD

Hello everyone!  This is part 4 of a series around how we work towards improving the patient experience!  Part 3 was on the importance of checking your Hgb A1c for diabetes, and today we will discuss the need to assess your physical activity and any associated risks based on your health!

Physical Acitivity

Assessing physical activity is very important because if people fall they can break their bones and cause a lot of other serious physical problems.  Part of a general medical evaluation is watching how people transfer from a chair to a standing position as well as how they walk.  In fact there have been studies that show that the time it takes to walk twenty feet, turnaround and come back can be a good indicator of an array of specific medical problems.  Once we have determined a patient is at risk for falls based on this measure and their level of physical activity there are specific recommendations that we can offer so that people can live safely by improving their strength, balance, nutrition and any other factors that may contribute to this risk.

Some of the courses of treatment may include:

  • Physical therapy – at home as well as at a physical therapy center.  This may include working to improve balance and mobility.  An at home evaluation can also be useful to make sure their home is sufficient to support their physical condition and any course of treatment going forward.  This can include the installation or use of certain equipment.
  • Adjusting current medications – sometimes patients are over or under medicated especially when it comes to diuretics (water pills) or blood pressure medications.  Many of these medications can affect a patient’s mobility.
  • Lifestyle and nutrition changes.  A healthy lifestyle can help maximize outcomes here.  You are what you eat, and if you’re adding too much alcohol or tobacco for example you may hinder your body’s ability to thrive.

Be sure to check back for the next segment where we’ll address urinary incontinence.

***************************************************************************************************************************

Improving The Patient Experience

A little background on this initiative and some highlights as outlined by Blue Cross Blue Shield of Michigan:

Medicare Star Ratings is a rating system developed by the Centers for Medicare & Medicaid Services to help consumers find the best Medicare Advantage plan for them. Blue Cross Blue Shield of Michigan has two MA plans – Medicare Plus Blue℠ for its PPO members and BCN Advantage℠ for its HMO members.

CMS assesses a member’s health plan experience through the Consumer Assessment of Healthcare Providers and Systems, or CAHPS, member survey. The survey asks patients to report on their experiences with a wide range of health care services. A large portion of the CAHPS survey is driven by the member’s experience with his or her physician’s team, including such things as follow-up on labs and imaging, and getting timely doctor appointments.

And, most importantly for patients, a positive patient experience results in better adherence to protocol, better relationships with health care providers and a feeling of mutual respect between them and their medical team.

***************************************************************************************************************************

South Macomb Internal Medicine

28401 Hoover Rd.  Warren, Michigan 48093

Phone: (586) 276-7530

South Macomb Internal Medicine has been designated a Patient Centered Medical Home by Blue Cross Blue Shield of Michigan.

Join us on Facebook at facebook.com/SMIMdoc!

Feel free to click on the categories and keywords below to find more content as we add more to the website!

Improving The Patient Experience: Part 3 – Checking Hgb A1c for Diabetes

October 22nd, 2021

By Dr. Scot Goldberg, MD

Hello everyone!  This is part 3 of a series around how we work towards improving the patient experience!  Part 2 related to checking your blood pressure, and here we are going to discuss the importance of checking your Hgb A1c for diabetes!

Diabetes

We should be screening for diabetes at age 35, and the way we do this is with a blood test called the hemoglobin A1c.  If that is elevated past 6.0 then we recheck in one year.  From 6.0 – 7.0 is considered “pre-diabetes” and over 7.0 is considered diabetes.  For pre-diabetes we treat it with diet and exercise and over 7.0 we add medications to the course of treatment.

As for diet and exercise we’ve mentioned here before that we recommend you exercise 30 minutes per day 5 times per week, and we have the resources to help you with your diet.  You can see our nutritionist Nanette Cameron – she’s fantastic!

So why do we need to treat diabetes?

Most people think that the acute care of diabetes or the blood sugar is more important than chronic care.  For very high sugars people will have increased thirst, urination, and generally poor feeling.  But actually chronic care of diabetes is much more important.  Diabetes is the leading cause of stroke, heart attacks, kidney failure and as a matter of fact can cause problems with any organ if left untreated.

So what is the treatment?

Treatment for diabetes has moved way past insulin shots.  We have even moved past sulfonylurea, metformin and older diabetic medications.  Although these medications have been around for decades and have been shown to be safe, effective and well tolerated, we now have newer medications that are even more effective and safer.  These medications include GLP1 (glucagon-like peptide-1 receptor agonists), or SGLT-2 inhibitors (sodium glucose cotransporter-2 inhibitors).  If that seems like a lot of acronyms and big words don’t worry – there won’t be a test… haha.  Let me explain:

  • GLP1’s come as a daily oral medication or a weekly self-injection.  Most patients prefer the weekly self-injection for convenience.  This class of medication works very well and has the added benefit of significant weight loss.
  • SGLT-2 inhibitors come as a daily oral medication as well.  It lowers the sugar thresholds in the kidneys so excess sugar in the blood stream is removed via urination.  The newest data shows that it is very effective and prevents heart and kidney disease even in patients who are not diabetic.

***************************************************************************************************************************

Improving The Patient Experience

A little background on this initiative and some highlights as outlined by Blue Cross Blue Shield of Michigan:

Medicare Star Ratings is a rating system developed by the Centers for Medicare & Medicaid Services to help consumers find the best Medicare Advantage plan for them. Blue Cross Blue Shield of Michigan has two MA plans – Medicare Plus Blue℠ for its PPO members and BCN Advantage℠ for its HMO members.

CMS assesses a member’s health plan experience through the Consumer Assessment of Healthcare Providers and Systems, or CAHPS, member survey. The survey asks patients to report on their experiences with a wide range of health care services. A large portion of the CAHPS survey is driven by the member’s experience with his or her physician’s team, including such things as follow-up on labs and imaging, and getting timely doctor appointments.

And, most importantly for patients, a positive patient experience results in better adherence to protocol, better relationships with health care providers and a feeling of mutual respect between them and their medical team.

***************************************************************************************************************************

South Macomb Internal Medicine

28401 Hoover Rd.  Warren, Michigan 48093

Phone: (586) 276-7530

South Macomb Internal Medicine has been designated a Patient Centered Medical Home by Blue Cross Blue Shield of Michigan.

Join us on Facebook at facebook.com/SMIMdoc!

Feel free to click on the categories and keywords below to find more content as we add more to the website!

Improving The Patient Experience: Part 2 – Checking Your Blood Pressure

September 24th, 2021

By Dr. Scot Goldberg, MD

Hello everyone!  This is part 2 of a series around how we work towards improving the patient experience!  Part 1 related to Covid-19 and Flu vaccinations, and here we are going to discuss hypertension and the importance of checking your blood pressure!

 

Blood Pressure

 

Checking Your Blood Pressure

The U.S. Preventitive Task Force gave their current recommendation statement on April 27, 2021 concerning hypertension.  The USPSTF recommends screening for hypertension (high blood pressure) for adults 18 years or older with office blood pressure measurements.  They also recommend obtaining blood pressure measurements outside the clinical setting for confirmation before starting treatment.

So what does that mean for you?

Well everyone knows that high blood pressure can cause major problems  These can range from the head (early dementia and bleeding strokes) all the way to the toes causing peripheral artery disease and amputations, and all organs in between.  Many studies have shown that lowering blood pressure to acceptable levels (140/90 and preferably 130/80) can prevent these problems.  We have many new medications that can help lower blood pressure but what a lot of people don’t recognize is that non-medical remedies can be just as effective such as diet, exercise and better sleep.

  • Diet: Here at South Macomb Internal Medicine we focus pretty heavily on lifestyle choices that help impact these things, especially when it comes to nutrition for example with many posts here on this blog by Nanette Cameron, RDN.
  • Exercise: We can also refer to physical therapists / trainers for proper exercise regimens.  Generally we recommend some form of aerobic activity for 30 minutes at least 5 days per week.
  • Sleep: We also analyze sleep disorders on a regular basis and if necessary can refer to a sleep lab or perform in-home sleep testing to make a diagnosis.  Often we are told of patients falling asleep while receiving their instructions at home when they first put on the CPAP mask because they are so sleep deprived – NOT because they are bored I assure you.  Ha!

Of course we offer the newest in medications and often we can control blood pressure with one pill per day, but what’s old is new, and one of the oldest medications available is spirnolactone which has seen a resurgence as this diuretic has been shown to lower blood pressure especially in difficult to treat cases.

Our doctors here are well versed in each of these approaches and treatments and continue to stay up to speed on any new medical developments.  Please make sure you are staying on top of this and let us HELP you to do it!

***************************************************************************************************************************

Improving The Patient Experience

A little background on this initiative and some highlights as outlined by Blue Cross Blue Shield of Michigan:

Medicare Star Ratings is a rating system developed by the Centers for Medicare & Medicaid Services to help consumers find the best Medicare Advantage plan for them. Blue Cross Blue Shield of Michigan has two MA plans – Medicare Plus Blue℠ for its PPO members and BCN Advantage℠ for its HMO members.

CMS assesses a member’s health plan experience through the Consumer Assessment of Healthcare Providers and Systems, or CAHPS, member survey. The survey asks patients to report on their experiences with a wide range of health care services. A large portion of the CAHPS survey is driven by the member’s experience with his or her physician’s team, including such things as follow-up on labs and imaging, and getting timely doctor appointments.

And, most importantly for patients, a positive patient experience results in better adherence to protocol, better relationships with health care providers and a feeling of mutual respect between them and their medical team.

***************************************************************************************************************************

South Macomb Internal Medicine

28401 Hoover Rd.  Warren, Michigan 48093

Phone: (586) 276-7530

South Macomb Internal Medicine has been designated a Patient Centered Medical Home by Blue Cross Blue Shield of Michigan.

Join us on Facebook at facebook.com/SMIMdoc!

Feel free to click on the categories and keywords below to find more content as we add more to the website!