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South Macomb Internal Medicine

Warren, MI

Macomb

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.

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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 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.

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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 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.

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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!

It’s Vaccine Season And We Are Here To Guide You Through The Options!

October 8th, 2021

Vaccine Season

 

Yes it’s that season again.

 

via GIPHY

Okay actually we are talking about VACCINE SEASON.  Hehe…

The Flu virus for example lives longer indoors in the winter, so we are just taking a quick break from our Improving The Patient Experience series to discuss vaccines and answer a few frequently asked questions.  Please keep in mind that this post isn’t meant to be the final word on all vaccines, and that we encourage you to call and ask us if you have additional questions!

Vaccine Season and Your Options:

Let’s address a few vaccines that you may already be considering and/or should consider.

  • Flu:  Flu shots are indeed safe and effective, are available for people over the age of 6 months and you can safely get one even if you’re egg allergic.  Folks over 65 can get the high dose vaccine which is a quadruple dose.  If you have any questions about the flu vaccine please let us know and you can make an appointment to get one with us.  Here is the CDC guidance on Flu vaccines.
  • Covid-19:  The Covid-19 vaccines are safe and effective so please get one if you still have not.  If you have any questions about them please ask, and if you are over 65 please schedule a booster – a third dose of the Pfizer vaccine if it has been 6 months since your second dose.  For now this is for those who have had the Pfizer vaccine, and you cannot mix them.  In other words if you had two doses of the Moderna vaccine you cannot get the Pfizer vaccine for your booster dose.  The Covid-19 vaccines and the Flu vaccines are safe to get at the same time, but the Covid-19 vaccine is not administered at our office.  They are available at other locations including some pharmacies.  Call us and we can help you with that, and here is the CDC guidance on Covid-19 vaccines.
  • Shingles, Pneumonia, and Tetanus are all available as well.  Here is the CDC guidance on Shingles, Pneumonia and Tetanus.

There are other diseases which are preventable with vaccines, so if you have questions about any of them please call us and we can advise you, and here is the CDC guidance on all the available vaccines as well.

Please take care of yourselves this vaccine season as the weather starts to get colder, and we are here to help!

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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!

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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 1 – Covid & Flu Vaccinations

September 10th, 2021

By Dr. Scot Goldberg, MD

Hello everyone!  I hope you are doing well, and we are introducing a series around how we work towards improving the patient experience!  A little background on this and some highlights of the initiative 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.

The Patient Experience

Improving The Patient Experience

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.

Covid-19 and Flu Vaccines

We know that our entire team can affect the health of patients and how they assess their health care experience, so we are going to discuss a number of points of emphasis starting with Covid-19 and Flu vaccinations!

First let’s talk about boosters.  The newest data coming out of Israel (which is administering the most boosters to date) is that they are very effective and safe.  We still are not sure if they are necessary because we haven’t seen a big increase in cases among vaccinated individuals.  We are happy to discuss your options with you.

As for Flu – the high dose is in and available and they are first come first served for those aged 65 and over.  We expect an increase in flu this year since people aren’t quite as socially distanced as they were at the height of the pandemic.

These are the types of very real questions that we know many of you have based on our interactions with you at our office.  We are doing our very best to keep up with the up to the minute data so that we can provide the best experience for our patients!  Check back for part 2 which will focus on hypertension!

Stay safe everyone! 

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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!