Most OTC products, excepting some medical equipment like crutches and diabetic supplies, now cannot be purchased with flexible spending account dollars without a physician prescription.One of my partners asked last week how I am dealing with this issue. He has had several patients ask for a long list of prescriptions for OTC products so that they can use their FSP to pay for these things with pre-tax dollars. This puts ...
Edward Pullen, MD
Explaining how an EKG works
What is an EKG?EKG stands for electrocardiogram. It should probably and sometimes is abreviated ECG, but EKG seems to have stuck as more popular.Scientists have known for over 120 years that the heart gives off electrical currents when it beats, but it was the Dutch scientist Willem Einthoven in the early 20th century who discovered the nature of this phenomenon and who developed the electrocardiogram as a tool to ...
Treatment of chronic pain puts doctors in a no win situation
First do no harm.Treat every patient with respect and dignity.These are values I try to live by and incorporate into my daily work. Treatment of chronic pain is the scenario that puts me and every practicing primary care physician in a no-win situation regularly in the office. To try to make physicians feel more comfortable treating pain most states have tried ...
Seeing a family physician at work is valuable for medical students
I recently headed off to a reception for students from the new Pacific Northwest University of Health Sciences in Yakima, WA who are spending their third year of osteopathic medical school in Puyallup, WA doing rotations with the physicians in our community. I’ve had a student with me recently, and it brings back memories of my third year in med school, and how things have changed. It also leads me ...
Living with cancer is different from living after cancer
This is a topic close to home.My wife was diagnosed with stage 3C cancer of the ovary a bit over a year ago. She was a chemotherapy superstar, had few complications, and has been in remission since her treatment finished last October. Still we know her chances of a cure are fairly low.Understanding statistics is a mixed blessing. Even though her chances of this cancer never recurring are pretty low, ...
How time can be used as a diagnostic tool
I can’t remember which lecture it was, or even just when in my first two years of medical school the lecture was given, but I do remember how the concept struck me as really important.The gist of the message was that the timing of onset of a patient’s symptoms is a key part of understanding the nature of the patient’s diagnosis. Symptoms from a neoplasm come on gradually, tend to ...
We need a better way to share information to care for patients
This evening I went to a meeting of many of the independent physicians in our community who came together to discuss ways we can help each other to remain viable as relatively small independent practices of medicine. Two things about the meeting really hit home for me.First is how seldom I get to meet socially with my fellow physicians in the community. Now that many of us use hospitalists to take care ...
Pay specialists less to save primary care
Since 1997 the number of US medical students choosing to go into primary care has decreased by more than 50%.It seems that sources as diverse as the Obama Administration and the Wall Street Journal think that we should find a way to encourage medical students to choose primary care specialties in order to allow Americans to have the best and most cost effective care. This is very problematic when primary ...
Euthanasia in dogs and the moral lessons for doctors
We had our dog put down yesterday.Simon joined our family when our son was 10 years old as a two year old that we adopted from the Purdy Prison Pet Parole Program and was with us until he developed status epilepticus forcing our decision to have Simon euthanized.Simon had been getting old, lame, nearly blind, and uncomfortable most of the time, but we felt he still had some enjoyment in ...
How to talk to patients with an EMR in the room
I see a lot of articles by physicians complaining about how the use of a computerized medical record (EMR) in the exam room with patients detracts from the physician-patient experience.The complaint usually follows the theme that the physician and patient are not able to have eye contact, and both the physician and the patient feel less intimate and connected during the visit because the physician’s need to use the keyboard, ...
Ritalin and Adderall to improve college grades
I watched 60 Minutes on CBS recently, and was surprised to hear how many college students are using stimulants like methylphenidate (Ritalin) and amphetamine/dextroamphetamine (Adderall) to get better grades.These drugs are amphetamines, and Schedule 2 drugs that require a written prescription, cannot be faxed or called into pharmacies, and are considered to have high abuse and addiction potential by the FDA. They have the same type of effect on the ...
Medicare will soon cover preventive exams
A nice surprise buried somewhere in health care reform is that, starting next year, Medicare patients will be able to get annual preventative care exams that are paid for by their health insurance.It may come as a surprise to those of you with commercial insurance who think of coverage of an annual exam as a routine thing for insurance to cover, but up to now Medicare has only covered a ...
Neosporin and other OTC drugs to avoid
Most people use non-prescription medications without giving much thought to the potential side effects or problems that may be associated with their use.Here are 5 popular OTC meds you should avoid, and better alternatives. I bet most of you use one or more of these. Neosporin, Topical Vitamin E, Afrin nasal spray (or other short acting nasal decongestant sprays), daily headache medications, and sedating antihistamines.1. Neosporin: Neosporin in the most ...
Oxycontin should be prescribed less often by doctors
Oxycontin is an oral pain medication that contains the single active ingredient oxycodone. Oxycodone is one of the most potent of the oral opiates, and has more euphoric effect than many other opiate analgesics.Oxycontin is the most notorious prescription drug of abuse in the US, and for good reason. Though marketed as a sustained release medication, as much as 30% of the medication is absorbed immediately and the rest absorbed ...
Patient costs when making medical decisions
At my office we provide care for a fair number of patients without medical insurance. Sometimes we are faced situations with no good options.At a patient visit, often times the diagnosis is not clear without doing some diagnostic tests other than the history and physical exam. Many of these tests are ordered from sources outside the office, where I have little or no control over the cost of the test ...
Why there needs to be a national healthcare information database
The majority of Americans have a great deal of personal health information in their physician’s medical record. Many of these physicians have an electronic healthcare record (EHR) to store this information.Unless you are in an integrated healthcare system, and most Americans are not, this information is just not available to you or any physician seeing you who does not belong to the same physician group as your primary physician. Even ...
