Primary Care

Medicare Educational Seminars at Emory

Whether you’re turning 65, already on Medicare, or helping someone with their coverage, plan to attend a free seminar to get your Medicare questions answered.

Offered at several Emory locations, Medicare Educational Seminars are designed for patients new to Medicare and those brushing up on their benefits. Learn about Medicare Parts A, B, C and D, and the different types of Medicare insurance. Find out if you may qualify for federal and state subsidy programs.

Foot Care for Seniors: 10 Important Tips

Proper foot care is essential for older adults to help prevent injuries, falls and complications from chronic conditions like diabetes.Proper foot care is essential for older adults because it can help prevent injuries, falls and complications from chronic diseases like diabetes. Learn how to properly care for your feet so they can continue to take you wherever you need to go.

1. Be good to your soles. As you age, the muscle tissue in your feet can thin and your nerves may not work effectively. This can lead to loss of feeling in your feet (neuropathy). Use a long-handled mirror – it will extend your reach several inches – to see what you may not feel. Examine the soles of your feet and in-between your toes every day for cuts, blisters, sores or any areas of skin breakdown from moisture. This is especially important if you have diabetes.

2. Choose the right footwear. Wearing the right footwear can help you keep your balance, prevent falls and reduce the risk of blisters and other injuries. Never purchase shoes that rub or slide around on your heel as you walk – this is a common way to develop blisters that can become more serious sores. Also avoid shoes that are too tight, slick on the bottom, have high heels or pointy toes.

If you have diabetes or neuropathy, talk with your doctor about prescription orthodics (supports or devices worn in your shoes). You may be eligible for custom othodics partially covered by Medicare.

3. Get the right fit. Here are a few suggestions:
• Visit the shoe store in the afternoon when your feet are slightly swollen from daily activities.
• Have a sales associate measure your feet so you can select the correct size. It’s normal for your feet to change sizes slightly as you age.
• Choose the shoe size that fits your larger foot (it’s common to have one foot that’s bigger than the other).
• Always try on shoes before you buy them to make sure they fit. A good rule of thumb: your toes should be half an inch from the tips of your shoes when you are standing.

4. Barefoot isn’t better. When going outdoors, always wear shoes (preferably closed-toe shoes) to prevent cuts, scrapes and falls. It’s also best to wear shoes as much as possible while indoors to protect your feet.

5. Keep your toenails in tip-top shape. Trimming your toenails correctly (straight across and no shorter than the tip of your toe) is key for preventing ingrown toenails. If you have diabetes or trouble reaching your feet, see a podiatrist (a physician who specializes in foot care), not a nail salon technician, for regular medical pedicures and nail trimming.

6. Get the blood flowing. As you age, you may have decreased blood circulation to your feet. To promote healthy circulation:
• Prop up your feet on a stool or couch when sitting down
• Wiggle your toes when you sit for long periods of time
• Stretch daily
• Give yourself regular foot massages
And, if you smoke, now’s the time to quit. Smoking can affect good circulation in the body.

7. Keep your feet dry. Change your socks regularly and make sure your feet aren’t damp from sweat or a shower before putting on your shoes.

8. …But not too dry. Keep your feet moisturized to prevent cracking, itching and calluses. Stick with gentle soap and apply cream or lotion daily after your shower or bath.

9. Fight fungal infections. Prevent athlete’s foot by wearing shoes that fit properly, changing your socks or stockings daily (or whenever they become damp) and applying foot powder each day. If you experience itching or burning, see your podiatrist for treatment.

10. Visit your podiatrist regularly for foot checks. Your podiatrist can catch problems like bone spurs, hammertoe, neuromas, bunions, warts, ingrown toenails or wounds before they cause more serious problems.

Would you like to find a podiatrist near you? Yes, I’d like to find one now. 

Primary Care Physician or Specialist? 4 Things to Consider

While a primary care physician often take the lead in preventive care and wellness, they also can treat health conditions that require ongoing maintenance.A primary care physician (PCP) can play a pivotal role in your health care, and are often the first point of contact you have with the health system. While PCPs often take the lead in preventive care and general wellness, they also can treat many health conditions that require ongoing maintenance. These may include allergies, hypertension, high cholesterol, diabetes, and mood disorders, to name a few.

However, certain conditions may lead your PCP to refer you to a specialist, a physician with focused training in a specific area in the field of medicine.

There are 4 reasons you may be referred to a specialist:

You have a complex ongoing condition.

Many primary care physicians are skilled at managing ongoing health conditions – often referred to as chronic conditions – including diabetes, arthritis and high blood pressure (hypertension). However, some diseases need a higher level of expertise in a medical specialty to provide treatments. You also may suffer from a more severe form of a disease that may put you at greater risk for a more serious health crisis.

For instance, a PCP may be able to help you with single kidney stone attack that keeps you out of work for a few days. But if you have multiple kidney stone attacks in as many months, or have a large kidney stone that is obstructing urine, there may be a deeper underlying problem. Your PCP may refer you to a nephrologist or urologist, doctors who specializes in kidney care and diseases that affect the kidneys and bladder.

You’re dealing with a rare disease.

When you have a rare disease like cystic fibrosis, a specialist can provide more resources for treatment and will likely be aware of the newest therapies available. By definition, a rare disease affects fewer than 200,000 Americans. Since your PCP functions as a health care generalist, he may not see your condition enough to fully manage it on his/her own. However, primary care physicians can work with a specialist to help fully manage the disease.

You received a life-altering or life-threatening diagnosis.

Certain medical conditions can mean you need to make significant lifestyle changes. Diabetes can mean insulin shots at regular intervals during the day, as well as significant changes in diet and more frequent visits to your doctor to monitor your condition. A stroke can require ongoing therapy and physical modifications to your home. It can be worth a visit with a specialist to assess your diagnosis and fine tune your treatment options.

Current treatments don’t seem to work

If a health problem persists in spite of a treatment that normally works or you have a set of symptoms that don’t make sense, you and your PCP may decide you need a specialist to take a deeper look at what may be affecting you.

Finding a specialist

Ask your primary care provider to recommend a physician who is in your health plan, or check your insurance plan’s list of physicians to see who participates and ask for a referral based on that list.

Related articles:
What is a PCP and Why Do I Need One?

What is a Patient Centered Medical Home?

Experts at Emory Healthcare break down the concept of a Patient Centered Medical Home – and explain why patients benefit.In this era of health care reform, as the topics of health care access and affordability frequently make headlines, it’s possible you’ve heard the term “patient centered medical home.” If so, you likely brushed it off as another example of medical jargon that is not relevant to you.

But believe it or not, the concept of a patient centered medical home, or PCMH, is quickly becoming more mainstream – and may eventually become the standard of care in your own doctor’s office.

In primary care clinics across the country, doctors and other medical professionals are adopting PCMH principles. Let’s explore how their efforts to implement this model of care make the health care experience more meaningful to patients.

Less About a Physical Place, More About a Philosophy

First, let’s break down the name patient centered medical home:

  • Despite what the phrase may imply, a medical home is not a nursing home or assisted living facility. Instead, think of it as your medical “home base,” the place and professionals you turn to when you get sick or need a routine check-up. In other words, your medical home is most likely your primary care provider’s office.
  • Perhaps more important are the words patient centered. In a PCMH, everything from office hours to treatment plans are designed with the patient in mind – so you can receive the care you need when you need it, and in ways that address your health, schedule, cultural and other personal needs. Some examples of this enhanced focus on patient needs are included below.

What Makes a Patient Centered Medical Home Different?

Let’s review how you and other patients benefit when you receive care from a patient centered medical home:

  • Consistent, team-based care. In a PCMH you have an entire team of health professionals at your disposal, most under one roof. This care team, led by your chosen primary care doctor, may include advanced practice providers such as physician assistants and nurse practitioners, as well as other licensed clinicians ranging from dietitians and case managers to behavioral and mental health specialists.

 When you need care, you only see members of your own care team, all of whom are familiar with your health history and contribute to managing your health. Over time, this consistency      allows you to develop strong, trusted relationships with your providers.

  • Better coordination of care. If you need services that your primary care doctor’s office can’t provide, your care team will help coordinate them so you don’t have to navigate the complicated health system on your own. Whether you need to see a specialist, are admitted to a hospital or require home health visits, your team will make sure you get the care you need and will stay on top of your ongoing progress.
  • More accessible care. You can see (or reach) your doctor or another member of your care team more quickly, thanks to non-traditional hours on evenings or weekends, and non-traditional means of communication including secure e-mail, video chats or after-hours phone calls.
  • More meaningful care. In a PCMH, you’re considered both a patient and a partner. This means you can take a more active role in advocating for and managing your own health. Care team members help facilitate this partnership by serving as teachers and coaches – so you always have someone to turn to when you need help managing your diet, understanding your medications or achieving your goals.

The Gold Seal of Approval

For most primary care clinics, the transformation to a PCMH requires significant investment and effort. Organizations may need to hire advanced practice providers, extend their business hours and implement the latest health care technology including electronic medical records and telemedicine software.

However, these efforts pay off – on average, practices that have become medical homes have higher quality, lower costs and greater patient satisfaction. To that end, organizations like the National Committee for Quality Assurance (NCQA) have created recognition programs to formally endorse clinics that have met stringent criteria for calling themselves a PCMH.

In the Emory Healthcare Network, 9 primary care practices have earned NCQA PCMH Level 3 Recognition in the past year.

  • Emory Clinic at Midtown
  • Emory Clinic at Decatur
  • Emory Clinic at Saint Joseph’s – General Internal Medicine
  • Emory at Covington – Adams Street
  • Emory at Covington – Newton Drive
  • Emory at Covington – Hospital Drive
  • Emory at Sugarloaf
  • Emory at Eagles Landing

These practices join two other Emory patient centered medical homes with NCQA PCMH Level 3 recognition: Patient Centered Primary Care at 1525 Clifton Road, which earned recognition in 2011, and Emory Clinic at Dunwoody – Family Medicine, which earned recognition in 2014.

To learn more about these locations, call Emory HealthConnection at 404-778-7777.

Coordinated Care Centers: A New Care Model for Older Adults

Emory Coordinated Care Centers promote wellness in older adults. The goal of the care center model is to educate patients and promote quality of life.Leaders from Emory Healthcare and California-based Caremore published an article in NEJM (New England Journal of Medicine) Catalyst presenting early results and highlights from the coordinated care program both company’s worked to launch in August 2014.

So what is a coordinated care program?

Coordinated care programs seek to streamline healthcare for older adults. As people age, they may find themselves juggling multiple doctors’ visits, chronic disease treatment plans and a number of daily medications.

To simplify this process, the Emory Healthcare Network opened two Emory Coordinated Care Centers, as well as several satellite locations, which use multi-disciplinary health care teams to improve quality of life for its patients. These centers are part of Emory Healthcare Network Advantage, a program that focuses on high-risk Medicare Advantage patients who either have, or are at risk for, chronic health problems such as diabetes, congestive heart failure and chronic obstructive pulmonary disease (COPD).

“The goal of the Emory Coordinated Care Centers is to promote wellness in the older patient population,” says Anthony Nguyen, M.D., regional medical officer at Emory Healthcare. “Many older patients have multiple chronic diseases that affect their health over time. With many different medical problems, medications and providers, it may become difficult for a patient to understand everything that is happening with their health.”

A New Approach to Health Care

“Often times, patients have many medical conditions and require care from multiple physicians,” says Dr. Nguyen. “Unfortunately, it’s common that patient care becomes fragmented. The Care Center team works to bring all of the patient’s information together.”

He adds, “The coordinated care center approach is different from the standard model of care because it focuses on the continuum of care. Our goal is to educate patients to be active in their own wellbeing to promote quality of life.”

Many of the services in the Care Centers are provided at low or no cost to patients to remove barriers to care. The model promotes preventive and proactive care rather than sick or reactive care.

Nearly a dozen programs are offered at the centers, including Healthy Start , a comprehensive assessment that identifies a patient’s health risks. Each of the programs supplement care patients receive from their PCPs and specialists.

The Coordinated Care Teams

The coordinated care teams include medical professionals who educate patients and help them manage conditions such as diabetes, hypertension or heart failure. This team includes:

  • A physician
  • A registered nurse outpatient case manager
  • A social worker
  • Advanced care providers, such as nurse practitioners and physician assistants
    Staff at Emory Coordinated Care Centers get nearly two months of comprehensive, interdisciplinary training.

“To provide the best patient experience and great clinical outcomes, everyone must work together,” explains Dr. Nguyen.

“The care center works very closely with a patient’s primary care physician to ensure we have the same goals for their care,” he says. “The coordinated care center model works collaboratively with the primary care physician and everything we do in the Care Center is communicated back to them. We don’t replace the primary care physician, but rather supplement their care.”

Once patients are part of an Emory Coordinated Care Center program, the team follows up with them on a regular basis by phone and schedules Care Center appointments as needed.

“If the chronic diseases are managed well, the rate of disease progression may be slowed, leading to a higher quality of life,” says Dr. Nguyen.

How do people become patients

Patients who already see a primary care doctor in the Emory Healthcare Network and are members of a participating Medicare Advantage plan can talk to their physicians about the program or simply call to make an appointment for a HealthyStart.

In addition, Emory Healthcare Network patients may be referred to an Emory Coordinated Care Center by a physician who cared for them during a hospital stay

Read about the early results of this model at the Emory News Center.

Managing Your Stress Live Chat on December 22nd

stress-chatThe holiday season is in full swing, and there’s no better time to think about stress management. In short spurts, stress is actually helpful and can propel us through a tough situation or help us react quickly to avoid one. However, prolonged or severe stress may trigger physical, psychological and emotional reactions that can lead to health problems or worsen existing ones.

On Tuesday, December 22, 2015 from noon to 1pm EST join Emory Healthcare Network’s Sharon Horesh Bergquist, MD for an interactive web chat on Stress Management. Sign up, send questions and learn about

  • Symptoms of stress
  • Long-term effects of stress on your health and body and
  • Techniques for reducing stress

sign-up2

About Dr. Bergquist

avatar-horesh-bergquist-sharonDr. Bergquist is an Emory Clinic Primary Care Physician and Assistant Professor of Medicine at Emory University School of Medicine. Her expertise includes healthy aging, heart disease prevention and management, women’s health, diabetes, nutrition and obesity counseling and treatment of mood disorders, such as anxiety and depression. She has appeared in over a hundred health segments, including Good Morning America, Fox New Network, CNN and Fox 5, has served as an editorial consultant for WebMD and wrote the TED Ed Lesson, “How Stress Affects Your Body.”

Spotlight: Men’s Fitness

Men's Health MonthJune is Men’s Health Month. It’s also the time of year when many men become more active. The warm temperatures and long days make it easier (and more fun) to play on a softball team, tend to the yard, or start a new exercise routine, like biking or swimming. But after months of rest, the sudden explosion of activity can wreak havoc on the body.

If you’re about to ramp up a new summer workout, keep these injury prevention tips in mind:

1. Get Professional Help

If you are new to exercise, or just haven’t been active in a while, see your doctor for a physical to make sure you are healthy enough to take on strenuous activity. Also consider hiring a professional trainer or coach who can teach you proper form and technique.

2. Wear Proper Clothing

Always wear appropriate footwear. Not only will you be more comfortable, but you will also be able to alleviate undue stress to your ankles, knees and hips by providing much needed support. Also choose appropriate clothing that fits well, allows you to move naturally, and doesn’t interfere with your safety.

3. Warm Up

Never start a workout in full throttle. Begin slowly and build the pace. This gets the blood flowing to your muscles gradually, giving them time to warm up and acclimate to the activity. This also gives you time to listen to your body and identify any aches or pains that may be red flags to more serious problems.

4. Leave Your Ego At The Door

Many men start a workout program thinking too much about what they should be able to do rather than what they are honestly capable of at the time. Attempting too much too quickly invites injury. So, take the pressure off. Concentrate on your individual progress rather than comparing yourself to or competing with others.

5. Stretch

When your muscles have warmed up, stretch. Many men skip this part of a workout. After all, stretching is for girls, right? But, as your muscles get stronger and tighter they start pulling on one another. Eventually, this tug-of-war affects your body posture and you start to feel aches in your back, hamstrings, and shoulders. These minor aggravations can turn into serious problems, all preventable if you take the time to stretch.

6. Take A Day Off

Rest is important. It gives your body time to recuperate and repair. If you’re just starting an exercise program, make sure you take two days off each week. Listen to your body and respond accordingly. Pain and fatigue are subtle signs of overtraining that can lead to more serious problems.

7. Eat Well

Pay attention to nutrition. In order to maintain healthy energy levels and have the physical endurance to push through tough workouts, you need to fuel your body with good, healthy food. Avoid high-fat foods and sweets and drink lots of water to stay hydrated throughout the day.

Related Resources:

Choosing a PCP: It’s a Big Decision

Primary Care PhysicianChoosing a primary care provider is a very important personal decision, and a number of factors should be considered to make sure you are selecting a healthcare professional with whom you can form a long-term relationship.

A primary care provider, or PCP for short, works with you to maintain your overall health by focusing on wellness and the optimum management of your chronic conditions to avoid future problems. And while your PCP is your health care hub, he or she can also help you with selection of and referral to a specialist should your condition warrant the additional expertise. While specialists focuse on their area of expertise, your PCP maintains a holistic perspective. In that way, your PCP will work with your specialist, or specialists, to guide you through your treatment course and provide high-level oversight of treatments, medications, therapies and recommendations to ensure your care is as coordinated as possible.

Here are a few tips to help you choose the right PCP for you:

  • Ask Around – Talk to friends, relatives, neighbors and co-workers about their providers. Also consider asking other healthcare professionals for their opinions. Many hospitals also offer referral services, and professional sites, like the state licensure boards, or certification boards (e.g. American Board of Medical Spectialties), confirm whether or not a doctor is Board certified or has any special qualifications you may require.
  • Consider The Details – Once you’ve got a list of potential providers, winnow it down by asking yourself some practical questions:
    • Do I prefer a male or female doctor?
    • Is the doctor in my age bracket? Will I be able to relate to him/her?
    • Where is the office located? Do I need a doctor close to home or the office?
    • What hours of the day is the office open and will those hours be convenient for me?
    • Is the office staff courteous and efficient?
    • Does the office use an electronic medical record and are they able to access your results electronically from the hospital, lab, or other providers.
    • If you are interested, does the PCP offer online and nontraditional options for communication and alternatives to face-to-face visits?
    • If I need to be admitted to the hospital, which hospital would I prefer? Does the doctor normally refer patients there?
    • Does this doctor accept my insurance? If not, am I willing to pay out of pocket ?
  • Board Certification – While there are several online lists and rankings of providers, very few have objective assessments of the provider’s clinical performance. However, while imperfect, Board Certification, does indicate that the provider has met some minimum requirements. It is important to recognize that many fine clinicians have not earned board certification for very appropriate reasons.
  • Board certified physicians have:
    • Earned their degrees from a qualified medical school
    • Completed three to seven years of accredited residency training
    • Are licensed by a state medical board
    • Have passed one or more exams administered by the ABMS
    • Career-long continuing education requirements they must meet to certification
  • In-person Interviews – Once you’ve decided which doctor looks best on paper, take the next step and interview him or her at his or her practice. Most doctors encourage this, although some may charge a small fee for their time.
  • During the visit, be aware of your total experience, including:
    • How easy – or difficult – was it to make the appointment.
    • Consider the way you are greeted by staff members when you arrive
    • Notice the length of time you spend waiting after you check in.
  • When interviewing the doctors
    • Feel free to ask tough questions.
    • Make sure you feel comfortable with his/her responses and that you are both on the same page when it comes to medications, treatments for chronic issues, and other factors important to you.
    • Consider the PCP’s bedside manner. If your personalities don’t align it will be hard to build trust.
  • Review Your Choice – Following the interview, carefully review the experience. If you weren’t happy with the outcome, continue your search. However, if all went well and the provider met your expectations, then it’s time to start building this very important relationship. You will rely on it for years to come.

About Dr. Gitomer

Richard Gitomer, MDRichard Gitomer, MD, is the President and Chief Quality Officer of the Emory Healthcare Network. Dr. Gitomer has been practicing internal medicine for more than 30 years at Emory.

Related Resources

What Is A PCP and Why Do I Need One?

Primary Care ProviderA primary care provider, or PCP, is your main point of contact for healthcare in non-emergency situations. Think of this type of healthcare provider as the quarterback of your entire health care team, the central point person whose role it is to coordinate your overall patient care, treatment and education.

Overall, your PCP is key to:

  • Providing preventive care and guidance on how to achieve a healthy lifestyle
  • Diagnosing and treating acute common medical conditions, such as cold, flu, infections, etc.
  • Treatment and management of chronic diseases such a high blood pressure, cholesterol and diabetes.
  • Determining the severity of your medical problems, so he or she can direct you to the most appropriate care provider
  • Referring you to medical specialists when a condition requires more targeted treatment

In addition, a PCP ensures prescribed medications will not adversely affect other medications or supplements you may already be taking. Over time, your PCP learns your health history and what is most important to you and your long-term wellness. This high-level oversight ensures all of the treatments, medications, therapies and recommendations from various providers are as effective as possible.

Even if you are relatively healthy right now, things can and do change. This is especially true of millennials (the segment of the population born between the early 80s and the early 2000s), who are in the perfect position to establish health and wellness baselines with a dedicated primary care provider.

PCPs are usually physicians; however, physician assistants and nurse practitioners (collectively referred to as advance practice providers), who work under a qualified physician can also be your PCP. There are also different types of primary care physicians, some of which you may need at different points in your life, depending on your health care needs.

This chart identifies the different types of primary care physicians and can help you pinpoint which can help you most, depending on your health care needs.

Primary Care Physician

About Dr. Colovos

nick colovos, MDNick Colovos, MD, received degree from the University of Miami School of Medicine in 1993, and completed his residency in emergency medicine at St. Vincent’s Medical Center in Toledo Ohio in 1996. His work experiences in the academic, public and private sectors of medical care have allowed him to develop a very unique perspective on the business of healthcare and its delivery to patients.

 

  • Program Director of Urgent Care Services
  • Assistant Clinical Professor of Emergency Medicine, Emory University School of Medicine, Atlanta Georgia
  • Assistant Clinical Professor of Family and Preventative Medicine, Emory University School of Medicine, Atlanta Georgia

 

Related Resources

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