Observed annually on the fourth Tuesday in March, Diabetes Alert Day is a wake-up call to inform the American public about the seriousness of diabetes – an illness that affects millions of Americans of all ages, particularly when diabetes is left undiagnosed or untreated. This year, Diabetes Alert Day falls on March 24, and it’s especially imperative that the people of Alabama take note considering our state has among the highest prevalence of diabetes in the United States.
Each year, the landscape for physician practices has experienced seismic shifts in the areas of reimbursement, regulatory requirements, technology, and competition. Meeting the challenges of such a shifting landscape is a formidable task for even the most sophisticated of physician practices. Doing so requires a keen eye on what’s ahead and careful planning. So, let’s look at a couple of trends that should be considered in the planning process for 2020.
We live in a three-dimensional world, where many physicians and surgeons diagnose, treat and operate on patients using flat images, but that is not the case at Children’s of Alabama. Seven years ago, I helped open Children’s first 3-D laboratory, which provides cutting-edge technology through advanced visualization. We help our medical staff provide a clearer, less invasive and more realistic view of joints and organs. With this type of information, doctors can also give patient families a clearer vision and understanding of their child’s condition.
I have a meniscus tear, now what?
Many patients who come to my clinic with an MRI that shows a meniscus tear are looking for advice on what to do next. Another physician may have told them that they need surgery because the MRI is abnormal. Some people just want another opinion. Not all meniscus tears need surgery.
I first want to understand the patient’s symptoms, and I look to see if the knee is locking, catching, or if it feels unstable. Meniscus tears that are unstable create these problems, which may indicate that more damage is being done to the articular cartilage in the rest of the knee. An additional concern here is that the knee could give way at a bad time, causing a fall or buckle leading to another injury. Be careful.
I am an Associate Professor of Pathology at UAB, and was surprised when, shortly after moving to the Birmingham are in 2013, I was diagnosed with leukemia. As a researcher of diabetes and cardiovascular diseases, I had no idea how many advances had been made in the world of oncology. However, owing to the discovery of tyrosine kinase inhibitors, like Gleevec and Sprycel, and the outstanding medical care I received at the O’Neal Comprehensive Cancer Center and Kirklin Clinics, I was quickly cured. However, not all have been so lucky, and that is why I have now put my love of running to help put an end to blood cancer for others.
During your first visit as a new patient to our fertility clinic, the American Institute for Reproductive Medicine, you will undergo a series of lab tests. These tests are critical in determining the right treatment plan. We focus on eight common lab tests.
Obstructive Sleep Apnea (OSA) is a common problem affecting nearly one-third of the adult population. The long-term health effects of untreated OSA are beginning to become established and are frightening: increased risk of cardiovascular disease, stroke, dementia, pulmonary hypertension.
One of the most common operations in orthopaedics and sports medicine is surgery for a torn meniscus. I get a lot of questions about what this surgery involves, how long it takes to recover, and when it should be done.
Recently, a friend in the pharmaceuticals business asked me about SGLT-2 Inhibitors. He wanted to know what a nephrologist thought of the drugs, and I expressed strong misgivings about potential complications.
Physical health, mental health, and substance abuse problems often are more apparent in prisons than in the community, and many incarcerated men and women are often only diagnosed with these problems after receiving care from a correctional health provider. Correctional health care is also tasked with providing experienced management, technologically advanced services, and programs that control costs while ensuring quality of patient care.
Teen Health Week, a global campaign to raise awareness of the unique health issues adolescents and young adults face, is observed every year during the first week of April. However, raising awareness is an everyday reality for the University of Alabama at Birmingham (UAB) Division of Adolescent Medicine at Children’s of Alabama, where our team of specialists provides a comprehensive array of services to help patients transition into a healthy adulthood.
One of the more common complaints evaluated by health care providers on a daily basis is Sciatica which is described generally as pain in the lower back or buttock that radiates into the leg and the foot along the path of the sciatic nerve. Patients will sometimes complain of associated numbness, tingling and even weakness in their lower leg with difficulty sitting. Symptoms can appear suddenly or gradually, and with or without a preceding precipitating event such as lifting or other back straining activities.
While there are seemingly countless spinal surgical approaches and techniques, all spinal surgeries fall into one of two categories: decompression or stabilization. Decompression involves taking pressure off neurologic structures including the spinal cord and, more commonly, nerve roots to improve function and relieve pain. Stabilization involves restoring structure to one or more spinal segments, i.e. two adjacent vertebra and the intervening disc, by creating an environment for bone to grow from one vertebra to the next. This may be performed to treat gross instability from a traumatic fracture or chronic instability from a degenerative spondylolisthesis.
Vince Lombardi once said football is not a contact sport. Dancing is a contact sport. Football is a collision sport. He was right. And when you or your family members are involved in collision sports like football (or soccer, wrestling, basketball, mountain biking, etc.) your shoulders may pay the price. Contact injuries to the shoulder are a common cause of down-time and occasionally result in surgery. What is the best management for these injuries?
In 2012, Transcatheter Aortic Valve Replacement (TAVR) became commercially available in the US to treat high-risk patients with severe aortic stenosis. It offered effective, minimally invasive, and often lifesaving treatment to tens of thousands of patients who previously had no option for aortic valve replacement surgery.
When I speak with a patient regarding knee replacement or hip replacement surgery, he/she often asks in detail about the post-surgical rehab. In my specialty of orthopaedics, rehabilitation is critical to the success of the surgery. However, one of the major risks, although uncommon, facing surgery patients is the formation of a blood clot within a deep vein. This complication is often overlooked, and can be fatal when symptoms are ignored.
I work with Chris Heck, MD an orthopaedic spine surgeon. We have developed an interest in treating osteoporosis, as a result of patients with have seen with broken bones.
Peripheral angioplasty is a minimally invasive procedure that can be performed now in an outpatient setting under local anesthesia for the treatment of peripheral artery disease (PAD). Medical technology has played a significant role in furthering this trend. PAD is a common circulatory problem in which the narrowed arteries reduce blood flow in the legs causing leg pain, numbness and/or discoloration.
On Sept. 6, representatives of Children’s of Alabama, the University of Alabama at Birmingham (UAB) Division of Pediatric Rehabilitation Medicine and the Lakeshore Foundation gathered to cut the ceremonial red ribbon for the grand opening of Children’s at Lakeshore – the latest chapter in a partnership among the institutions.
A 2016 report from the Centers for Disease Control and Prevention (CDC) found that 20 percent of Medicare participants 65 or older don’t take their blood pressure medicine as directed.1 Additionally, 20-30 percent of prescriptions for chronic health conditions are never filled and roughly 50 percent are not taken as recommended.1
It’s been more than twenty years since the 1997 revisions to Evaluation and Management guidelines, which focus mainly on physical examination. The 2019 proposed changes provide practitioners a choice in the basis of documenting E/M visits; alleviate the burdens, and focus attention on alternatives that better reflect the current practice of medicine. The implementation of electronic medical records has allowed providers to document more information, yet repetitive templates, cloning, and other workflows have pushed the envelope on compliance in documenting the traditional elements of the visit.
“We’re all wearing our team colors, but colors don’t matter when it comes to concussion,” says Dr. Jimmy Robinson, University of Alabama lead team physician. This year, at the Children’s of Alabama Annual Concussion Summit, a special science, vision, and engineering breakout session featured the insight of Dr. Robinson and others in the trenches of Division I sidelines. Led by UAB’s director of medical athletics, Dr. Heath Hale, and UAB Team Eye Doctor, Dr. Kathy Weise, lead team physicians and scientists from Alabama, Auburn, Florida and Clemson joined forces to weigh in on UAB’s advancements in concussion expertise. What if a contact lens could determine how much the eye sloshes around in the orbit to predict how much the brain moves in the skull when exposed to impact? What if retinal blood flow could predict cerebral blood flow following concussion? What if an objective pupil test could help predict prolonged concussion recovery?
As today’s healthcare drive pushes practices even further down the path of pay for performance versus the older models of pay for volume, administrators and executives throughout healthcare are researching and implementing ideas to provide an overall better experience for patients.
Pelvic organ prolapse (POP) is the descent of one or more parts of the vagina and/or uterus. Woman may experience displacement of the anterior, posterior or apex of the vagina, and often there is a combination. This is referred to as a cystocele, rectocele and enterocele.
According to a recent study by the Cleveland Clinic, more than one-third of physicians are in a silent battle with professional burnout. Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Kolb of Madison.
More than 10 million people in the United States are affected by Peripheral Artery Disease (PAD). About one in every twenty Americans over the age of 50 has PAD. Smokers are four times more likely to develop the condition. Peripheral Artery Disease is a strong indicator for potential heart attack and stroke. Most people are aware of coronary artery disease but few know the symptoms of vascular disease. The most common symptom of PAD in the lower extremities is a painful muscle cramping in the hips, thighs and calves when walking or exercising. Other symptoms to be aware of are leg numbness, skin discoloration of the legs or toes & loss of hair on the lower legs.
Are you sleeping well? One in three Americans suffer from sleep-related issues. If you or someone you know suffers from a sleep disorder, there has never been a better time to find a solution. Lack of good sleep can be detrimental to one’s quality of life in many aspects. Untreated sleep disorders make it difficult to control other health conditions such as migraines, anxiety, depression, pain, and more. Poor sleep due to a disorder such as sleep apnea can also have negative effects on your social life, as you are too tired to participate in social activities. People who snore could also interrupt the sleep of their bed-partners! Finally, sleep issues can lead to poor concentration, job performance, and lack of productivity.
In 2012, I read this article that made me question much of what I thought I knew about my profession of serving clients as a guide for their financial decisions. The designation following my name for which I had worked so hard at obtaining? Good, but not enough. The incredible technology –from complex financial forecasting to automated investment management? Lacking.
Lipedema (Lip- fat, edema- swelling) is a disease of abnormal and disproportionate adipose tissue deposition almost exclusively occurring in women1. While the disorder was originally described in 19402, lipedema remains under-recognized and underdiagnosed in the United States3. This article aims to elucidate the salient features of lipedema toward the goal of raising awareness among the medical community.
Physicians and other medical care professionals spend years studying, training and preparing themselves to provide best possible care to their patients. In many instances, these professionals spend the bulk of their attention and energy on treating their patients and meeting the day-to-day challenges that come with providing the best care possible. Unfortunately, practicing in today’s economic climate within a medical industry undergoing a vast transformation has forced many medical professionals to place equal value on business issues that effect their practice. Often times, the business of operating a medical practice is never discussed in medical school. Instead, many healthcare professionals are forced to learn fundamental business principles on the fly in private practice. With the emergence of electronic medical records and coding, many healthcare providers and practices are spending a substantial amount of time concentrating on the business of healthcare in addition to patient care. Of all the business issues that must now be prioritized by the medical industry, medical billing and managing account receivables can bear the most burden of all.
If “Varithena” sounds like the latest Marvel or DC superhero, there’s good reason. When it comes to treating varicose veins, such an idea isn’t so far fetched!
Q: Could you tell us about Norwood Clinic Ophthalmology?
A: We’re a part of Norwood Clinic, which is the oldest and largest multi-specialty medical group in the Birmingham area. At the ophthalmology location, we offer comprehensive ophthalmology services. This includes routine adult and pediatric eye exams; medical and surgical treatment for diseases of the eye and eyelids; and screening for ocular manifestations of systemic diseases such as diabetes.
We also have certified ophthalmic technicians and an optician to assist with the dispensing of glasses and contact lenses.
A couple should consider seeking help from a fertility specialist after attempting to conceive for three months, six months, a year—there really is no right answer. Infertility could be due to a single factor, or multiple factors, and fertility treatments vary in complexity. One factor in particular has become more prominent nowadays in couples who are trying to conceive: age, which effects both the husband and wife, has become a threat to fecundity as society pressures couples to start a family later in life.
Noncompliance (non-adherence) to medical recommendations can have a significant impact on a patient’s overall health quality, resulting in decreased opportunities for prevention, delayed diagnosis, and incomplete or ineffective treatment. There may also be significant liability and financial risks to a responsible healthcare professional treating this patient, particularly as patient outcomes increasingly become connected to quality indicators and reimbursement.
Two million Americans suffer from plantar fasciitis every year and 10 percent of the population will experience it in their lifetime. It has become recognized as one of the most chronic and, often times, most difficult foot problems to treat.
Dr. Sunshine arrives in her clinic at 8 am. Her lobby is full of patients. Mrs. Jane, a 45-year-old widower who has been Dr. Sunshine’s patient for 10 years. Mrs. Jane has recently been complaining about reoccurring back pain, the inability to fall asleep, and indigestion problems. Dr. Sunshine is aware of the sudden passing of Mrs. Jane’s husband a year ago and treats her physical symptoms as they present themselves with analgesics, sedatives and reflux medicine. Yet, Mrs. Jane’s complaints remain. Although compliant with her medications, Mrs. Jane’s symptoms are a result of Major Depressive Disorder.
Just because you’re getting older doesn’t mean that it’s too late to get in shape. In fact, research shows that older people who have never exercised can still benefit from physical conditioning. By starting a regular exercise program, you can help prevent coronary artery disease, high blood pressure, stroke, diabetes, depression and some cancer. Physical fitness reduces the effects of osteoporosis and arthritis — two conditions which can severely limit an older person’s lifestyle. Being in good shape physically can help you remain independent as you age and improve the quality of your life.
Full scale recruitment is under way for the Alabama Genomic Health Initiative (AGHI), a partnership of the University of Alabama at Birmingham (UAB), HudsonAlpha Institute for Biotechnology and Children’s of Alabama. Funded by a $2 million appropriation from the Alabama legislature to UAB, the AGHI is one of the nation’s first statewide efforts to use genomic analysis to identify those at high risk for genetic diseases.
As a hand and upper extremity Orthopaedic surgeon, I see many patients that present to my office with pain in their elbow and forearm. For a certain subsets of these patients, I ultimately diagnose them with lateral epicondylitis, or tennis elbow. Oftentimes, their reaction is the same. They say, “Doc, I don’t even play tennis, how could I have tennis elbow?!” Unfortunately, many people assume that lateral epicondylitis will only affect those individuals that are active in racquet sports, when in reality; tennis elbow can affect both men and women regardless of their hobbies.
Prostate cancer is the second most common cancer diagnosed in American men and the second leading cause of cancer death. While a majority of men will be diagnosed after the age of 65, younger men do need to consider screening for prostate cancer, especially if risk factors are present such as African American heritage or a family history of prostate cancer.
Most all medical practices are preparing a MACRA project this summer. Our healthcare team has had the opportunity to speak to many physicians and managers regarding preparation for the transition from volume to value based medicine and reimbursement. A large project can be overwhelming for any practice but this is more than a project, it is a culture change!
The city of Marion is an old town rich in Alabama history that pre-dates the Civil War. It’s home to many antebellum homes, Judson College and Marion Military Institute, the nation’s oldest military junior college. Few people may know that a young Coretta Scott, born and raised in Marion, wed her husband, Rev. Dr. Martin Luther King Jr., on the front lawn of her mother’s home just north of Marion in 1953. It’s this small town’s amazing history that called out to Dr. Shane Lee when he was looking to set up a practice.
TUSCUMBIA – When you walk into Dr. Suzanne Blaylock’s office at the Helen Keller Pavilion, there’s a medical journal on her desk, paused and waiting for her to return to continue reading the most recent article. On the wall behind her chair are framed reminders of why she choose anesthesiology as her specialty – awards recognizing her from the Peer Reviewed Professionals, the Consumers’ Research Council of America as one of America’s Top Anesthesiologists, and the Consumers’ Research Council of America’s Top Physicians. Dr. Blaylock always knew she’d have a career in medicine, but what she got was so much more.
The Mobile area has many sites for tourists to visit during a stay. From the Gulf Coast Exploreum Science Center & IMAX Theater, the USS Alabama Battleship, the beautiful flowers of Bellingrath Gardens, dipping your toes in the warm Gulf waters of Dauphin Island, to celebrating Mardi Gras at the Mobile Carnival Museum, there’s one attraction in Mobile that may not immediately catch your attention, but you surely should not miss…the Mobile Medical Museum.
A family medicine doctor is someone you can always feel comfortable voicing your concerns to and leave an appointment feeling as though you were really listened to. They will help you to become an informed and active member of your healthcare decision-making process.
As we approach the beginning of summer, our minds are likely not on summer vacation. The process of assessing our electronic medical record vendor, absorbing the details of MIPS, and making the decisions on how to prepare, is overwhelming for small practices. The transition to value based medicine has been evolving over the last 10 years in stages; adopting electronic health record, Quality Reporting, and Meaningful Use. Many administrators and physicians did not realize the importance of each project; from choosing the right EMR, to implementing it properly, therefore achieving best practice workflows.
MONTGOMERY – Boyde Jerome “Jerry” Harrison, a family practitioner from Haleyville, was formally installed as president of the Medical Association of the State of Alabama during the 2017 Inauguration, Awards Presentation and 50-Year Physician Recognition Dinner on Friday, April 14.
Physicians Giving Back with Lee Irvin, M.D.
You probably don’t know Lee Irvin, M.D., of Mobile, and he’s fine with that. He’s the kind of gentleman you’d love to hang out with and have a drink or dinner with…swap stories with. But it’s easy to see that his medical mission over the last couple of years wears heavy on his heart.
You may have thought that a sports orthopaedic center would be a place to go only after a catastrophic sports injury—something breaks or tears or starts hurting so badly you can’t physically use it.
“Most athletic injuries seen in sports clinics are indeed overuse injuries that have reached a point of taking the patient out of the game,” said Dr. Ricardo Colberg of Andrews Sports Medicine & Orthopaedic Center. “Although 85% of sports injuries do not require surgery, many patients wait until they are unable to compete to start correcting their issues.”
As pediatric medicine becomes more specialized, the demand for specialists grows. One need look no further than the Division of Pediatric Neurology at the University of Alabama at Birmingham (UAB) for evidence of this trend.
MONTGOMERY – On March 29, officials from the Medical Association of the State of Alabama participated in a proclamation signing ceremony declaring March 30, 2017, the Second Annual Doctors’ Day in Alabama formally recognizing Alabama’s nearly 17,000 licensed physicians serving millions of residents through private practice, in hospitals, in research, and in other health care facilities.
A 34-year-old male presented to a family medicine physician for chronic low back pain. The physician is comfortable prescribing opioids and has many patients on scheduled drugs. The patient has had chronic pain for many years and has undergone multiple treatments including physical therapy, steroid injections and many medications. On presentation, the patient was on Robaxin and oxycodone (four times a day). His past history is positive for hypertension and alcohol abuse, although he stated he hasn’t drank in the past year. He works as a laborer.
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