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  • November 1, 2022 MALE TESTOSTERONE REPLACEMENT A PRIMARY CARE APPROACH   SUMMARY Age related low testosterone is associated with aging as testosterone levels naturally decrease after the age of 30. The American Urology Association (AUA) has reported that two out of every 100 men deal with low testosterone levels. Testosterone therapy might seem like the ultimate anti-aging formula, yet the health benefits of testosterone therapy for age-related decline in testosterone aren't clear.   DISCUSSIO...

  • October 15, 2022   Does Quality Reporting make me a Worse Doctor?   Mrs. Jones, a 68-year-old woman, has a history and diagnosis of hypertension. Her blood pressure, taken correctly at her November office visit, is 139/89. Under the Medicare Measures section in the McLaren Physician Partners Top Ten Quality Metrics Quick Reference, blood pressure of 139/89 or less is “adequately controlled” Under the 2017 American Heart Association and the American College of Cardiology blood pressure guidelin...

  • October 1, 2022   Diabetic Eye Exam – Use Ophthalmologists and Optometrists. “The Best Preventative Service is the one that gets done.” About 4.1 million US adults 40 years and older have diabetic retinopathy – 1 of every 12 persons with diabetes mellitus in this age group has advanced, vision-threatening retinopathy (2004). (1) About one in three people with diabetes who are older than age 40 already have some signs of diabetic retinopathy (2014). (2) Finding and treating diabetic retinopathy earl...

  • September 15, 2022 OBESITY the EPIDEMIC   Obesity is epidemic in the United States today and a major cause of death, attributable to heart disease, cancer, and diabetes. As t he most prevalent Chronic Disease in the United States, o besity costs this country about $150 billion a year, or almost 10 percent of the national medical budget. Approximately one in three adults and one in six children are obese.   DEFINITIONS 4 : Adults: Healthy weight  is a BMI of 18.5 to 24.9 Overweight  i...

  • September 1, 2022 Vaping and E-Cigarettes Discussions to Have With Patients E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or a mix of small particles into the air. They can be used to deliver nicotine, marijuana and other drugs. E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).” 4   FACTS ABOUT VAPING: 1 1: Vaping is less har...

  • August 1, 2022 COLONOSCOPY FOLLOW UP SCREENING GUIDELINES   BACKGROUND: The U.S. Multi-Society Task Force on Colorectal Cancer updated recommended follow-up intervals after screening colonoscopy in average-risk individuals. This guidance does not apply to people with hereditary syndromes that increase Colorectal Cancer (CRC) risk, inflammatory bowel disease, serrated polyposis syndrome, or personal or family history of CRC. These guidelines consider colonoscopy results alone and do not evaluate the...

  • July 15, 2022   Antibiotic Aware – Beware of Inappropriate Care   “Data from the National Center for Health Statistics indicate that, in recent years, approximately 75% of all outpatient antimicrobial prescriptions have been issued for 5 conditions – otitis media, sinusitis, bronchitis, pharyngitis and upper respiratory tract infections” – JAMA 1995. (1) “Among the approximately 100 million antibiotic scripts written every year for acute respiratory tract infections, half are prescribed inappr...

  • July 1, 2022 Diabetes Control in the Elderly   SUMMARY: Management of the elderly patient with diabetes promote relaxed targets and avoidance of aggressive control. Choice of diabetes medications in the elderly requires careful assessment of hypoglycemic risk 1 . Adults > 65 years of age with diabetes should be a high priority for depression screening and treatment.   MANAGEMENT: Individualize Targets and Goals 2 7 - 7.5% is reasonable for healthy patients over age 65 with no or few comorbi...

  • June 15, 2022 Current Procedural Terminology Category II Codes (CPT-2 Codes)   WHAT ARE CPT-2 CODES: They describe the following: Clinical components, such as those typically included in evaluation, management, or other clinical services. Results from clinical laboratory or radiology tests and other procedures. Identified processes intended to address patient safety practices (such as fall risk). Services reflecting compliance with state or federal law.   PURPOSE: CPT II codes help define nati...

  • June 1, 2022   CAHPS - Patient Experience The Centers for Medicare & Medicaid Services (CMS) develop, implement, and administer several different patient experience surveys. One of them is the Consumer Assessment of Healthcare Providers & Systems (CAHPS). These surveys ask patients and care givers about their experiences and opinions of their health care providers, their health plan, hospitals, home health care agency, and drug plan. There are number of surveys that may pertain to your prac...