Concierge Medicine Review – Shared Doctor Appointments

Sharing a doctor to increase productivity? Sharing a doctor’s appointment to bond with other patients suffering from the same chronic condition? It is the kind of thing that concierge doctors are concerned over. Imagine paying full price, or your full co-payment, and going to a shared doctor’s appointment with 30 other patients who might be experiencing the same chronic condition that you are. Does this sound like a good idea, or a recipe for disaster?

“Shared medical appointments improve patient access, enhance patient and physician satisfaction, and increase practice productivity, all without adding more hours to a physician’s work week. There is even evidence that they promote better outcomes and lower overall costs of care.” That’s according to ManagedCareMag.com.

Lets add some insight into the previous image; imagine paying full price for a doctor’s visit, visiting with that doctor in a room full of other patients, or ‘observers,’ who are able to ‘sit-in’ on your doctor’s appointment, share ideas, discuss symptoms, and listen to every word that you are telling your doctor. Not much room for privacy, huh?

And when it comes to privacy, there are two different thoughts on the matter. One patient told NBC that his experience with the shared doctor’s appointment was not all it was cracked up to be; “One on one I can talk to the doctor and ask personal things, not that I can’t do that here but I don’t want to take up the time.”

And yet a physician told another media out let the exact opposite; “The biggest surprise was patient confidentiality,” says Rajan Bhandari, MD, chief of neurology at the Kaiser Permanente Santa Theresa Medical Center in San Jose. “They reveal more about themselves than I would ever have known about them otherwise. They seem to really blossom when they’re in a warm, empathic environment where they feel nurtured, supported, and not alone.”

While the money spent is exactly the same, the confidentiality seems to be lacking, and the overall medical treatment might be deficient, physicians say the “real benefit is that instead of pretending that patients who have been living with chronic medical conditions don’t know anything about them, you actually involve them in the care-giving process.”

According to ManagedCareMag.com, a two-year study funded by the Robert Wood Johnson Foundation showed that patients participating in the cooperative-clinic model stayed independent longer and were more satisfied with their physicians and with their understanding of their medical conditions. Physician satisfaction also increased, while hospitalization and ER use decreased by 12 and 18 percent, respectively. Cooperative-clinic participants were 2.5 times as likely to stay with their physician and with Kaiser.

This method of medicine becomes not so much about the chronic condition itself, but about the person living with the chronic condition. This bonding between patients with like conditions and the ability to help one-another out in these shared doctor appointments seems to offer an “installation of hope.” In shared doctor appointments, patients no longer feel like they’re the only ones dealing with the chronic condition. They can see others living with the condition as well, whether in a greater way or a less fortunate way.

Another aspect of shared doctor appointments is the time spent with the doctor, though it might be ‘shared’ time. A general appointment with the family physician will run from between 8 to 10 minutes, while in a shared appointment that time is extended to 90 minutes, a benefit that makes patients feel as if their getting their money’s worth.

While it might be a little different, and may take some getting used to, it is creating a buzz in the medical community and it is getting people excited about more possibilities for healthcare. Shared doctor appointments are bringing more attention to the fact that patients are frustrated with the system, with the way they are treated in their 8 minute doctor appointments, and that they are looking for alternatives to general medicine.

How to Find the Best Acne Medicine

Due to the prevalence of acne, a number of medications or treatments have surfaced. Each however claims that it is the best acne medicine available in the market today. With the myriads of medications that are available, it sometimes becomes hard to choose the specific acne medicine that would be considered as the best. The question to be answered – which one is the best?

In any product, the safest way to know whether it is effective or not is to ask the persons who have tried that certain product, right? The same goes with acne, it is a good idea to ask acne sufferers what product or medicine was able to get rid of their acne. One must also know the different side effects that the medicine caused, It is important to know these things in advance so that necessary precautions can be taken in case a similar side effect would be felt by the patient.

The length of time needed to take the medicine must also be known. There are medicines that don’t take a long time to heal. There are those that take a long time to take effect. Either ways, it is important to know the duration of the medication so that if it would be quite a lengthy period of time, finances can also be prepared ahead of time to sustain the medication.

It is not surprising if the best acne medicine would have a higher price than other treatments. This is primarily because when something has gained immense popularity at one time, it would always follow that its cost would be high as well. Acne medicine would always depend on the type that the doctor would be giving. Usually it is at around $30 – 90. However, not all medicines that carry a high price tag are synonymous with being effective. When it comes to the skin, it must work both ways. The medicines must adapt with the skin, and the skin must also adapt with the medicine to achieve the best results. Sometimes, it can be ironic when the medicine with the lower cost is actually the one which could give the best results.

One can also try reading reviews on medicines. This way, unbiased information can be derived regarding the different medicines being reviewed. It is normal to see medicines that are on the opposite sides of the pole being reviewed. The medicine could be really bad or superbly excellent. Mediocre medicines often do not get reviews because critics often feel that they can neither attract those who take life seriously nor those who do not.

If one uses a really high quality medicine to treat acne, it is not automatically an assurance that acne will be cured. In treating acne, the skin must find the right medicine that it can adapt to, before some positive changes on the affected area can be seen. It is very important to be very careful when choosing the best acne medicine to use since a wrong choice might lead to even bigger problems such as worsening the acne itself.

All About Alpha-Lipoic Acid

Alpha-lipoic acid (ALA) occurs naturally in the body and plays a crucial role in the energy-producing structures of cells. At the molecular level, it binds to protein and functions as a cofactor for several important mitochondrial enzymes. Although the majority of alpha-lipoic acid produced by the body is used almost entirely to generate energy, researchers have found that ALA may act as an antioxidant when incorporated into the diet.

Taken in supplement form, alpha-lipoic acid may defend the body against free radicals and single action molecules which can damage cells and lead to degenerative disorders associated with diminished health and aging. Other common and scientific names for alpha-lipoic acid include ALA, biletan, lipoic acid, lipoicin, thioctacid, thioctan and thioctic acid.

Sources of alpha-lipoic acid

Alpha-lipoic acid is synthesized in both animals and humans. But because little “free” alpha-lipoic acid is left circulating in the body after cells use it for energy, external sources of ALA are needed to produce an antioxidant effect. These include meats and select vegetables (such as spinach) and dietary supplements that contain alpha-lipoic acid.

How ALA works in the body

Alpha-lipoic acid, recognized for its antioxidant potential in the late 1980s, is said to function in both reduced and oxidized forms. It may neutralize free radicals in both the watery and fatty regions of cells and fortify the antioxidant power of vitamins C (water soluble) and E (fat soluble). It’s also been said to extend the metabolic lifespan of glutathione (a tripeptide essential to the metabolism of nutrients in cells and one that plays a major role in dissolving toxic substances in the liver) and coenzyme Q10 (a vitamin-like enzymatic cofactor needed for cells to produce energy). Supplemental forms of alpha-lipoic acid are easily absorbed into the bloodstream and may cross the blood-brain barrier.

Alpha-lipoic acid benefits; claims

Research indicates that ALA supplementation may slow age-related heart problems and brain degeneration, and help boost the physiological strength and cognitive function of older persons – hence its reference as an anti-aging nutrient. ALA may also stave off age-related macular degeneration and, when added to cosmetic creams and face masks, alpha-lipoic acid may enhance the elasticity and youthful appearance of skin.

Benefits of ALA supplementation may include:

o A reduction of oxidative stress and circulating free radicals in the body

o Improved heart and artery health

o Enhanced immune system strength and brain function

o Blood glucose regulation and balanced cholesterol

o Detoxification of the liver

o A healthy neural system

Alpha-lipoic acid side effects, safety and toxicity

Alpha-lipoic acid is said to be safe in doses ranging from 100 mg to 400 mg daily.* It may also be toxic, and even fatal, in doses as high as 1,800 mg a day.* Excessive doses of alpha-lipoic acid have been known to cause stomach upset and nausea and may lead to dangerously low blood glucose levels. The frequency and strength of ALA supplementation is typically based on the reason for treatment.

It is advisable to consult a physician prior to ALA supplementation if you’re:

o Taking any type of prescription medicine

o Allergic to any prescription or over-the-counter medicine or dietary supplement

o Pregnant or plan to become pregnant

o Nursing

o Suffering from any type of cardiovascular, heart, blood or arterial disorder

Though alpha-lipoic acid appears to be safe, the effects of long-term use have yet to be fully explored. Contraindications may exist, as might adverse reactions with certain medications or supplement regimens.

Research shows that the potency of alpha-lipoic acid may be diminished if mixed with certain compounds such as thiamine.

*Statement not evaluated by FDA

Clinical studies and alpha-lipoic acid research

The majority of current research available focuses on the impact of alpha-lipoic acid on rodents in the laboratory. ALA research has found that alpha-lipoic acid supplementation may aid inflammation in rats and reduce oxidative stress. It may also help to metabolize glucose and regulate blood sugar in mice.

Because oxidative damage is shown to be a major factor in the decline of physiological function in older persons, ALA’s potential in fighting immune disorders may be far reaching, as ALA has been found to protect cells from oxidative damage in older rats. It’s also been shown to suppress collagen-induced arthritis in mice and to slow retinal degeneration. Rodent studies suggest that ALA may improve epidermal blood flow and aid nerve damage caused by high blood glucose.

As a result of aggressive testing in the lab, alpha-lipoic acid is being studied for its potential in fighting human disorders as the cellular level. Alpha-lipoic acid research, however, is in the nascent stage, and the long-term potential of ALA supplementation in human health is relatively unknown.

Alpha-lipoic acid efficacy and the FDA

ALA is considered a dietary supplement in the U.S. and is neither regulated nor inspected by the FDA. As a result, there’s no guarantee to the purity, safety or strength of alpha-lipoic acid supplements. Research has revealed ALA benefits in rodents, but effective human clinical studies remain in the distance.

Laboratory tests in 2007 found that certain ALA supplements contained less alpha-lipoic acid than indicated on the label.

For more information on Alpha Lipoic Acid, visit www.VitaCost.com/Supplements/Alpha-Lipoic-Acid-ALA

References

1. All About alpha-lipoic acid. Frequently asked questions. The Complementary and Alternative Medicine Information Source Book. Edition 1, 2001 p159.

2. [alpha ]-Lipoic acid modulates gut inflammation induced by trinitrobenzene sulfonic acid in rats.(Author abstract)(Report) Meltem Kolgazi, Nermina Jahovic, Meral Yuksel, Feriha Ercan, Lnci Alican. Journal of Gastroenterology and Hepatology. Nov 2007 v22 i11 p1859 (7).

3. Antioxidants and narrow band-UVB in the treatment of vitiligo: a double-blind placebo controlled trial. (Author abstract)(Report) Clinical and Experimental Dermatology. Nov 2007 v32 i6 p631 (6).

4. The effect of [alpha ]-lipoic acid on symptoms and skin blood flow in diabetic neuropathy.(Author abstract)(Report) H.Y. Jin, S.J. Joung, J.H. Park, H.S. Baek, T.S. Park. Diabetic Medicine. Sept 2007 v24 i9 p1034(5).

5. Mitochondrial Aging and the Beneficial Role of [alpha]-Lipoic Acid. (Author abstract) A. R. Palaniappan, A. Dai. Neurochemical Research. Sept 2007 v32 i9 p1552 (7).

6. Wellness Guide to Dietary Supplements. UC Berkeley wellnessletter.com. 2007.

7. New alpha-lipoic acid from Aquanova Nutraceuticals International. July 2007 pNA.

8. ConsumerLab.com tests alpha lipoic acid supplements Nutraceuticals World. July-August 2007 v10 i7 p14 (1).

9. Alpha-lipoic acid suppresses the development of collagen-induced arthritis and protects against bone destruction in mice. Eun Young Lee, Chang-Keun Lee, Ki-Up Lee, Joong Yeol Park, Kyung-Ja Cho, You Sook Cho, Hee Ran Lee, Se Hwan Moon, Hee-Bom Moon, Bin Yoo. Rheumatology International. Jan 2007 v27 i3 p225 (9).

10. Alpha-lipoic acid. Alternative Medicine Review. Sept 2006 v11 i3 p232 (6).