admin
26 January 2020
Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is a new approach to family medicine and addiction medicine that creates the time and space your healthcare deserves. Beyond Primary Care is the only Direct Care clinic serving patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County giving families and employers peace of mind with healthcare costs by providing affordable, accessible, and authentic primary care services.
The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being.
In this blog post, I wanted to talk about an actual patient of mine about to fish antibiotics for humans, the barriers of obtaining affordable medications, and how to obtain affordable medications.
A kind man in his 30s finds out about my clinic last month saying ‘direct primary care’ is perfect fit because even though he works full time, his employer does not offer him health insurance. He explains his employer is a contractor for a major shipping company (think top 3), but since they are contractors, they are not entitled to the same benefits.
He has been without any healthcare for the past 3 years saying “I can’t afford BlueCross.”
The newly enrolled patient says discovering Beyond Primary Care was serendipitous, because he has been experiencing left ear pain so bad for the past 2 weeks, that he was going to do something about if finally. Curious, I ask what he plan was and he replied he had been reading about ‘fish antibiotics for humans’ on the internet.
Since you don’t need a prescription for that he could avoid the healthcare costs associated with establishing care with a new physician and price of medications at a retail pharmacy.
Yes, so taking fish antibiotics for humans is a real thing. A quick google search turned up numerous unscientific medical survival guides. I read the reviews for aquarium antibiotics. However, taking medications that are 1) not for humans, 2) not prescribed by a licensed physician and 3) not properly dosed is incredibly dangerous.
Misuse of any medication can cause serious illness. The medications used for many animals and vertebrates do NOT require FDA approval, so there is no regulation over the manufacturing of the medication that one would take.
I always tell my patients for any medication that they have effects, thus they may have side effects. Additionally, using antibiotics for self-diagnosed illnesses may lead to antibiotic resistance, which ultimately hurts the individual using the medication and society in the larger picture.
Antibiotics are not necessarily all expensive either. Some large retail pharmacies in the state of Michigan even offer certain types of antibiotics for free (you still need a prescription from a physician). The patient did have an ear infection. Because we are a ‘Direct Primary Care’ clinic, the patient was prescribed AND dispensed the antibiotic from our office at the time of the visit.
Many of us are accustomed to thinking that we pay health insurance premiums to get access to a lower cost for health care medications — that being the “negotiated rate” or “contracted rate” that the insurance company and the payer agree to in contract talks. But increasingly we are hearing that insured people are paying more than uninsured people.
Additionally, evil organizations out there called Pharmacy Benefit Managers (PBMS- more on them on a later post) are yet another middlemen in our insane medical billing industry that can increase the prices we pay for medications.
In late 2019, the current white house administration released new rules requiring hospitals to be more proactive with price transparency by publishing their charges and negotiated rates. Great right? If we go on Amazon, we can see the description, reviews, and price for everything. We expect and demand price transparency with all our other transactions. Same for healthcare now.
However, even within a few weeks of this executive order, hospital systems and insurer across the nation are suing to keep their prices a secret. The hospital systems and insurers know that if their costs become public knowledge, they stand to lose millions of dollars because people will simply shop around for the best market price, something we do for every other service.
In my opinion, the best advocates for patients to obtain affordable and transparent healthcare are those independent from a large hospital/health system– such as those who operate as Direct Primary Care (DPC) physicians.
admin
7 January 2020
Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is a new approach to family medicine and addiction medicine that creates the time and space your healthcare deserves. Beyond Primary Care is the only Direct Care clinic serving patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County giving families and employers peace of mind with healthcare costs by providing affordable, accessible, and authentic primary care services.
The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being.
In this blog post, I wanted to talk about severe allergic reactions, namely anaphylaxis and epinephrine.
Anaphylaxis is a severe, sometimes life-threatening, allergic reaction that occurs within minutes to several hours of exposure an allergy-causing substance (allergen).
In any body allergic reaction, your immune system will respond to the presence of an allergen (whether food or environmental) by releasing histamine and other body chemicals. These chemicals cause the symptoms of allergies, in their mild form are annoying, such as the runny nose of hay fever (allergic rhinitis) or the itchy rash of poison ivy.
Unfortunately though, the symptoms can progress and be much worse and involve the entire body. Anaphylaxis is the most severe allergic reaction. In anaphylaxis, body chemicals cause serious skin symptoms, such as hives and swelling, as well as severe breathing problems, such as swelling in the throat, narrowing of the lower airways and wheezing. Anaphylaxis is a life-threatening medical emergency.
There are different shapes and forms of a severe reaction. Symptoms of anaphylaxis usually occur within seconds to minutes of exposure to the allergen, but symptoms can be delayed for several hours.
Symptoms of anaphylaxis usually require treatment with epinephrine, by injection. People who have had anaphylaxis can carry a pre-loaded syringe containing epinephrine.
You have probably heard about this drug before, but some of what you think you know may not be correct.
Epinephrine is a naturally occurring hormone. At-rest plasma epinephrine levels are 0.035 ng/mL. It is the hormone that is part of our fight-or-flight response. When you are scared or excited, and also when you are exercising, your epinephrine levels surge, but even when you sleep, there is a little epinephrine circulating in your body. Levels over 10 times that amount have been measured in persons exercising, and even higher than that in people under mental stress.
The standard adult dose of self-injecting epinephrine (0.3 mg of 1:1000 epinephrine) raises the level of epinephrine in the body from an average of 0.035 ng/mL to about 10 times that amount. It would require more about 20 such injections to reach a toxic level.
If you were given the injection right now, all that would likely happen is that your heart rate and blood pressure would increase to a moderate degree and that you might feel slightly shaky. Epinephrine is metabolized very quickly, and you would not feel this effect for long.
You might hope the allergic reaction won’t be “that bad,” and you might be right, but it’s important to know that a delay in use of epinephrine is linked to poorer outcomes and prolonged hospitalizations.
The device itself might look big, but the injection needle is not. It’s just like getting a flu shot. As mentioned above, the main side effect you might experience is feeling a bit shaky after using the device.
You may have been told that you have to go to the ER after using your epinephrine device. That’s not because of the epinephrine; it’s because the allergic reaction probably requires further monitoring. In the past, I have talked about why NOT to go to the emergency rooms. Anaphylaxis is not one of those scenarios. Many patients also need more than one dose of epinephrine for anaphylaxis or other emergency treatments; that may be due to the severity of the allergic reaction or simply because the device was not used correctly (the most common mistake is not holding the device against your thigh for the time required for the full dose of medication to be delivered). So a trip to the ER is the safest thing to do after using epinephrine.
You may of heard EpiPen’s manufacturer, Mylan Pharmaceuticals, had increased the price of a two-pack over several years to $600 or more—even for people with insurance. For some families—especially those who needed more than one EpiPen pack to protect their kids during severe allergy attacks—that price was still way too high. As a Direct Primary Care doctor, I have worked towards making epinephrine affordable to my patients, with a 2 pack of injectors costing less than $100.
admin
11 June 2019
Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is a new approach to family medicine and addiction medicine that creates the time and space your healthcare deserves. Beyond Primary Care serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.
The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being.
In this post I am discussing a common condition that I see at my clinic: erectile dysfunction. Let me repeat that last part- a common condition. If you suffer from erectile dysfunction, you are not alone. Those two words can make any man nervous. It affects all men but becomes increasingly prevalent as we age. At least 12 million U.S. men between 40 to 79 years of age have it, but can occur at any age. Older individuals are more likely to experience health conditions that require medication, which can cause or even worsen ED. It is a very emotional and sensitive topic to discuss.
The penis consists of two parallel cylinder-shaped tissues called the corpora cavernosa that run the length of the penis, a hollow tube called the urethra that is responsible for expelling urine and ejaculate, erectile tissue surrounding this tube, and various arteries and veins. The process of erection involves increased blood flow and pressure to the penis, and those cylinder-shaped tissues mentioned above become engorged and expand- thus an erection. Erectile dysfunction (ED) occurs when those tissues fail to become engorged or the penis fails to maintain rigidity and resumes a normal shape.
How ED is affecting one male may not be the reason for you. Your doctor will help to differentiate which components are affecting you and this is important in differentiating treatment options.
Male sexual arousal is a complex subject. Discussing in broad terms, ED can generally be separated into two categories: physical and mental health. Many instances of ED may involve causes from both categories.
admin
2 November 2018
Cold and Sinus Infections invariably go hand-in-hand with winter. Snow isn’t bad for a month or so, and living in Michigan I do tolerate brief stretches of freezing temperatures. But for complete honesty, my favorite part of winter is that it always ends. Yet, for those days and months with freezing weather, everyone tends to huddle inside together and germs and viruses are increasingly spread. This can lead to the common cold or sinus infection.
Fortunately, the possible solutions for people with an infection have never been better. Now, before you rush to get antibiotics, consider some important points from this well-written piece:
Remember that coughs ad other URI symptoms can take between 7-21 days to resolve. The average duration of a cough is 18 days. You may just have to be patient. But do NOT get discouraged! The goal during this time is symptomatic care.
What can you do for symptomatic care? Ahem, FREE ADVICE!
admin
25 October 2018
The picture is a plastic suction bulb, or ‘booger sucker’ as newborn parents like to say. You can find these in most stores, typically in the newborn section for $1-2. Why am I posting about this you ask? Suction bulbs allow us to do nasal rinses. The traditional method has been the net pot, but I prefer the suction bulb. Nasal rinses are an ancient practice that has been shown to have benefit relieving both allergy and cold symptoms.
Essentially, it involves sending a stream of saline (salt-water) solution up one side of your nose and back out. No, I do not believe it has to go in one nostril and out the other. Gag! The act of bathing the turbinates and sinuses in saline water is all this is required, along with a thorough blowing of the nose afterwards.
You can buy individual packets to mix with water, but because my readers are thrifty- I suspect they want to make their own. To make your own:
Yes, what comes out is disgusting and you may get a salty taste in your mouth, but you will feel better. I typically advise people to rinse x4-8 per day. The bottom line is the more you do this, the better you will feel- quicker.
admin
10 October 2018
Did Beyond Primary Care mention that we have an in-house medication dispensary that saves money to our patients? Check out the pricing comparison of a common antibiotic, Penicillin, that is used for many ailments such as strep throat. Don’t worry if you have a penicillin allergy, we have affordable alternatives also! This can save our patients hundreds, if not thousands of dollars a year. How you may ask?
We buy medications wholesale. We then have our drug control license, that many traditional doctor offices refuse to get either due to contractual or logistic limitations. Another advantage of enrolling with a Direct Primary Care doctor. We then of course pass the savings on to you!
If you want to think differently about health care come join us! Not only are we personable, we work hard to save our patient’s $$$$.
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