Tag: Primary Care Physician

Tortellini Pasta Salad

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15 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. 

This featured recipe is Tortellini Pasta Salad. These recipes are my attempt, in a way, to bridge that Doctor’s adage of “Eat Better & Exercise More.” In this post, I will showcase a healthy meal made on a budget, my pictures are pretty decent, and that is how I got into this food endeavor.

Tortellini Pasta Salad

Prep Time: 20 minutes
Total Time: 1 hr
Serves: 4

Ingredients:

– 1 package tortellini, cooked per package instructions
– 4 carrots, sliced thin
– 2 cups Edamame
– 1 (6 oz) jar, Roasted Red Peppers
– 12 oz thick cut salami, diced
– 2 tbsp apple cider vinegar
– 3 oz honey goat cheese, crumbled

Instructions:

1) Add all ingredients to a bowl and allow to sit for at least 30 minutes before dividing and serving.

Guide to Erectile Dysfunction, Beyond Primary Care, Primary Care, Family Doctor

Guide to Erectile Dysfunction

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. 

Erectile Dysfunction

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.

Anatomy & Physiology

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.

Essential Components for Function

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.

  • Your interest and desire for sexual activity (libido)
  • Ability to obtain and maintain an erection
  • Ejaculation (orgasm)

Select Causes of ED

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.

Physical Causes

  • Medications: Take a look at your existing medications. Several medications may lead to ED. As example, anti-depressants like SSRIs (citalopram, fluoxetine paroxetine, sertraline) used to treat mental health concerns and Beta-blockers (metoprolol, carvidilol, labetalol)  used to treat blood pressure can cause ED. Review all your medications with your doctor.
  • Smoking: Compared with men who have never smoked, the risk of ED is increased by 51% in current smokers and 20% in ex-smokers. Ask your doctor for help in quitting.
  • Diabetes: If you’ve ruled out other causes, there’s a chance your ED is due to diabetes. Patients with diabetes are three times more likely to develop ED. Review your risk for diabetes or work with your doctor to bring your sugars under control.
  • Low Testosterone: Also called hypogonadism, is a condition that generally occurs to all men as they age. By age 80, 50% of men will have testosterone levels in the low range, however the decline is faster in some men than others. Testosterone levels can affect  a man’s overall health including sex drive and sexual function.

Mental Health Causes

  • Sexual Performance Anxiety: This happens when a man anticipates a problem during the sexual encounter and, as a result becomes anxious while attempting to have sex. Doubt and insecurities may take over your thoughts: “Will I get hard enough?” “Will I maintain an erection?” “How do I compare?” “What if I can’t finish?” These pervasive questions can ruin any performance. Talk to your doctor because once people understand the mental that cause anxiety and how to reduce or eliminate them

Treatment

  • Exercise and Nutrition: A change in eating and drinking habits can potentially reverse the contributing causes.
  • Therapy: Seeing and talking to an accredited sex therapist can lead to an overall happier sex life for men and their partners.
  • Medications: The availability of oral medications such as Viagra, Levitra, and Cialis, make it much easier to treat erectile dysfunction. However, medications should be part of a more comprehensive long-term plan. At Beyond Primary Care, we wholesale generic Viagra 100 mg, 10 pills to our patients for $4.20.
  • Testosterone Replacement Therapy: For men experiencing sexual frustration and have low testosterone, testosterone replacement therapy is a safe and effective way to return T-levels to the normal range.

Virtual Home Medicine in Direct Primary Care

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3 January 2019

Hi, thank you for reading! My name is Dr. Jeff O’Boyle. I am a board certified family medicine physician. My clinic, Beyond Primary Care is located in Ann Arbor, Michigan. In this post I am answering a common question that I receive, and that is how does Direct Primary Care (DPC) take care of it’s members with virtual home medicine? Virtual home medicine, also referred to as telemedicine, is a where you connect with your doctor via phone or computer’s webcam without physically being in the doctor’s office.

The Exception rather than the Rule

Why is it nearly impossible to get a doctor to talk with you over the phone in a timely fashion? Because because certain services like virtual home medicine are typically not be reimbursed by private insurance carriers and government payers. Nearly 40% of what we do in medical offices the patient doesn’t actually have to be there. But why are you there? That is the only way for doctors in a fee-for-service system to get reimbursed for your care, is to actually make the patient physically come in to the brick-and-mortar office to be seen- no matter how routine (eg- common cold, urinary tract infection) or obscure (filling-out paperwork for FMLA or work) the visit seems.  

Standard of Care with DPC

Under the DPC model of care, we naturally provide such care – yet another freedom we enjoy together as a result of our independence from the restrictions of third-party payment. As noted by this Forbes article, telemedicine pairs well with DPC. Since DPC has opted out of insurance contracts altogether, and we contract directly with you, the patient. DPC offers our patients around-the-clock access to primary care medical needs in exchange for an average fee of $50-75 per month. Phone calls, emails, texts, FaceTime- are included in a patient’s membership. Patient are routinely connected with their doctors within minutes to hours when reaching out, versus days to weeks with fee-for-service doctors.

Benefits of Virtual Home Medicine

One of the defining characteristics of DPC is that we keep our practices small so we can spend more time with our patients. Because we have the increased time in our visits to know you well, we can streamline your care when you’re sick away from home or even at home. Many illnesses can be diagnosed and treated with a simple conversation by phone or computer webcam.

Say you are traveling out of state and feel sick. You have access to a conversation with your DPC doctor from your pocket. We will discuss your symptoms, discuss management, then we’ll locate the nearest pharmacy and order the medications most appropriate for your present circumstances.

As a doctor, there have been times where I have seen patients- with just the act of walking from the waiting room to the examination room- get winded or experience excruciating pain. Why would doctor offices allow this? Where is the concept ‘first, do no harm?’ If you are local, often times the DPC doctor may deliver the medications right to your address, saving you the hassle of a trip that may potentially worsen the condition.

Curbside Referral Consult

Adding more value the DPC membership at no additional cost to our patients is many DPC practices participate with electronic consults, or online consultations for speciality care. Primary care can handle nearly 80-90% of all medical conditions, but there are times when a condition may be past our scope of practice. Instead of rushing the patient to the nearest specialist, which will result in a bill likely through the patient’s insurance, many DPC practices seek medical advice on behalf of our patients through an online service call RubiconMD. Through this online service, many DPC practices pay a monthly fee where we can get medical advice on behalf of our patients from more than 100 medical specialities. The company guarantees a response time within twelve hours. The DPC physician fills out the necessary forms, get’s the response through the RubiconMD service, then will pass this medical information onto the patient- at no cost! 

Finger Stick, Diabetes Care, Direct Primary Care, Beyond Primary Care, Ann Arbor Doctor

Your Sugar is a Little High- Diabetes Type 2

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11 December 2018

In researching your diabetes care, you may have heard people say they have “a touch of diabetes” or that their “sugar is a little high.” These words suggest that diabetes is not a serious disease. That is not correct. Diabetes is serious, but you can learn to manage it. Most of the steps needed to take care of diabetes are things you do yourself. I will help outline some of these steps in this blog post.

Progression of Diabetes

Keeping your blood sugar (glucose) in your target range can delay the health problems caused by the progression of diabetes. Yes, you read that correctly, diabetes is a progressive condition. Pancreatic Beta Cells (These cells produce, store, and release insulin) function will typically decrease over time. All the strategies listed here and discussed by your health care provider can help delay/prolong this progression.

Exercise & Nutrition

The doctor’s axiom of ‘eat less and move more’ is quite possibly the worst advice any doctor can give, especially if done in a rushed/ inconsiderate manner. Yet, regular movement and diet modification has been shown to improve insulin resistance–the main issue in those with type II diabetes. Moving your body and diet modification can improve A1C levels alone by as much as 4 points! This is far better than any single diabetic medication.

Cholesterol Counts

Diabetics have a higher risk of heart attack and stroke. That’s why doctors treat cholesterol levels more aggressively in those with diabetes

Pay Attention to Blood Pressure

The blood pressure goal of the diabetic person is below 140/80, just like the general non-diabetic population. A side-effect of elevated blood pressure and diabetes is the risk for kidney disease. Damaged filters don’t do a good job.

Get Your Vaccines

Diabetics also have a higher risk of infection. That is likely because bacteria love to live in high sugar environments. For that reason, doctors recommend diabetics get an annual flu shot, in addition to the pneumonia shot once before age 65 and once after age 65 (with at least 5 years in between).

Eye Doctors Aren’t Just For People With Glasses

Every diabetic should also get a yearly eye check that includes being examined by an ophthalmologist (eye specialist) who takes a look at the retina, or the back of the eye, for changes produced by diabetes.

Doctor Visit, Appointment Time, Direct Primary Care, Ann Arbor Doctor, Family Doctor

Exceeding Office Expectations

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26 November 2018

It is fairly easy in exceeding office expectations for the area of customer service, as people have an increasingly low expectation for the service they get at the doctor’s office. It’s normal in fee-for-service office systems to have to wait an hour or more to be seen, and then get only a few minutes of the doctor’s time (if a doctor is seen at all). Many patients often find they half-day off or work or activities, just to be seen. This has left people seeking alternative facilities, such as urgent-care type setting for their ailments. 

What Your Office Visit Looks Like In A Fee-For-Service Office

You likely scheduled a 15-minute time slot. When the doctor’s medical assistant calls you back, you are on the clock. 15 minutes includes everything: time to walk back from the waiting room to the exam room, time for the medical assistant to take vitals (eg- blood pressure, temperature), time for the medical assistant to do the office intake questions. All this, even with the best and fastest medical assistant takes 7 minutes at a minimum. That leaves 8 minutes. 8 minutes for the doctor to do any courtesy conversation (eg- how have things been, what have you been up to since we last spoke), time for the history of illness questions, time for the physical exam, time for discussing what the possible diagnosis is, and time to wrap up the visit by either dispensing medications, ordering laboratory studies, or helping to coordinate your care. By the way, the doctor is going to want to document that visit in your electronic health record. 8 minutes is NOT enough to discuss acute or chronic illness, let alone anything. This results in, at best, frustration. At worst, people avoid care they should be getting.

At Beyond Primary Care, the patient has a much different experience:

  • All days begin with multiple slots open for same-day urgent visits.
  • Patients seldom have to wait more than 10 minutes to be seen.
  • Appointments are 30 minutes per patient but can be extended to meet the needs of the patient.
  • More than one concern can be address at your visit. Come in to talk about your anxiety, but want to discuss that mysterious new rash? That is what we do.
  • Care is often done via text message or phone, reducing the need for coming to the office at all.
  • Late/early office days because health issues don’t always arrive between 9 am – 5 pm and you shouldn’t have to miss work/school/etc to be seen.

With Beyond Primary Care, a premium is placed on exceeding office expectations, and again this is done because it’s in the best interest of our clinic, but returning health care to what it once was- focused on patient care. 

Family Medicine: For The Entire Family

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23 October 2018

At Beyond Primary Care, we have a narrow focus- you and your family. Dr. O’Boyle is a dually board certified Family Medicine Doctor, and sees children of all ages, whether that is for the urgent needs, school physicals, check-ups, or that mysterious illness that you have questions about.

 

One of Dr. O’Boyle’s biggest annoyances of traditional physician offices are their limited hours and seemingly robotic answers from the on-call services. Does your child only get sick between 9 AM and 5 PM, Monday through Friday? If they do get sick during this time period, you have endless ability to take off time from your work (usually a half-day or more) to be seen at the office? Experience the on-call doctor reading the hospital script that if your child is sick you should take them to an urgent care or emergency room? Then the wait time at these locations!

 

At Beyond Primary Care, we will work with you to make time for convenient appointments, whether you need to be seen traditional working times or after-hours. Additionally, we because we know you so well, we offer our patients ‘virtual home visits,’ or ‘tele-medicine.’ Many illnesses can be diagnosed and treated with a simple conversation by phone or webcam. There is no corporate legalese with Dr. O’Boyle. When you enroll and call, you speak directly to Dr. O’Boyle and will get unabridged advice and care.

 

What are the benefits of having your family enroll in a direct primary care practice? According to this newspaper, DPC patients are 52 percent less likely to require hospitalization than patients under a traditional model. By providing the vast majority of care needed at the primary care level, a DPC doctor can allow a person to purchase the bare minimum insurance policy that is right for their family. The savings with this alone can be thousands of dollars each year.

Open House at Beyond Primary Care, 2018

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17 October 2018

Beyond Primary Care is hosting an open house this month and next month!

 

  • Friday October 26th, 2018 @ Noon
  • Friday November 2nd, 2018 @ Noon
  • Friday November 9th, 2018 @ Noon

 

All open house events start approximately at noon. Dr. O’Boyle will discuss his clinic Beyond Primary Care, and the movement of Direct Primary Care, for approximately 10 minutes. Afterwards he will take questions from anyone. If your question is really good, it may end up on our FAQ page!

 

Can’t make these dates or times but still interested? Don’t worry, just contact us or call 734-395-2850. We will work with your schedule to arrange a time where you can visit the clinic and discuss your health care!

 

Hearing about Beyond Primary Care for the first time? Beyond Primary Care is a family medicine clinic and a part of a new way for patients to access medical care called ‘direct primary care.’ The model is membership based health care, where the patient pays a monthly fee directly to the clinic. The doctor provides the patient with primary medical care without insurance or government involvement. The patients get great access at a low, predictable cost, about the same as a cell phone or cable plan. This model allows the clinic to offer innovative services to further add value to the membership.

Direct Primary Care is NOT Concierge Medicine

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3 October 2018

In this video I am answering a common question that I receive, so much so that I have added it to my FAQ page, and that is what are the differences between Direct Primary Care medicine and Concierge Medicine? A lot of people may unknowingly alternate between these terms, but these terms are not synonymous.

 

Direct Primary Care’s goal is to return as much value to our patients in exchange for the membership by being transparent about the true costs of services. Think Southwest Airlines,” as way of comparison. Southwest provides air travel accessible to everyone with a whole different vibe.” With Direct Primary Care, and specifically Beyond Primary Care in Ann Arbor, practices aren’t “changing the medicine, but changing the way we consume it.”