Health Matters September 2006

GreenField Health’s Health Matters: September 2006

Announcements
Yearly Flu Shot Reminder
Oral Contraception and Antibiotics
Giving a Medical History
Participating in Your Health
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Announcements

Dr. David Shute Joins GreenField Health
We are delighted that Dr. David Shute will be joining our team on September 25. Dr. Shute is a widely known and respected internist in Portland. He has been in practice or in administrative positions in the area for the past 20 years. He is now accepting new patients at GreenField.

Transformation begins in October
The third session of Transformation, GreenField’s weight management program had been postponed due to construction, but will begin with a kickoff weekend on October 13-15. This session is open to GreenField patients, and we are now welcoming individuals who get their care elsewhere as well. The sessions run for 10 weeks following the kickoff weekend, and will be held on Monday evenings. Total cost for the program is $995, and participants receive over $200 of materials and supplies to assist with developing and maintaining a healthy lifestyle. There are a few spots left in this program, so please contact us at 503-292-9560 if you are interested in participating.

GreenField’s Team Meets Regularly for You
We believe that great healthcare comes from a great organization, and one of the things we do to work on making GreenField great is to gather our team together once a week for an hour. This happens each Monday from 12:00 – 1:00 pm. This is the only time during business hours that we forward our phones to our answering service. We spend our time together reviewing our systems and quality standards, as well as learning more about our technology and how we can all work better together to serve you. We hope you’ll realize the importance of this time that we take, and that if you have a need you’ll call or stop in before noon or after 1:00 on Mondays. Thanks!

GreenField Bids Adieu
This month, GreenField bids adieu to two of our Health Coordinators – both Dia Gaede and Pam Mockenhaupt have left the practice for jobs that are closer to home. We’ll miss both of them, as they have each added a great deal to the team and to GreenField’s development. We know you’ll join us in wishing them the best, and we’ll be sure to introduce our new team members here in Health Matters. We are actively recruiting for Health Coordinators, and in the meantime, Tiana Schmitt and Lindy Thornbloom are working hard to cover the practices with support from the rest of the team. Please let either one of them or your physician know if you need anything from us, and thanks for your patience with us during this time of transition.

Yearly Flu Shot Reminder

We will once again be providing flu shots this year starting in early October. The best time to be vaccinated against the flu is in October and November, but vaccination in December or later can still be beneficial. Logistically, this will work just as it has in the past - you can come in at any time beginning October 2nd. Give us a quick call when you’re headed in, so we can prepare for you. We promise no lines, good coffee or hot tea, and relatively painless shots.

Although anyone who wishes to avoid influenza should be vaccinated, those at highest risk for complications from influenza include people 65 years of age and older, and those with chronic, long-term health problems such as heart or lung disease, kidney problems, diabetes, asthma, anemia, HIV/AIDS or any other illness that suppresses the immune system. In addition, healthcare workers and others in close contact with those at high risk should be vaccinated in order to reduce the possibility of transmitting influenza to those at high risk.

The cost will be $30. Most insurance companies do not cover the costs of a flu shot so it is generally an out-of-pocket expense. If your insurance has paid for this in years past, we will bill them although we’ll still need to collect the co-payment as this represents a significant portion of the total cost. If your insurance carrier has not paid in years past, we will let you know before you get your shot.

As always, if you receive your flu shot elsewhere, please drop us a note to let us know. We track this as a part of our overall quality program, and it helps to keep us from nagging you.

Oral Contraception and Antibiotics

Many women are aware that antibiotics are said to decrease the effectiveness of oral contraception. It is generally recommended that women on hormonal contraceptives who are prescribed antibiotics should use other forms of contraception while on the antibiotics.

The true risk of reduced contraception due to antibiotics is relatively low. Rifampin is an antibiotic most commonly used to treat tuberculosis, so not many of our patients are on it. It does decrease oral contraceptive efficacy by increasing the metabolism of estrogens.

Other antibiotics do not generally affect the metabolism of estrogens. However, there are reports of individual women who have significant decreases in the plasma concentrations of estrogens when taking certain other antibiotics, such as tetracycline, penicillin derivatives such as amoxicillin and Augmentin, and cephalosporins such as Keflex. Because it is not possible to identify these women in advance, a cautious approach has been advised.

Women should be aware of this small risk. Women who are either uncomfortable with this risk or who have had previous breakthrough bleeding or contraceptive failure during the use of antibiotics should use additional nonhormonal contraceptive methods.

Thus, while the risk is very small, most authorities simply suggest that all women on hormonal contraception use nonhormonal contraception while on antibiotics.

Giving a Medical History

Individuals often wonder what information they should provide when describing a medical problem – say a new rash, new stomach pain, or numbness in your foot for example. In fact, doctors do have a relatively structured way that we like to hear things. The structure helps us understand the nature of the problem, to avoid confusion about what you’ve experienced, and to create an accurate list of potential causes.

Here are things to keep in mind when you are describing a problem you’ve developed:

1. Chronology: The chronology is very important in a medical history. When describing a problem, you should always start from the very beginning of your symptoms or problem. Let us know the very first time you noticed something and what you first experienced that very first time. Note anything that happened in the few days before the onset that may have influenced the problem. For example, did you travel, were you exposed to someone with a similar problem, were you exposed to anything in the environment, was there any trauma?

2. Describing the Symptoms: Describe the specific nature of the symptoms as well as you can. Describe as well as possible the specific nature of the problem. For example, if you’ve developed shoulder pain, what does it feel like, specifically where on your shoulder does it hurt, what movements really bring on the pain, etc. Describe the symptoms at the very outset of the problem, and then how they might have changed since then, keeping the history as chronological as possible. Has it gotten worse? Have the symptoms changed? Is it constant or intermittent? What makes the problem better and what makes it worse? For example, a rash may have first appeared on one part of your body before moving to another part of the body. A pain may have developed in the middle of your stomach and then moved around to the right side of the abdomen. Your shoulder might be fine with regular activities but when you reach above your head, it really hurts and feels like something is being pinched. This type of information is very helpful to us.

3. Describing Pain: If you are describing pain, please describe its severity. Estimate this based on a scale of 1 to 10 with 1 being no pain at all and 10 being unbearable pain – the worst pain you can imagine. When describing pain, describe the nature of the pain – for example, is it a burning or squeezing sensation, or a deep, dull, aching, or stabbing sensation? Does it “radiate” or move from one place to another?

These tips are helpful to follow whether you are giving a history in person, over the phone, or over email. This kind of information helps us to assist you as expeditiously as possible.

Participating in Your Care

There are many reasons people value our services at GreenField Health. One of the reasons is because we try so hard to involve you in your own care. Remarkable care starts with an intensive partnership between you and our practice.

Our desire is for you to be informed about and engaged in your care. This requires you to understand your medical conditions and your appropriate preventive health needs – we are here to help you understand these things. We also want to engage you in meaningful decision making about your care – we view your input as being essential.

In fact, we need you to be involved in your care, and we need you to check in with us when appropriate, not just for acute care issues, but for prevention and wellness also.

To accomplish this partnership, here is what we ask of you:

1. Know your health conditions in detail. For example, if you have diabetes, you should know as much about diabetes as possible. If you are well, you should know what wellness and preventive health services are appropriate for you. The Internet contains some fantastic resources as well as a huge amount of bad information. To get good information on medical conditions, we advise that you use only very reputable web sites such as www.medlineplus.gov or www.patients.uptodate.com.

2. Monitor your health status and the status of your medical condition(s) closely, even if you are healthy. For example, if you are diabetic, you should know exactly how diabetes is monitored in general, and also how well your own diabetes is controlled. If you have high blood pressure, you should be monitoring it at home regularly. If you are well and without medical problems, then you should continue to follow your diet and exercise habits and track the preventive health measures appropriate for your age group and gender.

3. Partake actively in decision making with us. We want to make decisions about your health care with you, not for you. That requires you to be as informed as possible. Please ask us questions if you need more information or if you don’t understand something we’ve discussed.

4. Follow the decisions and prescribed treatments that we make together, and if you don’t, please let us know. Don’t be afraid to let us know if you’ve stopped something or are not taking a particular medicine any longer. We’re here to help you achieve your health goals – not to pass judgment.

5. Have a follow-up system. If we decide that we’ll repeat a blood test in 3 months, you should write this in your calendar or in some location where you are sure to see it. When that time arrives, you should contact us. We do have our own systems to track your needs, but you should be in the habit of also tracking your own needs such as this. Two systems of follow-up – yours and ours – are more reliable than one.

6. Get help when you need it. You know when you need our help. We want you to feel free to contact us any time to assist you.

The more you participate in your own care in this manner, the better your care will be. We’re here to help you be as knowledgeable and as in control of your health care as you should be.

Thanks as Always
Thanks as always to you, our patients and supporters – we wish you the best as we head back to school, work, and into our beautiful Northwest autumn. Please contact us if there is anything we can do for you, and again, it’s our pleasure to be along with you on your healthcare journey.

Thanks to our corporate partners

Kryptiq Corporation
Baker-Ellis Asset Management, LLC
Stahancyk, Gearing, Rackner, & Kent Law Firm
Go to our website to learn more about these corporate sponsors https://securemail.greenfieldhealth.com/Portal/General+Info/Corporate+Partners/Default.aspx

First Tuesday Reminder

First Tuesday Reminder
The schedule for our upcoming GreenField Health First Tuesday Open House is October 3, November 7, and December 5. This is a good introduction to our practice for relatives, friends or coworkers who might be interested in becoming a GreenField patient. The sessions begin promptly at 5:30 PM on the first Tuesday of each month. Learn more about our First Tuesday Open House Online at: https://securemail.greenfieldhealth.com/Portal/General+Info/First+Tuesdays/default.aspx

Sincerely,
Your GreenField Health Team:

Beth Davis, your Benefits Coordinator and Biller- beth.davis@greenfieldhealth.com
Chuck Kilo, MD - chuck.kilo@greenfieldhealth.com
Cynthia Ferrier, MD - cynthia.ferrier@greenfieldhealth.com
David Shute, MD - david.schute@greenfieldhealth.com
Elizabeth Hays, MD - elizabeth.hays@greenfieldhealth.com
Eric Murray, MD - eric.murray@greenfieldhealth.com
Heidi Downey, your Consultant - heidi.downey@greenfieldhealth.com
Jill Arena, your Clinic Administrator - jill.arena@greenfieldhealth.com
Joel Swartzmiller, IT Manager - joel.swartzmiller@greenfieldhealth.com
Lindy Thornbloom, your Health Coordinator - lindy.thornbloom@greenfieldhealth.com
Pam Mockenhaupt, CMA, your Health Coordinator - pam.mockenhaupt@greenfieldhealth.com
Paula Koeller, MD - paula.koeller@greenfieldhealth.com
Shelly Banta, your Clinic Manager - shelly.banta@greenfieldhealth.com
Tiana Schmitt, CMA, your Health Coordinator - tiana.schmitt@greenfieldhealth.com

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GreenField Health System
9427 SW Barnes Road, Suite 590
Portland, OR 97225

Phone: 503-292-9560
Fax: 503-292-9510
Web: http://www.greenfieldhealth.com
Questions, concerns, comments appreciated: questions@greenfieldhealth.com

copyright 2003-2006 GreenField Health