Ah, the why. The favorite word of many 2 and 3 year olds.
The short answer is that I see a need to maximize the time spent with providers while encouraging patients to take control over their own health.
Why?
Because with the increasing amount of patients now seeking primary care providers, there is an influx of patients while the number of providers has not changed. In some cases research shows the number of PCPs is declining. In my practice, I see one patient every 20 minutes. There are 3 slots/hour from 9am until 4:40 pm. I'm still breast-feeding so I have two empty slots every day to pump. I have 19 slots/day. Lets assume most providers in my clinic see 20 patients/day; 100/week. 5,200/year. Many of these are repeat patients but a lot are once-a-year physicals. I work in LA with a population of over 18 million in the Greater Los Angeles area. There are 20 providers at my clinic. We see over 100,000 patients a year, but as you can see with the population, it's a drop in the bucket. Therefore, we have to maximize our time! We have to make the most of the 20 minutes we get with you! Referrals, results, physicals, medication refills, hospital follow-ups, pre-ops.
We need more doctors, PAs and NPs!
The first, and most important IMO, issue is this: Pick (and stick with) a primary care provider!
I know there are extenuating circumstances; a move, change of job, loss of insurance, etc. If you have one PCP, the majority of your records are with them. They know you. It is so much easier to obtain records, make referrals, maintain continuity of care, etc., if you stick with one PCP. By PCP, I mean MD, NP, or PA within the same group. If you can see the same person every time, even better!
If you keep your PCP, so many issues will be alleviated!
Friday, December 30, 2016
Thursday, December 22, 2016
Where am I going?
Where is this blog going? Where are you going in life? Where is your health going?
Where is this blog going?! Well, I hope it will be a resource and source of encouragement!
Where are you going in life? New baby? New job? Newly divorced? Depressed? New terminal diagnosis? Lonely? It is my wish and desire to help manage, navigate, and enrich your life. Many of the lessons I've learned in the exam room have a lot of truth in real life. There is no experience much more sobering than telling a beloved patient she has cancer. I know this information before she does. I know before her family knows. This is powerful and the lessons of empathy, support, love, and silence can be empowering.
Where is your health going? This is where The Total Patient comes into play! What are your goals? What goals does your doctor or PCP have for you? Are you content with where you're going? Blood pressure creeping up? Fasting blood sugars too high? How are you changing your behavior? Do you want to change? Do you want to feel better?
Be honest with yourself. Would you lie to your BFF? Don't lie to yourself!
Where is this blog going?! Well, I hope it will be a resource and source of encouragement!
Where are you going in life? New baby? New job? Newly divorced? Depressed? New terminal diagnosis? Lonely? It is my wish and desire to help manage, navigate, and enrich your life. Many of the lessons I've learned in the exam room have a lot of truth in real life. There is no experience much more sobering than telling a beloved patient she has cancer. I know this information before she does. I know before her family knows. This is powerful and the lessons of empathy, support, love, and silence can be empowering.
Where is your health going? This is where The Total Patient comes into play! What are your goals? What goals does your doctor or PCP have for you? Are you content with where you're going? Blood pressure creeping up? Fasting blood sugars too high? How are you changing your behavior? Do you want to change? Do you want to feel better?
Be honest with yourself. Would you lie to your BFF? Don't lie to yourself!
Thursday, December 15, 2016
When do I need to do this?
When. When will I post? When do you need to implement these changes? When should you implement change?
I will try to post weekly; at a minimum. Like you, I have a busy life. Husband, son, work, cooking, cleaning, laundry, family, friends, etc. Social media is a much better place to get in touch with me!
You can implement change whenever you want! Some people like Mondays, the first of the month, New Years (please don't wait that long!), their birthday, you get the picture.
The Transtheoretical Model (Prochaska & DiClemente, 1983; Prochaska, DiClemente, & Norcross, 1992) or Stages of Change is a cycle of thoughts and actions we proceed through when we approach change. The stages are pre-contemplation, contemplation, preparation, action, and maintenance. An example could be smoking.
Pre-contemplation: I should quit...but I really enjoy it. How will I enjoy my coffee? When will I get to talk to so-and-so unless I smoke with him?
Contemplation: I really should quit. I'm going to quit on Monday. I can still drink my coffee without a cigarette....or maybe I'll quit coffee too?
Preparation: I've smoked all my cigarettes, I've removed all lighters and ash trays. Breaks have been rearranged.
Action: I'm ready! I've quit!
Maintenance: It's been a week/month, I can do this!
In a perfect world, it works seamlessly every time! But, life isn't perfect, so we encounter trials, bumps, detours along the way. What matters is that we make progress. We move forward. If you "fall off the wagon", get back on. If you slip down a few steps, don't throw yourself down the whole flight. Dust yourself off and get back on it!
All of this to say; implement the ideas of change now! Be a better patient now! Be a better worker, wife, mom, sister, etc., NOW!
I will try to post weekly; at a minimum. Like you, I have a busy life. Husband, son, work, cooking, cleaning, laundry, family, friends, etc. Social media is a much better place to get in touch with me!
You can implement change whenever you want! Some people like Mondays, the first of the month, New Years (please don't wait that long!), their birthday, you get the picture.
The Transtheoretical Model (Prochaska & DiClemente, 1983; Prochaska, DiClemente, & Norcross, 1992) or Stages of Change is a cycle of thoughts and actions we proceed through when we approach change. The stages are pre-contemplation, contemplation, preparation, action, and maintenance. An example could be smoking.
Pre-contemplation: I should quit...but I really enjoy it. How will I enjoy my coffee? When will I get to talk to so-and-so unless I smoke with him?
Contemplation: I really should quit. I'm going to quit on Monday. I can still drink my coffee without a cigarette....or maybe I'll quit coffee too?
Preparation: I've smoked all my cigarettes, I've removed all lighters and ash trays. Breaks have been rearranged.
Action: I'm ready! I've quit!
Maintenance: It's been a week/month, I can do this!
In a perfect world, it works seamlessly every time! But, life isn't perfect, so we encounter trials, bumps, detours along the way. What matters is that we make progress. We move forward. If you "fall off the wagon", get back on. If you slip down a few steps, don't throw yourself down the whole flight. Dust yourself off and get back on it!
All of this to say; implement the ideas of change now! Be a better patient now! Be a better worker, wife, mom, sister, etc., NOW!
Thursday, December 8, 2016
What is this about?
This week, we arrive at the What!
What is The Total Patient?
I believe it is advice, encouragement, practical tips and suggestions, and insight into what being a patient really means.
As a nurse, and especially as a Nurse Practitioner (NP, from here on out), I'm concerned with how your home life affects your health. Is your job increasing your stress which is creating worse neck pain? Are you having panic attacks because you're scared about taking a test? Does your blood sugar fluctuate beyond "normal" ranges every day? Is the anniversary of your sons death looming and causing your insomnia to worsen?
These are the topics I address with patients on a daily basis.
The longer I practice, the more I see the connection of mind and body and how that relates to every day choices. What did you have for breakfast? Did you exercise today? Have you had your mammogram? Did your boss yell at you? Did you binge on a package of Twinkies? Very rarely, IMO, are these decisions singular. Meaning, each decision is influenced by other choices and each decision has direct effects on outcomes.
Let me break it down further. I eat protein (eggs) for breakfast every day. I have learned that I need protein and fat to keep me satiated throughout the morning. If I eat breakfast, and have my coffee, I feel better, I am more clear mentally, I have enough energy to tackle my patients and get through until lunch. In order for me to be able to get breakfast, I have to wake up early enough which means I have to go to bed at a decent hour....etc. Have you read the childrens book, If You Give a Mouse a Cookie? This is so true!
I digress...
The Total Patient is helping you connect these dots for yourself so you can live life to the fullest! So you can get the most out of your doctor appointments and specialists. We want to enable you to manage your health on your own, as best you can, by integrating basic and often over looked methods.
What is The Total Patient?
I believe it is advice, encouragement, practical tips and suggestions, and insight into what being a patient really means.
As a nurse, and especially as a Nurse Practitioner (NP, from here on out), I'm concerned with how your home life affects your health. Is your job increasing your stress which is creating worse neck pain? Are you having panic attacks because you're scared about taking a test? Does your blood sugar fluctuate beyond "normal" ranges every day? Is the anniversary of your sons death looming and causing your insomnia to worsen?
These are the topics I address with patients on a daily basis.
The longer I practice, the more I see the connection of mind and body and how that relates to every day choices. What did you have for breakfast? Did you exercise today? Have you had your mammogram? Did your boss yell at you? Did you binge on a package of Twinkies? Very rarely, IMO, are these decisions singular. Meaning, each decision is influenced by other choices and each decision has direct effects on outcomes.
Let me break it down further. I eat protein (eggs) for breakfast every day. I have learned that I need protein and fat to keep me satiated throughout the morning. If I eat breakfast, and have my coffee, I feel better, I am more clear mentally, I have enough energy to tackle my patients and get through until lunch. In order for me to be able to get breakfast, I have to wake up early enough which means I have to go to bed at a decent hour....etc. Have you read the childrens book, If You Give a Mouse a Cookie? This is so true!
I digress...
The Total Patient is helping you connect these dots for yourself so you can live life to the fullest! So you can get the most out of your doctor appointments and specialists. We want to enable you to manage your health on your own, as best you can, by integrating basic and often over looked methods.
Tuesday, December 6, 2016
Come and like us!
We are on Facebook and Twitter! Come and like us!
Twitter: @thetotalpatient
IG: @thetotalpatient
Thursday, December 1, 2016
Who am I?
Over the next week or so, we will answer the basic who, what, when, where, why, how questions about The Total Patient.
This week: Who?
I am a Registered Nurse and Board Certified Nurse Practitioner. I have been practicing in California for over 6 years. My nursing experience has exposed me to telemetry, oncology, hospice, community clinic, pediatrics, adults, and geriatrics. My current work environment is in the community clinic setting where I work with patients who have little to no income and have no insurance coverage. Obamacare has increased our work load, which is good! But, it has also created a huge burden on our system. Patients will wait 3 years for a screening colonoscopy.
While my experiences are vast, they are just that; my experiences. Is healthcare like this all over the country? No. Are all patients like the ones I will describe? No. People are people. In private practice or community clinics, people are people. Human nature is what it is and this is what I will focus on with The Total Patient.
The personal details include: married, one son, live in So Cal, tall, loves Friends, have to have coffee daily, wine and beer occasionally, sucker for Housewives.
Welcome :)
This week: Who?
I am a Registered Nurse and Board Certified Nurse Practitioner. I have been practicing in California for over 6 years. My nursing experience has exposed me to telemetry, oncology, hospice, community clinic, pediatrics, adults, and geriatrics. My current work environment is in the community clinic setting where I work with patients who have little to no income and have no insurance coverage. Obamacare has increased our work load, which is good! But, it has also created a huge burden on our system. Patients will wait 3 years for a screening colonoscopy.
While my experiences are vast, they are just that; my experiences. Is healthcare like this all over the country? No. Are all patients like the ones I will describe? No. People are people. In private practice or community clinics, people are people. Human nature is what it is and this is what I will focus on with The Total Patient.
The personal details include: married, one son, live in So Cal, tall, loves Friends, have to have coffee daily, wine and beer occasionally, sucker for Housewives.
Welcome :)
Subscribe to:
Comments (Atom)