Lyme Disease continues to be very common in the Midcoast Maine area but we're seeing anaplasmosis and other tick-borne diseases more frequently. Knowing how to prevent tick bites and considering tick-borne diseases when symptoms occur continues to be important. The CDC has useful information on its web site and even an iPhone, iPad and Android app for this.
Direct Primary Care (DPC) is simple, but health insurance and its interactions are not. We accept insured and uninsured patients except that we (temporarily) cannot accept patients with Medicare, but plan to later this year. So far, all but one Maine insurance policy will cover tests and referrals we order. We do not bill insurances, but patients may submit for reimbursement. All patients get great access and lower costs than insurance based practices can offer.
Now that we've been open for three months, we feel it's time to start getting more formal feedback from patients. While there are plenty of complex (and expensive) surveys used for this by hospitals and the insurers, we're keeping it simple for now. Jen created our own anonymous survey asking the questions we're interested in as we continue to refine the practice.
We sent these out to those of you that have signed up for the patient portal (which I highly recommend you try) and we're also giving out paper surveys to those of you we see at the office this month. If you haven't received a survey yet and would like one, let us know.
So far the results are reassuringly positive. Patients like the direct primary care model once they understand how it works and try it out. Even without the survey, we've noticed that new patients are referring others to our practice.
While this survey helps us plan how to improve our growing practice, eventually we'll also look at some survey tools that help patients review their health care such as Dartmouth College's How's Your Health.
NPR recently broadcast a story about sinusitis treatment. Acute sinusitis or sinus infections are fairly common, but there are a lot of misconceptions about how to treat it.
The new treatment guidelines cited by NPR continue to downplay the role of antibiotics since most patients with sinusitis eventually get better without antibiotics and antibiotics don't seem to shorten the illness in many cases.
As needed nasal saline flushes seem helpful for relieving sinus pressure due to poor drainage. I learned this trick from a wonderful navy ENT (Ear Nose and Throat) surgeon in Japan where patients with chronic sinusitis would have to wait months for the ENT surgeon to visit our base. There are not many studies on this for acute sinusitis treatment but it is commonly recommended and is an inexpensive, if somewhat annoying, treatment. Some very rare infections were reported from doing this with infected tap water recently so using sterile water to make the saline isn't unreasonable.
Avoid using nasal decongestant sprays for more than three days as that can cause problems.
Some patients develop complications or have a different problem and not sinusitis. NPR quickly added a clarification to their story that includes "Signs and symptoms such as worsening headaches, visual problems, changes in mental activity, facial swelling and progressive fever can indicate impending complications."
Don't make medical decisions based on something you read on the internet, including this. If you have questions about possible sinus symptoms, call your primary care physician or get examined. If your physician won't answer your questions without an appointment or it's difficult to get a prompt appointment, consider Direct Primary Care.