In patients with diabetes, something malfunctions with this process of turning food into energy. There are two types of diabetes: Type I which is insulin …
FAMILY PRACTICE/INTERNAL
MEDICINE SPECIALTIES
A SPECIALTY OVERVIEW
Defined: Family Practice is defined as a medical specialty concerned with
the provision of continuing, comprehensive primary health care for the
entire family Internal Medicine is defined as the branch of medicine that
deals with the diagnosis and nonsurgical treatment of diseases affecting
the internal organs of the body, especially in adults
Providers: Family Practice physicians are trained and qualified to handle
the vast majority of complaints and chronic medical conditions that bring a
patient to the practice The Family Practice physician is a board-
certified, residency-trained medical specialist who serves as a patients
advocate in all health related matters - including the appropriate use of
specialists or other community resources In addition, preventative care as
well as acute and chronic illness care is provided Every Family Practice
physician trains for three years in real practice settings - treating
patients in the office, the hospital, and at home Continuing Medical
Education requirements ensure that the physicians are experts at
applying
the latest medical breakthroughs in the care of their patients
Internal Medicine, although is the same category as family practice and
general practioners, provides a different and more in-depth approach to
health care needs Internal Medicine physicians are considered primary care
physicians PCPs, and they typically treat a wide variety of patient needs
from preventive medicine to acute care cases Internists are doctors
trained in fields such as cardiology, pulmonary, and neurology, preparing
them to treat a wide variety of adult illnesses With a wide background of
intense training, Internists are well-informed on current treatments and
preventative medicine for the healthy adult patient
Treatment: Both Family Practice physicians and Internists are trained in
all major medical areas They diagnose and treat the full range of problems
that patients bring to the doctors
B COMMON DIAGNOSES
There are many common diagnoses made by Family Practice physicians or
Internists on a regular basis Below are some of the most common diagnoses
However, this listing is by no means exhaustive; rather, it is a synopsis
of some of the more frequently seen problems
HYPERTENSION:
Also known as high blood pressure, it is defined as
blood pressure greater than or equal to 140/90 mmHg; hypertension
results when the arteries narrow, causing increased pressure within
the vessels It can be a great risk factor for heart disease,
stroke, kidney disease, and peripheral vascular disease
DIABETES: Diabetes affects the way that the body uses food; it
causes sugar levels in the blood to be elevated to an unsafe level
Normally, during the digestion process, the body converts food into
glucose The blood then carries the glucose to the cells throughout
the body The glucose is changed into quick energy for used by the
cells or it can be stored for future usage In patients with
diabetes, something malfunctions with this process of turning food
into energy There are two types of diabetes: Type I which is
insulin-dependent and occurs most frequently in children and young
adults and Type II which typically strikes later in life
DEGENERATIVE JOINT DISEASE: Osteoarthritis, also known as
degenerative arthritis, is a type of joint disease caused by the
breakdown and eventual loss of the cartilage that lines and
lubricates the joints As a result, the ends of the bones within
the join are left unprotected, leading to pain and stiffness
BACK PAIN: Low back pain may be acute or chronic depending on the
duration A physician should treat any back pain that lasts more
than 2 weeks, follows an injury, causes pain or numbness in the
legs, or is associated with bowel or bladder problems For most
people, drugs work well to control the associated pain and
discomfort Back pain experts purport that over-the-counter
medications can reduce pain; however, some patients with more
severe pain require prescription drugs such as Demerol or
Oxycontin
ANGINA: Angina Pectoris is a recurring pain or discomfort in the
chest that happens when a part of the heart does not receive enough
blood Angina is a common symptom of coronary heart disease CHD,
which occurs when vessels that carry blood to the heart become
narrowed and/or blocked due to atherosclerosis The pain
associated with angina is usually relieved
within a few minutes by
resting or taking prescribed angina medicine
C COMMON MEDICATIONS
Listed below are some of the most common medications prescribed by Family
Practice physicians or Internists:
AMOXICILLIN: Amoxicillin is a frequently-prescribed penicillin used
to treat infections caused by bacteria; it works by killing the
bacteria and/or preventing their growth
HYDROCHLOROTHIAZIDE: Hydrochlorothiazdie and other thiazide
diuretics are commonly used to treat high blood pressure The drugs
control the blood pressure and are also used to reduce the amount
of water in the body by increasing the flow of urine
MICRONASE: Micronase is an antidiabetic agent used to treat a
certain type of diabetes mellitus type II Sulfonylureas work by
causing a pancreas to release more insulin into the blood stream
CLARITIN: Claritin is an antihistamine used to relieve or prevent
the symptoms of hay fever and other types of allergy
Antihistamines work by preventing the effects of a substance known
as histamine Histamine, which is produced by the body, can cause
itching, sneezing, runny nose, watery eyes, and even closed
bronchial tubes in some persons
FLEXERIL: Flexeril is used to help relax certain muscles in the
body; it helps relieve the pain, stiffness, and discomfort
associated with strains, sprains, or injuries to the muscles It
works by acting on the central nervous system CNS to product
muscle relaxing effects
CELEBREX: Celebrex is a medication used to relieve some of the
symptoms caused by arthritis, such as inflammation, swelling,
stiffness, and joint pain The medication, however, does not cure
arthritis and is only effective as long as the patient takes the
medication
D COMMON PROCEDURES
Listed below are some of the Family Practice physician and Internists most
commonly performed or ordered procedures:
CBC: Also known as a blood count or complete blood count, a CBC is
commonly performed and is actually several tests in one Cells
normally present in the blood include red blood cells RBCs, white
blood cells WBCs, and platelets; all of the cells need to be
present in adequate quantities in order for
a persons body to
function properly The appearance of these cells under a
microscope can usually show whether a particular kind of cell is
functioning properly Among the diagnoses made from a CBC is
anemia, which typically refers to insufficient RBCs, and an
elevated WBC count indicates a bacterial infection of some type
An analyzer will measure the number and size of RBCs, quantity of
hemoglobin, number of WBCs, and number of platelets
MRI: An MRI uses magnetic fields, radio frequency, and a computer
to illustrate the inner-workings of the body An MRI is an
effective way of viewing muscles, nerves, and soft tissue It
assists physicians in evaluating the brain, neck and spinal cords;
furthermore it allows them to study bones and joints to determine
the extent of injury
CAT SCAN: A cat scan short for computed axial tomography provides
a physician with a cross-sectional view of a patients body Once
the powerful scanner has made 10-30 images, the attached computer
combines parts of the different pictures to study the body from
almost
every angle
STREP TEST: A streptococcal screen is also known as a rapid strep
test The test is routinely performed when strep throat is
suspected or if symptoms of pharyngitis are present The test
requires a throat swab Antibody-antigen technology is then used to
identify the presence of Group A Streptococcus on the swab; the
test takes about 7 minutes to process
URINALYSIS: A urinalysis is most often ordered if a urinary tract
infection is suspected; however, there are a number of other
diagnoses that can be made by a urinalysis A routine urinalysis
will determine the number and kind of cells from the lining of the
kidneys and bladder that have appeared in the urine as well was the
number of both red and white blood cells The test will also detect
the presence of bacteria or other organisms and a variety of
chemicals that the kidneys filter Finally, a urinalysis will
measure the pH or urine and the concentration of the urine
GLUCOSE-TOLERANCE TEST: The glucose-tolerance test is the
laboratory test used to diagnose diabetes mellitus The
person
being tested is given a specific amount of glucose to drink The
glucose levels are measured before ingestion and then , 1 , 2, 3
and sometimes 4 to 6 hours after ingestion
E HOW MISYS EMR FITS IN
Without a doubt, the Misys EMR product would be an effective clinical
solution for any Family Practice or Internal Medicine practice Point-of-
care should be a key part of any proposal to this type of physician;
because these doctors typically see a lot of patients and deal with complex
documentation, point-of-care is an effective way to document these visits
For the physicians that arent ready to go to point-of-care documentation,
Transcription Assistant is a tool that can be used by that transcription
staff to enter dictation, and the information will still reside in a
single, easily accessible repository
Without a doubt, spend some time talking about the Messaging module in
Misys EMR and how this can easily handle the headaches associated with
medication refill requests and protocol clarifications Many Family
Practice and Internal Medicine practices receive hundreds of refill
requests a day; by using the Messaging module to track these, that
patients
paper chart no longer has to be pulled and the entire email
transaction automatically becomes a part of the patients electronic
medical record
Also emphasize the power of the Problem Oriented Summary POS - a Family
Practice physician or Internist may want to use it to track health
maintenance information, vitals, hospitalizations and surgeries Even if
he/she doesnt go full point-of-care, the POS is a great reference point
for critical patient information
Be sure to show them both the Immunizations module and Growth Charts The
Batch Entry feature in Immunizations will come in super handy on those flu
shot days Also, Growth Charts are an added benefit for those physicians
that routinely see pediatric patients
Coding Assistant is another feature that should appeal to a lot of these
physicians For those that are interested in going to point-of-care, it is
a great way for the physician to rest assured that his or her billing is
compliant with HCFA guidelines
Because laboratory work is critical to these practices, Orders Management
and its integration capabilities will likely be important to them Be
prepared to talk about our HL7 interfaces and how it can be used internally
as
well
Document Manager can also come in handy when dealing with the large amount
of paper that they receive from the hospital and also back from specialty
physicians that they refer to on a regular basis
F HOW DOCUMENT MANAGER FITS IN
The primary benefits of using Document Manager for any type of specialty
practice are increased staff productivity and reduced overhead costs When
a paper document enters a practice, it typically must be reviewed, copied,
distributed, filed, and eventually retrieved Once the staff time needed
to complete the tasks is calculated, the cost savings become extremely
clear According to The Records Retrieval Report Greenwood Publishing
Group, Westport, CT, the labor cost necessary to maintain a single
standard four-drawer file cabinet for one calendar year is estimated to be
1700 Furthermore, the average cost of researching and replacing a
misfiled record is almost 127 per record The space required to store ten
four-drawer legal-size file cabinets is approximately 70 square feet of
office space By scanning the documents stored in these cabinets into
Document Manager, that same office space could be converted into patient
care space or even
eliminated
Aside from the financial savings associated with Document Manager, it is a
very practical business solution for many practices Both the Family
Practice physician and Internist routinely receive a large amount of
paperwork from external sources Much of this paperwork ie, reports from
specialty physicians is critical to the patients care and needs to become
a part of the patients electronic medical record Document Manager enables
this pertinent information to quickly and efficiently be integrated into
the patients record
G WHERE DO WE GO FROM HERE?
Clearly, the EMR products offered by Misys are an effective solution for
the Family Practice and Internal Medicine practices The capability and
flexibility of the system is there; now the challenge is to prove to the
physicians that the system is the right one for them - regardless of
whether or not they want to go to point-of-care Historically, the
solution we can provide to the Family Practice and Internal Medicine
practices has been one of our strong suits The bottom line with these
physicians is that it is critical to make the demo meaningful, relevant,
and applicable Show them the value and ROI associated with
reduced chart
pulls, legible and complete documentation, fewer paper charts, and better
patient care, and watch them sign on the dotted line
H DID YOU KNOW?
Diabetes is the fourth leading cause of death by disease in the
United States; over 150,000 people in the United States die each
year from diabetes and its complications
Americans make more than 200 million office visits to Family
Physicians annually - more than any other medical specialty
More than 26 million Americans suffer from migraine headaches
Osteoarthritis afflicts 40 million Americans, and it is
responsible for 7 million physician visits per year
Coronary artery disease is the leading killer in American of
both men and women, accounting for over 700,000 deaths each
year
More than half of all Americans over the age of 65 have high
blood pressure
Eleven states - Alabama, Arkansas, Georgia, Indiana, Kentucky,
Louisiana, Mississippi, North Carolina, South Carolina,
Tennessee, and Virginia - have such high rates of strokes among
people of all
races and in both sexes they are known as the
Stroke Belt States
Experts claim that although back pain is preventable, 4 out 5
Americans will experience it at some point in their lives
Osteoporosis leads to 15 million fractures, or breaks per year,
and it costs 10 billion annually
