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Some doctors practice ’boutique’ medicine

By Erinn Hutkin, Special to U-T San Diego 6 a.m.Jan. 21, 2014

Dr. Gary Levinson has practiced internal and sleep medicine in the San Diego area for years, but he practices in an unusual way.

Some of his patients have his cellphone number and the number for a separate phone line into the office. They are also promised same or next-day appointments. And in the office, hes able to spend more time with them, build relationships and get to know patients and their health issues.

Hes able to do all of that under the concierge or boutique medicine model.

Its a model thats emerged in recent years in which some doctors offer patients the option of paying an annual fee or a retainer, which varies from physician to physician, in exchange for more access and time with their doctors.

Patients typically keep their private insurance, which pays for office visits and services, but the annual fee gives them perks such as being able to reach their doctor after-hours via email or phone, securing appointments within 24 hours and more one-on-one time with their doctor.

In turn, the fee allows doctors to lighten their patient roster, see fewer people each day and spend more time with patients in the office.

Some doctors have switched to the model full time, while physicians such as Levinson offer concierge service to 5 percent of his patients now with the hope of eventually offering the model to 10 to 15 percent.

Its not only advantageous to his patients, its often advantageous to him.

Its unrushed, said Levinson. Patients get what they want and we get more satisfaction without feeling like a cog in the health care wheel.

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Some doctors practice 'boutique' medicine

Medicine for the People | Lisa Sochocki

It was Monday morning and like most Monday's I'm rushing out my front door, slamming my green tea down and hoping into my car. To start the week of right I needed some morning Monday medicine. There is one band that does just that for me, you know the kind of music you play so loud that your speakers sound like they might crack. You roll up your windows as you drive to work as not to allow any precious sound to escape, and as you listen and sing along with the lyrics goosebumps creep over your forearms and then your eyes get all watery and a smile grows huge over your face. This is Nahko and Medicine for the People metaphorically and physically.

A band that's lyrics remind us how precious life is, how it is time to come out of our caves, that we are the ones we've been waiting for and our oh so painful, oh so thankful lives are for a greater purpose.

Let us be the light, to light the world in our own special humble way.

REAL TALK MUSIC

Grounded with Hawaiian roots they now spread their love across nations, you can find them in Ciudad Corts, Costa Rica by February.

http://nahko.com/home/

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American Board of Addiction Medicine Announces 2014 Officers and Directors

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Newswise The American Board of Addiction Medicine (ABAM) and The ABAM Foundation today announced their newly elected Directors and Officers for 2014. All are distinguished physicians from a range of medical specialties. These volunteer Directors lead ABAM in the formal certification of physicians as experts in addiction medicine, establish and accredit physician post-graduate addiction medicine training programs, and advance the quality of medical care for substance use disorders related to alcohol, tobacco and other addicting drugs, including some prescription medications.

Patrick G. OConnor, M.D., M.P.H., FACP, who serves as Professor of Medicine and Chief of the Section of Internal Medicine, Yale University School of Medicine, was named ABAM/ABAM Foundation President. Other Officers for 2014 include: Robert J. Sokol, M.D., FACOG, President-Elect; Jeffrey H. Samet, M.D., M.A., M.P.H., Immediate Past President; Gail DOnofrio, M.D., M.S., Secretary; and Lon R. Hays, M.D., M.A., DFAPA, Treasurer. (See below for affiliations and complete list of Directors.)

ABAM is an independent medical specialty board established in 2007 to certify addiction medicine physicians from several specialties, including emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, preventive medicine, psychiatry and other specialties.

ABAM has come a long way since its founding, with thousands of certified physicians, active certification and Maintenance of Certification programs, and training programs at leading medical schools across North America, said Dr. OConnor. I look forward to working with my colleagues on the board in this new capacity to further advance our critical mission of advancing the field of addiction medicine and providing much-needed expertise and care to millions of individuals suffering from addiction.

The ABAM Foundation has accredited 19 fellowship programs to train physicians in addiction medicine, and plans to establish additional fellowship programs. More than 3,000 physicians have been certified in addiction medicine by ABAM.

Trained addiction medicine physicians have joined other addiction professionals in the interdisciplinary care of patients with addictive disorders. Physician specialists in addiction medicine bring unique skills and competencies to the treatment team, contributing to the care of individuals and families with a multitude of needs, using all appropriate treatment modalities.

We want addiction prevention, screening, intervention and treatment to become routine aspects of medical care wherever health care is provided and to be available for all who need it, said Dr. OConnor.

Currently, relatively few physicians screen, intervene or refer, because they have not been sufficiently educated about addiction medicine in medical school, nor trained in residencies. Until the establishment of ABAM, one barrier to this training was the lack of an addiction medicine subspecialty for primary care physicians. A subspecialty of addiction psychiatry exists within the field of psychiatry, however, this does not provide the opportunity for addiction certification for primary care physicians and those in other specialties. While there are excellent addiction psychiatry fellowships, there are no addiction medicine residencies for physicians pursuing primary care specialties among the 9,262 Accreditation Council for Graduate Medical Education (ACGME) accredited U.S. programs that are training 119,588 residents.

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American Board of Addiction Medicine Announces 2014 Officers and Directors

Why a Safety Device That Can Stop Overdoses by Kids Isn’t Widely Used

A flow restrictor on liquid medicine bottles could prevent accidental ingestions, but drugmakers have yet to promise or deliver such protection on many pediatric medicines

Flow Restrictors: Using a syringe, Daniel Budnitz measures out a dose of medicine from a bottle fitted with a flow restrictor. Image: Bryan Metz/ProPublica

Starting in 2007, Dr. Daniel Budnitz, a scientist at the Centers for Disease Control and Preventions Medication Safety Program, began tracking an obscure but unsettling statistic about childrens health.

Each year, more and more kids were being rushed to emergency rooms after swallowing potentially toxic doses of medication. By 2011, federal estimates put the figure at about 74,000, eclipsing the number of kids under 6 sent to ERs from car crashes.

In most cases, children experienced no lasting harm from accidentally ingesting pills or liquids from the family medicine cabinet, but about 1 in 5 had to be hospitalized for further evaluation. About 20 children died each year from such accidents, CDC data showed.

As an epidemiologist and the father of two kids, including one who had a penchant for putting things in his mouth, Budnitz became fixated on reducing drug overdoses.

In particular, he saw an easy solution for the roughly 10,000 emergency room visits a year involving liquids, such as over-the-counter pain relievers and prescription cough syrups.

It was a type of safety valve called a flow restrictor. The small plastic device fits into the neck of a medicine bottle and slows the release of fluid, providing a backup if caregivers leave child-resistant caps unfastened or kids pry them off.

In 2008, Budnitz persuaded drug makers, federal regulators and poison experts to come together on an initiative to add flow restrictors, which cost pennies apiece, to medicine bottles.

Today, however, that promise to make medicine safer for kids remains largely unfulfilled, hindered by industry cost concerns and inaction by federal regulators, an examination by ProPublica found.

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Why a Safety Device That Can Stop Overdoses by Kids Isn't Widely Used

FRANCE: National and Stratified Development of Genomic Medicine in France – Thierry Frebourg – Video


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January 8, 2014 - Genomic Medicine Centers Meeting VI: Global Leaders in Genomic Medicine. More: http://www.genome.gov/27555775.

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Novel Nanotherapy Breakthrough May Help Reduce Recurrent Heart Attacks and Stroke

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Newswise Up to 30 percent of heart attack patients suffer a new heart attack because cardiologists are unable to control inflammation inside heart arteries the process that leads to clots rupturing and causing myocardial infarction or stroke.

But a report in Nature Communications by Icahn School of Medicine at Mount Sinai scientists showcases the development of a new technology that may provide a solution to this high risk of repeat heart attacks and potentially help save more lives.

An international research team, led by Mount Sinai investigators, designed and tested a high-density lipoprotein (HDL) nanoparticle loaded with a statin drug. In mouse studies, they show this HDL nanotherapy is capable of directly targeting and lowering dangerous inflammation in blood vessels.

Not only could the HDL nanotherapy potentially avert repeat heart attacks, it may also have the power to reduce recurrent strokes caused by clots in brain arteries, says the studys senior investigator, Willem Mulder, PhD, Associate Professor of Radiology in the Translational and Molecular Imaging Institute at the Icahn School of Medicine at Mount Sinai.

We envision that a safe and effective HDL nanotherapy could substantially lower cardiovascular events during the critical period of vulnerability after a heart attack or stroke, says Dr. Mulder.

While we have much more to do to confirm clinical benefit in patients, our study shows how this nanotherapy functions biologically, and how this novel concept could potentially also work in the clinical setting to solve a critical problem, says Dr. Mulder. This nanotherapy would be the first of its kind.

Inject HDL Statin Nanotherapy Right After Heart Attack and Stroke Treatment The research team, led by two PhD graduate students as first authors Raphael Duivenvoorden, MD, and Jun Tang, MS fashioned the nanoparticle to resemble an HDL cholesterol particle. In fact, the nanoparticle binds on to the same receptors as natural HDL in order to deliver the statin drug.

Oral statin medications used by millions of people today work primarily in the liver to reduce levels of unhealthy lipids, such as low density lipoproteins (LDL), that circulate in the blood. Statins also exert a very weak dampening effect on some inflammatory cells, foremost those called macrophages that hide within plaque in the arterial walls.

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Novel Nanotherapy Breakthrough May Help Reduce Recurrent Heart Attacks and Stroke