Want more time to ask questions of your doctor and an opportunity to meet other patients who share your medical concerns? Then a shared medical appointments (SMA) might be for you.
During SMAs, patients have much more time to discuss their issues with their physicians than they would during a typical 20-minute office visit,” explains Bruce Eisendorf, M.D., a family medicine doctor at the Palo Alto Medical Foundation (PAMF), who offers SMAs on managing pain and reducing your risk for heart attack or stroke at the PAMF clinic in Santa Cruz, California. “Patients also learn an incredible amount from listening to each other’s questions and are empowered by the positive feedback from other group members.”
Just as in a regular office visit, patients in a SMA can change or renew prescriptions, receive test results, learn to use prescribed medical equipment, and discuss medications, treatment and surgery options. The difference is that discussions take place in a group instead of one-on-one with the doctor, which makes for a more relaxed atmosphere.
“There is a less intimidating environment than in the physician’s office,” says Steven Bartis, DPM, a podiatrist who offers SMAs on plantar fasciitis (heel pain) at PAMF’s Fremont Center. “Patients feel more at ease when they realize they are not alone in their diagnosis.”
In addition, some SMAs allow patients to see two or more doctors at one time instead of having to come in for multiple separate office visits on different days. Dr. Bartis, for example, has teamed with ophthalmologist Timothy Scott, M.D., and Fremont Center nutritionists to offer a single three-hour SMA for patients newly diagnosed with diabetes.
“Combining foot and eye exams with nutritional education is a concept that not only enhances patient understanding of diabetes, it also limits the time the patient loses in scheduling and visits, taking less time away from work, family or fun,” Dr. Scott says.
PAMF currently offers SMAs for many health needs. Learn more about SMAs at PAMF Fremont, Los Altos and Palo Alto centers or call 650-853-2283. For SMAs at PAMF Santa Cruz area clinic locations, call 831-459-6418.
Findings Highlight Need for Intervention Programs Emphasizing Fitness, Nutrition
Lead researcher, Latha Palaniappan, M.D., M.S., and her team at the Palo Alto Medical Foundation Research Institute (PAMFRI) will present their most recent findings from three separate studies at the American College of Epidemiology Annual Meeting in San Francisco, California, on September 11-14, 2010.
Each year, the American College of Epidemiology invites submission of research topics for their annual meeting from different areas, such as medicine, statistics, sociology, genetics, and biology. Dr. Palaniappan and her research team will deliver three poster presentations on the following topics: 1) methods for overcoming partially missing data, 2) colon cancer screening rates, and 3) cardiovascular disease prevalence rates.
PAMF is one of the nation’s earliest adopters and leaders in the use of electronic health records (EHRs). Dr. Palaniappan and her team use de-identified data from the EHRs at PAMF to study trends in and risk factors for obesity, type 2 diabetes and cardiovascular disease.
Study investigates risk factors for and incidence of diabetes in Asian American subgroups.
Dr. Palaniappan is the primary investigator of the Pan Asian Cohort Study (PACS), a study funded by the National Institute of Diabetes, Digestive, and Kidney Disease to investigate risk factors for and incidence of diabetes in Asian American subgroups. Obesity, a major risk factor for diabetes, is most often defined by body mass index (kg/m2), and is calculated using measured height and weight. Body mass index is an important tool used by physicians to calculate risk for chronic diseases, such as diabetes and cardiovascular disease. For a variety of reasons, body mass index is sometimes partially missing within the EHR. Dr. Palaniappan and colleagues compared methods for overcoming partially missing body mass index data in the EHR. These findings will be applicable to researchers across the nation who study obesity as a risk factor.
Study uses EHRs to compare colorectal cancer screening rates at PAMF to statewide self-report survey data from the California Health Interview Survey (CHIS), the largest state health survey in the U.S.
While missing data is one limitation of an EHR, EHRs also provides a great deal of information, such as the number of patients with up-to-date colorectal cancer screenings. Colorectal cancer is the second leading cause of death in the U.S., and routine screening is recommended for patients ages 50-75. Several national and state surveys collect self-reported information on colorectal screening use. However, survey data are thought to overestimate receipt of screening tests. Dr. Palaniappan collaborated with Dr. Annette Maxwell, a researcher at UCLA, to compare colorectal cancer screening rates at PAMF to statewide self-report survey data from the California Health Interview Survey (CHIS), the largest state health survey in the U.S. The colorectal cancer screening rates from CHIS self-report data were higher than screening rates at PAMF, suggesting that there is over-reporting in colorectal cancer screening utilization in self-reported survey data.
Study investigates prevalence of stroke, coronary heart disease, peripheral vascular disease (PVD) in Asian American and Non-Hispanic White (NHW) patients at PAMF.
Cardiovascular disease is the leading cause of death in California and the United States. Dr. Palaniappan received a grant from the American Heart Association to investigate the prevalence of stroke, coronary heart disease (CHD) and peripheral vascular disease (PVD) in Asian American and Non-Hispanic White (NHW) patients at PAMF. There are considerable differences in Asian American subgroups with regard to stroke, CHD and PVD. Filipinos and Asian Indians are much more likely to develop CHD than other Asian subgroups and NHWs. While high rates of CHD among Asian Indians are increasingly recognized, Filipinos are less well studied. Dr. Palaniappan believes that future research should study Asian subgroups separately to better understand variation in disease patterns.
The American College of Epidemiology’s annual meeting will provide an important opportunity to present PAMFRI’s research findings and to raise awareness of health issues affecting patients.
Dr. Palaniappan was supported in part by a grant from the American Heart Association (0885049N ) and a grant from the National Institutes of Health (5R01DK081371-02).
