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Archive for the ‘Healthcare Professionals’ Category

How Do Docs Rate?

April 6, 2018 @ 5:04 pm
posted by Dr Ginther

Another study on how “docs” rate caught my eye.  This one compared ratings as collected on behalf of offices and hospitals  to those on social media sites on the same providers.

Formal ratings focused on the courtesy, communication skills, perceived medical or surgical skills, nursing staff,  wait times, etc.

Social media ratings tended to focus more on front desk staff, office décor, TV channels, pleasantness or not of others in the waiting area, etc.

Interesting dichotomy.  Looking at both should give a better picture.

And then there are ratings done by insurers.  These tend to focus on factors such as did I prescribe a generic oral bisphosphonate to everyone, rather than did I counsel the patient on improving nutrition.

Understanding ratings is not as easy as it looks.

Jay Ginther, MD

Iowa Bone Club Fall Meeting

October 22, 2017 @ 7:38 pm
posted by Dr Ginther

Iowa Bone Club met for the third time this past Friday, 20 October.  Ritu Munjal, MD was the program chair and hosted the meeting at PCI in Cedar Rapids.

Great program for those attending.  Guest CME topic was hypophosphatasia, which can be a cause of poor bone and increased fracture risk.  Low alkaline phosphatase and elevated B6 are the key labs.  The condition can be made worse by bisphosphonates, and probably other antiresorptives.

Spring 2018 meeting will be Friday 1 June in Spirit Lake.

Jay Ginther, MD

Treat to Target #1 – Which Target?

June 19, 2017 @ 6:30 pm
posted by Dr Ginther

Treat to Target has been standard for chronic diseases like high blood pressure and diabetes for decades.  These are chronic diseases, more common as we get older, that we can control with diet, exercise, and eventually medication.  We cannot cure them.

Bone health joins the Treat to Target club in 2017.  Increased Fracture Risk (Clinical Osteoporosis) is a chronic disease, more common as we get older, that we can control with diet, exercise, and eventually medication.  We cannot cure Increased Fracture Risk, so treatment of some sort is necessary “forever”.

What is our target?  Traditionally it has been maintaining the T-score found at the first assessment.   This does not necessarily make sense, especially if there already are fractures.  The target should be NO NEW FRACTURES.  This is a game changer.

This means that we are aiming for a Bone Mineral Density T-score higher than -2.5 in someone who has not yet fractured.  How we get there requires a new approach to medications, once we have reached the limits of Take Control Naturally detailed in previous posts.

This also means we need to check the VFA for previous Vertebral Compression Fractures, most of which go un-noticed, mistaken for pulled muscles.  (I did that a few years back.)

THE TARGET IS NO NEW FRACTURES.

Jay Ginther, MD

The Bone Health Guidelines are Changing

June 11, 2017 @ 4:58 pm
posted by Dr Ginther

University of Wisconsin hosts biennially the Bare Bones of Osteoporosis Care Symposium.  This year the Wisconsin Bone Club followed the symposium.

Felicia Cosman, MD from Helen Hayes in New York was the guest speaker at both.  She expanded on the new thoughts and guidelines presented at NOF in April.  These were a complete change of approach from just a few years ago.

Treat to Target.  Anabolics first to build bone and then preserve with Antiresorptives.  Reconsider VFA for all first time DXA evaluations.

More detail about these in the weeks to come.

Jay Ginther, MD