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4 Common Handwashing Mistakes

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Handwashing is important to reduce the spread of infection.  We pick up infections daily by touching contaminated surfaces, then touch our hand to our mouth, nose, or eyes. There are some infections that are airborne, but most are spread through contact with the hands. According to the CDC, handwashing can prevent about 30% of diarrhea-related sicknesses and about 20% of respiratory infections.

Handwashing takes on an especially important role during the winter months, so I thought I’d share with you the 4 most common handwashing mistakes that people tend to overlook.

      1. Not washing when you should
        After using the bathroom is not the only time you should be washing your hands. You should be washing them before, during, and after preparing food, after touching garbage, after blowing your nose, coughing, or sneezing, and after touching an animal, animal feed, or animal waste.
      2. Not washing long enough
        Many people tend to wash their hands for only 5 or 10 seconds but scrubbing your hands for at least 20 seconds is recommended. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
      3.  Not completely drying your hands
        Drying your hands is an essential part of handwashing. Germs love wet, moist areas so making sure your hands are fully dry will help prevent bacteria from spreading on your skin.
      4.  Touching germy surfaces directly after 
        If you wind up touching contaminated surfaces such as the faucet handles or door handle after handwashing, it becomes ineffective. Try using a paper towel when turning off the faucet or reaching for the door handle.

If you find yourself in a situation where there is no running water, use hand sanitizer. It doesn’t work nearly as well as soap and water, but does help.

No matter where you find yourself, good hand hygiene can protect and prevent you, your family, and others from illnesses.

 

 

Q&A: 10 Questions You’ve Always Wanted to Ask Your Doctor

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Something that is always talked about in Direct Care is the doctor-patient relationship. But how can patients get to know their doctor on a more personal level? Asking questions is one of the best ways to ensure you and your doctor are on the same page and a great way for you to get to know your doctor on a more personal level.

Meet Dr. Kimberly Jones-Mudd, you can call her Dr. Jones. She joined R-Health Ewing last month as a Board-certified Family Physician. You’ll find that Dr. Jones enjoys partnering with her patients to help them achieve their best health, and prefers to take a holistic approach incorporating mind, body, and spirit when creating a plan of care. But, to ensure Dr. Jones’ patients really know her, we asked 10 questions that you most likely always wanted to ask your doctor, yet never did.

 

Q: How did you end up going into medicine?

Jones: My decision to become a family medicine physician was a calling. Those who know me well will say I spoke of becoming a doctor in elementary school. I looked at other options after graduation from undergrad, but nothing gave me the same fulfillment. I feel compelled to serve others, help people lead healthy lives, and provide the assistance to help with healing when illness occurs.

 

Q: What would you be doing if you hadn’t gone into medicine?

Jones: I’d probably considered law. I was a Political Science Major.

 

Q: What job would you be terrible at?

Jones: IT, research, or anything that lacks day-to-day human interaction.

 

Q: What is one stereotype about doctors that you’d like to put to rest?

Jones: I would like people to know that not all physicians are judgemental and while we act as guides in offering care, the patient has autonomy in making decisions.

 

Q: What is your favorite TV show?

Jones: All things Hallmark. If someone were to turn on my TV at any given point, it would most likely be on the Hallmark Channel.

 

Q: What hobby would you get into if time and money weren’t an issue?

Jones: I wouldn’t call it a hobby, but I have always wanted to learn sign language.

 

Q: Do you have any pets or kids?

Jones: I have a 6-year-old daughter and a dog.

 

Q: How different was your life one year ago?

Jones: My life has been stable since my daughter was born. It just gets busier in juggling her extracurricular activities.

 

Q: What are you most likely to become famous for?

Jones: I have no desire to be famous. However, I hope when people think of me, professionally and personally, they see my desire to help others as the thing that motivates me.

 

Q: Who inspires you to be better?

Jones: My daughter, because I want to serve as a role model for her.

 

To learn more about Dr. Jones, visit https://www.r-health.md/dr-jones/.

Top 3 Things You Should Expect from Your Doctor

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Choosing a primary care doctor is one of the most important decisions you’ll make. Your primary care doctor essentially acts as your quarterback who helps you navigate the healthcare jungle. Without a primary care doctor, you could be putting your health and well-being at jeopardy. Why you may ask? Your primary care doctor should know your ins and outs in order to provide the best treatment option.  Whether you currently have a primary care doctor or are in the market for a new one, here’s a list of what you should expect from your primary care doctor.

  1. Someone that values your time.

No one likes to wait an hour to see the doctor for them to turn around and only take 5 minutes to review your symptoms. Primary care doctors should be active listeners and want to figure out the root of the problem rather than worry about hitting the patient quota for the day.

  1. Can give you access to them, when and where you need it.

Have you ever gone on vacation and got sick? Or not had time to see the doctor because by the time you get off work the doctor’s office is closed? Rather than turning to the ER or urgent care, you should be able to contact your primary care doctor to discuss your symptoms. That way they can point you in the right direction and help you plan your next course of action.

  1. Have a doctor-patient relationship.

With the internet available at your fingertips, and a lot of bad information out there, it’s hard to decipher what your symptoms truly mean. Sure, you could use an online “symptom checker” to figure out what your medical symptoms could mean, but this is why having a doctor-patient relationship is vital. Before Googling, your doctor should always be your first point to help figure out what your symptoms mean and to guide you through your options. So as a patient, use your doctor as a resource and continue to build on your relationship because having an open two-way communication and full trust in your doctor is really the key to good health.

So, when it comes to choosing your primary care doctor, be picky. After all, this is your health.

Why Antibiotics Aren’t Always the Answer

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Antibiotics can effectively kill bacteria. Oftentimes when a patient has a bacterial infection and needs antibiotics, the benefits outweigh the risks. However, there are many everyday situations where antibiotics are inappropriate and can even be harmful. For instance, antibiotics cannot cure colds, flu, or other upper respiratory infections caused by viruses.

Common side effects of antibiotics can include:

  • Rash
  • Dizziness
  • Nausea
  • Diarrhea
  • Yeast infections
  • Severe allergic reactions

Other serious side effects include Clostridium difficile (C. Diff.) infection, which results in diarrhea that can lead to severe colon damage and even death.

One less discussed potential risk of antibiotic usage is that antibiotics kill not only “bad”, but also “good” bacteria in the gut microbiome, the microbes in your intestines. Using antibiotics kills a significant amount of this “good” bacteria or stops them from multiplying, thus affecting the normal “ecosystem” and function of the gut microbiome.

Finally, from a public health point of view, imprudent antibiotic use lead to antibiotic resistance. According to a recent article in BMC Medicine, the rate of antibiotic prescriptions has doubled from 2000 to 2010.  The report further states that “nearly 50 percent of outpatient antibiotics prescribed are unnecessary.” A report from the Centers for Disease Control and Prevention show that in the U.S. at least 2 million people have serious infections with antibiotic-resistant bacteria every year, and at least 23,000 die directly due to those antibiotic-resistant infections. In addition, at least 14,000 people die each year in U.S. due to C. Diff. infections.

Before asking your doctor for another antibiotic, I would like everyone to think about the potential risks, from a personal and societal perspective. Antibiotics may not be the right answer and oftentimes it is better to wait a few days to see if your body can ward off the infection naturally. The side effects and potential risks of antibiotic usage must be carefully considered, and the prescription of antibiotics needs to be treated with greater gravity.

What is Leaky Gut Anyway?

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When our body is healthy our cells lining our intestines should allow the absorption of important nutrients, while keeping substances out that could make us sick. Leaky gut happens when there is an increase of the harmful and inflammatory substances being absorbed because the walls of the intestines have been injured and there are bigger gaps between the cells.  These gaps allow passage of these harmful substances inside the body where they ordinarily would not go.  Unfortunately, when our body is chronically exposed to these substances or bacteria in the blood stream, it can cause local (GI symptoms or malabsorption) and systemic (whole body symptoms) reactions and inflammation.  Some common things that have been seen in association with intestinal permeability are – chronic fatigue syndrome, inflammatory bowel disease, irritable bowel disease (IBS), celiac disease, eczema, food allergy, inflammatory arthritis and even psychological conditions.
But how do these gaps get there in the first place? 

They seem to begin for some people following an infection, illness, medical treatment, or other major stressful event. It may happen because the usual balance in the intestine is disrupted. The disruption may be caused by medications (e.g., antibiotics, steroids, nonsteroidal anti-inflammatory drugs) malnutrition, surgery, burns, infection, alcohol consumption, cow milk intolerance, age, or stressful events in your life.  We also know that even for people who do not have celiac or gluten sensitivity, exposure to gliadins (a protein in gluten which is found in wheat, barley and rye) causes a greater increase in intestinal permeability.

How can the gaps be closed? 

We can help heal leaky gut by trying to figure out a little of what might have caused it in the first place – and avoiding it.  So, if it was a medicine or a food, or stress you would want to limit your exposure.  We also want to support our bodies natural digestion and give it the nutrients it needs to heal and calm inflammation and replenish a good balance of bacteria.

For more information, check out the University of Wisconsin site.

The Importance of Breastfeeding Health

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There are few things more exciting than a newborn baby. But what’s important is a healthy baby. There are many ways to keep babies healthy and breastfeeding plays one of the most important roles. August is National Breastfeeding Awareness Month where the goal is to promote the health and well-being of babies by encouraging breastfeeding.

Part of encouraging breastfeeding is offering the mother proper encouragement. Three keys to this are providing time, space, and family support. While breastfeeding comes naturally for some, it may not for others. It takes patience and time to perfect, which is why paid maternity leave becomes very important. It’s essential for mothers to have areas to breastfeed in private, and spaces where they can rest and be free from interruptions, as family and friends are always eager to greet the mother and new baby.

It’s important that a mother feel supported by her decision to breastfeed. Comfortability will lead to more breastfeeding success in the short and long-term, especially during busy times where a mother may feel like it is not an accessible option.

Finally, breast milk supplies the infant with nutrients made especially for their growth and development. It’s natures perfect food for babies. It’s not only beneficial for the child, but for the mother as well. Per WebMD, the following are the benefits for both mother and child:

For Child:

  • Antibodies in breast milk help fight viruses and bacteria
  • Lowers risk of baby having asthma or allergies
  • Fewer ear infections, less diarrhea and respiratory illnesses
  • Linked to higher IQ scores in later childhood
  • Reduced risk of SIDS (Sudden Infant Death Syndrome)

For Mother:

  • Faster weight loss (can burn an extra 500 calories when breastfeeding)
  • Lower risks of cancer (breast and ovarian cancer) by about 20%
  • Lower risks of osteoporosis
  • More bonding through skin to skin contact, which stimulates release of oxytocin (a hormone that facilitates bonding)

As you can see, breastfeeding is important for all involved and there’s a need for its continued support. Not only is it a bonding experience, but it offers an abundance of health benefits. For more tips, such as best positions, additional medical considerations while breastfeeding, or if breastfeeding is a healthy option for you, reach out to your doctor for the best recommendation.

Partnership Announced Between Direct Primary Care Leader and National Insurance Captive

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PHILADELPHIA, Aug. 29, 2018 /PRNewswire-PRWeb/ — R-Health and Pareto Captive Services (“Pareto”) announced a partnership to bring enhanced primary care to Pareto’s clients (“captive members”). R-Health and Pareto, both based in the Philadelphia area, recognize the need to provide innovative solutions to tackle ever-rising healthcare costs facing employers and individuals.

R-Health is a national leader in enhanced primary care, supporting or managing over 40 practices in New Jersey and Pennsylvania. Pareto forms and manages employee benefit group captives that allow medium-size employers to mitigate the year to year volatility of self-insuring their health benefits. Nationwide, Pareto has more than 600 captive members, constituting more than 150,000 covered lives.

Through this new partnership, Pareto captive members will have access to R-Health’s growing number of Direct Care practices. In addition, the two companies plan to open four new practices in the Greater Philadelphiaarea in 2019. These innovative Direct Care practices will deliver enhanced primary care to Pareto captive members in the region, as well as other employers.

R-Health and Pareto are also partnering to launch two locations in the Kansas City area in September 2018, serving Pareto captive members in that market. With captive members located nationwide, Pareto and R-Health plan to launch other locations as dictated by need and growing demand.

“At R-Health, we believe that independent, relationship-based primary care is the foundation of transformational healthcare delivery,” said Mason Reiner, R-Health Co-Founder & CEO. “By partnering with Pareto, we can leverage our unique combination of clinical expertise and technology to provide patients with consistent access to their personal doctor, while achieving significant cost savings for employers through clinically integrated care delivery and innovative data analytics.”

“Pareto saw that our captive members needed a better primary care option for their employees, yet for most medium-sized employers, on-site clinics are not financially feasible and, often, can lead to further fragmented care,” said Andrew Cavenagh, Pareto Captive Services’ Managing Director. “By partnering with R-Health to create near-home practices, we can fill that void by offering better access to primary care and more time with their physicians. These offices offer convenient and comprehensive primary care to employees and their family members.”
Enhanced primary care can lower healthcare costs in many ways, including:

  • Reducing unnecessary emergency room and urgent care visits.
  • Better managing and therefore reducing the cost of chronic and high-risk conditions.
  • Offering longer appointments, that allow for more time for the patient and provider to interact.
  • Providing referrals to high-value specialists.
  • Increasing compliance with care plans by making many prescriptions available on-site.
  • Reducing costly complications by identifying and supporting high-risk and at-risk individuals.

About R-Health
R-Health delivers more effective care and a better patient experience – all at a lower cost. We partner with employers, unions, insurance companies and TPAs to offer primary care that’s truly collaborative. This is accomplished through the traditional core values of convenient, personal primary care; our innovative data analytics and patient engagement platforms that streamline care, delivering better outcomes, lower costs and a refreshing patient experience; and the proactive management of chronic conditions. R-Health delivers value-based healthcare two ways: through R-Health Direct Care, our innovative enhanced primary care model, and R-Health Accountable Care, our commercial and Medicare ACOs. For more information, visit https://www.R-Health.md.

About Pareto Captive Services
Pareto Captive Services forms and manages employee benefit group captives. The captives mitigate the year-to-year volatility and risk that is inherent in self-insurance, thereby allowing employers to focus on reducing healthcare costs. Members of Pareto captives gain access to an exclusive suite of risk management and cost-containment initiatives to help them in their quest to provide affordable and effective healthcare to their employees. Pareto continually seeks new and innovative solutions to employers’ healthcare benefit dilemmas and when solutions do not already exist, Pareto creates them. For more information, visit https://www.paretocaptive.com.

Media Contact
Carrie Hartman
carrie.hartman@r-health.md
Cell: 215.704.0917

 

SOURCE Pareto Captive Services

The Appointment Pre-Check

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Longer appointment times with your doctor are almost viewed as a myth. Given the current state of healthcare, most doctors only spend an average of 20 minutes – or in many cases even less – with each patient before moving on to the next patient. Having such an abbreviated time with your doctor can be frustrating, especially if you come in with concerns and leave with more questions than answers.

This is not the case with Direct Care. With smaller patient panels, this removes the shuffling from patient to patient, providing the doctors with the opportunity to spend more time with a patient – listening, answering questions, and coming up with a diagnosis. This not only makes for more pleasant visits, but also it creates a great foundation towards your doctor being a partner in your health.

Nevertheless, with this added time in the Direct Care model, you have to know how to make the most of the time with your doctor and be sure to have all your questions answered. What type of questions should you ask? While it’s all depends on your specific concerns, Time Magazine shared some of top questions you should ask your doctor.

  1. What are the different treatment options?
    • Decisions should be made jointly with your doctor, so be sure you’re aware of all options.
  2. Do we have to do this now, or can we revisit later?
    • Some tests can wait, and added time can also give your doctor more time to diagnose your patterns.
  3. What outcome should I expect?
    • It’s important to know if there will be any changes that may affect your lifestyle.
  4. What are the side effects?
    • Whether you’re undergoing a procedure or taking new medication, it’s important to know about side effects beforehand to determine if you want to alter your treatment
  5. How will I hear about my results?
    • Be sure to get an adequate timeline from your doctor on when to expect your results.

It’s important to take advantage of the longer appointment times with your doctor afforded by Direct Care. Questions for your doctor can help give you more clarity on your health status and provide the answers you need to guide your next steps.

Growing a Healthy Baby

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We can positively influence the health of our children for years to come – even while in the womb.

Making sure that we are getting the right nutrients, exercise, enough sleep, and surrounding ourselves with love, support, and laughter can influence epigenetics.  Think of epigenetics like a librarian. If the books in the library are your DNA, the librarian determines which genes will be opened and read.

There are experiments done in mice that show how what their mothers ate or were exposed to during gestation, determined their genetic expression of a gene that put them at risk for obesity.

So what can you do to live a healthy lifestyle during pregnancy to ensure the “good” books will be opened and the” bad” ones closed?

Try eating whole foods and organic foods as much as possible during pregnancy, with a rainbow of vegetables and fruits. This will increase phytonutrients or substances found in certain plants that are thought to prevent disease. By also eating whole, organic foods, you will cut down on pesticide and plastics exposure, which can interfere with epigenetics as well as a full-term pregnancy. A recent study at the University of Indiana that showed that higher exposure to glyphosate (found in Round up and Round up Ready GMO foods) shortened the length of pregnancy.

Here are some other helpful prenatal tips:

  • Take a prenatal vitamin especially with Folate, Vitamin D, Vitamin B6, Zinc, Vitamin K1 and L2 and eat foods or supplements rich in Omega-3 fatty acids (both DHA and EPA, as DHA is important for brain development, and EPA is required for DHA to get into the brain)
  • Morning sickness can be due to Zinc or Vitamin B6 deficiencies or to drops in blood sugar.
  • Avoid eating processed foods. Instead, eat plenty of healthy fats (from nuts, seeds, avocados, coconut, etc.) and protein, while avoiding refined grains and sugars that can quickly raise and then lower blood sugar. This will also help prevent gestational diabetes.
  • If allergies run in your family, taking probiotics during the 3rd trimester can decrease your baby’s risk of developing allergies and eczema.  Go for a variety of fermented foods. If that is not your thing, pick up a capsule of probiotics filled with good bacteria.
  • Most importantly, surround yourself with happiness and seek support from loved ones or your community.  Endeavor to practice techniques to manage your stress as your baby is exposed to those same stress hormones.  Put yourself first, listen and attend to your body, try prenatal yoga, diaphragmatic breathing, journaling, or guided imagery.  If needed, reach out to a therapist or a health coach.

Simply put, eat a healthy diet, enjoy life, enjoy being pregnant and enjoy your baby! If you have questions or are having trouble accomplishing your goals for a healthy pregnancy, please reach out to your doctor.

Optimizing Bone Health: Decrease Risk of Low Bone Density and Fractures

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Prevention is key for bone health – as with many health issues. Bone density peaks around age 30.  For most people after that, it steadily decreases with age. This even starts in the womb. Mom’s calcium and vitamin D levels influence bone density later in life, as does breastfeeding.  During childhood and young adulthood building a “bone bank” through adequate nutrition and weight bearing exercise is key to developing maximum peak bone density.  But, it’s never too late to start with healthy changes.  Maintaining good bone health can decrease the rate of bone loss and maintain quality of the bones, and there are many factors that play a role in this.

Food

Nutrition plays a big role in bone health. Calcium is often the first thing people think about, and though calcium is important it can be overdone. Too much calcium, especially if it is not balanced with magnesium and vitamin K can build up on artery walls.  Also, don’t rely on dairy – there is minimal link between dairy and bone health.
Try the foods in this list from the University of Wisconsin to promote bone health instead.

Onion family Fennel Parsley
Arugula French beans Pomegranate
Broccoli Garlic Prunes
Celeriac Leeks Red Cabbage
Chinese cabbage Lettuce Turmeric
Cucumbers Mushrooms Wild garlic
Dill Oranges & other citrus Soy (whole soy foods)

Too much of certain things can have a negative impact on your bones as well – so keep it to less than one alcoholic drink per day, and minimize cola and caffeine (except for tea) and don’t take more than 3000 iu of vitamin A.  Limit animal protein intake as well. The theory is that animal protein causes our blood to be slightly acidic, and to neutralize this effect our body steals calcium out of the bones.  Eat plenty of vegetables and fruit. A high vegetable to animal diet ratio seems to be protective against bone loss.

Vitamins and Minerals

Make sure you get adequate vitamin D. Vitamin D helps your body absorb calcium properly. Living in this area of the Northeast, we’re unable to make enough through the sunlight. Talk to your doctor about your levels and supplements.
Vitamin K, an important balance with calcium, is required for the activation of the hormone that tells our body to build bone.  Consider supplementing with vitamin K2 45-100mcg.  Magnesium helps keep the bones flexible. Try taking 400-800mg before bed. Talk to your doctor first if you are on blood thinners or if your magnesium dosage causes loose stools. Vitamin C, B vitamins, Potassium, and Zinc are all likely to be important as well.

Exercise

Benefits of exercise are seen at all age groups. Walking, other weight bearing exercise, and resistance training are all helpful. Vigorous walking at more than 3.8 miles per hour shows better benefit.

Smoking

Another reason to quit! Smoking increases fracture risk by as much as 40% compared to non-smokers.

Preventing Falls

The ultimate goal of prevention of bone density treatment is to avoid fractures, so preventing falls is a very important aspect of bone health. Exercise decreases fall risk and it maintains strength and coordination. Tai chi has been shown to reduce falls by improving balance.
Try these other tips from the Mayo Clinic to also help prevent falls:

1.  Talk to your doctor about your medications – some medications could cause dizziness
2.  Wear sensible shoes – avoid floppy slippers or shoes
3.  Remove tripping hazards – remove throw rugs that slip or stick up
4.  Make sure areas are well lit – use night lights
5.  Use assistive devices when necessary – like grab bars

Getting Your Bone Density Checked

Overall women have a higher risk of developing problems with low bone density because they have a lower peak bone density. Men with certain medical conditions or taking certain medications may be at higher risk too. Getting your bone mineral density checked is recommended if you are a woman over 65 years of age, or have the same fracture risk as a woman over 65.  You can calculate your fracture risk using this tool.  https://www.sheffield.ac.uk/FRAX/.

Bone density is checked with a test called a DEXA scan. Bone density in the hip and lower spine are the areas of the body that are X-rayed and then compared to a healthy 30-year-old of the same sex and given a score, called at T score. The more negative the number, the less dense the bones.  Osteoporosis is diagnosed with a T-score lower than -2.5.

Medication might be right for you if you have osteoporosis.  Talk to your doctor about this or any questions you have about your bone health or getting your bone density tested with a DEXA scan.