Retainer Medicine

Retainer medicine is practiced by physicians who have decided to drop out of all third party payer programs. These practitioners have offered a limited number of patients the opportunity to pay a fixed annual fee in exchange for premium services and amenities. Retainers doctors generally limit, by a drastic amount, the number of patients, which they will service. This makes the most sense for primary care physicians and those specialists who have ongoing and regular relationships with their patients. Many retainer practices also provide amenities which patients often do not get when Medicare or an insurer pays the doctor, including access to the physician’s cell phone, e-mail correspondence, same-day appointments, and plenty of face time during appointments. However, whatever the specifics of a particular practice may be, the key that defines “retainer medicine” is that the doctor works for the patient. It has become impossible in practical terms and in ethical terms for traditional primary care physicians to fight the pervasive pressures upon them to ration healthcare at the bedside. To escape this fate, they must become either specialists or a retainer practitioner. That is, primary care physicians must choose between remaining in a system that ruthlessly pushes them toward a practice of bedside rationing or, one way or another, getting out of traditional primary care medicine altogether. Retainer medicine restores the professional integrity of medical practice, and re-establishes a doctor-patient relationship in which the physician can again assume the duty of a true advocate. It is perhaps the only remaining means to restore the foundational medical ethic of always placing the patient first. Retainer fees let one practice handle more patients by phone or email.

Phototherapy Acne Treatment

Sunlight can improve skin care in the short-term. However, recent studies have shown that exposure to sunlight worsens acne in the long-term [citation needed]. More recently, visible light treatments (phototherapy) have successfully treated mild acne--in particular intense violet light (405-420nm) generated by purpose-built fluorescent lighting, dichroic bulbs, LEDs or lasers. Used twice weekly, this procedure resulted in a reduction of the number of acne lesions by about 64 percent. Studies show that this treatment is even more effective when applied daily. Scientifically speaking, the method of violet light treatment is effective because porphyrin (Coproporphyrin III), produced within P. acnes, generates free radicals when irradiated by 420nm and shorter wavelengths of light. Over the course of a few days, these free radicals ultimately kill the bacteria they spawned from. Since porphyrins are not otherwise present in skin, and the UV light applied is safe in its spectrum, this treatment is safe and licensed by the United States Food and Drug Administration (FDA). The ultra violet treatment works even better with red visible light (660nm) resulting in a 76 percent reduction of lesions after three months of daily treatment for 80 percent of patients. The overall skin clearing was similar or better than benzoyl peroxide. Unlike most of the other treatments, there are few if any negative side effects to this treatment and a development of bacterial resistance seems very unlikely. After treatment, a patient can achieve clear skin with topical or oral antibiotic treatments. The equipment or treatment, however, is relatively new and expensive, although the total cost of ownership may outweigh other costs (such as the total cost of benzoyl peroxide, moisturizer, and washes) over a couple of years.

Obstetrician

An obstetrician is a physician that specializes in caring for pregnant women through childbirth. Many obstetricians also train as gynecologists so they are able to give medical advice and treatment concerning a woman's reproductive system. Most students in residency study both gynecology and obstetrics and then decide on their career path. Often medical students find themselves drawn to this career due to the amazing occurrence of life through the birth of a baby. Obstetrician/gynecologist is a physician specialist who provides medical and surgical care to women and has particular expertise in pregnancy, childbirth, and disorders of the reproductive system. This includes preventative care, prenatal care, detection of sexually transmitted diseases, Pap test screening, and family planning. An obstetrician is a medical doctor who specializes in the management of pregnancy, labor, and birth. They also receive specialized education in the health of the female reproductive system and surgical care. Much of their education focuses on the detection and management of obstetrical and gynecological problems. An obstetrician/gynecologist, commonly abbreviated as OB/GYN, can serve as a primary physician and often serve as consultants to other physicians. OB/GYNs can have private practices, work in hospital or clinic settings, and maintain teaching positions at university hospitals. OB/GYNs may also work public health and preventive medicine administrations. OB/GYNs have a broad base of knowledge and can vary their professional focus. Many develop unique practices, providing high-quality health care for women. OB/GYNs may choose to specialize in the following areas: An obstetrician closely monitors their patient's health during pregnancy and delivery. They diagnose fetus abnormalities or health issues of their patients and offer healthy living advice and treatment. They see their patients on a regular basis for health consultations, ultrasounds, and any of their patient's prenatal medical needs including forming a birth plan. The frequency of a patients check up often depends on risk factors and resources.

Dry Skin

Many older people suffer from dry skin, particularly on their lower legs, elbows and forearms. The skin feels rough and scaly and often causes a distressing, intense itchiness. Low humidity--caused by overheating during the winter and air conditioning during the summer--contributes to dryness and itching. The loss of sweat and oil glands with age may worsen dry skin. Anything that further dries out the skin--such as overuse of soaps, antiperspirants, perfumes or hot baths--will make the problem worse. Dehydration, sun exposure, smoking and stress also may cause dry skin. Dry skin itches because it is irritated easily. If your skin is very dry and itchy, see a doctor. Dry skin and itching can affect your sleep, cause irritability or be a symptom of a disease. For example, diabetes and kidney disease can cause itching. Some medicines make the itchiness worse. The most common treatment for dry skin is moisturizing to reduce water loss and to soothe the skin. Moisturizers come in several forms: ointments, creams and lotions. Ointments are mixtures of water in oil, usually either lanolin or petrolatum. Creams are preparations of oil in water, which is the main ingredient. Creams are more often than ointments to be as effective. Lotions contain powder crystals dissolved in water, again the main ingredient. Because of their high water content, they feel cool on the skin and do not leave the skin feeling greasy. Although they are easy to apply and may be more pleasing than ointments and creams, lotions lack the same protective qualities. Lotions should applied more frequently to relieve the signs and symptoms of dryness. People should always use moisturizers to prevent recurrence of dry skin.