Last month, many of us made New Year’s resolutions and we were being deluged with advice about how to eat sensibly, how to exercise our way to fitness, and how to develop and keep healthy habits. But let’s get down to basics: how well do you follow your doctor’s advice?

Doctors will be increasingly held accountable for your overall health and wellness, and your progress towards sustained good health, under the Affordable Care Act (ACA). The ACA aims to increase the quality of care given and reduce the costs, thereby ensuring that the right care is given in the right place at the right time. More care has not proven to be better care, and reducing unnecessary and expensive screens and tests will go a long way to reducing health care costs.

But patients have a responsibility too – and that is to listen to your physician and follow their recommendations regarding nutrition, exercise and taking your medications as prescribed. “Medication adherence” or “medication compliance” are terms used to describe what patients do once they receive a prescription from their provider, including filling, and then re-filling when indicated,

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We often hear about drugs being prescribed “off-label.” Many patients have questions about what this means. Is it safe? Is it legal? How can we know that off-label use will help us get better?

Off-label use is the practice of prescribing pharmaceuticals for an unapproved indication, age group, dose or form of administration. We will explain more about this shortly.

But first, let’s look at how drugs are approved for use in our country.

In the U.S., the Food and Drug Administration Center for Drug Evaluation and Research review’s a company’s New Drug Application for data from clinical trials to see if the results support the drug for a specific use or indication.

If the drug is found to be safe and effective, it can be marketed for the specific condition for which it was approved by the FDA.  Until recently, however, it was against FDA regulations for pharmaceutical companies or their representatives to market a drug for any conditions for which the FDA hadn’t approved. 

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Just about everyone seems to be online these days. Communication with family and friends via email and social media outlets including Facebook and Twitter, as well as texting appear to be replacing telephone calls and letter writing. We wonder what we may be losing in this shift: is our privacy being compromised? Are these news methods of communicating enhancing the depth of our interactions, or are they just surface? And what happens with our medical care?

Do you email your doctor? Would you want to? In late November, a new survey revealed that patients want digital engagement with their healthcare providers. Fierce Healthcare (11/29/12) reported on a survey that sought to examine types of relationships between patients and providers including how often, and through which channels they prefer to communicate. Called “Engaging the Healthcare Consumer and Improving the Patient Experience,” Varolii and the Patient-Centered Primary Care Collaborative (PCPCC)  report that the majority of consumers would

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Many folks still have questions about medical homes, so we thought we would try to answer some of your questions today.

Q. How does having a medical home benefit the patient?

Having a medical home means that you have a healthcare team to take care of you, headed by your primary care physician, who will coordinate your care and ensure good communication among your team members. The concept of “Care” appears to have evolved to “caring for the whole person,” so medical needs will certainly be addressed, but the patient’s social and family situation, mental health, and spiritual and emotional needs will also be considered.

Q. How is it different from having a PCP (Primary Care Physician)?

In some ways the concept isn’t that different. Your PCP should be the one who coordinates your care. Under this model, your PCP will work with an expanded team to ensure you are getting the care you need, at the right time, in the right place. Communication between team members is highlighted, and unnecessary care, such as duplicative tests, will be reduced, resulting in reduced costs.

Q. Will having a medical home cost me extra money?

This

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We hope you and your families enjoyed safe, happy and healthy holidays! Now that we are in the New Year, we have much to look forward to regarding healthcare in the U.S. As we’ve discussed in our previous three posts, we are moving towards insuring more people than ever before! That is good news, but there is much to be done. The ACA is not a perfect law, but it is our best opportunity to date to ensure that more Americans receive health insurance coverage.

Where We Are Now

At present, there are approximately 50 million uninsured people in the U.S. When the ACA has been fully implemented, we are hoping that number will drop to 25 million uninsured, a definite improvement, but by no means a cure!

One of the hallmarks of the ACA is the “medical home.” Medical home can be defined as follows (via National Center for Medical Home Implementation):

A medical home is not a building, house, hospital, or home healthcare service, but rather an approach to providing comprehensive primary care.

In a patient-centered medical home model, the primary care team works in partnership with the patient and the family to assure that all of the medical

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