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The Disappearing Doctor The Disappearing Doctor: How MegaMergers Are Changing the Business of Medical Care Big corporations — giant retailers and health insurance companies — are teaming up to become your doctor. Is the doctor in? In this new medical age of urgent care centers and retail clinics, that’s not a simple question. Nor does it have a simple answer, as primary care doctors become increasingly

scarce. “You call the doctor’s office to book an appointment,” said Matt Feit, a 45-year-old screenwriter in Los Angeles who visited an urgent care center eight times last year. “They’re only open Monday through Friday from these hours to those hours, and, generally, they’re not the hours I’m free or I have to take time off from my job. “I can go just about anytime to urgent care,” he continued, “and my co-pay is exactly the same as if I went to my primary doctor.” That’s one reason big players like CVS Health, the drugstore

chain, and most recently Walmart, the giant retailer, are eyeing deals with Aetna and Humana, respectively, to use their stores to deliver medical care. People are flocking to retail clinics and urgent care centers in strip malls or shopping centers, where simple health needs can usually be tended to by health professionals like nurse practitioners or physician assistants much more cheaply than in a doctor’s office. Some 12,000 are already scattered across the country, according to Merchant Medicine, a consulting

firm. On the other side, office visits to primary care doctors declined 18 percent from 2012 to 2016, even as visits to specialists increased, insurance data analyzed by the Health Care Cost Institute shows. There’s little doubt that the front line of medicine — the traditional family or primary care doctor — has been under siege for years. Long hours and low pay have transformed pediatric or family practices into unattractive options for many aspiring physicians….Read More

Control Blood Pressure to Keep Dementia at Bay: Study Bringing high blood pressure under control can reduce older black Americans' risk of dementia, a new study finds. Black people are at high risk for high blood pressure and dementia, the researchers noted. The study included more than 1,200 black Americans, aged 65 and older, with high blood pressure who did not have dementia. The patients took different types of medications for their high blood pressure and were followed for up to 24 years. The medications included beta blockers, ACE inhibitors,

calcium channel blocks and diuretics. "We have found even if African Americans control blood pressure when they are 65 and older, the risk of dementia can be reduced," study corresponding author Michael Murray said. He is a research scientist with the Regenstrief Institute in Indianapolis and Purdue University's College of Pharmacy. "And we also can now pass along the useful information that you don't need to take the expensive new drugs on market," he said in an institute

news release. "Older generic medications will work just as well in lowering risk of dementia and are less expensive." The study authors concluded that blood pressure reduction -not the medications themselves - is what lowers dementia risk. "Controlling blood pressure is important for lowering risk of heart attack, stroke and kidney disease," Murray said. "We can now add prevention of dementia to the list of benefits of good blood pressure control at all ages." Preventing dementia is

critical. "Once you start the decline from cognitive impairment to mild and eventually severe dementia, there is no known cure," he explained. The study was published in the April issue of the Journal of General Internal Medicine. More information The U.S. National Heart, Lung, and Blood Institute has more on high blood pressure. SOURCE: Regenstrief Institute, news release, April 9, 2018

Drug Test Spurs Frank Talk Between Hypertension Patients And Doctors There’s an irony at the heart of the treatment of high blood pressure. The malady itself often has no symptoms, yet the medicines to treat it — and to prevent a stroke or heart attack later — can make people feel crummy. “It’s not that you don’t want to take it, because you know it’s going to help you. But it’s the getting used to it,” said Sharon

Fulson, a customer service representative from Nashville, Tenn., who is trying to monitor and control her hypertension. The daily pills Fulson started taking last year make her feel groggy and nervous. Other people on the drugs report dizziness, nausea and diarrhea, and men, in particular, can have trouble with arousal. “All of these side effects are worse than the high blood pressure,” Fulson said.

Research shows roughly half of patients don’t take their high blood pressure medicine as they should, even though heart disease is the leading cause of death in America. For many unfortunate people, their first symptom of high blood pressure is a catastrophic cardiac event. That’s why hypertension is called the “silent killer.” A drug test is now available that can flag whether a patient is actually taking the prescribed

medication. The screening, which requires a urine sample, is meant to spark a more truthful conversation between patient and doctor. Fulson’s blood pressure has been a moving target, she said. She regularly checks it at home, but it sometimes registers as a little high. Even having it taken in a doctor’s office can add enough stress to elevate the results….Read More

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RI ARA April 22, 2018 E-Newsletter

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RI ARA April 22, 2018 E-Newsletter

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