Concierge Medicine Directory

The complete directory of Concierge Medicine in the United States is online. Concierge Medicine goes by many names, boutique medicine, retainer medicine, executive health, VIP medicine, and personalized medicine. Finding the right Concierge Doctor is the most important step for patient considering the best care. Concierge Doctor is a new style of practice with old roots, in which doctors limit their patient base in order to provide patients with personalized service, high quality care, 24-7 availability, and other amenities. In exchange for this enhanced personal attention, patients pay physicians an annual fee. This concierge fee enables physicians to increase their compensation while managing their workload. In addition to receiving an annual fee, most Concierge Medicine continue to receive reimbursements from health plans and private pay clients. Concierge Medicine is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design. The practice is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine. While all Concierge Medicine practices share similarities, they vary widely in their structure, payment requirements, and form of operation. In particular, they differ in the level of service provided and the amount of the fee charged. There are an estimated 5,000 concierge, or membership medicine doctors throughout the U.S. Concierge Medicine care for fewer patients than in a conventional practice. All generally claim to be accessible via cell phone or email at any time of day or night or offer some other special service beyond the normal care provided. The annual fees vary widely, from $600 to $5,000 per year for an individual, with the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services. Some concierge practices do not accept insurance of any kind. These are as cash-only or direct primary care practices. By refusing to deal with insurance companies, these practices can keep overhead and administrative costs low, thereby providing affordable healthcare to patients. They become concierge only if the practice assesses an annual or monthly fee instead of or in addition to a fee for each medical service. Other concierge practices do take insurance, even Medicare, but ask for an annual fee for additional services exclusive of insurance plans. This annual fee is not a substitute for medical insurance, and generally does not cover consultations outside the practice, laboratory procedures, medicines, hospitalizations, or emergency care from other providers.

Retinoids Topical Acne Treatment

Retinoids are a group of medications that normalize the follicle cell lifecycle. There are topical retinoids such as tretinoin (brand name Retin-A), adapalene (brand name Differin) and tazarotene (brand name Tazorac). Like isotretinoin, these medications are similar to vitamin A, but they are topical treatments and generally have much milder side effects. However, they can cause significant irritation of the skin. The retinoids appear to influence the creation and death lifecycle of cells in the follicle lining. This helps prevent the hyper-keratinization of these cells that can create a blockage. Retinol, a form of vitamin A, has similar but milder effects and doctors prescribe because it also contains moisturizers. Doctors have prescribed topical retinoids for over 30 years, but are not available over the counter, so they are not as widely used as other topical treatments. Topical retinoids often cause an initial flare up of acne and facial flushing.

Ophthalmology

Ophthalmology is the branch of medicine, which deals with the anatomy, physiology and diseases of the eye. The term ophthalmologist refers to a specialist in medical and surgical eye problems. Since ophthalmologists perform operations on eyes, they are both surgical and medical specialists. The eye is a fragile organ, requiring extreme care before, during, and after a surgical procedure. An expert eye surgeon must identify the need for specific procedure and be responsible for conducting the procedure safely. Anesthesia is essential for any eye surgery. Local anesthesia is most commonly used. Retrobulbar and peribulbar techniques for infiltrating the local area surrounding the eye muscle cone are to immobilize the extraocular muscles and eliminate pain sensation. Topical anesthesia using lidocaine topical gel is preferred for quick procedures. In topical anesthesia, patient cooperation is a must for a smooth procedure. General anesthesia is for children, traumatic eye injuries, major orbitotomies, and for apprehensive patients. Cardiovascular monitoring is preferable in local anesthesia and is mandatory in general anesthesia. Proper sterile precautions are used to prepare the area for surgery, including use of antiseptics like povidone-iodine. Sterile drapes, gowns and gloves are necessary. A plastic sheet with a receptacle helps collect the fluids during phacoemulsification. An eye speculum is used to keep the eyes wide open. Although the terms laser eye surgery and refractive surgery are used as if they were interchangeable, this is not the case. Lasers may be used to treat nonrefractive conditions, while radial keratotomy is an example of refractive surgery without the use of a laser. A cataract is an opacification or cloudiness of the eye's crystalline lens due to aging, disease, or trauma that typically prevents light from forming a clear image on the retina. If visual loss is significant, surgical removal of the lens with lost optical power is performed and it is usually replaced with a plastic intraocular lens. Due to the high prevalence of cataracts, cataract extraction is the most common eye surgery. Rest after surgery is necessary. LASIK is Laser-Assisted In Situ Keratomileusis. LASIK is a type of refractive surgery, performed by ophthalmologists using a laser. The operation is with the patient awake and mobile; however, the patient is sometimes given a mild sedative (such as Valium) and anesthetic eye drops. LASIK is in three steps. The first step is to create a flap of corneal tissue. The second step is remodeling of the cornea underneath the flap with the laser. Finally, the flap is repositioned.

Jock Itch

Tinea cruris is the scientific name for a fungal infection in the groin region. An official alternative name is jock itch. As the common name for this condition implies, it causes itching or a burning sensation in the groin area, thigh skin folds or anus. It may involve the inner thighs and genital areas, as well as extending back to the perineum and perianal areas. Affected areas may appear red, tan and brown, with flaking, rippling, peeling, or cracking skin. The acute infection begins at an area in the groin fold measuring about a half-inch across, and usually presents on both sides. The area may enlarge, and other sores may develop in no particular pattern. The rash appears as raised red plaques (plate-like areas) and scaly patches with sharply defined borders that may blister and ooze. If the rash advances, it usually advances down the inner thigh. The advancing edge is redder and more raised than areas affected for longer. The advancing edge is usually scaly, and very easily distinguished or well demarcated. The skin within the border turns a reddish-brown and loses much of its scale. The border may exhibit tiny pimples or even pustules, with central areas that are reddish and dry with small scales. If infected with candidal organisms, the rash tends to be redder and wetter. Opportunistic infections (infections that are caused by a diminished immune system) are frequent. Fungus from other parts of the body (commonly tinea pedis or "athlete's foot") can contribute to jock itch. A warm, damp environment allowing the fungus to cultivate greatly contributes to the infection, especially with sweaty or tight clothing such as a jockstrap.