Concierge Physician

Concierge Physicians goes by many names, boutique medicine, retainer medicine, executive health, VIP medicine, and personalized medicine. By any name, Concierge Physician is the solution for doctors trying to maintain their integrity and independence in today’s difficult healthcare environment. Concierge Physician 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 physicians continue to receive reimbursements from health plans and private pay clients. Concierge Physicians 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 Physicians 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 physicians 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.

Melanoma

Melanoma is a malignant tumor of melanocytes, which present in skin but also in the bowel and the eyes. It is one of the more rare types of skin cancer, but causes the majority of skin cancer-related deaths. Malignant melanoma is a serious type of skin cancer. Uncontrolled growth of pigment cells, called melanocytes cause cancer. Despite many years of intensive laboratory and clinical research, the sole effective cure for melanoma is surgical resection of the primary tumor before it achieves a Breslow thickness greater than 1mm. Each year doctors diagnose around 160,000 new cases of melanoma and it presents more frequently in males and Caucasians. It is more common in Caucasian populations living in sunny climates than other groups. According to a WHO report, about 48,000 melanoma-related deaths occur worldwide per annum.

Warts

A wart is generally a small, rough tumor, typically found on the hands and feet, but often in other locations. A wart can resemble a cauliflower or a solid blister. Warts are common, and develop from a viral infection, specifically by the human papillomavirus. Warts are contagious and spread by contact to skin of an infected person. It is also possible to get warts from using towels or other objects. Warts typically disappear after a few months but can last for years and may recur.

Podiatry

Podiatry is a branch of medicine devoted to the study, diagnosis and treatment of disorders of the foot, ankle and lower leg. In the United States, two groups of physicians mainly provide medical and surgical care of the foot and ankle: podiatrists and orthopedists. Podiatrists are certified in Foot and Ankle Surgery or certified in Foot Surgery and certified in Reconstructive Rear foot/Ankle Surgery by the American Board of Podiatric Surgery and are specifically trained to diagnose and perform complex surgical treatments of the foot and ankle. They are an integral part of the health care team, and combined with all other podiatric physicians, currently treat the majority of foot-related medical issues in the U.S. Orthopedists are the second largest providers of foot-related medical care. Each board-certified Podiatric Foot and Ankle Surgeon has a professional doctoral degree, which requires the completion of four years of Podiatric Medical School. The Podiatric Medical School curriculum covers basic and clinical sciences, including, but not limited to: general anatomy, pathology, biochemistry, pharmacology, general medicine, surgery, pediatrics, behavioral sciences, and ethics. Unlike MD and DO medical schools, the Podiatric Medical School curriculum also provides intensive foot and ankle “specialty” specific education beginning in the first year. They have completed a post-graduate Podiatric Medicine and Surgery Residency. While current Podiatric Residency models range from two to three years, the majority of graduates complete three years of podiatric surgical training and some continue on to do fellowships. This training follows a four-year undergraduate college degree. The first year of podiatric medical school is somewhat similar to training that physicians receive, but with a limited scope on foot, ankle, and lower extremity problems. As a second entry degree, for admission an applicant must first complete a minimum of 90 semester hours at the university level and/or complete a bachelor's degree. A residency follows the four-year podiatric medical school, which is hands-on post-doctoral training. There are two standard residencies named Podiatric Medicine and Surgery. These represent the two- or three-year residency training. Podiatric residents rotate through all main areas of medicine such as emergency, pediatric, internal medicine, and general surgery and of course podiatry — both clinic and surgical. During these rotations, attending podiatrists train the resident physicians in medicine and surgery. Podiatric Foot and Ankle Surgeons certified have successfully completed an intense board certification process comparable to that undertaken by individual MD and DO specialties. Certification involves written, oral, and computer-based patient simulation questions, in addition to submission of surgical case logs. Prerequisites for board qualification in Foot and Reconstructive Rear foot /Ankle Surgery require successful completion of a three-year podiatric surgical program and passing a written examination. Board certification in Foot Surgery is a prerequisite for board certification in Reconstructive Rear foot / Ankle Surgery. A candidate must pass both the written, oral, and computer-based patient simulation questions in Foot Surgery as well as the written, oral, and computer-based patient simulation questions in Reconstructive Rear foot /Ankle Surgery. Certification requires submission of 65 cases for certification in Foot Surgery and an additional 30 cases for certification in Reconstructive Rear foot/Ankle Surgery, for 95 cases. Certification requires four years of post-degree clinical experience before taking the certification examination. Additionally, must re-certify every 10 years to maintain their board-certified status, although some members who were certified prior to 1991 undergo a "self-test" examination, essentially circumventing taking the written exam all others must take in order to become re-certified. In the United States, the previous titles used for the Doctor of Podiatric Medicine degree were Doctor of Surgical Chiropody (DSC) and Doctor of Podiatry. Podiatry in the U.S. currently encompasses a broader spectrum of practice than it used to. Podiatrists can now perform medical and surgical procedures in all 50 states, though the specific scope of practice varies slightly in each state. History The professional care of feet was in existence in ancient Egypt as evidenced by bas-relief carvings at the entrance to Ankmahor's tomb dating from about 2400 BC with the depiction of work on hands and feet. Hippocrates recognized the need to reduce hard skin, described as corns and calluses. He invented skin scrapers for this purpose and these were the original scalpels. Aulus Cornelius Celsus, a Roman scientist and philosopher, was probably responsible for giving corns their name. Later Paul of Aegina (AD 615-690) defined a corn as "a white circular body like the head of a nail, forming in all parts of the body, but more especially on the soles of the feet and the toes.” Until the turn of the 20th century, chiropodists—now known as podiatrists—were separate from organized medicine. They were independently licensed physicians who treated the feet, ankles, and related leg structures.