How many of us can honestly say we have an advanced directive for health care completed for our loved one as early as their 65th birthday? I think a very few of us would nod our head yes. This includes me - well, I tried, but my dad is stubborn and this is a tough conversation to even bring up. So, I am in the same boat as the majority who struggle to have these conversations.
Advanced Directive is defined as legal documents a person completes while still in possession of decision capacity about how treatment decisions should be made on her or his behalf in the event she or he loses the capacity to make such decisions.
Advanced directives can be revoked orally by the patient at any time so long as they maintain decision making capacity.
The most difficult question for patients and families is "which medical treatment is right for me?"
The answer to this question will vary upon personal reflection of his/her own values and preferences. Clinicians play the role of guiding patients and families in reflecting on these questions. Thus, it truly is a team approach and should be approached in a systematic way. The easiest and most efficient way to go about doing this is to create a advance care planning process. What the heck is that?
Advance Care Planning process (ACP) is an ongoing process where patients, families, and their healthcare providers reflect on the patients goals, values, and beliefs, discuss how they should inform current and future medical care and ultimately use this information to accurately document their future health care choices. In the most ideal situation, this is all done after exploring the patients and caregiver's knowledge, fears, hopes, and needs.
When do we start this process? Anytime! Sooner the better. Several experts have advised the following:
Point here is - TALK ABOUT IT AS SOON AS YOU CAN AND IT IS AN ONGOING PROCESS. Death is natural and inevitable. We must become comfortable talking about it and sharing our thoughts with one another.
What are the benefits of establishing a ACP? Randomized and prospective studies have shown the following:
So, can Dr. Ahmed help me with this and what benefit does LiveActive Primary Care offer me?
We all perceive life through a different lens. We are all human beings with our own personal limitations. Life has a definite start and stop time that never pauses in between for neither you or me. So if we all agree that our time is limited, does it not make sense to make the most of our time and enjoy each day? Why not live life to the fullest and a quality of life that is defined only by you alone?
So, why not partner with a physician who is doing whatever they can to preserve that patient-physician relationship so that they can better understand you and be your partner in living a healthy, high quality, fulfilling, and most importantly... FUN life?
Hope you found this post full of reflection and useful. Contact me if you want resources to this post or have any questions. Join our practice now! Our clinic will complete construction by early 2015 we hope.
Take care and happy holidays to all! Enjoy your time with family and friends. Please remember to give your loved ones a nice big hug and remind those whom you love how much you love them at least once a day.
So, the past several months I have been losing sleep, working long hours, and traveling all across the state of Kansas. All this in hopes of creating one of the best best practices for my clients. I want people to come to my practice and simply enjoy their visit with their doctor. I hope to get rid of the old "Oh, no! I have to go to the doctor again!"
Instead, I hope to stimulate a "YES! Let's go see Dr. Ahmed!" type of response. I thought I would share something that I found interesting in my practice set up so far - medications and laboratory do not have to be so expensive!
Those of you who may know me, this dream all started from my frustration with the reality that most folks cannot afford their medications or their medical care, especially with the recent economic recession. The face of poverty and uninsured has changed over the years. I bet none of us can look around and predict who has or does not have insurance or means to afford health care.
As I struggled to get the support and resources to establish a foundation, I came across this new model of delivering primary care. I started to discuss this with other physicians, got on the phone and reached out to physicians in California, Kansas, North Carolina, etc.
It became clear to me that many physicians were in my shoes! I was not alone! This fueled me. I still was not certain if I wanted to take the plunge. I was out at lunch with an attorney and a broker. The theme of the lunch was "what the heck should Dr. Ahmed do with his life!"
On one hand I love taking care of patients and on the other, I was being broken by the unnecessary red tape, protocols, and the difficulty in providing resources for my patients to follow through with our treatment plan because of financial barriers.
That is when my delicious chicken sandwich became even more delicious! The broker yelled, "heck, why don't you just start your own practice! Why do anything else? You seem to be looking for ways to allow you to practice the way you want to practice."
Those words changed my life. I am thankful for him. I am thankful for my attorney friend who later said, "I really was hoping you would start your own practice" after I made the decision to start my own practice.
Life is really interesting. As I learn more ways to provide services for my future clients FREE of charge or at a cheap price, I am meeting people who constantly say, "This is a bargain!"
I hope you will join my practice and enjoy the hard work we put in and will continue to put into providing you quality health care at low to NO cost to you!
AtlasMD is a practice in Wichita, Kansas who is guiding us all along! Check out their saving that will be very similar to our savings come 2015!
Did you know that the practice of internal medicine can be traced back to ancient India and China? In fact, the term Internal Medicine originates from the German term Innere Medizin. This term was popular in the 19th century and was brought to the United States from American physicians who trained in Germany in the early 20th century. The term Innere Medizin was used to describe physicians who combined the science of laboratory to patient care.
Internal Medicine physicians specialize in adult and geriatric medicine. So what defines "adult?" Well, nowadays that can be as young as 14 years old as kids are reaching adult weight of 50-70kg. In the past when I was in training we used to say anyone older than 16 or 18 years old. But, given the size of the average American, this definition has changed. I am comfortable seeing anyone who is "adult" weight. Therefore, I picked 14 years old as my starting age. You can twist my arm to see 13 year old folks...
The American College of Physicians defines Internal Medicine as the following:
"Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness."
So our favorite question is "why?" This used to drive my parents crazy when I was young. I was that annoying little one that always popped his head up and asked "why?"
It is a lot of detective work and we love looking at data and forming hypotheses. We do not zone in on one diagnosis, but have a list of possibilities and eliminate each one as more clinical information becomes available. I feel like this is being lost in today's "hamster wheel" medicine where everyone is rushed and the average exam time is 7 minutes.
We treat ear infections, eye infections, headaches, post stroke care, post heart attack, high cholesterol, diabetes, adrenal issues, thyroid issues, copd, asthma, pneumonia, skin infections, depression, anxiety, any mental disorder, arthritis, urinary tract infection, prostate issues, trouble urinating, impotence, diarrhea, constipation, any gasterointestinal diseases, arrythmia, heart failure....I think you get the idea.
If the illness is beyond the scope of internal medicine or a special procedure is needed, a referral is made to a specialist.
We are skilled in suturing, skin biopsy, skin tag removal, cautery, joint injections, some do botox injections and liposuction, and various other small office procedures.
In addition, the major skill is prevention and early recognition of disease or pathology. So, coaching clients through current guidelines for screening for breast cancer, colon cancer, heart disease, high cholesterol, and much more is critical in the care of our community.
This is what excites me about my new practice! As a hospital physician I treated post stroke care, acute heart attacks, head bleeds, severe infections with multi-organ failure and all that was gratifying. But, there were some cases where I would sit with my head in the palms of my hands thinking, "if only she had an internist or the internist had more time in taking care of her, or her medications would be affordable...if only..."
I'll be honest, I did cry at times for my patients because many times it is not their fault. The system has failed them and they suffered such a catastrophic event that will only cost the system and more importantly the individual significant dollars.
Thus, prevention, wellness, and being a coach is as, if not more important, than treating an acute illness. So when people ask, "why do I need an internist?" I usually tell them, "well you can get one when you get terribly sick in the hospital with a large bill or you can get one now and prevent a catastrophic event if possible." More importantly, life is about building relationships. The sooner you find an internist you like and can partner with, the better you will feel and likely live healthier. Statistics show that people do better with a good support system regardless of what the issues they are dealing with - medications are not always the answer.
Sometimes people just need to talk. In my model, I will have time to listen. Maybe the anxiety or panic attacks you are experiencing is because of an acute issue you are dealing with. Does it make sense to prescribe an anti-anxiety medication in 7 minutes of hearing your story or does it make more sense to listen and see if we can work out a solution together and only prescribe if needed? I argue that these quick visits are leading to unnecessary prescribing, imaging, and laboratory - this all drives rising costs for everyone.
I have passion for science and am amazed at our progress. But I also understand that there are things in this world that we still do not understand. Sure, not everything is in our control. But, I believe with the knowledge and technology that we have today, prevention of disease and the management of disease is not only our responsibility but it will allow us to take care of each other. As I tell all care-takers, you have to take care of yourself before you take care of others. We have to be there for each other and more importantly be healthy when we stand together; or else we both fall.
Living healthy does not have to cost so much nor should it be a burden.
So, join my practice and let's do this together! Let's live life to it's fullest and I will be honored if I can be your internist in this journey we like to call life!
"He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all."