RE: Re: clinical guidelines for use of EKG

[Guest guest]

Okay then different guideline, same

answer: look at Griffith’s Clinical Consult 2006 (standard reference text). It says

the same thing, as does Epocrates, etc, etc.

Re: Re: EKG

machines

RE: EKG machine in office, why from practicemgt

standpoint.

My opinion:

1) Preop consultations often require.

2) Acute symptoms palpitations, etc, or otherwise

picked up on PE, such as

newly dx afib. HTN good to get idea for

those " borderline " cases or

presumed " white coat HTN, better to treat if

LVH. This really is the best

way to do things.

3) Cost payment per unit (Medicare rates) my area

is $29.95, but it IS paid.

Cost my self-interpretive Welsch-Allyn EKG was

about $3K. After 100, I'm in

the black except for supplies. Wish it was

as good for other things.

But, some people also do X-rays in office, rapid

strep tests. I don't do

those. With price and vaccine 10 packs, I

don't do well-care for kids under

5 anymore (sad!). Everyone needs t! o decide

for themselves.

And pulse oxes I bill to track but don't get paid

for them. I do

spirometry.

Everyone needs to look at their pt population, and

make their own

cost-effective decisions.

Dr Matt Levin

Pittsburgh (Western) PA

FP

Re:

EMRs

>> >

>> >

>> >

>>

> Chad:

>> >

>> >

>> >

>>

> I use eMDs after a hospital

startup. I bought eMDs instead of

>> hiring staff. 1.5 years later my

wife and I still do not have any staff,

>> but the EMR lets us practice the way we

want. We are paperless once old

>> paper charts are scanned into the system.

>> >

>> >

>> >

>>

> Use both and get prices up front.

>> >

>> >

>> >

>>

> Lots of others can speak for AC.

>> >

>> >

>> >

>>

>

>> >

>>

> I am opening my own FP

practice in January with hospital

>> backing. I

>>

> am looking at opening

paperless, but torn between low

>> overhead

>>

> (Amazing Charts) and

e-MD's. My lease payment on e-MD's

>> would factor

>>

> into my overhead and thus

take away from my bonus while I am

>> owned by

>>

> the hospital and, of

course, I would take over the lease pymt

>> if i buy

>>

> the practice, which I plan

to do. I'm 31 years old, moving

>> back to my

>>

> hometown, and opening

solo. Any input on AC vs. eMDs? Any

>> input on

>>

> if AC has a lab interface,

CCR capability, and document mgmt

>> yet? Any

>>

> input on starting a

practice in general and on opening with

>> an EMR?

>>

> Thanks,

>>

> Chad Jumper, MD

>>

> cmjumper@...

>> >

>> >

>> >

>> >

>> >

>> >

--------------------------------------------------------------------------

>> >

>>

> Yahoo! Music Unlimited - Access over 1

million songs. Try it

>> free.

>> >

>> >

>> >

>> >

----------------------------------------------------------------------------

--

>> > Yahoo!

FareChase - Search multiple travel sites in one click.

>> >

>> >

----------------------------------------------------------------------------

--

>> > YAHOO!

GROUPS LINKS

>> >

>> >

a.. Visit your group " " on the web.

>> >

>> >

b..

[Guest guest]

Okay then different guideline, same

answer: look at Griffith’s Clinical Consult 2006 (standard reference text). It says

the same thing, as does Epocrates, etc, etc.

Re: Re: EKG

machines

RE: EKG machine in office, why from practicemgt

standpoint.

My opinion:

1) Preop consultations often require.

2) Acute symptoms palpitations, etc, or otherwise

picked up on PE, such as

newly dx afib. HTN good to get idea for

those " borderline " cases or

presumed " white coat HTN, better to treat if

LVH. This really is the best

way to do things.

3) Cost payment per unit (Medicare rates) my area

is $29.95, but it IS paid.

Cost my self-interpretive Welsch-Allyn EKG was

about $3K. After 100, I'm in

the black except for supplies. Wish it was

as good for other things.

But, some people also do X-rays in office, rapid

strep tests. I don't do

those. With price and vaccine 10 packs, I

don't do well-care for kids under

5 anymore (sad!). Everyone needs t! o decide

for themselves.

And pulse oxes I bill to track but don't get paid

for them. I do

spirometry.

Everyone needs to look at their pt population, and

make their own

cost-effective decisions.

Dr Matt Levin

Pittsburgh (Western) PA

FP

Re:

EMRs

>> >

>> >

>> >

>>

> Chad:

>> >

>> >

>> >

>>

> I use eMDs after a hospital

startup. I bought eMDs instead of

>> hiring staff. 1.5 years later my

wife and I still do not have any staff,

>> but the EMR lets us practice the way we

want. We are paperless once old

>> paper charts are scanned into the system.

>> >

>> >

>> >

>>

> Use both and get prices up front.

>> >

>> >

>> >

>>

> Lots of others can speak for AC.

>> >

>> >

>> >

>>

>

>> >

>>

> I am opening my own FP

practice in January with hospital

>> backing. I

>>

> am looking at opening

paperless, but torn between low

>> overhead

>>

> (Amazing Charts) and

e-MD's. My lease payment on e-MD's

>> would factor

>>

> into my overhead and thus

take away from my bonus while I am

>> owned by

>>

> the hospital and, of

course, I would take over the lease pymt

>> if i buy

>>

> the practice, which I plan

to do. I'm 31 years old, moving

>> back to my

>>

> hometown, and opening

solo. Any input on AC vs. eMDs? Any

>> input on

>>

> if AC has a lab interface,

CCR capability, and document mgmt

>> yet? Any

>>

> input on starting a

practice in general and on opening with

>> an EMR?

>>

> Thanks,

>>

> Chad Jumper, MD

>>

> cmjumper@...

>> >

>> >

>> >

>> >

>> >

>> >

--------------------------------------------------------------------------

>> >

>>

> Yahoo! Music Unlimited - Access over 1

million songs. Try it

>> free.

>> >

>> >

>> >

>> >

----------------------------------------------------------------------------

--

>> > Yahoo!

FareChase - Search multiple travel sites in one click.

>> >

>> >

----------------------------------------------------------------------------

--

>> > YAHOO!

GROUPS LINKS

>> >

>> >

a.. Visit your group " " on the web.

>> >

>> >

b..

[Guest guest]

From Griffith’s 2006 5-minute

clinical consult:

hypertension, essential:

special tests-à”only if history,

physical, or lab indicates”-àIVP/renal aterioriogram, plasma ctecholamines/VMA, plasma rennin, aortogram, ECG

Re: Re: EKG

machines

RE: EKG machine in office, why from practicemgt

standpoint.

My opinion:

1) Preop consultations often require.

2) Acute symptoms palpitations, etc, or otherwise

picked up on PE, such as

newly dx afib. HTN good to get idea for

those " borderline " cases or

presumed " white coat HTN, better to treat if

LVH. This really is the best

way to do things.

3) Cost payment per unit (Medicare rates) my area

is $29.95, but it IS paid.

Cost my self-interpretive Welsch-Allyn EKG was

about $3K. After 100, I'm in

the black except for supplies. Wish it was

as good for other things.

But, some people also do X-rays in office, rapid

strep tests. I don't do

those. With price and vaccine 10 packs, I

don't do well-care for kids under

5 anymore (sad!). Everyone needs t! o decide

for themselves.

And pulse oxes I bill to track but don't get paid

for them. I do

spirometry.

Everyone needs to look at their pt population, and

make their own

cost-effective decisions.

Dr Matt Levin

Pittsburgh (Western) PA

FP

Re:

EMRs

>> >

>> >

>> >

>>

> Chad:

>> >

>> >

>> >

>>

> I use eMDs after a hospital

startup. I bought eMDs instead of

>> hiring staff. 1.5 years later my

wife and I still do not have any staff,

>> but the EMR lets us practice the way we

want. We are paperless once old

>> paper charts are scanned into the system.

>> >

>> >

>> >

>>

> Use both and get prices up front.

>> >

>> >

>> >

>>

> Lots of others can speak for AC.

>> >

>> >

>> >

>>

>

>> >

>>

> I am opening my own FP

practice in January with hospital

>> backing. I

>>

> am looking at opening

paperless, but torn between low

>> overhead

>>

> (Amazing Charts) and

e-MD's. My lease payment on e-MD's

>> would factor

>>

> into my overhead and thus

take away from my bonus while I am

>> owned by

>>

> the hospital and, of

course, I would take over the lease pymt

>> if i buy

>>

> the practice, which I plan

to do. I'm 31 years old, moving

>> back to my

>>

> hometown, and opening

solo. Any input on AC vs. eMDs? Any

>> input on

>>

> if AC has a lab interface,

CCR capability, and document mgmt

>> yet? Any

>>

> input on starting a

practice in general and on opening with

>> an EMR?

>>

> Thanks,

>>

> Chad Jumper, MD

>>

> cmjumper@...

>> >

>> >

>> >

>> >

>> >

>> >

--------------------------------------------------------------------------

>> >

>>

> Yahoo! Music Unlimited - Access over 1

million songs. Try it

>> free.

>> >

>> >

>> >

>> >

----------------------------------------------------------------------------

--

>> > Yahoo!

FareChase - Search multiple travel sites in one click.

>> >

>> >

----------------------------------------------------------------------------

--

>> > YAHOO!

GROUPS LINKS

>> >

>> >

a.. Visit your group " " on the web.

>> >

>> >

b..

[Guest guest]

From Griffith’s 2006 5-minute

clinical consult:

hypertension, essential:

special tests-à”only if history,

physical, or lab indicates”-àIVP/renal aterioriogram, plasma ctecholamines/VMA, plasma rennin, aortogram, ECG

Re: Re: EKG

machines

RE: EKG machine in office, why from practicemgt

standpoint.

My opinion:

1) Preop consultations often require.

2) Acute symptoms palpitations, etc, or otherwise

picked up on PE, such as

newly dx afib. HTN good to get idea for

those " borderline " cases or

presumed " white coat HTN, better to treat if

LVH. This really is the best

way to do things.

3) Cost payment per unit (Medicare rates) my area

is $29.95, but it IS paid.

Cost my self-interpretive Welsch-Allyn EKG was

about $3K. After 100, I'm in

the black except for supplies. Wish it was

as good for other things.

But, some people also do X-rays in office, rapid

strep tests. I don't do

those. With price and vaccine 10 packs, I

don't do well-care for kids under

5 anymore (sad!). Everyone needs t! o decide

for themselves.

And pulse oxes I bill to track but don't get paid

for them. I do

spirometry.

Everyone needs to look at their pt population, and

make their own

cost-effective decisions.

Dr Matt Levin

Pittsburgh (Western) PA

FP

Re:

EMRs

>> >

>> >

>> >

>>

> Chad:

>> >

>> >

>> >

>>

> I use eMDs after a hospital

startup. I bought eMDs instead of

>> hiring staff. 1.5 years later my

wife and I still do not have any staff,

>> but the EMR lets us practice the way we

want. We are paperless once old

>> paper charts are scanned into the system.

>> >

>> >

>> >

>>

> Use both and get prices up front.

>> >

>> >

>> >

>>

> Lots of others can speak for AC.

>> >

>> >

>> >

>>

>

>> >

>>

> I am opening my own FP

practice in January with hospital

>> backing. I

>>

> am looking at opening

paperless, but torn between low

>> overhead

>>

> (Amazing Charts) and

e-MD's. My lease payment on e-MD's

>> would factor

>>

> into my overhead and thus

take away from my bonus while I am

>> owned by

>>

> the hospital and, of

course, I would take over the lease pymt

>> if i buy

>>

> the practice, which I plan

to do. I'm 31 years old, moving

>> back to my

>>

> hometown, and opening

solo. Any input on AC vs. eMDs? Any

>> input on

>>

> if AC has a lab interface,

CCR capability, and document mgmt

>> yet? Any

>>

> input on starting a

practice in general and on opening with

>> an EMR?

>>

> Thanks,

>>

> Chad Jumper, MD

>>

> cmjumper@...

>> >

>> >

>> >

>> >

>> >

>> >

--------------------------------------------------------------------------

>> >

>>

> Yahoo! Music Unlimited - Access over 1

million songs. Try it

>> free.

>> >

>> >

>> >

>> >

----------------------------------------------------------------------------

--

>> > Yahoo!

FareChase - Search multiple travel sites in one click.

>> >

>> >

----------------------------------------------------------------------------

--

>> > YAHOO!

GROUPS LINKS

>> >

>> >

a.. Visit your group " " on the web.

>> >

>> >

b..

[Guest guest]

As Tim eluded to: fasting above 126 or random above 200. If a patient

is absolutely against going to the lab for a 2 hour gtt then there is

the unoffical IHOP test.

Give the patient a lab req. for a random blood glucose. Have them go to

IHOP (Denny's, or any other place that they can eat to there hearts

content). 2 hours after they are done, they can go get there blood

done. I suppose they could always come back to the office for a

fingerstick. I understand this is completely " unofficial " , but is a way

to look at there PP sugar, especially for those that are impaired

glucose tolerant. It is not something I do very often though.

rocky

--- Eads wrote:

> Anyone seen info on using HgA1c for diagnosing DM? It's not

> officially

> used per the recs I've seen, but I catch a lot of people with

> elevated A1cs

> and impaired fasting glucose (hard to get them to do multiple

> glucoses), and

> am in a quandary on when to start treating them.

>

> A. Eads, M.D.

> Pinnacle Family Medicine, PLLC

> phone fax

> P.O. Box 7275

> Woodland Park, CO 80863

>

> Re: Re: EKG machines

> >>

> >> RE: EKG machine in office, why from practicemgt standpoint.

> >>

> >> My opinion:

> >>

> >> 1) Preop consultations often require.

> >>

> >> 2) Acute symptoms palpitations, etc, or otherwise picked up on PE,

> >> such as newly dx afib. HTN good to get idea for those

> " borderline "

> >> cases or

> >> presumed " white coat HTN, better to treat if LVH. This really is

> the

> >> best way to do things.

> >>

> >> 3) Cost payment per unit (Medicare rates) my area is $29.95, but

> it IS

> >> paid.

> >>

> >> Cost my self-interpretive Welsch-Allyn EKG was about $3K. After

> 100,

> >> I'm in

> >>

> >> the black except for supplies. Wish it was as good for other

> things.

> >>

> >> But, some people also do X-rays in office, rapid strep tests. I

> don't

> >> do those. With price and vaccine 10 packs, I don't do well-care

> for

> >> kids under

> >>

> >> 5 anymore (sad!). Everyone needs t! o decide for themselves.

> >>

> >> And pulse oxes I bill to track but don't get paid for them. I do

> >> spirometry.

> >>

> >> Everyone needs to look at their pt population, and make their own

> >> cost-effective decisions.

> >>

> >> Dr Matt Levin

> >> Pittsburgh (Western) PA

> >> FP

> >>

> >> ----- Original Message -----

> >>

> >> To: < >

> >> Sent: Saturday, February 25, 2006 12:39 PM

>

=== message truncated ===

Rakesh Patel MD

Arizona Sun Family Medicine, P.C.

633 East Ray Road, #101

Gilbert, Arizona 85296

www.azsunfm.com

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