Premier Concierge Medical Blog

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04/28/09--06:08: Apr 28, Swine Flu (chan 3168398)

For general information about the Swine Flu, go to the patient information section of Up To Date. The latest news on the Swine Flu can be found at the CDC (Center for Disease Control) in Atlanta...


06/14/09--18:05: Jun 15, Personal Health Record (chan 3168398)

Developing and maintaining your own personal health record is an important way to keep track of your health care.


10/11/09--17:08: Oct 12, Concierge Medicine (chan 3168398)

The concept of concierge medicine and how it compares with traditional medical offices.


10/18/09--16:44: Oct 18, Breast Cancer Awareness (chan 3168398)

October is National Breast Cancer Awareness Month. Make sure you are up to date on your mammograms. If you would like to assess your potential risk for breast cancer, visit the UVA breast cancer risk assessment site. For general information about breast cancer, visit the National Breast Cancer Foundation site. While you're at it, this would be a good time to make sure you are up to date on all the things you can do to help prevent disease or find illnesses early - including vaccines, colonoscopy, cholesterol checks, etc. If you're not sure whether you have done all you can to protect your future health, make an appointment with your doctor right now. It's very important for you and for your family as well.


10/25/09--06:47: Oct 25, The Art of Patient Care (chan 3168398)

Feel free to visit another website authored by Dr. Warth. It was written primarily for health care professionals, but the philosophy of our approach to patient care is exemplified on those pages...


10/25/09--15:33: Oct 25, YOUR Comments (chan 3168398)

Here's where you can enter your own thoughts about this practice, this website, concierge medicine or health care in general.


10/25/09--16:57: Oct 25, Physicals (chan 3168398)

Premier complete physicals are very thorough and offer many benefits related to protecting your future health.


10/27/09--10:49: Oct 27, H1N1 (Swine) Flu Shots Are In!! (chan 3168398)

We just received our supply of H1N1 vaccinations and are giving them now in our office. If it's been 2 weeks since you have had your regular seasonal flu shot, then it's time to get your H1N1 shot. Come in between 9:30 -4:00 at our office to get yours. Call if you have any questions.


11/01/09--13:50: Nov 1, Wellness (chan 3168398)

Premier wellness requires four elements for fulfillment. Read this page to see how to achieve this goal.


11/07/09--04:16: Nov 7, H1N1 Shots (chan 3168398)

Unfortunately, our supply of H1N1 vaccinations has run out. We are hoping to get another shipment soon. Watch this page for more info.


11/07/09--14:40: Nov 7, Internal Medicine (chan 3168398)

A description and definition of internal medicine and what an internal medicine doctor does.


11/07/09--17:07: Nov 8, Medical Resources (chan 3168398)

For generic medical information, this page contains multiple references and medical resources that may be helpful to you.


11/08/09--13:20: Nov 8, Concierge Medicine - Just for the Wealthy? (chan 3168398)

Concierge medicine is becoming widespread, but who can afford it? Is it just for the wealthy?


11/10/09--17:59: Nov 11, Health Care Reform (chan 3168398)

Concerns about health care reform usually seem to fall into one of three categories: a) Can each of us keep our current physician?
The proponents of reform say yes and, indeed, there are no rules that say you can't keep your own physician. However, you may be forced to change physicians because if your employer decides to change plans because of the reform bill and if your physician is not in the network on the new plan, then you will have to change physicians. Of course, to be honest about it, this same thing could happen under the current system. b) Can we keep the same health insurance that we have now (for those of us who have it)?
Again, proponents say yes, but if your employer changes plans, you will have to change as well. Or, if your plan goes bankrupt because the public option undercuts their premiums, you will have to change. c) The third and most worrisome concern to me is whether "rationing" will become more of a restriction on patient care than it is now.
Rationing is definitely already here in the form of "cost containment" by almost all current forms of health insurance - private or public. In order to pay for health care reform, many people believe there will have to be further "cost containment" by denying coverage for various commonly used diagnostic and therapeutic tests or procedures when patients' symptoms or signs do not fall into a specific set of conditions. There may be no room for physician judgment in these situations. If the conditions are not met, as determined by clerks employed by either the government or the private companies, then the test or procedures obviously won't be covered. There will probably be the usual ability to appeal the decision. However, this is often such an onerous procedure full of time-consuming red tape that the average physician's office won't be able to cope with it. This is not a pretty picture. The upside is that more people will have access to some kind of care, but it probably won't be the kind of care that now exists - the kind that we are currently complaining about and the kind that will probably look pretty good 10 years from now. I am not saying that this is what will happen. The final combined House and Senate bill doesn't even exist yet. Furthermore, I don't want to be listed as someone who is using scare tactics to defeat health reform. In fact, I have often thought that we do need some type of health reform since the current system is getting progressively worse and seems unsustainable. I am concerned, however, that progressive "cost containment" will further deteriorate physician-patient autonomy with regard to what type of care will be available. Increasing restrictions precluding what a physician regards as best for his/her patient might be an unfortunate side effect of health care reform. I am hopeful that won't be the case.


02/17/10--10:20: Feb 17, Hold the Salt! (chan 3168398)

A recent article in the New England Journal of Medicine authored by Bibbins-Domingo, et al demonstrated that if all of us in the US would reduce our daily salt intake by 3 grams per day (normal consumption is 7-10 grams/d), we could significantly reduce the frequency of new cases of coronary heart disease, stroke and heart attack by tens of thousands per year for each. This would potentially reduce mortality rates by as much as 92,000 deaths per year. Even if we just reduced our intake by 1 gram per day, the improvements would be substantial, not to mention the significant reductions in medical costs that would occur. So if you're a "salt-oholic", think twice before you pick up that salt shaker! An ounce of prevention can make a huge difference in your future health. - GJW


02/26/10--10:57: Feb 26, Lung Cancer Risk (chan 3168398)

The best way to reduce risk of lung cancer for smokers is to quit smoking. Former smokers still have some risk depending on how long ago it was that they quit. A recent study funded by the National Cancer Institute suggests that former smokers may be able to reduce their risk by eating more leafy green vegetables or folate, or by taking multivitamins. This seems to help repair the DNA in lung cells and improves cellular function. -JAMA, Feb. 24, 2010, p.722


02/26/10--11:14: Feb 26, Exercise Reduces Anxiety (chan 3168398)

A study by Herring, et al, demonstrated that, in sedentary patients with chronic illness and anxiety, the anxiety symptoms are greatly improved by going through exercise training on a regular basis for 3 or more weeks. Ask your doctor if this might be helpful for you -Arch Internal Med/ Vol 170, No.4, Feb. 22, 2010


05/28/10--11:16: May 28, Quality Medical Services (chan 3168398)

What do we mean when we talk about high quality medical services? Is your primary care office providing the best available care for you and your family?


06/06/10--11:00: Jun 6, New Office! (chan 3168398)

We are excited to be moving into our new office on July 1, 2010 - located across the parking lot from where we are now! The address is 1860 Colonial Medical Court, Virginia Beach, VA 23454. The phone numbers should remain the same. We will have significantly more space and are hoping to initiate more exercise and nutritional training for our interested patients after we move. Ask any of our staff if you have any questions or suggestions. 416-6750


08/22/10--15:41: Aug 22, Our Newsletter - VBPM Connection (chan 3168398)

Keep up on the latest office news and health information with our email newsletter!


08/22/10--17:24: Aug 23, Moving again! (chan 3168398)

As many of you know, after an unavoidable delay, and 2 more moves, we are happy to be back in our new office at 1860 Colonial Medical Ct., hopefully permanently this time. Feel free to come by and take a tour!


Home Sweet Home!



09/01/10--14:51: Sep 1, Calcium and Vitamin D (chan 3168398)

Calcium metabolism and Vitamin D are very important for maintenance of strong bones and muscles. However, there has been some controversy recently about the safety of Calcium supplements. Here is an article from the Prescribers' Letter that may help explain this further...


09/01/10--15:06: Sep 1, Flu and Flu Shots (chan 3168398)

Flu shots are available now, although most doctors believe the best time to start giving them is in mid September through October and November. They can be given as late as Feb or March. The H1N1 will be incorporated into the main flu vaccine along with 2 other strains this year so there should not be a need for 2 separate shots. There are lots of myths that have floated around over the years about flu shots. Here is a document derived from the CDC that may help to dispel some of these myths...


09/03/10--13:20: Sep 3, Discount Referral Program! (chan 3168398)

Here's a good way for our current members to get a significant discount on next year's fee! After September 1, 2010 , and for the next 6 months, for every patient that you refer who actually joins the practice, we will give you $200 off your next year's fee!


09/13/10--10:05: Sep 13, Low Carbohydrate diet - Is It Healthy? (chan 3168398)

A recent study published in the Annals of Internal Medicine showed that those people who ate a low carbohydrate diet substituted with animal sources had a higher mortality rate than those who ate a low carbohydrate diet with vegetable sources. In other words, it depends on what you eat in place of the carbohydrates. If you eat mostly eggs, bacon, and red meat this is not good for you. If you substitute vegetables like green beans, broccoli and other vegetables in place of the carbs, you will fare better in the long run. However, the accompanying editorial indicated that more studies are needed, before we can close the case on this. Stay tuned.


09/14/10--16:56: Sep 14, Oral Osteoporosis Drugs May Increase Risk of Esophageal Cancer (chan 3168398)

A new article appeared in the British Medical Journal showing evidence that suggests that if you use drugs like Fosamax, Boniva or Actonel for a prolonged period of time, there may be an increased risk of esophageal cancer. The usual risk in the average population is around 1 out of a thousand. If you take one of these oral bisphosphonates for 5 years or more, the risk goes up to 2 out of a thousand. This is just one more thing to consider when deciding whether or how long to stay on one of these drugs. You have to weigh the risk of developing multiple bone fractures due to osteoporosis vs. the increased risk of esophageal cancer. If you're taking one of these medications, you may want to have your doctor help you decide whether or how long to continue.


09/14/10--17:48: Sep 15, ARB Medications May Increase Risk of Cancer (chan 3168398)

When it rains, it pours! Here's another study showing evidence suggesting that the widely used ARBs (Angiotensin Receptor Blockers) - specifically telmisartan, but may include others like losartan, valsartan, etc. may modestly increase the risk of cancer, particularly lung cancer. These drugs have been shown to be very beneficial in the treatment of heart disease, diabetes and hypertension. They actually reduce mortality in those conditions. So, if you are on one of these drugs, DON'T stop it immediately. It may be helping you more than harming you. The best thing to do is discuss it with your doctor and see if there may be an appropriate substitute for you, or if the benefit of continuing the drug is greater than the risk. To help put the risk in perspective, the overall risk of developing some type of cancer in a person's lifetime is around 41%. According to this study, taking an ARB over 4 years increases the risk by 1.2% - not that much, relatively speaking. In addition, the study did not show any increase in the number of cancer deaths.


09/19/10--15:59: Sep 19, How Can Diet Improve Your Blood Pressure? (chan 3168398)

People often ask what they can do to keep their blood pressure down without having to take medication. "Eat less salt" is the usual quick answer, but sometimes it's not always easy knowing how to go about doing this. This handout from the Prescriber's Letter may help - "How to Eat Less Salt". An even better diet however is the one called the DASH (Dietary Approaches to Stop Hypertension) diet. This includes salt reduction, but goes further to help reduce saturated fat and cholesterol and increase fiber. It not only lowers blood pressure but decreases risk of heart disease as well. Click the link below to learn more about it.


09/23/10--18:45: Sep 24, **New Restrictions on the Use of Avandia by the FDA (chan 3168398)

Due to the increased risk of heart problems, the FDA has restricted the use of Avandia (rosiglitazone) to those diabetic patients in whom no other treatment is effective or tolerated. The Europeans have banned its use altogether in those countries. If you are on Avandia, don't stop it right away, but you should contact your physician and see if any other treatment could be substituted effectively.


10/10/10--11:03: Oct 10, October Newsletter! (chan 3168398)

The October newsletter is now available for download. It's full of news and tips to help you stay healthy!


01/28/12--13:46: Jan 28, Pharmacy News (chan 3168398)

Many of our patients who use Express Scripts for their long-term medications have been dismayed by the recent loss of association between Express Scripts and Walgreens. What we are suggesting for those patients is that they should consider signing up with CVS CareMark. They should go ahead and establish an account now. Then when they need a medication renewed that previously was handled by Express Scripts, let us know, so that we can call it into CVS Caremark. This seems to be the easiest and smoothest way of making the transfer.