Allergic Reactions and Extrapyramidal Symptoms

Different symptoms, similar treatment.

Some of the most commonly-used and prescribed medications can also cause severe allergic reactions with similar treatments but very different appearances.

Allergic Reactions to Ibuprofen, Naproxen or other NSAIDs

Ibuprofen, naproxen and NSAIDs are all used to reduce inflammation and relieve mild to moderate pain. They are all used to treat and relieve symptoms associated with a variety of ailments including dental pain, muscle aches and strains, arthritis and fever. These medications are produced under a variety of generic and brand names, which can make it difficult for patients with allergies looking to avoid them.

In rare cases, these medications can cause severe allergic reactions almost immediately after consumption. What do the symptoms include?

  • Swelling of the face, lips or tongue
  • Trouble swallowing
  • Accelerated heart rate
  • Tightness or pain in the chest
  • Shortness of breath

Another dangerous reaction to these painkillers and anti-inflammatories can include extrapyramidal symptoms (EPS). These symptoms are much more subtle and can be very frightening for patients experiencing them. They can include:

  • Uncontrolled muscle spasms and contractions in the head, neck, torso and limbs
  • Restless energy
  • Tremors
  • Stiff posture
  • Uncontrolled facial movements including blinking or chewing
  • Irregular breathing

How Can These Reactions Be Treated?

Treating these frightening reactions can be done in a few different ways. Of course, once a reaction has been recorded, it’s important for patients to avoid using these medications again until their doctor has time to order testing and make recommendations. If the patient is experiencing extrapyramidal symptoms, drug interactions and tapering will often be considered before stopping the drug entirely. In other cases, diphenhydramine and diazepam can be used to calm extrapyramidal symptoms.

Prepare for Allergic Reactions and Improve Patient Safety with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

The Reemergence of Psychedelics

Recently, there has been renewed interest in psychedelics for treating depression and mental illness. While these were established treatments for mental illness in the mid-1950s, they’ve come a long way since then.

What Happened to Their Medical Use?

While psychedelic drugs were once hailed as the perfect solution for treating a wide range of otherwise-difficult-to-treat disorders, they have not been used to treat anything for quite some time. Research into psychedelic drugs stopped almost entirely in the 1970s due to the backlash against their recreational use. They were labeled as “drugs of abuse” by the federal government, and any medical value was dismissed.

Today’s Psychedelics

Today, research is finally restarting into the medical use of LSD, psilocybin (the compound in magic mushrooms), MDMA and ayahuasca. If these drugs can pass rigorous rounds of scientific testing, they may become the new standard in mental health treatment. So far, researchers have found that controlled administration of psychedelic drugs can foster an extreme flood of positive emotion and major behavioral changes.

The Potential Impact of Psychedelics

Studies of psychedelics have found that:

  • Psilocybin has relieved severe anxiety and treated substance abuse disorders
  • MDMA has assisted many people coping with PTSD
  • These drugs have been effective in patients with eating disorders, OCD, major depression and adults trying to stop smoking

While there is still a long way to go before psychedelics are readily available as common prescriptions for periods of depression and anxiety, if research continues as it has we may see them available in prescription bottles soon. 

Improve the Health and Safety of Your Patients with Vetters Enterprises

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

The Exciting Prospects of Pharmacogenomics

One of the newest and most promising developments in genetic testing could also help counteract the opioid epidemic. Pharmacogenomics is the practice of gene testing to determine how a patient’s body will react to specific medications. Pharmacogenomics is now covered by most insurances.

 

Genetics Affect More Than Previously Thought

Every person has thousands of genes that dictate their characteristics, from the color of their eyes to their blood type. As scientific research continues to advance, it is becoming apparent that genetics affect far more than was previously thought. Pharmacogenomics examines a patient’s genes for variations that may show whether or not a medication could be an effective treatment. Aside from helping to determine the efficacy of a drug treatment, this can also help to identify potential allergies before they occur.

The Basics of Pharmacogenomics Testing

The core purpose of pharmacogenomics testing is to determine whether or not a medication is appropriate for a patient. A patient will have a blood or saliva sample taken, and various tests will be performed to determine:

  • If a medication could be an effective treatment for the patient’s condition
  • What the ideal medication dosage should be
  • Whether or not an allergic reaction is likely to occur

Why Pharmacogenomics

Aside from the obvious benefits of the above, pharmacogenomics serves a variety of medical purposes. The study hopes to lead to drugs that are more customized to proteins, enzymes and RNA within each patient’s DNA. These high-powered medicines will do less damage and work more efficiently thanks to their customization.

The dosages for current medications will also become more accurate as height, weight and age will not be the only parameters. Instead, genetics will help customize the medication’s dosage, lower the chances of an overdose and help to reduce the likelihood of drug abuse.

Countless Patients Can Benefit

Depression is an incredibly common condition, and finding the right medication and dosage for patients is notoriously tricky. Pharmacogenomics could greatly assist with finding ideal psychiatric medications for struggling patients without the need for constant adjustments. With over 1 in 20 Americans suffering from depression, many people could stand to benefit.

Increase the Efficacy of Your Practice with Vetters Enterprises

Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Alternatives to Narcotics for Pain

The opioid crisis is affecting every state and every practice across the country. Every day, over 90 Americans die from opioid overdoses. This national crisis is growing in severity by the second, as prescription pain killers, heroin and synthetic opioids grow in popularity and availability. The need for non-narcotic pain killers is becoming more apparent.

The Dangers of Prescription Drugs

Prescription opioids like Vicodin, Percocet and Oxycontin are the leading cause of drug overdoses in the United States, as they account for a whopping 44% of overdose deaths. These drugs were designed to be slowly released in the stomach for extended pain relief, but abusers crush the pills for an immediate and intense high. Even attempts to reduce the crush-ability of Oxycontin by manufacturers did nothing to curtail drug use.

Difficult to Abuse

One of the current priorities of drug companies is creating prescription pain killers that are effective at pain relief, but more difficult to abuse. There are many different ways to treat pain that are harder to abuse. Topical medications are growing in popularity for arm, knee and hand strains. These creams can be applied direction to the skin and have been shown to provide the same level of effective relief without the extreme possibility of abuse.

Compounding pharmacies can custom-produce topical pain killing medications to meet the needs of your patients. These medications are harder to abuse, due to their form, and can provide a great deal of relief for patients with arthritis, who are recovering from surgery and who are recovering from an injury.

In addition to topical medications, you can encourage your patients to explore other pain relief alternatives including:

  • Physical therapy for the treatment of post-surgery pain or chronic pain
  • Acupuncture, particularly for managing chronic pain
  • Regular low-impact exercise like yoga or walking

Increase the Efficacy of Your Practice with Vetters Enterprises

Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Nosocomial Infections and Your Practice

Nosocomial infections are also known as healthcare-associated infections (HAIs) or hospital-acquired infections. These infections can range in severity from minor hiccups in treatment to causes of death. Protecting patients and family members from contracting these infections is an essential part of properly managing your practice.

Where Do Nosocomial Infections Occur?

The most common place where nosocomial infections are contracted is the intensive care unit or ICU. Approximately 10% of all hospital patients, at some point during their stay, will contract one of these infections. Technically, nosocomial infections must occur within 48 hours of hospital admission, 72 hours after discharge, 30 days post-operation or inside of a healthcare facility.

The most common types of nosocomial infections include urinary tract infections, surgical site infections, gastroenteritis, meningitis and pneumonia.

What Causes Nosocomial Infections?

These dangerous infections can be caused by the usual culprits—bacteria, fungus and viruses. 90% of nosocomial infections are caused by bacteria. Since many people in healthcare facilities have temporarily or permanently compromised immune systems, they are also at an elevated risk of contracting something.

Bacteria, fungi and viruses all spread through person-to-person contact in the form of unwashed hands and improperly cleaned medical instruments like catheters. If a healthcare facility excessively uses antibiotics, antibiotic-resistant bacteria can evolve rapidly and cause greater numbers of nosocomial infections.

How Can You Prevent Nosocomial Infections?

Your practice can prevent nosocomial infections in a wide variety of ways, including:

  • Education, which is your most powerful weapon against them. Make sure patients and their families understand why certain sanitation measures are in place and the risks of not following them.
  • Identify patients in need of isolation as quickly as possible.
  • Always observe proper hand hygiene and regularly brief employees on what that consists of.
  • Provide your healthcare employees with the appropriate tools for the job including proper face protection, gloves and gowns.
  • Ensure that rooms in your facility have proper ventilation.

Improve the Health and Safety of Your Patients with Vetters Enterprises

Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Cerebral Palsy Patients Can Benefit from Botox Therapy

One of the most common off-label uses for Botox is continuing to gain popularity and helping countless cerebral palsy patients. Botox can be used to help combat spasticity, or the muscle stiffness associated with the condition. Muscles that are spastic make it difficult to move and perform basic tasks. While there are conventional oral medications, Botox can treat spastic muscles at the exact site.

What Is Botox?

Botox is a material created by bacteria. It can be used safely and effectively to treat spastic muscles in patients with cerebral palsy. Botox treats the muscles by blocking the signal between the nerves and the muscles that tighten or contract. As a result, it can give patients major relief from muscle spasms and discomfort.

How Can Botox Help Patients with Cerebral Palsy?

Botox can provide cerebral palsy patients with:

  • A radically improved gait
  • Increased range of motion
  • A decrease in pain in spastic muscles
  • Reduction in spasticity
  • Less discomfort when stretching
  • Increased comfort in braces

How Long Does Botox Help?

Most cerebral palsy patients experience relief from spasticity within 5 days, with maximum relief occurring around 3 weeks after the injections. Patients will typically experience symptom relief for up to 3 months after the injections, and the symptoms and spastic muscles will gradually return until they have another injection. As with any medication or treatment, make sure that parents fully understand the potential benefits and risks to their child. Since Botox is created from the bacteria that causes food poisoning, there are risks involved with treatment.

Reach Your Patients More Effectively with Help from Vetters Enterprises

Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Entitlements and Insurance

Entitlements and insurance are two of the most common partial payment methods practices encounter on a daily basis. Each entitlement and insurance policy grants the holder different benefits, so it is critical to understand the differences between the two.

Entitlements 101

Entitlements guarantee access to a certain range of benefits by either established rights or by federal or state legislation. Entitlement benefit programs are not just restricted to healthcare, and include Social Security Disability Insurance, Social Security Retirement Income and Medicare. Some of the common entitlements you will encounter at your private practice include Medicaid, Medicare, TRICARE and CHAMPVA. 

Every practice chooses to see patients with certain types of insurance or certain entitlements. Since each entitlement has different requirements, they each offer a certain amount of reimbursement to your practice. On average, Medicaid only pays 60% of what Medicare pays. Medicare already only pays a portion of the “retail” value of your services, so if your patient sees a large number of patients with entitlements, you will also need to see patients who pay in full to offset the cost.

Entitlements vs. Insurance

Unlike insurance, entitlements are either promised or needs-based. Medicare is a federally guaranteed health insurance offering for adults who are 65 years or older or disabled. Anyone receiving Social Security Disability Insurance payments will be able to use Medicare after 24 months of benefits. Medicaid, on the other hand, is needs-based. Medicaid is a state program that also receives federal funding. It is used to provide healthcare for low-income people.

Insurance, on the other hand, can be purchased by individuals through a variety of sources, whether it is their employer or the ACA exchange. Most private practices choose to accept at least one or two types of insurance, but not all of them choose to accept Medicare and Medicaid.

Reach Your Patients More Effectively with Help from Vetters Enterprises

Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Fitness Boxing for Physical Therapy Patients

The right low impact, high intensity workout can completely transform the lives of physical therapy patients. One local class, Rock Steady Boxing, is hoping to do just that.

Rock Steady Boxing: Charm City

Rock Steady Boxing uses a compelling combination of fitness and physical therapy to treat a wide range of clients with movement disorders. Physical therapy clients respond differently when focusing on the traditional elements of boxing—rotational movement patterns, speed, endurance, accuracy, hand-eye coordination, agility and footwork. The Charm City chapter of Rock Steady Boxing was founded by Patty Wessels to help treat those with Parkinson’s Disease.

In addition to their classes specifically for those with movement disorders, Rock Steady Boxing Charm City is also adding fitness boxing classes to their line-up. Boxing is an awesome form of aerobic exercise that can be both low impact and high intensity. This allows you to receive a phenomenal workout without putting excess strain on your joints.

High Impact vs. Low Impact

High impact exercises are those where your body is making continuous contact with the ground, like running, jogging, jumping or other active workouts. Low impact exercises are those where at least one foot stays in on the ground, like walking, riding a bike or boxing. High impact exercises typically put an increased amount of stress on your joints including your knees, hips, back or ankles. As a result, low impact exercise is the best option for those dealing with movement disorders.

High Intensity vs. Low Intensity

Intensity, in the world of exercise, is used to refer to how hard you are working. Intensity also refers to how intense your concentration is and how high your heart rate can climb. Boxing is definitely a high intensity workout, which is part of why it is so effective for patients with Parkinson’s Disease. Your body will experience a great workout without doing excess harm to your joints. Other low impact and high intensity workouts include dancing, power walking and swimming.

Get Local with Rock Steady Boxing Charm City

Through her a passion for movement and dedication to the Baltimore community, Head Coach, Patty Wessels developed a plan to open a boxing gym for individuals with Parkinson’s Disease, in cooperation with Mind Body Physical Therapy. There is now a gym that functions solely as a boxing space at the Mind Body office, located at Coppermine Fieldhouse. Patty couldn’t be more thrilled to bring Rock Steady Boxing to Charm City!

Reach Your Patients More Effectively with Help from Vetters Enterprises

Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

The Importance of Verifying Patient Eligibility

When does your practice verify patient eligibility, co-pays and deductibles? If your answer is anything other than “in advance,” you are wasting valuable time and money. Why is verifying patient eligibility in advance such a necessity for today’s practice?

The Patient Verification Process

When a patient visits, your office needs to know what their insurance company requires for co-pays and deductibles in addition to the patient’s eligibility for services. This can be done by using the patient’s insurance card to verify information with the carrier. While primary care doctors typically only worry about whether or not the insurance is valid and what the patient’s financial responsibility is, specialists are often under different sets of rules. Waiting to verify a referral or specialist eligibility until a patient shows up for their appointment is never a good idea.

In addition to the above, your practice also needs to know whether you are considered in network or out of network. Are you seeing Medicare patients? Understanding the benefits that your patient has is critical, because many patients confuse Medicare Managed Care Plans with other Medicare offerings.

Checking in Advance is Critical

If you aren’t already convinced after reading the above, consider how much time it takes you to verify that information for each patient. Some insurance companies have excellent customer service, while others take at least 30 minutes to reach on the phone. If a patient comes in without a referral, your receptionist will spend valuable time trying to track down the referral instead of assisting other patients.

Verifying New Patients

Every time a new patient calls to schedule an appointment, take the time to discuss their insurance coverage with them and forward any necessary paperwork. Investing a small amount of time before the initial appointment can save money and time the day of. To determine a patient’s insurance eligibility, you should always collect the following:

  • Name and date of birth
  • Name of the primary insured
  • Social security number of the primary insured
  • Carrier
  • ID number and group number
  • Contact information for the insurance company (should be listed on the insurance card)

Next, take the time to call the insurance company and confirm:

  • That the patient is currently covered by the insurance
  • The coverage effective dates
  • Whether your practice is in network or out of network
  • If the services that the patient will be receiving are covered
  • If a referral or pre-authorization is needed

Verifying Current Patients

Every time you see a current patient, verify that nothing has changed with their insurance since their last visit. Again, a little bit of time invested before they come to your office will ensure prompt payment and correct eligibility.

Bring Your Verification Into the Modern World

For a faster way of verifying patient eligibility, use a web-based system like IntakeQ. Your practice can load intake forms directly to a secure website and get notified every time a patient completes them. This allows you to verify eligibility in advance and without the hassle.

Vetters Practice Management Consulting

Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Obtaining Approval for Home Visits

While doctors aren’t known for making house calls anymore, there are major advantages to making home visits for primary care. If you are considering making the move from in-office care to home care, the transition might be easier than you think.  

Why is Home Care Needed?

Home health care is still in demand today, despite the model of a doctor visiting the homes of well patients for check-ups and annual physicals seeming antiquated. There is a huge demand for home health care today because:

  • Many adults avoid seeking medical treatment for themselves because they work during traditional doctor’s office hours and cannot take leave for a wellness visit.
  • Some areas of the country don’t have many doctor’s offices, so patients can live in areas without access to regular primary care doctors outside of emergency rooms and urgent care clinics

Getting Started with Home Visits

Insurance companies offer a small degree of flexibility when it comes to primary care doctors visiting patients in their home, but you need to fill out all of the proper paperwork. It is relatively easy to be approved for home healthcare when working with homebound or recovering patients.

Medicare Part A and Medicare Part B will cover in-home healthcare that falls under intermittent skilled nursing care, physical therapy, speech-language pathology services or continued occupational services. The most important variable when justifying home health visits to insurance companies and Medicare is the inability of the patient to access regular medical practices. Apply for approval by contacting individual insurance agencies. Always explain to patients that approval for home healthcare services can depend on whether or not the need can be justified.

Vetters Practice Management Consulting

Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.