Physician Solutions May 2016

PHYSICIAN SOLUTIONS magazine

May 2016

What Health Issues or Conditions Affect Women Differently Than Men? pg. 26

How to Engage With an Empowered Generation of Female Patients pg. 22

the

Women’s Health issue

Deaths From Prescription Painkiller Overdoses Rise Sharply Among Women pg. 28

contents features

22 HOW TO ENGAGE WITH AN EMPOWERED GENERATION OF FEMALE PATIENTS 26 WHAT HEALTH ISSUES OR CONDITIONS AFFECT WOMEN DIFFERENTLY THAN MEN?

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28 DEATHS FROM PRESCRIPTION PAINKILLER OVERDOSES RISE SHARPLY AMONG WOMEN 30 THE STORY OF MAYA: An Accredited Social Health Activist from India 6 SIGNS YOU NEED TO REDESIGN YOUR WEBSITE

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THE STORY OF MAYA: An Accredited Social Health Activist from India

practice tips 6

6 SIGNS YOU NEED TO REDESIGN YOUR WEBSITE

10 SUCCESSFUL OPERATIONAL PLANNING 12 HOW TO MANAGE YOUR ONLINE REPUTATION…And Why You Should!

14 RECENT TELEMEDICINE SURVEYS MAKE FOR INTERESTING READING

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Physician Solutions May 2016 Publisher Creative Director Contributors

Philip Driver Thomas Hibbard Naren Arulrajah Barbara Hales, M.D. Nick Hernandez, MBA, FACHE Amanda Kanaan Dr. Anuradha Katyal René Y. Quashie Vikas Vij

contributors Naren Arulrajah is President and CEO of Ekwa Marketing, a complete Internet marketing company which focuses on SEO, social media, marketing education and the online reputations of Dentists and Physicians. If you have questions about marketing your practice online, call Naren direct at 877-249-9666.

Barbara Hales, M.D. is a skilled expert in promoting your health services. As seen on NBC, CBS,ABC and FOX network affiliates as well as Newsweek, Dr. Hales writes all the content you need to promote your medical services.

Her latest book is on the best seller list and she can do the same for you. Check out her site at www.

TheWriteTreatment.com

Nick Hernandez, MBA, FACHE

Physician Solutions is a national monthly magazine committed to providing insights about the health care profession focusing on practical advice for physicians and practices.

We are currently accepting articles to be considered for publication.

For more information on writing for Physician Solutions, please email us at physiciansolutions@gmail.com.

P.O. Box 99488 Raleigh, NC 27624 medmedia9@gmail.com Online 24/7 at medmonthly.com

is the CEO and founder of ABISA, a consultancy specializing in solo and small group practice management. He has consulted with clients in multiple countries and has over 20 years of leadership and operations experience. Visit www.abisallc.com for more information.

Amanda Kanaan is the owner/founder of WhiteCoat Designs – an online marketing agency committed to growing doctors’ practices through cost-effective and powerful online marketing solutions. Amanda regularly speaks at medical association meetings and conventions and is a published expert in the field of medical marketing. To learn more or for a free website evaluation, contact her at Amanda@whitecoat-designs.com or http:// www.whitecoat-designs.com.

Dr. Anuradha Katyal is a Research Consultant with ACCESS Health International, ISB, Hyderabad, India. She is a dentist and an MSc in Healthcare Management from University of Surrey.

UK. She practiced for two years and now works in the social sector with an inclination towards health financing. She can be contacted at anuradha.katyal64@gmail.com.

PHYSICIAN SOLUTIONS MAGAZINE | 5

practice tips

6 Signs You Need to Redesign Your Website

By Amanda Kanaan President of WhiteCoat Designs

When it comes to new medical technology, physicians are usually the first in line to adopt the latest and greatest. Ironically, those same physicians don’t always take a similar approach when it comes to technology to market their practices. You can offer patients the most state-of-the-art treatments available, but if your website looks like a throwback to the late 90’s then you can’t expect to attract new patients online.

Your website has seven seconds to make an impression – for good or for bad. Patients are online shopping for doctors in the same way they buy anything 22|| MAY DECEMBER 6 2016 2013

on the internet these days. They are researching their options and making snap judgments based on what they see and read. Your website’s job is to first be easily found and then second, strategically lay out all the information patients need to make the decision to choose your practice. You only have one shot at this so ask yourself, “Can my website attract a patient’s attention in seven seconds?”

If you are unsure of the answer to that, here are six signs that it’s time to redesign your website:

1. It’s not mobile friendly

If you pull your website up on your phone and you need a magnifying glass to read it, then your website is most likely not mobile friendly. Having a mobile friendly site is important for two reasons: 1.) Over half of patients online looking for health information are searching on their smartphone, and 2.) Google now gives ranking priority to those sites that are mobile friendly.

If you want to verify whether your site is mobile friendly or not, search online for “google mobile test” and the first result should be a link that takes you to an online tool where you can instantly check your site.

When discussing the idea of making your website mobile friendly with your web agency, consider going one step further and making the site “responsive”. This is a programming technique that allows the site to adapt to any device (desktop, tablet, phone). Responsive design is truly the industry standard these days.

2. The design is outdated or unprofessional

If your website looks like it was designed at the rise of the internet or like your neighbor’s son designed it for a school project, then it’s time to pursue a redesign. From the design techniques, to the colors, to the layout, it all matters when trying to make an impactful first impression on patients.

This is why those do-it-yourself web builder programs are often insufficient, because you can’t truly customize the site to your needs.

Also, don’t forget to update your pictures in the process. Let’s face it, it’s a bit jarring for patients when you feature a picture of your 35 year old self on the website but then walk in the exam room with gray hair and bifocals.

3. It’s difficult to navigate

If patients have trouble finding the information they need on your site, then you either need to consider changing the layout of your site or increasing the amount of content. A good place to start with assessing this issue is to ask your office staff what types of calls they get over and over. If patients are constantly asking how to access their portal, where to download their patient paperwork online, or if you offer evening hours, then you aren’t serving your patients well online. You

are also making your office staff inefficient by answering unnecessary calls.

This concept can be applied to your services as well. It’s important your website prominently feature services that patients are most interested in, but also services that you would like to make patients aware of. Don’t assume your patients know all your practice has to offer. It’s your job to effectively upsell them to other services your practice offers. Remember, it’s much less expensive to upsell a current patient than to attain a new one.

4. It doesn’t represent your brand well

Your website isn’t representing your brand well if, for example, you are a pediatrics office with bright fun colors in your office and a warm, friendly staff, yet your website is colorless, generic and features very few pictures. The look and feel of your website should match the experience you want patients to have when they walk in your doors.

It’s also important that your branding be consistent; from your logo to your business cards, your brochures and even your website, the branding should be identical in order to make it memorable for patients.

Don’t forget that part of your brand is the services you offer. Your website is an opportunity to promote this to patients. If you’re one of only a handful of robotic surgeons in your area but this is hidden down in the text somewhere then patients likely aren’t getting the message.

5. It’s not an effective marketing tool

If, for the most part, the only people who visit your website are your friends and family then you’re missing a huge opportunity to attract patients online. Attracting new patients online usually requires two steps, 1.) An online marketing strategy and 2.) An effective website.

Your online marketing strategy, and the budget you spend on it, is highly dependent on your specialty, the competition in your market and how your site is currently performing. Your online marketing strategy may include some or all of the following services: search engine optimization (SEO), pay-per-click (PPC) advertising, social media posting, social media advertising, blogging, and online reputation management (ORM). continued on page 8

PHYSICIAN SOLUTIONS MAGAZINE

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continued from page 7

However, you can drive all the traffic in the world to your website but it will be wasted energy if your website isn’t effective. Your website must be able to quickly grab patients’ attention, engage them, and have strong calls to action in order to convert traffic to actual patients.

That’s why you need both traffic and an effective website to be successful online. Otherwise you’re wasting your money. Your website and online marketing strategy should be your largest annual marketing spend, by far.

6. Doesn’t feature marketing differentiators

If a patient goes to your website and then your competitor’s website and can’t find one thing that sets the two of you apart then you aren’t doing a good job of marketing your differentiators.

Of course this all starts with knowing what exactly your differentiators are. Hint: the answer isn’t “personalized care”. So many practices say they have personalized care these days that it has become yet another generic marketing statement. You need to discover what truly sets you apart from your competition (for example, perhaps you have the most years of experience, have performed the most surgeries, are the only practice offering evening hours, etc.). Being equipped with these differentiators makes your marketing more effective, makes your brand more memorable, and makes it easier for patients to choose you over the competition.

If any of these 6 signs apply to your current website then it’s likely time to consider a redesign. It will require an investment up front, but the cost is negligible compared to the amount of new revenue it can attract to your practice. For most practices, your website is your most powerful marketing tool and therefore where the majority of your marketing budget should be spent.

Lastly, please remember that even when you design a new beautiful website, it will still require an investment in online marketing if you want to drive traffic to it, as well as consistent upkeep. A website is not a “set it and forget it” type investment. If you don’t have the time to manage and market the site yourself, consider working with a skilled online marketing agency that can leverage your website to its full potential.  Amanda Kanaan is the President and CEO of WhiteCoat Designs – Medical Marketing Made Simple. WhiteCoat is a medical marketing agency whose mission is to help physicians nationwide stand out in today’s competitive healthcare market. Services include medical website design, internet marketing, online reputation management, social media, branding and physician liaison programs to increase referrals.

Learn more at www.whitecoat-designs.com.

22|| MAY DECEMBER 8 2016 2013

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practice tips

Successful Operational Planning

By Nick Hernandez CEO & Founder ABISA

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| MAY 2016

P

hysicians are well aware of the need for planning. Indeed, they devise clinical plans on a daily basis as they formulate the best way in which to care for a patient. However, when is the last time you spent time working on operational planning for your practice?

Many physicians reading this will be thinking, “Who has the time for that?” And while that may be true, those practices that do make the time or work with consultants to help them through operational planning are the practices that are better able to compete. There should be no argument on the value of planning. Operational planning will keep your practice oriented on objectives, despite the problems and requirements of the present situation.

There are many types of planning that do (or should) take place within a practice and at varying frequencies. For example, capital planning is generally done annually while preparing budgets, whereas marketing planning may be done quarterly to coincide with various advertising timelines and community events. Nonetheless, all planning should contain four basic categories of information: 1. Desired outcome. This element of a plan includes the purpose for achieving that outcome and often includes a time by which the assignment must be accomplished.

Goals and objectives here may be either general or specific. In a complex and difficult industry like healthcare, few things are as important or as difficult as setting clear and useful goals. This is a skill set requiring judgment and vision. The reality is that, given the nature of today’s healthcare environment, we will often have to act with unclear goals. Unclear goals are generally better than no goals, and waiting for clear goals before acting can paralyze your business.

2. Actions intended to achieve the desired outcome. Most plans include several actions which are organized in both time and space. These actions are usually tasks assigned to secondary components. Depending on circumstances, these tasks may be described in greater or lesser detail over farther or nearer planning horizons.

3. Resources to be used. In order to execute actions, the plan must describe the type, amount, and allocation of resources. Furthermore, the plan must include the how, when, and where those resources are to be provided. Resource planning covers the staff assigned to different tasks and other resources.

4. Control process. This element allows you to supervise execution of the plan and includes necessary coordination measures as well as some feedback mechanism to identify shortcomings in the plan and make necessary adjustments. It is a design for anticipating the need for change and for making decisions during execution. In other words, the plan itself should contain the means for changing the plan. Some plans are less adjustable than others, but nearly every plan requires some mechanism for making adjustments. This is a component of plans which often does not receive adequate consideration. Many plans stop short of identifying the signals, conditions, and feedback mechanisms that will indicate successful or dysfunctional execution.

Diligent operational planning will allow you to see if at some point your practice will encounter a problem. A solid operational plan will allow you to proactively adjust to an oncoming crisis, rather than face the crisis unexpectedly.

Where do you want your practice to go? How are you going to get there? Every medical practice’s strategy should be distinctive. A qualified consultant brings a good planning process which will move your practice toward greater coherence; and greater coherence leads to added value.  PHYSICIAN SOLUTIONS MAGAZINE

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practice tips

How to Manage Your Online Reputation…

And Why You Should!

By Barbara Hales, M.D. www.thewritetreatment.com Nowadays, patients don’t make appointments with new physicians without checking them out first. According to a 2014 Local Consumer4 Review Survey written by Search Engine Land, 88% of users state that they trust online reviews as much as recommendations by friends and family.

There are an abundance of physician rating sites with star ratings and a critique ranging from: • Bedside Manner • Time Spent with Patient • Correct Diagnosis • Promptness • Difficulty getting appointment • Wait time in the office • Polite Staff You are also given the opportunity to type your comments in boxes such as: • Would you go to this office or health facility again?

• How would you describe your experience to a friend?

• What stood out in your memory about your experience?

• What is it that you really liked or was cutting edge?

• What did you dislike?

Notice that the entire review involves your office staff as well as you, so make sure that your employees know how to handle difficult patients- they are usually the first to make a poor online rating.

If you are vying for patients in your specialty, the one with the stellar reviews are going to get the busi12

| MAY 2016

ness. If that’s not you, the number of patients on your schedule could plummet over night. (And that’s not a pretty site) According to a study by the Harvard Business School, a one star drop in your rating can mean a loss of as much as ten percent of your medical business.

Since a negative review can cause major damage to your reputation as well as a growing practice, you as a physician, can no longer bury your “head in the sand” and hope that the problem blows over or disappears.

Don’t expect reviews to be amended or deleted from the site (even upon request). It is clearly stated in terms of use on the Vitals.com site that “the opinions expressed on Platform are those of Our Users and not Ours.” “We do not recommend or endorse any particular Healthcare Provider whose information, reviews, or ratings appear on our Platform. Rather we are only a conduit or intermediary that provides the aforementioned content regarding Healthcare Providers. No content or other information contained on the Platform should be construed as a recommendation or endorsement.”

Strategy in 4 Easy Steps So, What Can You Do? Step 1 The most important step is to be aware of what is being said and the reviews that patients are making of you online. Disgruntled patients may spread the news rather than letting you know in person. It is easier for them and avoids confrontation.

While monitoring sites can be quite time-consuming, there are companies and applications that do it for you: • ReviewPush- provides monitoring with several sites, issuing email alerts and notifications • GoogleAlert- lets you know when people are “talking” about you and on what site, providing email alerts and notifications. This is free and well worth the time to register.

Make a list of the most common review sites and check them once a month or on a regular basis. There are many websites to choose from but online sites used most often include: • Vitals • Healthgrades • WebMD • Yelp • RateMds • ZocDoc Step 2 If a negative review comes your way (which will happen at least once for every doctor), handling it in a positive way can put out the fire instead of sparking the flames. Responding immediately will prevent it from festering and doing more damage.

If in fact the poor review is warranted, place a comment thanking the reviewer for bringing the problem to your attention and stating that the issue has been corrected. If it isn’t warranted, rather than going on a verbal tirade, ask the reviewer to contact you at your office so that you can address the problem directly.

This also shows prospective patients that you are flexible and willing to work with patients as well as validating what they have to say. This becomes a very positive picture.

Step 3 Dilute the negative reviews. Target your best patients and just like referral and loyalty programs that are already implemented in your office, encourage them to post reviews. Don’t coerce them. Rather provide your loyal patients with easy to understand, written instructions on how to rate you online. Many glowing reports will drown out any negativity.

Step 4 Suing a patient in court for a bad review and loss of reputation, only garners a worse review and the story about the case not only puts you in a bad light, but

usually goes viral. I can’t urge you enough, DON’T SUE FOR A BAD REVIEW! There is an exception to this rule of course. (Isn’t there always!)

Disgruntled employees or those you have fired, competing colleagues or those with their own agenda that hope to harm you can actually post fake reviews.

In this situation, hire an expert to deal with the problem, root out the source of the fiction and sue the perpetrator in court.

If all this is too emotionally taxing and goes beyond your attention, there are companies that provide reputation management services for physicians and medical facilities. These reputation firms monitor posts as well as providing content management and tools for use by staff. They help fix bad online reputations caused by a myriad of problems including name confusion and malcontents.

The important thing for you to remember is that regardless of how you want to approach the reputation management, that there be a specific system in place.

For more ideas, check out the blog posts at www.

TheWriteTreatment.com 

The Write Treatment

Ezines and NewslettersCost Effective Powerful Tools • Drive traffic to your business website • Build relationships between yourself and patients • Get new patients • Announce a new service or product • Give great impact Have you got a newsletter yet or want to spread a message?

Contact Barbara Hales, M.D. for a free consultation.

Barbara@TheWriteTreatment.com 516-647-3002

PHYSICIAN SOLUTIONS MAGAZINE

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practice tips

Recent Telemedicine Surveys Make For Interesting Reading

By RenĂŠ Y. Quashie Epstein, Becker & Green, P.C.

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| MAY 2016

Telemedicine has made great recent strides in terms of greater acceptance and deployment. That said, a lot of work still needs to be done. Two recent surveys, one of tech savvy consumers and another of health care stakeholders make that case.

The first survey was done on behalf of a consumer health engagement company. It makes for sobering reading. The survey polled 500 insured consumers who are also users of mobile health applications.

Some interesting findings: l Almost 40% have not heard of telemedicine. l 42% who have not used telemedicine and prefer an in-person physician visit instead. l 28% don’t know when it is appropriate to use telemedicine. l 14% don’t trust a telemedicine provider to diagnose and/or treat. l 14% are not sure if telemedicine services are covered by health insurance Survey participants were also asked for which services they would consider using telemedicine: l 44% for follow-up care for acute illness. l 44% for symptom tracking/diagnosis. l 44% for medication management/prescription renewal. l 34% for follow-up care for a chronic condition. l 31% for remote monitoring of vital signs. l 24% for behavioral/mental health.

There was better news in the survey. First, 55 percent of consumers who have access to telemedicine have used it. Second, and more interestingly, 93 percent who have used telemedicine conclude that it lowered health care costs. While it is only one survey, I think the results clearly show a consumer education and exposure gap regarding telemedicine that needs to be addressed. Remember, the survey respondents were tech savvy consumers, and the high numbers of those unaware of telemedicine should be a call to action to those of us who believe in the viability of proper telemedicine.

The second recent survey I would like to discuss was conducted by a leading enterprise software company. The survey polled health care executives and health care clinicians regarding their views on the challenges and objectives of telemedicine programs.

The survey paints a compelling and encouraging picture.

Amongst the highlights: l Almost 66% of survey participants indicate that telemedicine is their top priority or one of the highest priorities for their healthcare organizations. l The top three telemedicine objectives are: t Improved patient outcomes. t Improved patient convenience. t Increasing patient engagement and satisfaction. l Among the most significant obstacles to telemedicine success are reimbursement, lack of integration between telemedicine and EMR systems, and determining ROI. l Maturity of telemedicine programs varies widely among service lines and care settings. Those settings requiring highly specialized treatment are more mature than those requiring generalized treatment. l Approximately a quarter of those surveyed report that ultimate accountability for telemedicine program success rests with a C-level executive. t Another 22% report that accountability is at the vice president level. l 75% report that the source of the telemedicine platform is primarily purchased or licensed from a vendor.

Based on this survey, the news from health care stakeholders is quite promising for the future of telemedicine. Most respondents view telemedicine as one of their top priorities and more than half show their commitment by making C-level executives or vice presidents accountable for telemedicine program success.

Ultimately, I think the two surveys raise interesting and conflicting perspectives. On the one hand, many health care stakeholders appear all in or thereabouts regarding telemedicine despite significant obstacles such as reimbursement. On the other, there is an unsettling consumer exposure/education gap with significant segments of consumers unaware of telemedicine. In the final analysis, consumer awareness and education will need to improve significantly to better drive telemedicine demand and growth.  Source: http://www.techhealthperspectives. com/2016/04/05/recent-telemedicine-surveys-make-forinteresting-reading/

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U.S. OPTICAL BOARDS Alaska P.O. Box 110806 Juneau, AK 99811 (907)465-5470 http://www.commerce.state.ak.us/dnn/ cbpl/ProfessionalLicensing/DispensingOpticians.aspx Arizona 1400 W. Washington, Rm. 230 Phoenix, AZ 85007 (602)542-3095 http://www.do.az.gov Arkansas P.O. Box 627 Helena, AR 72342 (870)572-2847 California 2005 Evergreen St., Ste. 1200 Sacramento, CA 95815 (916)263-2382 http://www.do.az.gov Colorado 1560 Broadway St. #1310 Denver, CO 80202 (303)894-7750 http://www.dora.state.co.us/optometry/ Connecticut 410 Capitol Ave., MS #12APP P.O. Box 340308 Hartford, CT 06134 (860)509-7603 ext. 4 http://www.ct.gov/dph/cwp/view. asp?a=3121&q=427586 Florida 4052 Bald Cypress Way, Bin C08 Tallahassee, FL 32399 (850)245-4474 http://www.pof.org/opticianry-board/ Georgia 237 Coliseum Dr. Macon, GA 31217 (478)207-1671 http://sos.ga.gov/index.php/licensing/ plb/20 Hawaii P.O. Box 3469 Honolulu, HI 96801 (808)586-2704 http://hawaii.gov/dcca/pvl/programs/ dispensingoptician/

Idaho 450 W. State St., 10th Floor Boise , ID 83720 (208)334-5500 http://www.ironforidaho.net/

Oregon 3218 Pringle Rd. SE Ste. 270 Salem, OR 97302 (503)373-7721 http://www.oregonobo.org/optque.htm

Kentucky P.O. Box 1360 Frankfurt, KY 40602 (502)564-3296 http://www.opticiantraining.org/optician-training-kentucky/

Rhode Island 3 Capitol Hill, Rm 104 Providence, RI 02908 (401)222-7883 http://sos.ri.gov/govdirectory/index.php? page=DetailDeptAgency&eid=260

Massachusetts 239 Causeway St. Boston, MA 02114 (617)727-5339 http://1.usa.gov/zbJVt7

South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4665 www.llr.state.sc.us

Nevada P.O. Box 70503 Reno, NV 89570 (775)853-1421 http://nvbdo.state.nv.us/

Tennessee Heritage Place Metro Center 227 French Landing, Ste. 300 Nashville, TN 37243 (615)253-6061 http://tn.gov/health

New Hampshire 129 Pleasant St. Concord, NH 03301 (603)271-5590 www.state.nh.us New Jersey P.O. Box 45011 Newark, NJ 07101 (973)504-6435 http://www.njsop.org/aws/NJSOP/pt/sp/ home_page New York 89 Washington Ave., 2nd Floor W. Albany, NY 12234 (518)402-5944 http://www.op.nysed.gov/prof/od/ North Carolina P.O. Box 25336 Raleigh, NC 27611 (919)733-9321 http://www.ncoptometry.org/ Ohio 77 S. High St. Columbus, OH 43266 (614)466-9707 http://optical.ohio.gov/

Texas P.O. Box 149347 Austin, TX 78714 (512)834-6661 http://www.tob.state.tx.us/ Vermont National Life Bldg N FL. 2 Montpelier, VT 05620 (802)828-2191 http://vtprofessionals.org/opr1/ opticians/ Virginia 3600 W. Broad St. Richmond, VA 23230 (804)367-8500 http://www.dpor.virginia.gov/Boards/ HAS-Opticians/ Washington 300 SE Quince P.O. Box 47870 Olympia, WA 98504 (360)236-4947 http://www.doh.wa.gov/LicensesPermitsandCertificates/MedicalCommission. aspx

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U.S. DENTAL BOARDS Alabama Alabama Board of Dental Examiners 5346 Stadium Trace Pkwy., Ste. 112 Hoover, AL 35244 (205) 985-7267 http://www.dentalboard.org/ Alaska P.O. Box 110806 Juneau, AK 99811-0806 (907)465-2542 https://www.commerce.alaska.gov/web/ cbpl/ProfessionalLicensing/BoardofDentalExaminers.aspx Arizona 4205 N. 7th Ave. Suite 300 Phoenix, AZ 85103 (602)242-1492 http://azdentalboard.us/ Arkansas 101 E. Capitol Ave., Suite 111 Little Rock, AR 72201 (501)682-2085 http://www.asbde.org/ California 2005 Evergreen Street, Suite 1550Â Sacramento, CA 95815 877-729-7789 http://www.dbc.ca.gov/ Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7800 http://www.dora.state.co.us/dental/ Connecticut 410 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/cwp/view. asp?a=3143&q=388884 Delaware Cannon Building, Suite 203 861 Solver Lake Blvd.

Dover, DE 19904 (302)744-4500 http://1.usa.gov/t0mbWZ Florida 4052 Bald Cypress Way Bin C-08 Tallahassee, FL 32399 (850)245-4474 http://floridasdentistry.gov/ 18

| MAY 2016

Georgia 237 Coliseum Drive Macon, GA 31217 (478)207-2440 https://gbd.georgia.gov/ Hawaii DCCA-PVL Att: Dental P.O. Box 3469 Honolulu, HI 96801 (808)586-3000 http://cca.hawaii.gov/pvl/boards/dentist/ Idaho P.O. Box 83720 Boise, ID 83720 (208)334-2369 http://isbd.idaho.gov/ Illinois 320 W. Washington St. Springfield, IL 62786 (217)785-0820 http://www.isds.org/LawsLegislation/ boardOfDentistry.asp Indiana 402 W. Washington St., Room W072 Indianapolis, IN 46204 (317)232-2980 http://www.in.gov/pla/dental.htm Iowa 400 SW 8th St. Suite D Des Moines, IA 50309 (515)281-5157 http://www.state.ia.us/dentalboard/ Kansas 900 SW Jackson Room 564-S Topeka, KS 66612 (785)296-6400 http://www.dental.ks.gov/ Kentucky 312 Whittington Parkway, Suite 101 Louisville, KY 40222 (502)429-7280 http://dentistry.ky.gov/ Louisiana 365 Canal St., Suite 2680 New Orleans, LA 70130 (504)568-8574 http://dentistry.ky.gov/

Maine 143 State House Station 161 Capitol St. Augusta, ME 04333 (207)287-3333 http://www.mainedental.org/ Maryland 55 Wade Ave. Catonsville, Maryland 21228 (410)402-8500 http://dhmh.state.md.us/dental/ Massachusetts 1000 Washington St., Suite 710 Boston, MA 02118 (617)727-1944 http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/ dentist/about/ Michigan P.O. Box 30664 Lansing, MI 48909 (517)241-2650 http://www.michigan.gov/lara/0,4601,7154-72600_72603_27529_27533---,00. html Minnesota 2829 University Ave., SE. Suite 450 Minneapolis, MN 55414 (612)617-2250 http://www.dentalboard.state.mn.us/ Mississippi 600 E. Amite St., Suite 100 Jackson, MS 39201 (601)944-9622 http://bit.ly/uuXKxl Missouri 3605 Missouri Blvd.

P.O. Box 1367 Jefferson City, MO 65102 (573)751-0040 http://pr.mo.gov/dental.asp Montana P.O. Box 200113 Helena, MT 59620 (406)444-2511 http://bsd.dli.mt.gov/license/bsd_ boards/den_board/board_page.asp

Nebraska 301 Centennial Mall South Lincoln, NE 68509 (402)471-3121 http://dhhs.ne.gov/publichealth/Pages/ crl_medical_dent_hygiene_board.aspx

Ohio Riffe Center 77 S. High St.,17th Floor Columbus, OH 43215 (614)466-2580 http://www.dental.ohio.gov/

Nevada 6010 S. Rainbow Blvd. Suite A-1 Las Vegas, NV 89118 (702)486-7044 http://www.nvdentalboard.nv.gov/

Oklahoma 201 N.E. 38th Terr., #2 Oklahoma City, OK 73105 (405)524-9037 http://www.ok.gov/dentistry/

New Hampshire 2 Industrial Park Dr. Concord, NH 03301 (603)271-4561 http://www.nh.gov/dental/

Oregon 1600 SW 4th Ave. Suite 770 Portland, OR 97201 (971)673-3200 http://www.oregon.gov/Dentistry/

New Jersey P.O Box 45005 Newark, NJ 07101 (973)504-6405 http://njpublicsafety.com/ca/dentistry/

Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)783-7162 http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Dentistry/ Pages/default.aspx#.VbkfjPlPVYU

New Mexico Toney Anaya Building 2550 Cerrillos Rd. Santa Fe, NM 87505 (505)476-4680 http://www.rld.state.nm.us/boards/Dental_Health_Care.aspx New York 89 Washington Ave. Albany, NY 12234 (518)474-3817 http://www.op.nysed.gov/prof/dent/ North Carolina 507 Airport Blvd., Suite 105 Morrisville, NC 27560 (919)678-8223 http://www.ncdentalboard.org/ North Dakota P.O. Box 7246 Bismark, ND 58507 (701)258-8600 http://www.nddentalboard.org/

Rhode Island Dept. of Health Three Capitol Hill, Room 104 Providence, RI 02908 (401)222-2828 http://1.usa.gov/u66MaB South Carolina P.O. Box 11329 Columbia, SC 29211 (803)896-4599 http://www.llr.state.sc.us/POL/Dentistry/ South Dakota P.O. Box 1079 105. S. Euclid Ave. Suite C Pierre, SC 57501 (605)224-1282 https://www.sdboardofdentistry.com/ Tennessee 227 French Landing, Suite 300 Nashville, TN 37243 (615)532-3202 http://tn.gov/health

Texas 333 Guadeloupe St. Suite 3-800 Austin, TX 78701 (512)463-6400 http://www.tsbde.state.tx.us/ Utah 160 E. 300 South Salt Lake City, UT 84111 (801)530-6628 http://1.usa.gov/xMVXWm Vermont National Life Building North FL2 Montpelier, VT 05620 (802)828-1505 http://governor.vermont.gov/boards_ and_commissions/dental_examiners Virginia Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4538 http://www.dhp.virginia.gov/dentistry Washington 310 Israel Rd. SE P.O. Box 47865 Olympia, WA 98504 (360)236-4700 http://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/Dentist.aspx West Virginia 1319 Robert C. Byrd Dr. P.O. Box 1447 Crab Orchard, WV 25827 1-877-914-8266 http://www.wvdentalboard.org/ Wisconsin P.O. Box 8935 Madison, WI 53708 1(877)617-1565 http://dsps.wi.gov/Default. aspx?Page=90c5523f-bab0-4a45-ab943d9f699d4eb5 Wyoming 1800 Carey Ave., 4th Floor Cheyenne, WY 82002 (307)777-6529 http://plboards.state.wy.us/dental/index.asp

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U.S. MEDICAL BOARDS Alabama P.O. Box 946 Montgomery, AL 36101 (334)242-4116 http://www.albme.org/ Alaska 550 West 7th Ave., Suite 1500 Anchorage, AK 99501 (907)269-8163 http://www.medlicense.com/alaskamedical-license.html Arizona 9545 E. Doubletree Ranch Rd. Scottsdale, AZ 85258 (480)551-2700 http://www.azmd.gov Arkansas 1401 West Capitol Ave., Suite 340 Little Rock, AR 72201 (501)296-1802 http://www.armedicalboard.org/ California 2005 Evergreen St., Suite 1200 Sacramento, CA 95815 (916)263-2382 http://www.mbc.ca.gov/ Colorado 1560 Broadway, Suite 1350 Denver, CO 80202 (303)894-7690 http://www.dora.state.co.us/medical/ Connecticut 401 Capitol Ave. Hartford, CT 06134 (860)509-8000 http://www.ct.gov/dph/cwp/view. asp?a=3143&q=388902 Delaware Division of Professional Regulation Cannon Building 861 Silver Lake Blvd., Suite 203 Dover, DE 19904 (302)744-4500 http://dpr.delaware.gov/ District of Columbia 899 North Capitol St., NE Washington, DC 20002 (202)442-5955 http://doh.dc.gov/bomed 20 | MAY 2016

Florida 2585 Merchants Row Blvd.

Tallahassee, FL 32399 (850)245-4444 http://www.stateofflorida.com/Portal/ DesktopDefault.aspx?tabid=115

Louisiana LSBME P.O. Box 30250 New Orleans, LA 70190 (504)568-6820 http://www.lsbme.la.gov/

Georgia 2 Peachtree Street NW, 36th Floor Atlanta, GA 30303 (404)656-3913 http://bit.ly/vPJQyG

Maine 161 Capitol Street 137 State House Station Augusta, ME 04333 (207)287-3601 http://bit.ly/hnrzp

Hawaii DCCA-PVL P.O. Box 3469 Honolulu, HI 96801 (808)587-3295 http://hawaii.gov/dcca/pvl/boards/medical/

Maryland 4201 Patterson Ave. Baltimore, MD 21215 (410)764-4777 http://www.mbp.state.md.us/

Idaho Idaho Board of Medicine P.O. Box 83720 Boise, Idaho 83720 (208)327-7000 http://bit.ly/orPmFU

Massachusetts 200 Harvard Mill Sq., Suite 330 Wakefield, MA 01880 (781)876-8200 http://www.mass.gov/eohhs/gov/departments/borim/

Illinois 320 West Washington St. Springfield, IL 62786 (217)785 -0820 http://www.idfpr.com/

Michigan Bureau of Health Professions P.O. Box 30670 Lansing, MI 48909 (517)335-0918 http://michigan.gov/lara/0,4601,7-15472600_72603_27529_27541-58914--,00. html

Indiana 402 W. Washington St. #W072 Indianapolis, IN 46204 (317)233-0800 http://www.in.gov/pla/ Iowa 400 SW 8th St., Suite C Des Moines, IA 50309 (515)281-6641 http://medicalboard.iowa.gov/ Kansas 800 SW Jackson, Lower Level, Suite A Topeka, KS 66612 (785)296-7413 http://www.ksbha.org/ Kentucky 310 Whittington Pkwy., Suite 1B Louisville, KY 40222 (502)429-7150 http://kbml.ky.gov/Pages/default.aspx

Minnesota University Park Plaza 2829 University Ave. SE, Suite 500 Minneapolis, MN 55414 (612)617-2130 http://bit.ly/pAFXGq Mississippi 1867 Crane Ridge Drive, Suite 200-B Jackson, MS 39216 (601)987-3079 http://www.msbml.state.ms.us/ Missouri Missouri Division of Professional Registration 3605 Missouri Blvd.

P.O. Box 1335 Jefferson City, MO 65102 (573)751-0293 http://pr.mo.gov/healingarts.asp

Montana 301 S. Park Ave. #430 Helena, MT 59601 (406)841-2300 http://bsd.dli.mt.gov/license/bsd_ boards/med_board/board_page.asp Nebraska Nebraska Department of Health and Human Services P.O. Box 95026 Lincoln, NE 68509 (402)471-3121 https://www.nebraska.gov/LISSearch/ search.cgi Nevada Board of Medical Examiners P.O. Box 7238 Reno, NV 89510 (775)688-2559 http://www.medboard.nv.gov/ New Hampshire New Hampshire State Board of Medicine 2 Industrial Park Dr. #8 Concord, NH 03301 (603)271-1203 http://www.nh.gov/medicine/ New Jersey P. O. Box 360 Trenton, NJ 08625 (609)292-7837 http://www.medlicense.com/new-jerseymedical-license.html New Mexico 2055 S. Pacheco St. Building 400 Santa Fe, NM 87505 (505)476-7220 http://www.nmmb.state.nm.us/ New York Office of the Professions State Education Building, 2nd Floor Albany, NY 12234 (518)474-3817 http://www.op.nysed.gov/ North Carolina P.O. Box 20007 Raleigh, NC 27619 (919)326-1100 http://www.ncmedboard.org/

North Dakota 418 E. Broadway Ave., Suite 12 Bismarck, ND 58501 (701)328-6500 http://www.ndbomex.com/

Texas P.O. Box 2018 Austin, TX 78768 (512)305-7010 http://www.tmb.state.tx.us/

Ohio 30 E. Broad St., 3rd Floor Columbus, OH 43215 (614)466-3934 http://med.ohio.gov/

Utah P.O. Box 146741 Salt Lake City, UT 84114 (801)530-6628 http://www.dopl.utah.gov/licensing/physician_surgeon.html

Oklahoma P.O. Box 18256 Oklahoma City, OK 73154 (405)962-1400 http://www.okmedicalboard.org/ Oregon 1500 SW 1st Ave., Suite 620 Portland, OR 97201 (971)673-2700 http://www.oregon.gov/OMB/ Pennsylvania P.O. Box 2649 Harrisburg, PA 17105 (717)787-8503 http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/ Pages/default.aspx#.Vbkgf_lPVYU Rhode Island 3 Capitol Hill Providence, RI 02908 (401)222-5960 http://1.usa.gov/xgocXV South Carolina P.O. Box 11289 Columbia, SC 29211 (803)896-4500 http://www.llr.state.sc.us/pol/medical/ South Dakota 101 N. Main Ave. Suite 301 Sioux Falls, SD 57104 (605)367-7781 http://www.sdbmoe.gov/ Tennessee 425 5th Ave. North Cordell Hull Bldg. 3rd Floor Nashville, TN 37243 (615)741-3111 http://tn.gov/health

Vermont P.O. Box 70 Burlington, VT 05402 (802)657-4220 http://1.usa.gov/wMdnxh Virginia Virginia Dept. of Health Professions Perimeter Center 9960 Maryland Dr., Suite 300 Henrico, VA 23233 (804)367-4400 http://1.usa.gov/xjfJXK Washington Public Health Systems Development Washington State Department of Health 101 Israel Rd. SE, MS 47890 Tumwater, WA 98501 (360)236-4085 http://www.medlicense.com/washingtonmedicallicense.html West Virginia 101 Dee Dr., Suite 103 Charleston, WV 25311 (304)558-2921 http://www.wvbom.wv.gov/ Wisconsin P.O. Box 8935 Madison, WI 53708 (877)617-1565 http://dsps.wi.gov/Boards-Councils/ Board-Pages/Medical-Examining-BoardMain-Page/ Wyoming 320 W. 25th St., Suite 200 Cheyenne, WY 82002 (307)778-7053 http://wyomedboard.state.wy.us/

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features

How to Engage With an

Empowered Generation of Female Patients Women have long been stereotyped into roles that focused exclusively on motherhood and being the perfect homemaker. However, in the last few decades women have been slowly but steadily breaking free of gender based perceptions to become more social and economically significant. Increased focus on education and the need for gaining financial independence have played a major role in shaping today’s woman. With a greater role in the economy women are also significantly impacting a change in brand marketing.

22

| MAY 2016

In the last few years in particular, women have emerged as a multifaceted and empowered generation of consumers who are not swayed by brands that indulge in clichĂŠd marketing. Brands that want to connect with this new aware generation of women consumers will need to take on a more holistic approach to marketing. However, if there is one industry that needs to and can make headway in connecting with women consumers, it is the healthcare sector. In their roles as mothers, wives, sisters, and daughters, women are actively involved not

only in their own physical, mental and emotional health but also of their families.

Women Outnumber Men as Primary Healthcare Decision-makers Women are actively involved in the role of caregivers at all stages of their lives. They play a vital part in maintaining healthy families and tend to access the health system for themselves and their families more when compared to men. They are also the primary caregivers for their children and hence are more heav-

By Naren Arulrajah with Vikas Vij Ekwa Marketing

women again outnumber men. So the kind of influence that women yield when it comes to healthcare decisions is huge and should not be overlooked by any healthcare brand.

However, any women centered healthcare marketing will only hit its mark when it addresses the needs and preferences of women in different stages in their lives and from all walks of life.

Boost Your Practice Traffic by Targeting Women Patients

ily invested in the overall health of the family. Another reason why women tend to be more proactive about healthcare and wellness is because they run the risk of having higher rates of disability and face a number of chronic health conditions as they age.

An interesting yet often overlooked fact is that a significant percentage of patients at any healthcare office are female. In most instances male patients seek medical consultation on the insistence of an important woman in their lives. When it comes to seeking healthcare information online and in print,

your content that provide high quality information on issues and concerns associated with the main topic.

• You could offer to talk about specific health conditions in a local women’s group or arrange a group talk with your female patients.

• The digital space is a popular place for women to congregate and talk about health and wellness issues that matter to them; take part in forum discussions and identify other online platforms where you can engage and communicate with female audiences.

Female patients constitute a powerful audience segment of informed decision makers who are interested Use Social Sites to Build Audience Engagement in brands that offer service and • Social is a great place to connect product value that resonates with with a majority of millennial their needs and the needs of their mothers who are quickly going families. They also hold the power to become your biggest patient of choice in their hands which base; Facebook in particular is means engaging with them is a a social platform of choice for marketing priority for all healthcare most mom groups where the practices. Building a buzz around focus is on children and family women’s health issues is one of health. the most effective ways of getting • Encourage your female patients the attention of your target female to connect with you on social audience. Focus on marketing that sites. is formulated on the lines of creat• Check out trending topics and ing women’s health awareness or on create quality content on those providing highly relevant informatopics; if your content is good tion about specific conditions and/ they will actively share your or on preventive care because this is content with others in their the kind of brand value that will sit vicinity. very well with this audience seg• Use your social sites to respond ment. to queries and questions on Here Are a Few Other health concerns, raise awareThings to Consider; ness about risk factors, and provide information on prevenAddress Women’s Health Issues in tive care. a Big Way • Ensure you dedicate specific Adopt a Sensitive Approach to sections of your healthcare Women’s Healthcare Needs website, blog and social space to • It is important to adopt a sensiwomen’s health issues. tive approach to the needs • Include highly relevant links in continued on page 24 PHYSICIAN SOLUTIONS MAGAZINE

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continued from page 23

of your female patients with regards to certain issues and concerns.

• Women function within certain family, community, social, cultural and economic boundaries and are different from men in this aspect. For example, you might find that women from certain communities or age brackets might be reluctant about discussing modern choices for family planning or about common gynecological and its associated health issues if the healthcare professional in question is a male.

• An effective way to avoid such situations is by building a rapport and focusing on improving patient trust by providing longer and more in-depth consultations.

• Offer your patients information on preventive care as well as offer counseling if required.

• The physical examination and/or taking history process can either go smoothly or be traumatizing for a patient. Providing adequate explanations for the process and its purpose can in large parts reduce patient discomfort.

Communication is Key to Improving Relationships with Female Patients • Relationship dynamics with female patients differs vastly when compared to male patient-doctor relationship.

• Women respond better when they have trust in their healthcare providers and are encouraged to share their concerns.

• An open channel of communication is the key to building relationships with your female 24

| MAY 2016

patients; listen to their concerns and honestly acknowledge their inputs.

• Women also tend to respond positively to preventive care information as a way of improving their health and the health of their families. Use your newsletters, blog, website, and social sites to deliver highly relevant information on tips and best practices on preventive health and wellness.

• Empathy over sympathy and a non-judgmental approach is absolutely important when dealing with your female patients.

Keep in mind that women are more aware of their own bodies and generalizing a condition or an uncaring attitude is the quickest way to pushing your patients away.

• Work with your staff to im-

prove scheduling for working or single moms. Also in most instances children and senior patients are accompanied by women (mothers, daughters, or close family relatives) so it is important to build a rapport with them during the consultation as they will most likely be involved in the treatment and care process.

Conclusion

Women’s attitudes and motivations towards healthcare and wellness differ from men in many ways.

Understanding these motivations is essential to delivering quality care and improving relations with your female patients. As social and economic conditions for women improve, their role as primary decision makers and their involvement in improving health and wellness

issues for themselves and their family is only going to strengthen.

Healthcare practices that acknowledge and understand this will be able to build meaningful relationships with their target female audiences.  About the Author: Naren Arulrajah is President and CEO of Ekwa Marketing, a complete Internet marketing company which focuses on SEO, social media, marketing education and the online reputations of Dentists and Physicians. With a team of 140+ full time marketers, www.ekwa.com helps doctors who know where they want to go get there by dominating their market and growing their business significantly year after year. If you have questions about marketing your practice online, call 855 598-3320 to speak one-on-one with Naren.

features

What Health Issues or Conditions Affect Women Differently Than Men?

By National Institutes of Health

Some health issues that are common to both men and women affect women differently. Although the symptoms may be similar, the effects of the condition and the care necessary can differ significantly for women. In addition, some of these conditions might affect women primarily or more severely than men.

For example, almost 12% of women in the United States are at risk for developing breast cancer during their lifetime.1 Male breast cancer accounts for less than 1% of existing breast cancer cases.2 Certain health issues and their effects on women are listed below.

Alcohol Abuse 3 As many as 5.3 million women in the United States abuse alcohol, putting their health, safety, and general well-being at risk. While men are more likely to become dependent on, or addicted to, alcohol than women are throughout their lifetime, the health effects of alcohol abuse and alcoholism (when someone shows signs of addiction to alcohol) are more serious 26

| MAY 2016

in women. These health effects include an increased risk for breast cancer, heart disease, and fetal alcohol syndrome, in which infants born to mothers who drank during pregnancy suffer brain damage and learning difficulties.

Heart Disease 4 Heart disease is the leading cause of death for women in the United States. Although heart disease is also the leading cause of death for men in the United States, women are more likely to die following a heart attack than men are. In addition, women are more likely than men are to experience delays in emergency care and to have treatment to control their cholesterol levels.

Mental Health Women are more likely to show signs of depression and anxiety than men are. Depression is the most common women’s mental health problem,5 and more women than men are diagnosed with depression each year.6

Osteoarthritis Osteoarthritis is the most common form of arthritis. It causes joint pain, stiffness, and swelling. Arthritis is the leading cause of physical disability in the United States. The condition affects almost 27 million people, and affects more women than men.7 Sexually Transmitted Diseases/Sexually Transmitted Infections (STDs/STIs) 8 The effect of STDs/STIs on women can be more serious than on men. Untreated STDs/STIs cause infertility in at least 24,000 women each year in the United States. STDs/STIs often go untreated in women because symptoms are less obvious than in men or are more likely to be confused with another less serious condition, such as a yeast infection.

Stress According to a recent survey by the American Psychological Association, stress is on the rise for women.

Women are more likely to report having stress, and almost 50% of all women in the survey, compared to 39% of the men, reported that their stress had increased over the past 5 years.9 Stress also has unique effects on women. A recent NICHD study found that stress might reduce a woman’s chance of becoming pregnant.10 Stroke 11 More women than men suffer a stroke each year.

Although many of the risk factors for stroke are the same for men and women, including a family history of stroke, high blood pressure, and high cholesterol, some risk factors are unique to women. These include: • Taking birth control pills • Being pregnant • Using hormone replacement therapy, a combined hormone therapy of progestin and estrogen designed to relieve menopausal symptoms • Having frequent migraine headaches • Having a thick waist (larger than 35.2 inches), particularly if post-menopausal, and high triglyceride (blood fat) levels Urinary Tract Health Women are more likely than men are to experience urinary tract problems. For example, urinary incontinence affects twice as many women as men12 due to the way the female urinary tract is structured.13 

______________ 1 National Cancer Institute. (2010). Probability of breast cancer in American women. Retrieved August 6, 2012, from http://www.cancer.gov/cancertopics/factsheet/detection/ probability-breast-cancer 2 National Cancer Institute. (2012). General information about male breast cancer. Retrieved August 6, 2012, from http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/patient 3 National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol: a women’s health issue. Retrieved August 3, 2012, from http://pubs.niaaa.nih.gov/publications/brochurewomen/women.htm 4 Agency for Healthcare Research and Quality. (2010). Cardiovascular disease and other chronic conditions in women: Recent findings. Retrieved August 3, 2012, from http://www. ahrq.gov/research/findings/factsheets/women/womheart/ index.html 5 World Health Organization. (n.d.). Gender and women’s mental health. Retrieved August 3, 2012, from http://www. who.int/mental_health/prevention/genderwomen/en/ 6 National Institute of Mental Health. (2012). Women and Depression: Discovering Hope. Retrieved August 22, 2012, from http://www.nimh.nih.gov/health/publications/womenand-depression-discovering-hope/complete-index.shtml 7 Centers for Disease Control and Prevention. (2011).

Arthritis-related statistics. Retrieved August 22, 2012, from http://www.cdc.gov/arthritis/data_statistics/arthritis_related_stats.htm 8 Centers for Disease Control and Prevention. (2011). 10 ways STDs impact women differently from men. Retrieved August 6, 2012, from http://www.cdc.gov/std/health-disparities/stds-women-042011 9 American Psychological Association. (n.d.) Gender and stress. Retrieved August 6, 2012, from http://www.apa.org/ news/press/releases/stress/gender-stress.aspx 10 NIH. (2010). NIH study indicates stress may delay women getting pregnant. Retrieved August 6, 2012, from http:// www.nichd.nih.gov/news/releases/pages/081110-stress-delaywomen-getting-pregnant.aspx 11 National Stroke Association. (n.d.) Women and stroke.

Retrieved August 6, 2012, from http://www.stroke.org/understand-stroke/impact-stroke/women-and-stroke 12 National Kidney and Urologic Diseases Information Clearinghouse. (2010). Urinary incontinence in women.

Retrieved August 6, 2012, from http://kidney.niddk.nih.gov/ kudiseases/pubs/uiwomen/ 13 National Kidney and Urologic Diseases Information Clearinghouse. (2011). Urinary tract infections in adults.

Retrieved August 7, 2012, from http://kidney.niddk.nih.gov/ kudiseases/pubs/utiadult/index.aspx/uti

Source: https://www.nichd.nih.gov/health/topics/womenshealth/conditioninfo/pages/howconditions.aspx PHYSICIAN SOLUTIONS MAGAZINE

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features

Deaths From Prescription Painkiller Overdoses Rise Sharply Among Women CDC study shows emergency department visits also on the rise among women 28

| MAY 2016

T

he number of prescription painkiller overdose deaths increased five fold among women between 1999 and 2010, according to a Vital Signs report released today by the Centers for Disease Control and Prevention. While men are more likely to die of a prescription painkiller overdose, since 1999 the percentage increase in deaths was greater among women (400 percent in women compared to 265 percent in men). Prescription painkiller overdoses killed nearly 48,000 women between 1999 and 2010.

“Prescription painkiller deaths have skyrocketed in women (6,600 in 2010), four times as many as died from cocaine and heroin combined,” said CDC Director Tom Frieden, M.D., M.P.H. “Stopping this epidemic in women – and men – is everyone’s business.

Doctors need to be cautious about prescribing and patients about using these drugs.”

The study includes emergency department visits and deaths related to drug misuse/abuse and overdose, as well as analyses specific to prescription painkillers. The key findings include: l About 42 women die every day from a drug overdose. t Since 2007, more women have died from drug overdoses than from motor vehicle crashes. t Drug overdose suicide deaths accounted for 34 percent of all suicides among women compared with 8 percent among men in 2010. t More than 940,000 women were seen in emergency departments for drug misuse or abuse in 2010. l Prescription painkillers have been a major contributor to increases in drug overdose deaths among women. t More than 6,600 women, or 18 women every day, died from a prescription painkiller overdose in 2010. t There were four times more deaths among women from

prescription painkiller overdose than for cocaine and heroin deaths combined in 2010. t In 2010, there were more than 200,000 emergency depart- ment visits for opioid misuse or abuse among women; about one every three minutes.

For the Vital Signs report, CDC analyzed data from the National Vital Statistics System (1999-2010) and the Drug Abuse Warning Network public use file (2004-2010).

Previous research has shown that women are more likely to have chronic pain, be prescribed prescription painkillers, be given higher doses, and use them for longer time periods than men. Studies have also shown that women may become dependent on prescription painkillers more quickly than men and may be more likely than men to engage in “doctor shopping” (obtaining prescriptions from multiple prescribers).

“The prescription painkiller problem affects women in different ways than men and all health care providers treating women should be aware of this,” said Linda C. Degutis, Dr.P.H., M.S.N., director of CDC’s National Center for Injury Prevention and Control. “Health care providers can help improve the way painkillers are prescribed while making sure women have access to safe and effective pain treatment.”

Steps that health care providers can take when treating women include: l Following guidelines for responsible opioid prescribing, including screening and monitoring for substance abuse and mental health problems. l Using their states’ prescription drug monitoring program; this can help identify patients who may be improperly using opioids and other drugs. l Discussing pain treatment options, including ones that do not involve prescription drugs. l Discussing the risks and benefits of taking prescription painkillers

including when painkillers are taken for chronic conditions, and especially during pregnancy. l Avoiding prescribing combinations of prescription painkillers and benzodiazepines unless there is a specific medical indication.

Women can take steps to help stay safe from prescription painkiller overdoses, including: l Using prescription drugs only as directed by a health care provider. l Discussing all medications they are taking with their health care provider, including over-the-counter medications (such as for allergies). l Discussing pregnancy plans with their health care provider before taking prescription painkillers. l Disposing of medications properly, as soon as the course of treatment is done. Not keeping prescription medications around “just in case.” l Helping prevent misuse and abuse by not selling or sharing prescription drugs. Never using another person’s prescription drugs. l Getting help for substance abuse problems (1-800-662-HELP and calling Poison Help (1-800222-1222) with questions about medicines.

CDC’s Injury Center works to protect the safety of everyone, every day.

For more information about prescription drug overdoses, please visit www.cdc. gov/Homeand RecreationalSafety/ Poisoning.

Vital Signs is a CDC report that appears on the first Tuesday of the month as part of the CDC journal Morbidity and Mortality Weekly Report, or MMWR. The report provides the latest data and information on key health indicators. These are cancer prevention, obesity, tobacco use, motor vehicle passenger safety, prescription drug overdose, HIV/AIDS, alcohol use, health care–associated infections, cardiovascular health, teen pregnancy, food safety and viral hepatitis.  Source: http://www.cdc.gov/media/ releases/2013/p0702-drug-overdose.html PHYSICIAN SOLUTIONS MAGAZINE

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features

The Story of Maya:

An Accredited Social Health Activist from India

By Dr Anuradha Katyal, Research Consultant, ACCESS Health International

ASHA is the first level of preventive and promotive care to women and children in rural India Accredited Social Health Activists (ASHA) are frontline health workers, working in the rural areas providing the first level of preventive and promotive care to women and children. They have a vital role to play in the reduction of Infant and Maternal Mortality, improve the nutritional status of children and mothers, provide very basic medication in epidemics of diarrhoea, and providing basic health education on anaemia, family planning, symptoms of infectious diseases and adolescent health. Ideally ASHAs are wom30

| MAY 2016

en between the age of 25 and 45, have at least 8 years of formal school education and rigorously trained to serve a population of about 1000.1 They carry drug kits to help meet the basic healthcare demands of very low income and vulnerable sections of the population Accredited Social Health Activists receive performance based incentives to promote vaccination and to promote sound referral to higher levels of care. They are also expected to escort patients to government health facilities for reproductive and child health ser-

vices and other healthcare programs. Forming the first level of care in a country where there are no doctors in many rural areas, they have an extremely relevant yet difficult and underappreciated role to play.

I happened to meet Maya at a small village called “Dwari” hidden in the forests of Central India. We were there as a team to conduct “focus group discussions” with various frontline workers including ASHAs. She insisted that we visit her village and understand the problems she faces. I was reluctant, it would mean another tiring road trip. As I was leaving the nurses at the community health centers insisted that I visit the village and I did.

Dwari has a total population of about 4000 people.

It has good connectivity by road, something which I was not expecting. We walked around the village with Maya. She has been working as an ASHA for nine years. Dwari is everything you would have read about rural India. The village has untouchability, superstitions, migration to cities for employment, lack of sanitation, thatched roof homes called kuccha houses, and, above all, open defecation (there is only one toilet in the entire village). But Maya’s and many women of Dwari are not just struggling to make ends meet.

In a country with marked economic disparity Indian villages are a sharp contrast to the fast paced city life. Many of the villages are not just economically backward but are also socially in the dark ages. While it is encouraging to note that the present government is leaving no stone unturned to modernise the rural pockets, it is still a long road ahead. One of the major challenges which the ASHAs face is untouchability. It is a social epidemic in which so called religious high castes are not allowed to touch or share food or water with those from lower castes. Untouchability is an ancient practice that remains prevalent in many parts of India. It is considered highly inauspicious for someone from a high caste happens to touch or share food or water with someone from a lower caste.

We asked her if we could talk to some of the beneficiaries (young mothers benefitting from the government’s conditional cash transfer scheme, in which they receive a fixed amount of money if they deliver their baby institutionally). The young mothers told us that in a village where women are uneducated, do not work, are not allowed to talk to men, Maya ensures personally that every mother receives Ante and Post Natal Care here and every child is immunized.

In a village where people don’t touch lower castes

she personally holds babies suffering from diarrhea in her arms and carries them to the primary health center. She keeps a track of the dates of immunization for every child in the village and personally reminds their mothers, who are uneducated and come from families who do not endorse modern medicine.

Maya But why Maya?

What is so special about her? Well, most of the ASHAs we met during our journey in Central India complained about not having even a small room to work in. Maya’s solution – she borrowed some space from the local school (Anganwadi as they are popularly known) and made it her area of operation. We heard the problems of untouchability from many frontline workers. She fought the problem head on. She mentioned, “I thought I would become a social outcast, but I knew that women were dying due to home deliveries and I fought. Today after a courageous fight I am revered and I am called the “second mother” of every child in the village.”

As we were leaving, Maya grew teary. “It is the first time in nine years that an outsider has visited me, and yet I struggle everyday.”

This is not a piece of fiction. This is a true story and is the story of many frontline workers in India. Many studies and surveys indicate that institutional deliveries have increased manifold in the past decade. These women are fighting battles everyday and winning for the nation. One could argue that they are just doing their jobs and are being paid for it, so what? But it is not just a social battle. Many of them do not receive any family support. Yet they feel strongly about the social cause and fight. They are fighting a major battle – every child’s right to live.  http://www.thelancet.com/pdfs/journals/lancet/ PIIS0140-6736(10)61888-0.pdf 1

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Practices for Sale Medical Practices Primary Care specializing in Women’s Practice Location: Morehead City, N.C. List Price: Just reduced to $20,000 or Best Offer Gross Yearly Income: $540,000 average for past 3 years Year Established: 2005 Average Patients per Day: 12 to 22 Building Owned/Leased: MD owned and can be leased or purchased Contact: Philip at 919-848-4202

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PEDIATRICIAN

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Eastern North Carolina Family Practice Available Well-appointed Eastern North Carolina Family Practice established in 2000 is for sale in Williamston, NC. This organized practice boasts a wide array of diagnostic equipment including a GE DEXA scanner with a new tube, GE case 8000 stress testing treadmill and controller and back up treadmill, Autoclave and full set of operating equipment, EKG-Ez EKG and much more. The average number of patients seen daily is between 12 to 22. The building is owned

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PRIMARY CARE PRACTICE - Hickory, North Carolina This is an outstanding opportunity to acquire one of the most organized and profitable primary care practices in the area. Grossing a million and a half yearly, the principal physician enjoys ordinary practice income of over $300,000 annually.

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Primary Care Practice For Sale in Wilmington, NC Established primary care on the coast of North Carolina’s beautiful beaches. Fully staffed with MD’s and PA’s to treat both appointment and walk-in patients. Excellent exam room layout, equipment and visibility.

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PHYSICIANS NEEDED: Mental health facility in Eastern North Carolina seeks: PA/FT ongoing, start immediately Physician Assistant needed to work with physicians to provide primary care for resident patients. FT ongoing 8a-5p. Limited inpatient call is required. The position is responsible for performing history and physicals of patients on admission, annual physicals, dictate discharge summaries, sick call on unit assigned, suture minor lacerations, prescribe medications and order lab work. Works 8 hour shifts Monday through Friday with some extended work on rotating basis required. It is a 24 hour in-patient facility that serves adolescent, adult and geriatric patients.

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Call us today if you are available for a few days a month, on-going or for permanent placement. Please contact Physican Solutions at 919-845-0054 or physiciansolutions@gmail.com PHYSICIAN SOLUTIONS MAGAZINE

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Physician Solutions, Inc. Medical & Dental Staffing The fastest way to be $200K in debt is to open your own practice The fastest way to make $100K is to choose

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THE DECISION IS YOURS Physician Solutions, Inc. P.O. Box 98313 Raleigh, NC 27624 Scan this QR code with your smartphone to learn more.

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