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The Three Top ADHD Medication Pitfalls and How to Avoid Them

One of the most effective management strategies for minimizing the challenges and symptoms of ADHD is medication. This might not be the most popular statement I have ever made, but research over and over again has shown that ADHD medications can “level the playing field” for adults with ADHD. Medications can be effective in helping adults with ADHD increase their focus on less interesting tasks, reduce impulsivity of actions and words and calm inner restlessness. I often hear clients describe the experience of being on the right medication as similar to having “the fog clearing”, “the water globe settling” or a “light switch being turned on”. They feel more focused, energetic, calm and productive. However, many adults never have the chance to experience the full benefits of ADHD medication due to three problem areas that I call “ADHD medication pitfalls”…taking the wrong medication, the wrong dose or taking medications at the wrong time.

“Medication Pitfall” #1

The first of these ADHD medication “pitfalls” is that many Adults with ADHD are not on the right medication. For good or bad, there is not a lot of variety in medications used to manage ADHD. In fact there are really only three. The good news is that with such limited options these medications have been studied over and over again for the past 50 years and we know the long term effects. The bad, is that there is a very limited choice of medications when it comes to treating the core ADHD symptoms.

ADHD medications can be divided into three categories: 1) Stimulants, 2) non-stimulants, and 3) “other”. Even though stimulants tend to be the most effective in decreasing the key symptoms of ADHD in adults, many people tend to avoid these due to real or feared side effects of the ADHD medication. Medications in this category include: Ritalin, Adderall, Dexedrine, Vyvanse, Concerta, etc. These medications are designed to “stimulate” the dopamine neurotransmitters of the brain; the key neurotransmitter that seems to be functioning ineffectively or in insufficient amounts in the brains of people challenged with ADHD. This category of medications is typically very effective in decreasing hyperactivity, distractibility and impulsivity.

The second category of ADHD medications is non-stimulants. These include such medications as; Strattera, Wellbutrin and Effexor. These typically increase the levels of norepinephrine and serotonin in the ADHD brain and can help increase the mood, energy and motivation of people with ADHD. The third category is what I call “others”. These include such medication as: klonopin, Tenex or Provigil. These ADHD Medications are typically prescribed to reduce ADHD symptoms such as impulsivity or to increase alertness (as in the case with Provigil). Each of these categories of medications works differently to help manage symptoms of ADHD.

“Medication Pitfall” #2

The second pitfall is not taking the right “dose”. The experience of ADHD is different for every adult and everyone’s experience of taking medications is a bit different. There are guidelines prescribers follow, but the dose that is right for you may not be right for someone else and vice versa. If you are on too low a dose of medication you will not get the full positive benefit of the medication. If you are on too high a dose, you may experience more negative side effects than you have to. The goal is to find just that right dose that balances the positive effects and minimizes negative side effects.

“Medication Pitfall” #3

The third pitfall is “wrong time”. You can be taking the right type of medication, at the right dose, but if you take it at the wrong time, you may not be experiencing the most benefit. Some medications work best taken when we wake to help get us started with the day. Some need to be taken multiple times a day at specific intervals to get their full consistent benefit. And finally, some medications, when taken at night, may help us sleep more soundly.

When you are trying to find the right ADHD medication for yourself, it is important to work with a prescriber who is knowledgeable about adult ADHD and ADHD medications. This may sound simple, but it’s not. You want your doctor to help you understand how the medications work, which ones might work best for you and support you in understanding your choices. Find out as much as you can for yourself about what choices are available and keep a consistent daily ADHD medication log or ADHD medication record to help you determine what medication works best, at what dose and at what intervals.

Stabilizing Chronic Health Conditions Depends On The Compliance Of Medical Treatment

Aging brings with it several problems, including many chronic health conditions that can require regular care. One of the important parts of this care is making sure to properly comply with the medical treatment prescribed by doctors and caregivers. This may include regular intake of medications, routine medical check-ups, and scheduled testing. Whether it is a chronic medical condition like diabetes or hypertension, or problems related to sleep, anxiety, and so on, adhering to the advice of doctors and caregivers is absolutely essential.

Challenges Faced by Caregivers with Regard to Compliance

One of the biggest challenges faced by caregivers is seniors who refuse to comply with their recommended medical treatment. Caring for the elderly, especially those with chronic health conditions, can be quite daunting, given that most of these people prefer their independence and often balk at having to take medications. Non-compliance can happen both when a person doesn’t fill his or her medication as prescribed by their medical practitioner, and when they neglect (or refuse) to complete the recommended dosage. In any case, before going on to finding ways to ensure compliance with medical treatment, it is important to identify the exact reason for such non-compliance.

Reasons for Non-compliance

In the case of seniors, non-compliance with the recommended medical treatment or procedure occurs due to multiple reasons:

– Forgetful nature: One of the main reasons why many senior citizens forget to take their medicines and miss their checkups or other medical tests is simple: they forget. The aging process reduces the ability of the person to remember things. Under these circumstances, it is natural for older individuals to forget that they need to take medications or go to a doctor’s visit, which results in non-compliance. Having a medical alert system set up with reminders goes a long way in ensuring that they will not forget these important things.

– Non-belief: Another reason for non-compliance is that the elderly often do not believe that the drug in question is actually working. For instance, when a senior citizen has to take medications for blood pressure or cholesterol, chances are that there is no immediate sign of the drug working. In fact, these drugs take a long time to show actual results, which makes the patient feel that the medications are pointless, and encourages them to forego their recommended dosage.

– Side effects: The presence of actual side effects, as well as the fear of side effects, also leads to non-compliance in the elderly. Medications taken for various ailments by the elderly often cause certain side effects, which, given their advanced age, can be quite alarming to experience. When such a situation occurs, the senior in question refrains from taking the medications rather than experience the side effect. Add to this the fact that the independent nature of the senior will not allow him or her to actually talk about such occurrences or fears to the caregiver.

– Multiple prescriptions and medications: When the senior citizen is swamped with numerous medications that need to be taken, non-compliance is a commonality. This occurs either due to the overwhelming nature of the sheer number of drugs, or the inability of the senior to keep track of each dose and its timing.

Disappearance of symptoms and the need to save money are two other factors that contribute to such non-compliance. If an individual believes that the symptoms which caused the doctor or practitioner to prescribe the drug do not exist, non-compliance sets in even if the dosage is not complete. Additionally, when the elderly person believes that there is a need to save money, which can be achieved through stopping his or her medications, non-compliance rates shoot up.

Tips for Improving Compliance

Once the reasons for non-compliance are identified, the next step is to determine how to ensure compliance. Here are some simple tips that will help in this endeavor:

– Set a daily routine: Forgetfulness is the most common cause of non-compliance in elders. This can be overcome by setting daily routines with the help of the caregiver. For instance, medications could be taken in relation to another activity, such as while eating meals or right before going to bed. Once this routine is established, the senior in question will automatically take the medicines at this time.

– Using aids for boosting memory: Another simple way to ensure compliance is through the use of memory boosting aids. Medical alert systems are perfect companions for seniors who live independently and need to remember their medication dosage and timings. These units can be programmed in advance for the exact dosage that needs to be taken, as well as the time of taking such a dose. It is important to note that medications, especially those related to the central nervous system, need to be taken at exact times to ensure proper effect. These alert systems can be used to make sure that the senior is reminded of the medication at the appropriate moment.

– Reminder services for filling prescriptions: Similarly, medical alert systems can be used for programming reminder services for filling prescriptions. Non-compliance often occurs because seniors don’t fill prescriptions on time. With the help of such services and alarms, elders can ensure absolute compliance by filling their prescriptions on time.

Since adherence to recommended medical procedures and treatment is vital for stabilizing chronic health conditions, the above mentioned tips can be used along with medical alert systems to ensure compliance.

Safe Medications Management At Home

Realizing the importance your medication plays in your treatment will help you get the most benefit from your prescription. It is important to take an active role in your health care by being a participating member of your own health care team. Work with your doctor, nurse, and pharmacist to learn as much as possible about your prescription.

Here are some questions to ask your doctor or pharmacist when you are prescribed a new medication, and suggestions on how to safely manage medications at home.

1. Ask for the name of the medicine, including generic and brand name. This can help avoid prescription mistakes. When your doctor prescribes you a new medication, disclose the names of all the medicines you are currently taking, including all supplements, over-the-counter and prescription medications. State any allergies to any medication.

2. Ask for indications, exactly what is this medication prescribed for.

3. Ask for possible side effects and what to do in case of an adverse reaction.

4. Ask for dose and frequency to be taken.

5. How is the medication to be taken? The most common routes for medication’s administration are orally or by mouth, injection; or topically or locally applied such as creams or eye drops.

6. Are there special instructions while taking this medication such as foods, use of alcohol, other medicines; or activities you should avoid while taking this medicine? Ask about any specifics such as take with food, take on an empty stomach, do not crush or activities to avoid such as driving, use of machinery, swimming or exposure to sunlight.

Is there any written information you can take home? Most pharmacies have information sheets that you can use as an at-home reference.

If a doctor is prescribing a medication that is to be taken multiple times a day ask if it can be substituted for a prescription that is equally as effective but given only once or twice a day, thus reducing chance of forgetting to take the medication and even be more cost effective.

Ask if the medication is available in both generic and brand name, ask the pharmacist the difference between the two and decide based on that information. In many instances is more beneficial to request the generic name versus the brand name.

7. How many refills of the prescription are allowed? Some drugs and medication’s management plans have the option to purchase multiple refills at once, up to three months’ supply, for medications that are to be taken for a long-term or are part of the patient’s permanent treatment plan. Usually this system is more cost-effective for the customer.

Ask the doctor for samples, especially if it’s a medication that will be for short-term use, or if you are doing a trial.

8. What should you do if you miss a dose? What should you do if you accidentally take more than the recommended dose?

9. Ask for alternative’s prescription form that best suits you or your patient’s needs. If your child cannot swallow pills, request the medication on liquid form if available. The same applies for the elderlies or adult patient who has difficulty swallowing.

Do not change the form of any medication without speaking to your pharmacist. Some medications can be crushed, chopped and mixed with apple sauce or juice whereas some medicine is unsuitable in any other than the original form. Always ask before altering a medication’s form. Sustained release pills should not be crushed, and some capsules should not be opened.

During your treatment, you may want to schedule a follow-up visit with your physician in order to monitor your progress. Make sure to report any problems or side effects you are experiencing with your prescription.

Drugs and medications safety management.

One in three hospital discharge results in re admissions due to noncompliance with medication’s regimen or miss uses of medications after discharge from the hospital.

Two in five pediatrics Emergency Department visits are related to medications use, misuse or accidental ingestion.

Millions of elderlies and disabled people are being over medicated due to the lack of a centralized system that will monitor patient’s prescriptions and treatments.

A few simple precautions to avoid medication’s incidents, whether in adults or children

1. Keep all medications away from children reach.

2. Use child proof caps on medication’s bottles if possible. Some adults may have difficulty opening bottles with child-proof caps due to pain on their hands, weakness caused by a stroke or other conditions.

3. Medication’s labels should be clear and easy to read. If the labels on the bottles are worn off, take the medication bottle to the pharmacy and ask for a new label.

4. When the patient is discharged from a hospital admission, ask the clinician to reconcile all the patient’s medications to be taken at home.

5. Ask questions to the pharmacist before leaving the pharmacy after picking up the medication.

6. Make good use of a medication dispensing system such as a pillbox.

7. Make good use of medication’s reminders. There are many medication’s reminders systems in the market; many of them are free services. Many pharmacies offer services for refill reminders.

8. Create a medication record listing all the medications used, update it frequently and carry a copy with you at all times. Take the medications list to every physician’s appointment and share it with the attending physician and specialist.

9. Follow the golden rule while taking or administering a medication.

• The Right Patient

• The Right Medication

• The Right Dose

• The Right Time

• The Right Route

Ileana Perez is a Registered Nurse and Health Educator. She is the founder and CEO of thecaregiverconsole.com – an e-coaching website designed specifically for caregivers of the terminally ill and elderly. Ileana has amassed over 40 years of experience working as a Registered Nurse in the emergency department and operating room, as well as working as a home-care nurse. Having served as the caregiver of her late parents, Ileana knows firsthand the struggles that a caregiver faces while providing for the elderly.

Understand the Options for Choosing Diabetes Medications

Do you ever wonder how your physician chooses an appropriate medication for you? Do you feel overwhelmed by the sheer number of available medications? These tips will help you understand the choices that are available. In subsequent articles, there will be more information about each class of medication.

While there are hundreds of medications and combinations of medications available, there are seven different classes of medication. Each class works in a different way. Your physician uses his knowledge about you as well as your specific type of diabetes to first decide if you need any medication, and if so, which class to use. He then chooses a medication from that class. If you require medication from more than one class he may choose to prescribe more than one medication or a combination pill which has two or more medications contained in it. This article will provide a brief overview of the classes of medications and how they work.

1.) The oldest class of medication is the sulfonylureas. Until the mid-1990s, this was the only class of oral medications available. Your body must be able to produce insulin in order for these to be beneficial, as they work by stimulating the beta cells of the pancreas to secrete insulin. Some examples of the first generation of these medications are: Tolbutamide (orinase), Tolinase (tolazamide), and Diabinese (chlorpropamide). Some of the second generation medications are: Glipizide (glucatrol), extended release Glipizide (glucatrol XL), Glyburide (Micronase, Diabeta), Glynase (micronized glyburide), and Glimepiride. These medications are distinguished by how long they last in the body, and whether they are cleared by the kidney or the liver. There are two other drugs in this class: Prandin and Starlix, which can be used before meals because they last for a very short time.

2.) The biguanide class has just one medication, called Metformin. Other names are Fortamet, Glucophage, Gluymetza, and Riomet. This medication works by decreasing glucose production in the liver, and it also causes a small increase in glucose uptake by skeletal muscle. If there are no contraindications, the American Diabetes Association as well as the American college of clinical endocrinologists recommends using this medication first.

3.) In the mid-1990s, the Thiazolidinedione class of medications (also known as glitizones or TZDs) was developed. Their primary mechanism of action is to increase insulin sensitivity, which leads to more glucose being taken up by skeletal muscle. Three medications were developed. The first, Rezulin (troglitazone), was taken off the market because it was suggested to cause liver problems. The second, Avandia (rosiglitazone), was withdrawn from the market in Europe but was allowed under selling restrictions in the US because of an increase in cardiovascular events. The third medication, Actos (pioglitazone) had sales suspended in France and Germany because a study suggested it may increase the risk of bladder cancer.

4.) Drugs that affect the incretin system are divided into two subclasses:

a. The first division is composed of injectable drugs which mimic the effect of natural incretins produced by the body. Medications in this class include Byetta (exenetide), Bydureon (long acting exenatide) Victoza (liraglutide), and Symlin. They work by increasing insulin secretion in response to glucose (sugar), decreasing the rate at which the liver puts out glucose, decreasing appetite, and by slowing the rate the stomach empties. These medications have become quite popular because they can help with weight loss, and have an extremely low incidence of hypoglycemia. However, these medications have been in the news because they have been associated with pancreatitis, and may lead to a slight increase in medullary thyroid cancer.

b. The oral medications in this class work by blocking the enzyme which breaks down the incretins. While the level of natural incretins increases somewhat, these drugs are not as effective as the injectable ones. Medications in this class include Januvia (sitagliptin), Onglyza (saxagliptin), and Tradjenta. They are being observed to watch out for complications similar to the injectable medications. They very rarely cause hypoglycemia and do not cause weight gain. They are all being evaluated for a potential cancer risk.

5.) There are three Alpha Glucosidase Inhibitors: Acarbose (Precose), Miglitol (Glyset), and Voglibose. These work by preventing digestion of carbohydrates in the intestine. By preventing carbohydrates from being converted into simple sugars and absorbed into the blood stream from the intestine, this class of medications can help keep the blood sugar from rising after meals.

6.) The newest class of medications is the SGLT2 inhibitors, which block absorption of glucose by the kidney. By increasing the amount of glucose lost through the urine, and decreasing the amount of sugar absorbed back into the blood stream, blood sugar may be decreased. Because none of these medications has been approved by the FDA, the names of the medications are omitted from this article.

7.) Insulin must be used for people with type I Diabetes and is often needed for those with type 2 Diabetes. There are many types and delivery systems which will be discussed subsequently.

With a thorough understanding of your specific type of diabetes, your physician can wade through all the options to select the best match for you. More detailed information about each drug class will be presented in subsequent articles here, and on my website, diabeticsurvivalkit.com. Please feel free to visit at any time for information about medications, cooking videos featuring diabetic meal and dessert recipes, and current news articles.

And now, Dr. Kramer invites you to her website, which she operates with her daughter Tova. There, you will find cooking videos featuring recipes appropriate for people with diabetes, a blog containing diabetes news and other interesting content, and the ability to connect directly with Dr. Kramer. She and her daughter would like to know how they can serve you!

How To Properly Utilize a Medical Alert System While Alone During a Medical Emergency

There are ways to use just about any device improperly. Lack of knowledge is typically one of the most common reasons why devices are improperly used. For devices that are created with the intent to be used in a medical emergency, such as a medical alert system, the difference between proper and improper use can be life or death.

Do you know how to react in a medical emergency? With or without a medical alert system in your home? One of the hardest things to do in a medical emergency is to not panic, but unfortunately it is one of the most common things people do in these types of situations. Panic is just the simplest response to an emergency because it is instinctual and it is done without thinking. People also panic because they have no idea what else to do! This is very sad because panicking is the most dangerous reaction a person could have in an emergency situation. People who panic can cause a lot more harm than good during a medical emergency. One of the best ways to keep yourself from panicking during a medical emergency is to know how to handle one, especially for when you are all by yourself. Here are some great tips to help you know how to handle a medical emergency and get through it in the safest way possible.

Press Your Medical Alert Button
For the most part, since you have equipped your home with a medical alert system, you can easily call for help by hitting your medical alert button located on your medical alert bracelet, necklace or pendant. This will automatically dial a care center where a trained help advisor will be on the line in just seconds, ready to call your family members, friends, neighbors or send emergency assistance to help you with any medical emergency. The help advisor will also stay on the line with you until help arrives. However, if you are out of your home, or maybe you have unfortunately not invested in a medical alert system, you will need to call 911. In cases where you are alone, reaching the phone may be difficult to do if you are injured after a fall and you are unable to move. That is why a medical alert system is very valuable to have, especially during a medical emergency when you are all by yourself.

Some people don’t call 911 first because they are trying to assess the situation, and not bother 911 if the emergency is not that dire. This can cause the person to lose valuable time that is necessary for helping them survive the situation. Do not wait to call 911 or press your medical alert button. Even if the emergency turns out to not be that serious, it could have been, and hesitation is another enemy of medical emergencies.

If Physically Injured, Try Not to Move
Many times when people fall, they try very hard to get themselves back up or move around to attempt to find a comfortable position. This is the absolute worst thing a person can do in the case of a medical emergency when a fall is involved. You may not realize, but you may have a neck or spinal cord injury. Moving can cause even more harm and possibly cause you to become paralyzed.

If you have a medical alert system in your home as you should, you will be able to call for help with such minimal movement because you will only need to move your hand to press the medical alert button on your medical alert bracelet, pendant or necklace. Not having to move much to call for help during a medical emergency in which you are alone is a very important aspect of trying to maintain mobility after the fall.

If you do not have a medical alert system and need to try to get to a phone, you run the risk of injuring yourself further. If you have nearby neighbors, try to shout for help and hope someone hears you. Otherwise, you can either wait until someone finally comes, or risk injuring yourself further by trying to move and get to a phone to call 911.

Keep Medication With You
Some people take many medications that can help them immediately in the event of a medical emergency. Obviously, sticking ten different pill bottles into your pockets will never be practical, but keeping a small pill case in your pocket with a few of each important pill in it is good practice just in case of a medical emergency. This way, you can have the medication you need in seconds.

When you are alone, you can not exactly ask anyone to get your medication for you, so if you collapse due to a issue that one of your medications can fix, the pill case in your pocket will be your best friend. However, if you have not prepared for this situation, a medical alert system can act as another person in your home and call medical personnel to help you promptly. Without a medical alert system, it will be difficult to tell how long you might be without your medication, or if you will even survive the situation.

Medical emergencies can happen at any moment, even when you are alone. It is vital that you prepare yourself before they happen and not after the fact. Being knowledgeable about how to handle a medical emergency will be the best way to prepare yourself to combat one. Having a medical alert system in the home will even further help the situation since it basically acts as another person that can help you get the help you need.

Reasons Why Your Medical Career Crashes

Once you become a doctor, it marks a turning point at which most doctors start slipping backwards. There’s a reason! 
Your burning passion and rugged determination for your medical career goals is not enough to overcome the barriers to your planned and expected maximum success in medical practice. It’s a reality that you shouldn’t have to face, and that you don’t deserve.

There are reasons why and what you can do about it. It’s one of the most distressing, yet understandable, factors leading to career failure. The meaning of failure as used here is the complete inability of over 95% of doctors to reach their maximum potential as a doctor.

It also includes your inability to create and maintain a medical practice that will ever reach the profitability potential it has the capacity to foster. In clearer terms, unless you are prepared to do what needs to be done to reach those highest levels of accomplishments, you will fail to a significant degree.

The inability refers to the absence of training and education that are required to rise above the others. As a result you are effectively programmed to fail by the institution that qualified you to be a doctor.

Consider a few factors that lead you to this unholy position: 
You have not been provided with the essential tools to run your medical practice business efficiently and profitably. It means you have no business or marketing training or education.

A challenge to your intellect and common sense:
Is it possible in our present economic environment to create a successful, constantly growing, medical practice business when the doctor owner has no real knowledge about how to do that effectively without expert help?

A “no” answer indicates you are quite comfortable about extracting from your medical career just enough abundance and satisfaction to make do. In other words, you are a hostage to your circumstances.

A “yes” answer indicates that you have not yet matured in business far enough to recognize that all of your sheer-brilliance in medical knowledge is never enough to create a maximally productive medical practice business-just enough to get by with for a while.

You have “educational burnout” without even recognizing it. The evidence of this is obvious when you consider these issues:

  • Why is it necessary to require doctors to complete CME hours for maintaining medical licensure?
  • Why is it compulsory to recertify for specialty credentialing?
  • Why is it that once you start medical practice there is no urgency or self-implied obligation to voluntarily maintain and continually update your medical knowledge?
  • Why is it that the need to have a business education is such an unnecessary and objectionable necessity that is totally ignored by most doctors? Yes, you promised yourself there would be no more burning the midnight oil again.

What possible reason would medical education pundits have to neglect the need to provide a business as well as medical education to medical students? Could it be that they knew about the educational burnout phenomenon and didn’t want that to happen during your medical education and training? But was it OK if it came afterwords?

Your passion for practicing medicine gradually becomes crowded out of your mind. That’s because once you become aware of the fact that your medical career is not able to provide you with the higher goals you had in mind at the start and turned out to be only a pipedream in reality.

For those doctors who already have wealth and adequate funding, there seems to be no real concern about these kinds of issues. However, for most doctors that is not the case. My concern is about the latter.

The real life examples of how these arcane factors are born:
The sequence of ominous changes in your passion for your medical career is one of the most distressing, yet understandable, factors leading to career failure. It begins with graduation from medical school, sometimes even sooner. It’s something older doctors see in their rear view mirror.

Prestige, recognition, fulfillment, happiness and expectations in your medical career seldom increase with time but rather fade with time. As you proceed in your medical career goal setting beyond medical school, the bright lights, celebrations and spectacular accomplishments disappear in the sunset. It starts almost immediately on entering your medical practice.

The day you completed your internship, were you given a loud sendoff, glory and recognition that would shake the pillars of medicine? Did you deserve that? Absolutely… but it doesn’t happen.

The revelation suddenly hits you in the face that there will be no more public pats-on-the-back. From now on your dedication to your obligations and career success becomes an investment in personal satisfaction.

Your reward for completing a residency in your specialty is simply whittled down to a medical certificate of residency completion, not a rousing cheering crowd. Your self-esteem benefits, but your wallet suffers.

Either you are headed for private medical practice of some nature, or you are feeling the overpowering need for security by becoming an employed physician.
Right here at the end of all your formal medical training, you are at the highest level of your medical knowledge with the incredible skills and ambition to take-on any of medical practice challenges put in front of you. From here on you are on your own.

No one is there to push or inspire you further and higher, except yourself. Previously, you had back up. Now you don’t. Even your family that has not lived in your shoes themselves can’t really help you much in your medical career choices and goals.

The next step in your career is even more stressful. And it’s outrageously insulting to all new doctors. Why? Because you don’t deserve this second step of disappointment as your reward for years of sacrifice and struggle.

Medical practice becomes your next teacher and mentor:
This new environment of medical practice has a bundle of harsh lessons to teach you. Of course, no one has discussed these things with you in any depth because they didn’t want to discourage you. These soft lies of omission leave scars. It leaves you naïve and vulnerable, which is much worse than giving you the truth to begin with.

This one thing is far more damaging to your medical career than you can believe. Every medical doctor is affected to a significant degree during his or her career as a result of being forced to adapt to the persistence of unexpected events that they could have prepared for if someone had told them what’s ahead.

Can you imagine how much stress in your practice over the years could have been prevented by knowing and preparing?

What are your options for avoiding or resolving these destructive factors regarding your medical practice career?
As with the activities and strategies required for success, there is no one simple laser-guided response for every person to follow to arrive at their personal highest level of achievement that they call “success.”

However, there is only one commonality found among the successful people that you may not care to hear about.

“It is a stronger, deeper, more unrelenting commitment to success far beyond what most ever marshal.”
(Source: No B.S. Marketing Letter, GKIC, Dan S. Kennedy, Nov. 2012)

This simple golden rule of success implies that we must reach a point in time when our minds become aware of the chain of events, predictable side effects, and consequences that are adherent to your decisions. Thus, it enables you to correctly ascertain whether a decision you make is complimentary to your objective, diverges from your objective or is in direct conflict with your objective.

Your decisions about your medical career are even more complex than any you have previously made. It involves making good decisions at the start but doesn’t exclude good decisions being made throughout your medical practice years.

For most doctors and other medical professionals who haven’t lost their desire to perform at maximum levels, it will often require one or more of the following:

1. You must know yourself:
What are your skills, talents, interests, activities that create satisfaction, biases, and toleration limits, among others? You need to spend a few hours quietly putting these attributes in order, even in priority. Sometimes it takes several sessions with other people (usually parents) who know you quite well and listening to what they see in you that you don’t see.

Many college graduates are unaware of who they really are inside, and what capacity they have to succeed. Therefore, they stumble along relying on their “above average” intelligence to keep them on track to a few objectives.

If you aren’t aware of what you need to do to be happy with your life and profession by the time you finish college, you are likely not to discover that later on. This factor becomes a life long millstone around your neck.

2. You must continue to set goals to be accomplished during your whole life: 
Without goals, you lose your passion and determination. Over 95% of doctors are hamstrung because they either have no idea what they are really capable of accomplishing, or have fears that prevent them from moving to higher levels of accomplishment such as:

  • Fear of being taken advantage of-easily led astray-analytical minded.
  • Fear of not being a success-of failing.
  • Fear of not fitting in-ostracized by peers-not a leader-hidesin the herd.
  • Fear of lack of approval of peers and friends-always social, energetic and fun-loving are the cover-up features.

You don’t set goals because of these same fears. It’s why so many great people tell you to face you fears and go right on through them no matter what.

3. Don’t expect a blueprint for success: 
Lee Milteer, professional highly regarded business mentor, says, “Success Is an Inside Job”. She teaches that you create your own success using the path from “visualization” to “mindset”. If you don’t understand that process, you need to find out how it works and trust it.

4. Create a laser focus on one primary objective: 
When you dilute your path with multiple goals, you are multitasking and are constantly changing decisions. You have set yourself up for a watered-down life and career.

If you find you have chosen the wrong objective, then move to a new focus on another primary objective. Never focus on more than one.

5. Real success in your medical career often results from maintaining your family obligations: 
Your level of success is corrupted when you neglect your family relationships. Divorce, broken homes, financial disasters, and lack of a religious heart results in not being able to fully enjoy your success when and if it arrives.

6. Make your personal integrity the basis of your career: 
Your integrity creates your character that others see and respect. You maintain the principles you live by under all circumstances in your profession. When your “word” is unreliable, you corrupt everything around you one way or another. You then live off the garbage other people discard.

There are many more examples of solutions you probably have experienced and know the value of that may be just as important as the ones I’ve mentioned above. If you thought I was going to give you a 1-2-3-4-5 answer to gaining total control of your medical career, you haven’t been reading between the lines of this article well enough.

Business experts universally agree that medical doctors are set-up to fail. If you care to debate the point, you should start by reading what Michael Gerber, business expert and author, has confirmed by working with many doctors over many years. He presents that in his best selling book, The E-Myth: Physician. Give yourself a huge dose of reality! Then swallow it with a gracious flow of genius.

The Right Prescription to Prevent Medical Identity Theft

What do you do with your empty prescription bottles? What about all of the medical information you receive, such as your explanation of benefits? Being careless with your personal medical information can be dangerous, and the theft of this priceless data can be deadly.

Approximately 1.5 million Americans are victims of medical identity theft each year, a crime that costs the nation $41.3 billion annually. Prescription fraud is a growing form of medical identity theft that is not only extremely costly and time-consuming; it can also put your health at risk and even be life-threatening. Unfortunately, medical identity theft isn’t commonly known by many Americans, and often isn’t detected until it’s too late. When we don’t take precautions to prevent prescription fraud and other forms of medical identity theft, we put ourselves in jeopardy of becoming another victim.

What is Prescription Fraud?

Prescription fraud occurs when identity thieves use your personal information to fill prescriptions in your name. They use your medical identity to receive medical treatment at hospitals and doctors’ offices, obtain medications, and access other healthcare services.

Prescription fraud doesn’t just leave you with a huge bill-it can potentially put your health at risk as well. You may find that false information has been added to your personal health record, such as a change in blood type or supposed allergies. Every medical procedure received and prescription filled by the identity thief becomes part of your medical history, which means you may not be able to obtain the life-saving treatment you need in an emergency medical situation.

Detecting and resolving medical identity theft can be difficult as well. You may not discover that you’re a victim until a pharmacy refuses to fill a prescription because it conflicts with another medication you appear to be taking. To make matters worse, fixing errors in your record can be very challenging due to medical privacy laws. Ironically, the same laws that were implemented to protect your privacy and health information are now protecting the medical identity thief. This restricted access to medical records prolongs the duration of the theft, costing you countless time, money, and frustration.

How to Prevent Prescription Fraud

One of the easiest ways to avoid this type of medical identity theft is simply to be aware of what you throw in the trash. Prescription medication labels carry such sensitive information as your full name and address, the prescribing physician, the type of medication, prescription number, and the pharmacy’s contact information-all of the things a thief needs to perform prescription fraud. Instead of throwing empty prescription bottles in the trash, including the drug information forms, remove the labels and shred them. Other ways to prevent prescription fraud:

• Review every explanation of benefits (EOB). Examine the charges for medical visits or prescriptions you didn’t receive, and report any suspicious activity immediately.

• Never simply toss medical information in the trash. Dumpster divers can easily access your personal information if you fail to shred the documents.

• Secure medical records. Keep your medical records in a safe place inside your home or in a safe deposit box, away from the prying eyes of visitors. Believe it or not, friends and relatives who have easy access to your personal information are often the culprits.

• Safeguard prescription bottles. Hide or lock-up your medication rather than leaving it in plain sight or in a medicine cabinet. This will prevent anyone from walking off with your prescription medication and, later, your identity.

• Manage written prescription slips. Don’t throw them away or leave them out where they can be stolen. These slips are all an identity thief needs to fill a prescription in your name, leave you without your medication, steal your medical identity, and even put your life in danger.

• Enlist the help of an identity theft protection service such as ID Theft Solutions, which can proactively help prevent medical identity theft and even restore your identity when it’s stolen.

Protecting your identity is an ongoing process that takes vigilance. By taking some common sense precautions, you can avoid the exorbitant costs and health risks of medical identity theft.

What Is Medical Malpractice?

In medical malpractice, a doctor or medical facility has failed to live up to its obligations, resulting in a patient’s injury. Medical malpractice is usually the result of medical negligence – a mistake that was unintentional on the part of the medical personnel.

Determining if malpractice has been committed during medical treatment depends on whether the medical personnel acted in a different way than most professionals would have acted in similar circumstances. For example, if a nurse administers a different medication to a patient than the one prescribed by the doctor, that action differs from what most nurses would have done.

Surgical malpractice is a very common type of case. A cardiac surgeon, for example, might operate on the wrong heart artery or forget to remove a surgical instrument from the patient’s body before stitching the incisions closed.

Not all medical malpractice cases are as clear-cut, however. The surgeon might make a split-second decision during a procedure that may or may not be construed as malpractice. Those kinds of cases are the ones that are most likely to end up in a courtroom.

The majority of medical malpractice lawsuits are settled out of court, however, which means that the doctor’s or medical facility’s malpractice insurance pays a sum of money called the “settlement” to the patient or patient’s family.

This process is not necessarily easy, so most people are advised to hire an attorney. Insurance companies do their best to keep the settlement amounts as low as possible. A lawyer is in a position to help patients prove the severity of the malpractice and negotiate a higher sum of money for the patient/client.

Lawyers generally work on “contingency” in these types of cases, which means they are only paid when and if a settlement is received. The lawyer then takes a percentage of the total settlement amount as payment for his or her services.

Different Types of Medical Malpractice

There are different kinds of malpractice cases that are a result of a variety of medical mistakes. Besides surgical errors, a few of these cases include:

Medical chart mistakes – In this case, a nurse or physician makes an inaccurate note on a medical chart that leads to more mistakes, such as the wrong medication being administered or an incorrect medical procedure being performed. This could also lead to a lack of proper medical treatment.

Improper prescriptions – A doctor might prescribe the wrong medication, or a pharmacist might fill a prescription with the wrong medication. A doctor may also fail to check what other medications a patient is taking, causing one medication to mix in a dangerous way with the other. Some pharmaceuticals are “contraindicated” for certain conditions. It might be hazardous, for example, for a heart patient to take a particular medication for an ulcer. This is why doctors need to know a patient’s medical history.

Anesthesia – These kinds of medical malpractice claims are usually made against an anesthesiologist. These professionals give patients medication to put them to sleep during an operation. The anesthesiologist usually remains in the operating room to monitor the patient for any signs that the anesthesia is causing problems or wearing off during the procedure, causing the patient to awaken too soon.

Delayed diagnosis – This is one of the most common types of non-surgical medical malpractice cases. If a doctor fails to determine that someone has a serious illness, that doctor might be sued. This is especially dire for cancer patients who need to detect the disease as early as possible. A wrong diagnosis can cause the cancer to spread before it has been detected, endangering the patient’s life.

Misdiagnosis – In this case, the physician diagnoses a patient as having a disease other than the correct condition. This can lead to unnecessary or incorrect surgery, as well as dangerous prescriptions. It can also cause the same injuries as delayed diagnosis.

Childbirth malpractice – Mistakes made during the birth of a child can result in permanent damage to the baby and/or the mother. These kinds of cases sometimes involve a lifetime of payments from a medical malpractice insurance company and can, therefore, be extraordinarily costly. If, for instance, a child is born with brain damage as a result of medical malpractice, the family might be awarded regular payments in order to care for that child throughout his or her life.

What Happens in a Medical Malpractice Case?

If someone believes they have suffered harm as a result of medical malpractice, they must file a lawsuit against the responsible parties. These parties might include an entire hospital or other medical facility, as well as a number of medical personnel. The patient becomes the “plaintiff” in the case, and it is the burden of the plaintiff to prove that there was “causation.” This means that the injuries are a direct result of the negligence of the alleged medical professionals (the “defendants.”)

Proving causation usually requires an investigation into the medical records and may require the assistance of objective experts who can evaluate the facts and offer an assessment.

The settlement money offered is often restricted to the amount of money lost as a result of the injuries. These losses include medical care costs and lost wages. They can also include “loss of consortium,” which is a loss of benefits of the injured patient’s spouse. Sometimes, money for “pain and suffering” is offered, which is a non-financial payout for the stress caused by the injuries.

Money for “punitive damages” is legal in some states, but this generally occurs only in situations where the negligence was extreme. In rare cases, a physician or medical facility is found to be guilty of gross negligence or even willful malpractice. When that happens, criminal charges may also be filed by the local authorities.

In examples of gross negligence, the health department might revoke a doctor’s medical license. This does not happen in most medical malpractice cases, however, since doctors are human and, therefore, all capable of making mistakes.

If the plaintiff and the defendant’s medical malpractice insurance company cannot come to an agreeable sum for the settlement, the case might go to trial. In that instance, a judge or a jury would decide the amount of money, if any, that the plaintiff/patient would be awarded for his or her injuries.

What Is Medical Negligence?

Medical negligence occurs when medical treatment falls below expected standards. If a patient becomes injured as a result of medical negligence, that patient might file a lawsuit claiming medical malpractice. If a patient dies, the family might then file a wrongful death lawsuit.

The most common type of medical negligence involves surgery, but it can happen with any nurse, physician, medical technician, or medical facility. The different types of medical negligence are almost endless. Here are some examples:

Damage to a neighboring organ during surgery.
A wrong diagnosis that leads to no treatment for the condition or the incorrect treatment for the condition.
A doctor who tells a patient that he or she is okay, causing a delay in treatment that eventually leads to injury. This is especially dire if an illness is progressive, such as cancer.
A dentist whose negligent treatment causes the patient to lose teeth.
An incorrect medication or the prescription of a medication in a harmful dosage. This can be negligence on the part of a doctor prescribing the medication, a nurse administering the medication, or a pharmacist.
Unnecessary surgery that results, for example, in the inability of the patient to have children.
A botched cosmetic procedure that causes an injury or a severely displeasing result.
A medical instrument accidentally left inside a patient during surgery.
Mistakes on a medical chart that lead to incorrect medical procedures or medications.
Improper or ineffective anesthesia administered prior to surgery.
A mistake made during childbirth that leads to the death of the infant or permanent injury to the infant, such as brain damage. Cerebral palsy is often a result of this kind of medical negligence.

The Difficulty of “Causation”

In order for a patient to have a medical malpractice claim for medical negligence, he or she has to prove (1) that the medical professionals had a duty to provide a standard of care and failed to do so, (2) that the patient suffered an injury or injuries, and (3) that the injury was caused by the alleged medical negligence.

What does “standard of care” mean? It varies from state to state. Some laws restrict the standard to physicians in the same area of the country, while others extend the standard to doctors on a national level. For example, a heart surgeon will be held to the standard of other surgeons in the same field. If he or she acted in a way that differs from the way most heart surgeons would have acted in similar circumstances, that surgeon may be found to have been medically negligent.

Since the body consists of interconnected systems, “causation” is a complicated issue in medical negligence. The medical personnel might argue that the treatment did not cause the injury but that it was instead caused by a condition the patient already had.

Psychologists and psychiatrists can also be sued for medical negligence, although these types of cases are much more difficult to prove because not only are the injuries non-physical, but causation is particularly complex.

In any type of case, the attorneys assigned by the physicians’ malpractice insurance company will likely try to argue that the injury was not caused by medical negligence.

For this reason, people who suffer injuries are advised to hire a lawyer to help them negotiate a settlement to recover the costs they incurred. Lawyers in this situation work on a “contingency” basis, which means that they do not require the client to pay them. Their fees are contingent upon receiving settlement monies from the medical malpractice insurance company. If the lawyer is successful in obtaining a settlement for the client, he or she then takes a percentage of the money as a fee. If the lawyer is not successful, he or she does not earn any money for the work. As a result, lawyers work hard to obtain settlements for their clients.

In some states, the settlement might include funds for pain and suffering, which is not a reimbursement for costs but a payment for the emotional stress experienced from the injury. Some states also allow for “punitive damages” if gross negligence or misconduct is involved. The amount allowed for such damages is often restricted. In the state of California, for example, no more than $250,000 can be awarded for non-economic damages.

When gross negligence or misconduct is involved, the local authorities might also bring a criminal action against the physician or medical facility. This action is separate from a medical malpractice case. In a criminal action, the plaintiff is the city or the state. A medical malpractice lawsuit is called a “civil” action, and the plaintiff in that case is the injured patient. Both the criminal and civil cases would have one or more defendants in common, however. The defendant is the person who is defending the claim – the party or parties who are alleged to have been medically negligent.

Note that only in cases of gross negligence does the health department take away a doctor’s medical license.

Do All Medical Negligence Cases Go to Trial?

Most of these cases are settled out of court, but when the parties cannot agree on a settlement amount, the case goes to trial. A judge or jury then makes the decision as to whether the patient is entitled to monies and how much. Before a case goes to trial, however, years of negotiations might pass. During that period, the lawyers for both sides prepare legal papers that answer the questions of the other party. These are called “pre-trial discovery” papers.

Depositions are also often taken of the parties. These are interviews that allow the opposing side’s attorneys to ask questions.

It is not unusual for a settlement to take place at the courthouse during the jury selection process. This is a tactic that pushes both sides against the wall, trying to coerce them to give in. The plaintiff wants the defendant to give in by offering more money in the settlement, while the defendant wants the plaintiff to give in by accepting the current settlement offer. No one ever wants to take a case to trial if it can be helped because the costs of court are much higher than out-of-court settlements.

Should You Become a Sonographer or a Medical Assistant?

As the title implies, Diagnostic Medical Sonographers or ultrasound technologists assume diagnostic responsibilities as related to assessing sonographic images. Sonographers are highly skilled professionals who are proficient at using specialized ultrasound medical equipment and interpreting the images produced. They must use professional judgment when determining the images needed and while interpreting results. The Medical Assistant does limited clinical duties, as directed by physicians and other healthcare professionals, and a variety of administrative duties. It is a more generalized profession than ultrasound technology.

Typical Duties of the Sonographer

A Diagnostic Medical Sonographer uses medical equipment that produces high frequency sound waves to create visual images of the body’s organs, tissues and systems. Using a transducer that sends regular high frequency sound waves into the body, the ultrasound technologist moves it around the skin over the internal structures to be assessed. The sound waves bounce off the tissues, organs and systems, and the computerized medical equipment constructs an image of the internal structures.

To ensure quality images are produced, the sonographer does the following work activities during a normal shift:

  • Create, review and update patient’s medical history
  • Verify ultrasound equipment is working properly, performing routine tests and maintenance activities
  • Input data into imaging software systems and process relevant information
  • Assist patients with getting on and off the imaging table and position the patient’s body as needed to obtain the ideal images
  • Determine the type and number of images needed for ideal diagnostic results
  • Assess images, looking for signs of physical disorders or diseases, and document technical findings for transmission to physicians
  • Maintain a variety of medical records and required forms, both medical and legal
  • Work with a variety of healthcare professionals, including physicians, radiologists, registered nurses, patient aides and numerous other people
  • Regularly interact with department personnel

Typical Duties of the Medical Assistant

A Medical Assistant performs a wide range of duties under a physician’s direction. The job responsibilities may include office work like insurance billing and clinical work like drawing blood. The range of duties assigned is often dependent on the size of the medical office or the type of medical facility where the Medical Assistant works. The typical daily tasks include the following:

  • Review medical history with the patient and ask patient for description of main reason for medical office visit
  • Record, update and maintain patient information, including the medical history and medical test results
  • Escort patients to medical examination rooms, take vital signs and instruct patient on preparing for the physician’s exam
  • Maintain patient examination and treatment rooms and treatment room instruments, ensuring everything is kept clean and orderly
  • Prepare medications and administer as required by physician, including giving shots
  • Collect laboratory specimens as directed by physician, including blood, urine and tissue and ensure specimens are properly stored and documented
  • Assist physician in examination room
  • Operate routine diagnostic medical equipment like an electrocardiogram machine or x-ray equipment
  • Call pharmacies convey prescription drug orders or authorize refills
  • Deliver physician instructions to patients, plan diets, explain medical treatments and necessary advance preparations, and review medications and possible side effects
  • Perform medical office duties like answering the phone, scheduling appointments, completing patient check-in procedures, completing insurance forms and other general duties
  • Track and manage medical supplies inventory

Comparing Salaries

Diagnostic Medical Sonographers earn twice as much as Medical Assistants. This is according to the Bureau of Labor Statistics’ May 2012 occupational wages survey. Sonographers earned an average annual wage of $66,360 or $31.90 per hour.

During the same time period, Medical Assistants earned an average annual wage of $30,550 or $14.69 per hour. The average annual wage scale for ultrasound technologists was $44,990 to $91,070. For Medical Assistants it was $21,080 to $41,570.

Comparing Training Requirements

Two of the reasons for the salary differential include the fact that Diagnostic Medical Sonographers are trained at a higher skills level because they do diagnostic work, and they must use judgment concerning the number and type of images produced. Most employers now require that sonographers complete a sonography program at a school accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and earn ARDMS registration.

According to the American Job Center Network O*Net Online, 47 percent of sonographers have an Associate’s degree, 17 percent have a Bachelor’s degree, and 19 percent have some college but no degree. Approximately 72 percent of Medical Assistants have some college and no degree, 18 percent have an Associate’s degree, and 10 percent have a high school diploma or equivalent.

Diagnostic Medical Sonographers may find employment in a variety of healthcare facilities that include hospitals, clinics, physician offices and mobile units. A medical assistant is likely to find employment in medical offices and clinics, or ambulatory care facilities.

Anyone interested in a rewarding healthcare career may find that Diagnostic Medical Sonography best fits their needs. Employment opportunities are likely to exceed expectations as the healthcare industry moves towards wellness care and non-invasive medical procedures. It offers a choice of career paths, excellent pay and interesting work.

Choosing An Air Medical Service With The Right Medical Flight Equipment

Every day people are transported in air ambulances for both emergency and non-emergency reasons. Often a medical flight is simply a way to transport a patient from one medical facility to another, perhaps in a different state or even country. Perhaps a patient needs the attention of a physician trained in a medical specialty that is not available where they live. On the other hand, medical flights are also used for patients who are critically ill and whose very life depends on being transported from a rural hospital to a life-saving trauma center — even though it may be several hundred miles away.

Even though the reasons for the medical flights may vary, whenever someone needs air transportation for medical reasons the plane should be properly equipped with the right medical flight equipment as well as properly trained medical personnel.

But how do you go about choosing an air ambulance service? You might start by looking at the reputations of several different services. Companies with outstanding reputations will always have modern airplanes, skilled professional medical personnel, and up-to-date life saving medical equipment on board every flight.

Let’s focus first of all on the medical personnel who are on board. A good air medical service should come with a skilled team of qualified medical personnel, including doctors, paramedics and nurses. Realizing that emergencies may take place during the flight, these professionals are in charge of the patient’s well being every step along the way. They should have all of the required certifications for safe medical air transport. In addition, they should regularly attend certified educational courses in order to keep current with the latest procedures in this highly specialized field.

Even though the majority of medical flights may not be for true medical emergencies, the planes should be up-to-date, the staff fully trained, and the medical flight equipment the most modern available.

After all, each flight presents a patient with unique needs. Some patients may only need to be kept warm and comfortable during their flight. Others, however, may require life saving equipment to be pressed into service while they are in the air.

What type of aircraft is best suited for medical transportation? It really depends on the location and duration of the flight. Many air ambulance services use small jets, such as Lear jets. But turboprop and twin engine airplanes can also be used quite adequately.

Before an assignment of aircraft is made, a trained coordinator should make the determination based upon the distance of the flight, the size of the nearest airport, and his or her knowledge of the city of destination. The goal is to arrive at the final destination with as little stress and disturbance to the patient as possible. It is important that the company you choose has the right medical equipment to best fill the needs of each patient.

By the way, a really good air ambulance service should be able to fly both within its national boundaries as well as to international destinations. They should view the patient and accompanying family members as welcome guests. They should show the patient and his or her family the same care as if they were their own personal family members.

What type of medical flight equipment should be included on an air ambulance flight? Let’s review some of the standard equipment that may prove to be life saving whenever a patient is being transported on a medical flight.

More than half of all medical flights take place during non-daylight hours. Therefore crews should be equipped with enhanced night vision goggles that will permit them to see and recognize any and all obstacles that may be in their path on the ground both before takeoff and after landing.

Special monitors that are designed to read and diagnose the vital signs of a patient are critical for air ambulances. Many monitors have been specifically designed for use on medical transport flights. Without going into a lot of scientific jargon, air pressure at varying altitudes can affect monitors. Therefore it is essential that the monitors used on board are designed for use on air ambulances.

An Isolette® incubator is designed for infants who are critically ill. These can monitor the baby’s vital signs, provide oxygen, and maintain a comfortable temperature, especially for premature babies, or neonates.

An i-STAT is a special hand-held blood analyzer that provides truly high quality analysis in real time. With an i-STAT on board the medical crew members will be able to perform extensive blood testing – and get the results immediately during the flight.

Ventilators are essential pieces of equipment. High quality ventilators can meet the needs of any patient and can be programmed to control the patient’s breathing. Again, the equipment used on any medical flight should be designed for use at varying altitudes.

Many cardiac patients, as well as other patients who are critically ill, may require more than one IV line so that the medical staff can administer both fluids and life-saving medications. Infusion pumps are vitally important, therefore, on every medical flight. Patients who were once considered too ill to travel by air can now be safely transported. This is largely due to the advancements of the infusion pumps which are now used on medical flights.

Any one of us may have to take a medical flight for any number of reasons. It is vitally important that the company you choose has the right airplanes that are properly outfitted with necessary life-saving medical flight equipment as well as highly trained medical personnel.

How to Get Through the ADHD Medication Maze

  • Have you ever had to go a day or more without your prescription medication?
  • Do you know the physical discomfort and anxiousness of waiting to get the medication reordered?
  • Have you spent hours on the phone with the doctor’s office, insurance company or pharmacy waiting for your ADHD medications to be filled?

If so, you, like me, have been trapped in the medication maze.

For years I have listened as clients told me about their challenges to be diagnosed, only to have their hopes dashed when they find themselves trapped in the ADHD medication maze. What is the ADHD medication maze? It is that tangled cycle of trying to get ADHD medications refilled. Prescriptions not relayed to local pharmacies or faxes getting lost to online medication mailing systems. Suspicious looks from pharmacists when picking up medications. Refusals by insurance companies to pay for prescribed medications. The countless dead ends, backtracking, twists and turns of getting a written prescription through the process and have it filled. The ADHD medication maze is a frustrating web where so many people with ADHD find themselves stuck not knowing which way to turn and unfortunately many give up and never get a chance to experience the possible benefits of ADHD medications.

In theory, filling medication prescriptions is supposed to be easy work. In reality, it rarely goes smoothly. Let me tell you about my own recent experience with trying to get my medications filled. I know many of you will relate.

I called to make an appointment and a month later got in to see my doctor who, after a 25-minute wait and a 10-minute appointment, prescribed me my medications. As I left the clinic, I was told a 14-day short-term prescription would be called to my local pharmacy and an email/fax would be sent to Express Scripts, my mail-order pharmacy. Okey dokey.

Not so bad. Except (you saw this coming, didn’t you?) a plan is only as good as its execution.

The following day my local pharmacy auto responder called (nice feature by the way) to let me know my short-term interim medications were ready to be picked up. I was pleasantly relieved and somewhat surprised it had been that uncomplicated. Easy peazy, I thought. I will pick them up on my way to the airport and just to be sure, allow 15 minutes extra.

You see where this is going, right?

I arrived at the pharmacy with plenty of time, trying to have faith and confidence in the system… after all they had confirmed my prescription was ready for pick up, right? I waited patiently in line for the two people before me to pick up their prescriptions and have a pharmacy consult… do dee do… no worries, plenty of time.

My turn. I stepped up, gave the pharmacist my name and they turned around to reach for my prescription. The pharmacist placed two bags on the counter, rang me up… my cost was under $10 dollars… Yay! Woo Hoo… happy dance. I even scolded myself for doubting all would work out.

And then…

Wait a minute. I had three prescriptions. “Uh hello Mr. Pharmacy Man, I’m supposed to have three medications filled today… there are only two.”

At this point I was still hopeful… wanting to trust in this “fill a pill system” and then I heard those fated words… “The doctor reordered three medications, but the XYZase is not covered by your insurance until the first of next month.”

Wait what?

And then, in a nanosecond, my stomach dropped, my pulse quickened and I began to see red. I was frustrated by the whole system. Frustrated because I trusted everyone to do their job. Angry with the realization that so many people get stuck in this medication maze with little support or map to find their way out…

Side note: I’ll admit it… I have a real problem with the way medications are dispensed in this country. It’s a crazy system, full of twists and turns we are expected to navigate in order to get prescriptions filled. It’s complicated by monetarily motivated insurance companies who decide what medical care I receive and what I don’t. Last time I checked, insurance companies do not have a medical license; they don’t have the training to decide whether I continue on a medication or not. My doctor with the advanced M.D. degree should be the one to decide medically what is in the best interest of my health.

So where was I… oh yes, standing at the pick-up counter at the pharmacy…

Mustering my courage and trying very hard not to be rude, I told the pharmacist that “the insurance company did not get to decide my medical care, my doctor did and I would pay for that prescription out of my own pocket if needed… thank you.” Then, I was asked to step out of the line and told my prescription would be filled as soon as possible.

So I waited… I don’t mind waiting… after all I had allowed an extra 15 minutes just in case. So I waited while the pharmacist filled other prescriptions, answered three phone calls… and a half hour later and 8 people less in line, the pharmacy assistant grabbed the coveted white bag, looked at me and said “it’s ready.”

Not trusting myself to say a word, fuming with the needless half hour wait, the senselessness of our insurance companies dictating our medical care and the realization of so many other people going through similar experiences… I paid the $25 for my medication and left.

Two weeks later, my interim medication bottles were almost empty, but my Express script online mail prescriptions were scheduled to arrive. (Insert laugh track.)

Yep… you guessed it… no white plastic bag with jingling pill bottles had yet graced my mailbox. I was a day away from my medications running out a second time that month.

Curses… here we go again! Who knew what had happened this time? So once again I was on the phone calling my mail-order pharmacy to see if they had received the refill order from my doc… nope they hadn’t received it. I called the doctor’s office again… “oops”… they had emailed my local pharmacy the short-term refill (we all know how that went), but “sorry” the email/fax with the prescription to my mail-order pharmacy hadn’t been sent. Do I need them to do it now?

People! Work with me here! I’m doing all I can… I need you to follow through. Who in their right mind would ever go through this craziness over and over again if their medication wasn’t necessary?

The fact is I know so many of you go through this confusing, exhausting medication maze… month after month, year after year. You bravely and boldly step into the process where you almost need a medical degree yourself to get prescriptions filled. It is ineffective, inefficient, and, unfortunately, it is what we are left to work with.

We cannot escape it… so if you have found yourself in the medication maze, here are some tools to sustain you when you find yourself in this labyrinth:

    1. Remember – you and your doctor get to decide your medical treatment.
    1. Your insurance company refusing to pay for a medication doesn’t mean you can’t pay for it out of your own pocket. I know some medications are costly, however, you might be surprised at how inexpensive some really are. Always ask.
    1. Always double and triple check to make sure emails/faxes/phone calls have been made/sent and received so the delivery of your medications goes as smoothly as possible. Specifically call the pharmacy and your medication-mailing service to confirm they received the prescription orders… if not, call your doctor’s office to make sure they were sent. Don’t assume.
    1. Keep the doctor’s office, pharmacy and mail delivery systems numbers where they can be easily found.
  1. Don’t give up. Remember the benefits of your medication far outweigh the frustration to get them.

The confusing, exhausting medication maze is an all too common problem those with ADHD face. I understand your frustrations and admire your courage to go forth despite the craziness of it all! I’ll bet you have some “medication maze” stories of your own… I’d love to hear them!

Okay, rant over.

Laurie Dupar, Senior Certified ADHD Coach and trained Psychiatric Nurse Practitioner, specializes in working with clients who have been diagnosed with ADD/ADHD and want to finally understand how their brain works, minimize their challenges and get things done! Through individual/group coaching, live speaking, and her writing, she helps clients and their loved ones use effective strategies to minimize their ADHD challenges so they can experience success. She is the co-author and editor of Inspirational ways to succeed with ADHD and author of Brain surfing and 31 other Awesome Qualities of ADHD.

3 Causes of Errors in Medical Interpretation

As far as medical interpretation is concerned, one may assume it’s just hearing and interpreting a word into another language that is required, no, the medical field is too technical when it comes to providing interpretation services for doctors and patients because it’s all about dealing with lives and the health of individuals. There is too much care needed when interpreting medical jargons, terminologies into a target language.

The Major Causes of Medical Errors

Let’s see and discuss the major causes of medical errors during the interpretations by the medical interpreters.

Cultural beliefs and tradition; most cultures are too complicated which impacts medical service delivery in such communities, so to deliver medical services in such a community you must ensure you get medical translators and interpreters who can abide by the cultural beliefs and rules in that community because they will be knowing how to deal with their cultural beliefs. Some culture and beliefs do not allow females to conduct speeches in public; when operating a medical clinic in a particular community, you must get to know how their cultural beliefs and norm are such that it becomes easier to provide interpreting services, failure to do that you may make mistakes that may end up causing medical errors in the medical interpretation.

Using family members as translators and interpreters, this is also too dangerous, due to fear of paying for professional medical interpreters or translators, medical services providers may resort to using the patient’s family members or the patient’s caretakers who may be fluent in English to provide medical interpretation, as we all know that being fluent in English is not enough for somebody to be a medical translator of interpreter, because of the technicality of medical terminologies, a caretaker can’t accurately interpret medical terminologies due to lack of knowledge about it, let’s assume you have no knowledge in the medical field, and you are given to interpret, the doctor mentions a statement that you’ve never heard of in life, can you manage to understand that statement and interpret into a layman language?

Use of clinicians who have the basic foreign language skills to communicate with patients and doctors instead of qualified medical interpreters, medical services providers might resort to use of clinician who may have a little knowledge in a particular language understood by the patient. Medical interpretations need fluent native speaking medical interpreters and translators of the respective language so as to be accurate, but because a clinician who is a Japanese speaker knows some little French is given to act as an interpreter between the doctor and the French-speaking patient, there is no way that interpretation will be free from misinterpretation of some words.

Areas where medical errors may occur

Medical errors are always common in medical areas like;

• Admission forms
• Patient discharge reports
• Medical reconciliation
• Emergency department visits and surgical care

Possible ways to avoid medical errors in medical interpretation

To avoid medical errors, medical service providers should focus on strengthening professional medical interpretation services, doctors and patients should be able to communicate and understand each other, they should also provide already translated materials in several foreign languages for the targeted users, cultural awareness and advocacy, improving medical staff training and etc.

The use of the patient’s specific identity, this will help to ensure that the medical interpreter is given the right medical information for the respective patient for interpretation. If any mistake happens that different information about the medical prescriptions is interpreted for a different patient, medical errors have to occur; hence the medical history of the patient bearing the name of the patient, admission date, is necessary since it includes the medicine prescribed for the patient.

Avoiding medical errors in the interpretation process is partly the role of the patient, a patient is supposed to present all the previous medical reports, including all the drugs that were used, this can help the doctor to know what next step to opted if a particular medicine didn’t work, otherwise the doctor may give back the same medication prescription which during the process of interpretation, processed in exact format and meaning. In addition to that a patient should also be careful and observant to know which drugs can problems to his/her health. This basically letting the informed about the medicines that the patient is allergic to because, during the interpretation process, the interpreter’s work is to speak what the doctor mentions.

Medical errors can be avoided if the doctor’s prescriptions to the patient can clearly be understood by the interpreter, hence the interpreter should be sharp, attentive and a good listener when the doctor is talking to the patient, this can make the interpretation accurate and successful with any minor error that may cause problems to the patient’s life.

Medical Assistant Career – Opening Doors To A Profession In Healthcare Services

Medical Assistants

Medical Assistant Career – Opening doors to a profession in healthcare services.

Medical Assistant careers are gathering demand in the background of a healthcare industry boom worldwide.
A Medical Assistant essentially is a healthcare professional with multiple responsibilities and skill sets required to execute the same. Both administrative and medical tasks that do not need much medical proficiency fall into the ambit of a Medical Assistant.

Medical Assistants are indispensable in any modern day healthcare practice. Engaged under physicians, podiatrists, chiropractors, and other health practitioners. Medical Assistants attend to the complexities involved in delivering medical services.

By accomplishing administrative and other responsibilities, Medical Assistants make it easier for the practitioners to concentrate on attending to and treating patients.

Medical Assistants execute varied administrative, laboratory and clinical tasks in different health care institutions.

Often, Medical Assistants are seen as generalists who are involved with many aspects of the medical profession but do not specialize in them.

A detailed overview of the activities of a Medical Assistant is given here:

Administrative duties:

General administration which includes day-to-day activities and other tasks. These include:

Communication – both internal and external and office correspondence.

Patient welfare – maintenance of patient records, insurance forms, scheduling appointments, arranging for hospital admission.

Billing and bookkeeping.

Maintain medical and drug supplies.

Clinical duties:

Clinical duties require discreet manual dexterity and visual acuity. A Medical Assistant has to support the medical practitioner with the following:

Recording vital signs.

Preparing patients for examination, explaining treatment procedures to patients.

Assisting the physician during the examination.

Instructing patients about medications and special diets.

Preparation and administration of medications.

Laboratory tasks:

Laboratory tasks include:

Collection and preparation of laboratory specimens.

Performing basic laboratory tests on the premises.

Draw blood, prepare patients for X-rays, take electrocardiograms, remove sutures and change dressings.

Disposal of contaminated supplies and sterilization of medical instruments.

Medical Assistants employed at small medical outfits may undertake both administrative and clinical duties and report directly to the office manager or health practitioner.

Larger medical outfits have Medical Assistants reporting to department administrators and specializing only in a particular area.

Medical Assistant – Essential qualities and skills:

Duties entailed in medical assisting vary with the type of health care facility, size, location and specialisation.

A pleasant disposition is a must as Medical Assistants constantly interact with patients and public. Courteous manners, a well groomed personality and an aptitude for making people feel at ease are essential.

Simple medical and clinical skills and administrative abilities are integral to the profile of a Medical Assistant.

Traditionally, Medical Assistants did not need to be certified as they learnt on the job. This scenario has changed and contemporary medical practices prefer trained and certified Medical Assistant professionals to untrained individuals.

Medical Assistant Training and Certification:

Healthcare industry is increasingly in favour of trained Medical Assistants. The need for technically sound personnel who have the flexibility of handling both clinical and administrative tasks is on the rise. The trend is an offshoot of the need felt by doctors to concentrate on treating patients rather than on other functional details.

Certification is a mark of the individual having been trained and qualified in the profession.

A Medical Assistant certificate stands as a certainty of successful training. Also, securing a Medical Assistant certificate assures higher professional satisfaction and recognition. Compared to uncertified individuals, the formal education and the Medical Assistant certificate help them in advance faster in their profession.

The Medical Assistant certificate can be secured by both experienced and inexperienced individuals. Experienced professionals may not have to take a certification exam. Inexperienced candidates though will have to undergo rigorous training from an accredited vocational training institution.

Medical Assistant certification or registration will put the individual a step ahead from counterparts.

Medical Assistant registration and certification are the same. It’s just that different certifying bodies have different terms for referring to a Medical Assistant cerificate.

With many Medical Assistant schools mushrooming in the market, it is important that one acquires education and secures Medical Assistant registration from a reputed and reliable source.

Medical Assistant Education:

Medical Assistant education obtained from a high grade vocational training institution is a sure way to a successful Medical Assistant career.

Schools offering Medical Assistant education abound in the market. Making the right choice of schools makes the difference in education in medical assistance.

St.Augustine’s School of Medical Assistants offers accredited and affordable distance Medical Assistant education online.

Medical Assistant education at St.Augustine’s is comprehensive and does not leave out any element crucial to training. The 24/7 online training facility provides classes, knowledge resources and virtual laboratory training online.

Distance Medical Assistant education:

St. Augustine’s Medical Assistants school offers distance education through online courses. Distance education is favoured by Medical Assistant aspirants who are already working and studying part time. Distance Medical Assistant education gives such candidates the flexibility of scheduling their study time around their working hours.

The Medical Assistant Program at St.Augustine’s:

Medical Assistant program at St. Augustine’s is an online training course that is available anytime and anywhere. With this program, accomplishing certifications is a matter of just 6-8 weeks from commencement.

The program includes complete online courses along with training on laboratory skills and facilities to perform laboratory tasks.

The advantage with St. Augustine’s Medical Assistant program is that, the student can take up the course at his own pace and convenience. Since it is online, the course can be accessed from anywhere in the world.

Whether it is a full time student or a working person wanting to study part time, the online Medical Assistant program is a convenient way to Medical Assistant registration.

The course ware for the Medical Assistant program is developed and regularly updated by experts from diverse disciplines, health care professionals and practitioners making it one of the best available programs for Medical Assistants.

Medical Assistant classes online:

On signing up for the Medical Assistant program, students have the convenience of accessing classes online. According to individual schedules, Medical Assistant students can access these classes at their own convenience.

Medical Assistant classes at St. Augustine’s deal with the following subjects:

Medical Terminology, Human Body Planes, Basic Human Anatomy and Physiology, Medical Office Professionalism, Patient Communication, Medical Records, Basic Medical Law, Scheduling Appointments, Medical Billing and Insurance Claims, Infection Control, Surgical Instruments, Emergency Care, Clinical Equipment, Patient History and Physicals, EKG and Lab Testing, Specimen Collection and Lab Safety, Introduction to Patient Medications.

The classes also cover Clinical Laboratory training online. These include:
Virtual Phlebotomy Lab (Collecting a Blood Sample), Virtual Injection Lab, Medication injections, Measuring A Pulse, Introduction to CPR and Basic Ultrasound.

At St. Augustine’s School of Medical Assistants, enrolling gives students the advantage of well designed Medical Assistant programs, curricula, online classes, an accredited Medical Assistant certificate within 6-8 weeks!

St. Augustine’s educational services:

Educational services offered by St. Augustine’s Medical Assistant school aim at providing vocational training for Medical Assistant aspirants.

St. Augustine’s educational services are unique in their approach to training, course design, teaching techniques etc. The ultimate goal is to give students the best value for the money they have invested in Medical Assistant registration training.

The distance education program offered under St. Augustine educational services online is a high turnaaround, quality program that is accredited, affordable and convenient.

St. Augustine’s online educational services are affordable as they cut down travelling, instructional material and other costs. It can be accessed by students wherever they are, whenever they want and brings the convenience factor into education. Online educational services at St. Augustine’s are accredited and hence give best value for money spent on educating oneself.

St. Augustine’s educational services online are a passport to a shining career as a Medical Assistant.

Health care careers are fruitful for certified Medical Assistants:

Health care careers are being sought after nowadays as high return professions both on the monetary front and on the satisfaction front. The booming health care industry is demanding technically qualified personnel and the market is ripe for professions like Medical Assistants, Hospital Assistants and others.

Thanks to the boom, health care careers are highly in need of well trained staff. Vocational education in professions like Medical Assistants provides an effective solution for the demand. By training students for the specific job and also focusing on overall life skills, educational services like that offered by St.Augustine’s are enhancing employability of individuals.
Health care professionals – upgrade skills for advancing careers:
Employment opportunities in flexible health care careers like that of Medical Assistants are predicted to increase mutifold. Infact Medical Assistant health care careers are expected to grow much faster than the average for all other occupations.

Certified Medical Assistants with experience will definitely be highly sought after as a result. Health care professionals like registered Medical Assistants with experience stand to gain in a big way.

Experienced and trained Medical Assistants may be able to advance faster than other health care professionals. By adding on to their existing skill sets and certifications, they can gain over health care professionals.

Moreover pliable health care professionals like Medical Assistants have open occupational choices and opportunities form a variety of health care setups.

The future certainly seems to be beckoning Medical Assistant careers. All one needs to do is to gear up with an accredited Medical Assistant certificate.

Bone Density – How Important is It?

Bone density has not been talked about very much until the last 5-7 years. However, today startling facts have come to light. One in 2 women, and one in 4 men,over the age of 50, will break a bone due to osteoporosis. Pretty scarey when you see statistics like that.

So, what is Osteoporosis and is it really such a big deal? Osteoporosis is a progressive bone disease in which the density of the bone is decreased & the structural integrity of the bone is impaired, thus making the bone more brittle. The cortex, or outer portion of the bone, becomes thinner and more porous, thus making it more prone to fractures. This disease affects 75 million people in the United States, Europe, and Japan. It is known to cause at least 1.3 million fractures each year in the U.S. alone. Since the disease often shows no symptoms, many people do not know they have it until they actually break a bone.

Now, that we see how important bone density is to our health, just what can we do to protect our bone health or even improve it? You should start with a sit down visit to your physician. They will begin by taking a look at your diet and your lifestyle. A good healthy diet with adequate calcium and Vitamin D can help to keep your bones strong. Bones store extra calcium for basic body functions. However, when we don’t get enough calcium our body robs our bones of this calcium and it makes our bones weaker. Talk honestly to your Doctor about your diet and possible calcium supplements. You should also think about increasing your activity level. Exercise, especially weight bearing exercise, is proven to increase your bone strength and bone density. It can also help your muscle strength which takes pressure off your bones. Another important fact; Smoking, excessive alcohol intake, and also phosophoric acid from carbonated beverages, have all been shown to decrease the calcium in your bones. There is a lot you can do to help protect your bones and your health the natural way.

Your Dr. will next recommend that you have a Bone Density Test. This a simple, painless procedure usually performed in the X Ray Department. It can help the Dr. diagnose osteoporosis in the earliest stages. The test is a major predictor of the strength of the bones and how they can withstand stresses. If your bone density is reduced by a significant amount then you are considered to have osteoporosis.

The most common test to measure Bone Density is called the DEXA Scan. It takes xrays using a minimal amount of radiation, of the lower spine, hips and perhaps the hands and wrists. This test compares your bone density levels to those of a healty young adult. Anything above a Minus 1 is considered normal bone density. For those within the -1 to -2.5, you are depleting your bone mass. Below the 2.5 level you are considered to have osteoporosis. Doctors recommend all women over the age of 60 to have a DEXA scan, and all men over 70. The disease is especially prevalent in this age group. Some younger patients with a family history of osteoporosis may need to followed closely and have a DEXA scan sooner.

For patients who are diagnosed with Osteoporosis there are many options for treatment. There are several medications on the market that have proven very effective in combating the disease. Also, there is more information than ever out there regarding better diets, different exercise methods, etc. All these things are vitally important in helping you to stay healthy and protect your bone density.