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Jul 27, 2020 | Dr. Notes | 0 comments

Mobile Physician Associates Practice Update

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Alex-Foxman,-M.D.,-F.A.C.P.

Written by Dr. Alex Foxman

Dr. Alex Foxman is a leading internist and preventive care specialist in Beverly Hills, CA, providing patients with advanced, compassionate care for an array of medical issues.

We have added additional services that can greatly assist in a patients management. These include:

 Remote Patient Monitoring (RPM), a Medicare program where we are able to send the patient devices such as blood pressure cuffs, digital scales, pulse oximeters and blood sugar monitoring that automatically sends information to our office for review. 

 Chronic Care Management (CCM), a Medicare program where certified care managers contact the patient, caregiver or family, at least 20 minutes per month, to assist, monitor and educate the patients health and well-being.

 Both programs have shown a SIGNIFICANT reduction in use of Urgent Care, ER, Hospital and Nursing Homes. If you would like to enroll, please contact our office at www.mymobilephysician.com or (310) 256-2426.

 We have now successfully fully implemented “Virtual” Tele-Health medical visits at the level of mobile medical visits. These visits include acute/chronic medical management, Annual Wellness visits, medical refill management and can be scheduled same or next day.

 The process to schedule the “Virtual” medical visits  is exactly the same as scheduling our typical mobile medical visit by visiting  www.mymobilephysician.com or calling our office at 310-256-2426. Visits can be performed several ways to even assist the technologically naive patient, caregiver or family member. We have trained our medical staff to assist you in this process. Our “Virtual” Visit success rate has been > 95%.

More complex medical care may still require a home visit and we will continue to have our office open to meet your needs, same day or next day.

Additional services including lab work, blood testing, x-rays and ultrasounds can be performed in your home. 

Now with the flexibility of Virtual,  In-Home medical visits and diagnostic services, there is NO EXCUSE to put off or forego your your medical care.  

Due to the high demand for quality primary health care, we have expanded our services and now accept NEW patients throughout the State of California. We appreciate all of the referrals and support!

COVID-19 Treatment Update: More Infections DOES NOT mean MORE DEATHS!

The number of COVID-19 infections are surging in many parts of the United States and especially in Los Angeles. To date,  up to 10% of the Los Angeles population has been infected with COVID-19 and this will continue to increase due to a number of factors including poor compliance with face masks, social distancing, poor infection control/hygiene, to name a few. The GOOD NEWS is that 99.5% of individuals who are of average risk will fully recover without need for an ER or hospital visit. 

We MUST continue to protect and isolate the high risk individuals (advanced age, obesity, diabetes, cardiac and/or pulmonary disease) as they continue have up to a 30% risk of death, though this too is rapidly falling. 

If you or a loved one are exposed to COVID-19, DO NOT PANIC. Contact our office for a tele-health visit and consider isolating yourself, take Vitamin C 1000 mg twice daily and Zinc Lozenges.  At this time, there is no additional treatment recommended for mild to moderate symptoms. For severe symptoms, hospital based treatments have significantly reduced COVID-19 related deaths.

DO NOT RUSH OUT FOR COVID-19 PCR testing, because if you do not have symptoms, the likelihood that the test will be positive is < 1%.  A recent study at Cedars Sinai Medical Center is below and provides additional proof for this finding.

“APEC COVID-19 TESTING DATA: JULY 5 – 11

During the week of July 5 – July 11, the Anesthesia Pre-Procedure Evaluation Center (APEC) performed 330 COVID-19 screening tests, and one asymptomatic carrier was identified (prevalence 0.30%). Since March 20, 5,984 screening tests have been performed through APEC, and the prevalence of asymptomatic carriers is <1%”

Getting unnecessary COVID-19 testing has led to a severe shortage in testing supplies and significant delays in having results return from the lab (up to 7 day delay). 

Though some recent news regarding vaccine progress is promising, this is still far in the distance. 

COVID-19 Testing Options:

There are several types of COVID-19 tests available: 

  1. COVID-19 PCR (polymerase chain reacton) test– This uses a nasal or oral swab to test for active COVID-19 infection. The test is highly sensitive (99%) and specific (99%) with a proper sample. Results return in 12 hours – 7 days (based on lab volume).
  2. COVID-19 Rapid Antigen test– This uses a nasal or oral swab to test for active COVID-19 infection. The test is NOT as Sensitive  (85%), but highly specific (99%) with a proper sample. The results return in 15-20 minutes. This test is similar to an office based flu (influenza) nasal swab test. 
  3. COVID-19 Immunoassay (antibody) test– This test uses a finger stick or vein blood sample to measure for antibodies that are created after a COVID-19 infection. The test is Sensitive (96%) and Specific (96%) when performed at least 7 or more days after COVID-19 infection. It is currently unclear how long and how strong the immune response will be for COVID-19. It is my professional medical opinion that individuals infected with COVID-19 will likely have immunity for this year and possibly up to 3 years (similar to SARS and MERS infection results). 

The goal is to identify if an individual has been previously exposed to COVID-19, if they may be acutely ill and infectious (in conjunction with PCR testing or Antigen testing) or have cleared the virus and may now  have immunity allowing the ability to reduce social isolation, proceed back into the community and work force. 

If you want to learn more about Sensitivity and Specificity see the link below:

https://www.healthnewsreview.org/toolkit/tips-for-understanding-studies/understanding-medical-tests-sensitivity-specificity-and-positive-predictive-value/

While NO test is 100% accurate, identifying as many people as possible with current or previous exposure to COVID-19 will dramatically reduce the continued spread of this virus in the home, community and workplace.

A PERSONAL COMMENT

I urge you to continue to stay vigilant and compliant with the CDC guidelines. You can reduce your risk of all types of infections, including COVID-19 by following these simple steps:

Wash your hands frequently, do not touch your face, cover your mouth/nose (when others are around) and isolate if you have any viral type symptoms, then contact my office). We will continue to see a spike in infections with, BUT as I predicted, the mortality rate is MUCH lower, so DO NOT PANIC!

Data continues to show that for the vast majority of us, this is just another cold, BUT we need to be diligent to protect the highest risk individuals (elderly, chronic conditions).

Wishing everyone HEALTH—> HAPPINESS —-> SUCCESS (not just financial). You MUST have these in this order, as you cannot enjoy one without the other. 

Please visit our website at www.mymobilephysician.com and click on Coronavirus Info to receive updated information.   

If you or someone you know is elderly, suffering from chronic conditions, ill, having difficulty getting to a medical  office or just rather be seen at home, I have partnered with Mobile Physician Associates www.mymobilephysician.com who has increased their capacity to provide both  mobile medical visits and Virtual medical visit services. 

Below please find additional information. I will continue to keep you updated. 

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