Why retail based health clinics are here to stay

by Sharon Ruth Hil

Several months ago I had my first experience with a Retail Based Medical Clinic, also known as an In Store Health Clinic. I merely popped in CVS to buy a pack of gum, noticed the flu shot sign and followed the directional arrow to the rear of the store where the small clinic area was arranged. The efficiency of registering myself in the computer system and the speed with which I received treatment was very impressive. I did make a mental note that I was just there to get a simple flu shot and not a more complex service. Then I went back to the office and convinced two co-workers to do the same over the course of the remaining workweek. Our employee insurance benefit covered the expense of the flu shot entirely.

Towards the end of last month I came down with the "crud". Since I didn't want to take time off of work I decided I would visit The Little Clinic in Kroger that Saturday. The check-in process wasn't quite as efficient as CVS in that I filled out a paper form prior to being seen by the Nurse Practitioner and when I was seen she keyed in all the information while posing several important questions. At the time we were into flu season full force and there was quite a line, including those sent over by the busy local hospital emergency room. However, the Nurse Practitioner did not let this rattle her and she took here time with me in order to be thorough. I felt "like death" that day but again walked away with a very positive experience.

I began to ponder the whole aspect of these Retail Based Medical Clinics. In their industry they are known as Convenient Care Clinics having their own association with the most stringent healthcare standards. I have done the research and discovered so many interesting facts and benefits pertaining to these clinics and the governing association.

The very effective model for these small clinics, located in busy retail based stores with adjacent pharmacy and usually staffed by a well educated Nurse Practitioner, maximizes efficiency by offering a limited menu of basic services. A typical roster of services includes treatment for flu, pink eye, sore throat, allergies, immunizations, and school physicals. These same services are affordable for self pay individuals and cost between about twenty five percent less than the same service at a physicians office and thirty to eighty percent less than an emergency room or urgent care facility while at the same time taking some of the pressure off of local emergency rooms. Further, most insurance plans are accepted with the standard co-payment.

No appointment necessary for these clinics with many open seven days a week and extended hours available for increased flexibility. Clinics must comply with all state and local health regulations, offer a variety of referrals to other health care providers, and can even forward patient records to the primary physician to be included in the patients file. In the event a Nurse Practitioner require assistance with a diagnosis he or she is in direct phone contact with an on call physician

Make no mistake, Retail Based Medical Clinics is a growth industry of about 1500 clinics in the United States that is here to stay given the convenience, shortage of primary care physicians, and high number of uninsured citizens with limited financial access to health care. I am not alone in reporting a positive experience as some studies gauge the quality of care at about ninety percent.

Learn more about this author, Sharon Ruth Hill.
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Correlation between medical conditions and dental health

by Lisa Fillers

It is rather easy for the experienced dentist, hygeinist, or dental staff to see the correlation between medical conditions and dental health. Over the years of working in a dental practice they see patient after patient who come in with high blood pressure, diabetes, and other medical problems as well as healthy patients. Healthy patients, in general, have far fewer dental health problems. The longer a patient has had a medical condition, the greater degree of dental health problems they have.

All patients of a dental practice must complete a medical history form. It is required so the dentist and staff can be alerted to the need for premedication prior to dental procedures. During my years in the medical field I saw a great many patients with the same medical condition that also had the same type of dental health issue. Listed below are some commonly seen medical conditions among patients with a lot of dental health issues.

LUNG DISEASE

Lung disease can affect a patient's overall health in multiple ways. Most lung disease patients have been smokers at some time in their life and a large percentage of them were considered heavy smokers. Smokers eventually lose their teeth. Smoking increases the amount of bacteria in a person's mouth by aiding it in growing. Decaying food and bacteria form plaque and plaque causes cavities and gum disease. When gum disease is present in the mouth, any continued smoking makes the gums raw and irritatated. It also increases the swelling of the pockets in the gum around the teeth caused by gum disease. Gum disease causes the gums to recede, exposing portions of the teeth that were not meant to be exposed. It weakens the jaw bone structure, as well, that holds the teeth in place and the patient's teeth can literally fall out of their mouth.

Lung disease, asthma, and other chronic respiratory problems can cause black line teeth in patients who were born to a parent with goiters or a family history of goiters. These patients have a higher than normal amount of iron and other minerals in their body and constantly produce mucous. The mucous carries the minerals into the mouth where they combine with the bacteria in decaying food, forming the dark plaque around the neck of the tooth at the gum line.

Lung disease patients have a supressed immune system and the weakness of their immune system make them more susceptible to all infections. Infection can occur at sites with bleeding gums or any dental trauma causing

a scrape or cut in the mouth.

DIABETES

Diabetes can cause tooth decay, gum disease, infection, delay in healing, fungal infections, salivary gland dysfunction, and impairment of taste. Patients can suffer from any of these dental health problems if their diabetes is not kept well under control. High glucose levels found in the saliva of uncontrolled diabetic patients cause faster deterioation of the teeth and gum disease in diabetic patients with poor dental hygeine. Uncontrolled diabetes also weakens the immune system and makes the patient more susceptible to infection.

HIGH BLOOD PRESSURE

High blood pressure causes constriction of the arteries which can decrease blood flow vital for healthy teeth. Repeated constriction of blood flow to a tooth can cause the pulp of the tooth to die. This results in the need for a crown, or cap, to be placed on the tooth or can result in total loss of the tooth. Medications used to treat high blood pressure cause xerostoma, dry mouth, which causes a higher incidence of tooth decay, gum disease, tooth loss, and halitosis.

Medications for high blood pressure can interact with pain medications prescribed by a dentist. Patients who have fluid retention due to high blood pressure or diabetes may also suffer adverse effects. It is imperative your dentist is told immediately should you develop high blood pressure or diabetes.

HEART DISEASE

Heart disease can lead to gum disease and loss of teeth. This is true of non-smokers as well as smokers.

Heart disease which has caused artificial valves to be placed, heart transplants patients with a valve problem, a history of endocarditis and certain congential heart defects can cause bacterial endocarditis. This is a serious infection which can occur in these patients when they have dental procedures done if they have not been premedicated prior to the procedure. All patients need to be truthful in completing their medical history.

Hardening of the arteries causes the patient to have to take blood thinners such as Warfarin, which is a generic form of Coumadin. Any blood thinner causes the dentist to be extremely cautious during dental procedures due to the patient bleeding more freely.

GERDS

Acid Reflux Disease and other gastrointestinal problems cause a higher rate of tooth decay and tooth loss due to the patient regurgitating acidic bile. The bile not only eats away the esophogus over time, but also eats away the enamel on the patient's teeth. Once the protective enamel is damaged, cavities begin to form and the tooth pulp can eventually die. Any chronic stomach condition can cause severe halitosis.

EPILEPSY

Patients who suffer from Epilepsy or epileptic type seizures are usually prescribed Dilantin, which can cause gingival hyperplasia. This is a drug induced gingival overgrowth. Organ transplant patients on Cyclosporine and high blood pressure patients or any heart patient using calcium channel blockers can also suffer from gingival hyperplasia.

There are other medical conditions which can cause dental health problems but these are the most common seen. In general, any systemic medical condition can be a source of dental health problems itself or through the medication required to treat the condition.

Learn more about this author, Lisa Fillers.

Poetry: The clinic

by crow messenger

She stepped on the bus
alone
Holding her fear
beside the hurt in her heart.

The clinic felt cold
as she unsnapped snaps
un-fastened hooks
pulling a white sheet across her.

Fists clenched and eyes closed
she remembered the words,
the faces that smiled;
we're here for you,
as she
felt the pain
alone.

She walked to the bus stop
holding the burdon
of alone
beside the pain
growing like the cancer
inside her.

wondering which was worse.

Learn more about this author, crow messenger.