Do I still need shots?

That was the question that came from my 40 year old patient here for a routine physical. My answer-yes, you still need to be aware of your immunization status, and get updated "shots" when needed. Creating immunity via an injection (such as a flu shot) offers significant protection from the bad critters (viruses, bacteria) that roam our world. Think that bottle of purel is just as effective? Have you ever anonymously watched people when they think they aren't being watched? We touch ourselves in all sorts of areas that seed our hands with all sorts of critters. Those critters are then deposited on door handles, telephones, cardoors, lunch tables-you get the picture. This should NOT make you a phobic, but should induce you to wash hands regularly, keep your hands out of your nose and eyes (a common way of seeding others, but also seeding yourselves with someone elses smarm), and get your immunizations. The scare concerning illness or injury induced by immunizations is well overblown, and can not be objectively justified. The hope that immunizations will continue to give us more and greater benefit are true. Immunzations for certain kinds of cancers already exist and have proven to work (gardasil for prevention of cervical cancer). More are on the way-my personal hope is that very soon there will be a shot for melanoma since I have a family history. Perhaps other types of cancer as well. I urge you not to be afraid!
So, make sure that you've had your tetanus shot every 10 years, get a flu shot yearly (unless you can afford to miss a week of your life). If you have asthma make sure you've had a pneumonia shot, and if you are over 65 go get a Zostavax (shingles vaccine). Ask your doc next time you see him/her to make sure you are up to date!

update on our clinic

We've been busy for the last few months deciding on a business strategy, hopefully one which will help us survive the coming changes in healthcare. We've decided to decline the offer to be bought by a hospital or large medical group. But we also do not want to become irrelevant or obsolete. So, insert drum roll here, we have decided to grow! This was not an easy decision. The doctors at our clinic have a unique and enviable chemistry, and we like working together. We genuinely love our staff and care about them as people. Growing our clinic could threaten all of that. However, much of what is coming in healthcare from the new federal healthcare law threatens clinics which are too small (see my first blog on ACOs). So, we've decided to grow, and next month hope to open our second location in the Lake Travis area. There may be a third sometime this year as well. Our target likely will be to have 20 or so providers who are part of our team within the next 12-24 months (we have about 16 now). The trick will be to grow deliberately and wisely so as to maintain our small practice feel, yet rapidly enough to qualify to be an ACO by 2012. We'll also be changing our name!
In the end we all may work for the Federal government. My guess is ACO mania will prove to be a flop, and cost savings will be inadequate to pay for increased utilization. But, that may take 10 years to play itself out, and we will continue to run the race as best we can.
Dr. Frederick

Flu Vaccine

The flu vaccine has arrived for the fall, and I have already noticed several local grocers have signage notifying folks to "come and get em". Premature in my opinion. I have seen no cases of flu in my office yet. The flu season lasts until spring break. The immunity that the flu vaccine imparts, however, lasts only3-4 months. For healthy adults less than 65 who do NOT have chronic asthma or other respiratory illness, and who are NOT on immunosupressive drugs( you would know it if you were) I recommend waiting until mid October before you get your shot. Otherwise, if we have a busy flu season after January, your immunity from a September shot may not last.  There should be plenty of vaccine for everyone! Keep checking back here. I will post here when I see my first confirmed case.