This Newsletter Brought to You by the Physicians and Staff of the Center for Primary Care

Spring Brings Host of Allergic Asthma Triggers

Asthma is a chronic disease in which the breathing passages constrict and become congested with mucus. The narrowing of the small airways that branch off from the windpipe restricts the flow of air in and out of the lungs, which makes breathing difficult and uncomfortable and causes symptoms such as shortness of breath, wheezing, and coughing. More than 17 million Americans, 5 million of whom are children, suffer from various forms of asthma, such as those induced by exercise, cold air, and allergens. Of these, the most common form of the disease is allergic asthma.

In allergic asthma, symptoms are intensified by exposure to things in the environment to which the immune system is sensitive. Common allergens include spring and fall pollens, animal dander, dust, mold, smoke, pollution, fumes, aerosol sprays, and perfumes. These allergens are somewhat irritating to many people, but in those with allergic asthma, inhaling these substances can trigger serious asthma episode.

There are excellent inhaled medications available for both short-term, emergency relief of symptoms and long-term control of asthma, available in inhaled and pill form. Quick-relief inhaled medications are used to provide immediate relief from wheezing attacks and should be used only as needed. Long-term medications do not provide emergency relief, but when used on a regular basis over time, can help reduce the frequency and severity of asthma attacks.

A person with allergic asthma can be treated with medications to prevent the allergies from flaring their asthma and also can be allergy tested and receive immunotherapy to reduce sensitivity to substances that typically cause allergic reactions.

Because each case of asthma is unique, treatment plans should be developed on an individual basis. However, there is one preventive step that benefits everyone with allergic asthma: remove substances in your environment that you know contribute to your asthma symptoms. Depending on which allergens you are sensitive to, you should consider keeping your pets outdoors rather than inside, not allowing people to smoke in your home, substituting natural, mild cleansers for toxic or irritating chemical products, and minimizing dust, particularly in the room where you sleep.

The best approaches to managing asthma are to learn all you can about the disease, including the symptoms and treatments, be aware of your personal environmental triggers, be alert to early warning signs of an approaching attack, and be prepared at all times to respond appropriately to an episode. It is particularly important to have a quick-acting inhaler on hand, if this is part of your treatment plan.

If you think you may have allergic asthma, talk with your family doctor about your symptoms so that you can work together to develop a treatment plan that is appropriate for you. For more information about asthma and allergies online, visit www.aaaai.org and www.aafa.org.

Source: Asthma & Allergies, Asthma and Allergy Foundation of America (AAFA), Washington, DC, 2002 (website); Spring Allergies & Asthma Survival Guide, “Understanding Allergic Asthma” American Academy of Allergy, Asthma, and Immunology (AAAAI), 2002 (website).

Medical Office Staff Members Have Broad Range of Responsibilities

When you walk in the front doors of any Center for Primary Care office, you’re there to see your doctor, but chances are you’ll also come in contact with many of our office staff during your visit. Some have administrative responsibilities, some have clinical duties, and many are trained to handle both.

More than likely, you know the names and faces of many of our staff members with whom you interact on a regular basis. Behind the scenes, there are even more who are working diligently to ensure that your visit is pleasant and efficient and that your medical needs are addressed promptly and with the highest quality care.

The staff members you probably know best are those who greet you at the front desk when you sign in, answer any questions you may have, and update your insurance information. When you arrive for your visit, they pull your medical chart for the back office staff. An MA will then get a brief history of why you’re seeing the doctor that day, and check your weight and vital signs. After you see your doctor, staff members make sure test results are recorded in your chart, insurance is filed, referrals and insurance precertifications are handled, and prescriptions are called in. If you have a medical procedure done at the office – anything from drawing blood to minor surgery – you may meet additional members of our staff. Many more staffers are also responsible for assisting with your office visits and your medical needs. Much of the lab work ordered by your physician is done on site by laboratory technicians in our certified laboratories. Some of our staff members also enter lab results on the automated test results line so that you can access them in a timely manner by phone. After you see your doctor, the front office staff then assists you with checkout and arranges follow-up appointments.

In between the flow of patients, two phone clerks are constantly handling calls and taking messages, and file clerks are pulling charts for messages and test results. When you call for a prescription refill or to have your doctor contact you, the person who takes your call makes sure she has all the information your doctor will require to meet your needs, such as a history of your current medical problem. If you have a general question, a staff member will either address your concern or make sure you are referred to someone who can.

CPC staff members with clinical responsibilities have completed training programs, such as those offered by Augusta Technical College, and have earned their credentials through organizations such as the American Association of Medical Assistants. MAs are certified or registered in both the clinical and administrative aspects of a medical office, and our licensed practical nurses have clinical responsibilities but also handle referrals and schedule appointments. Our laboratory technicians have also completed training programs and certification examinations and have a great deal of practical experience. For all staff personnel, continuing education is an important part of staying current with new information and trends in their respective areas of expertise as well as ensuring that you continue to receive the highest quality of care from CPC.

“Every employee stays constantly busy from the time we open until we close each day,” says Rhonda Brown, CPC Staff Training Coordinator. “Teamwork plays a big role in our office.” With the huge volume and broad spectrum of responsibilities our staff handles, there’s no other way to run the office smoothly. “In a primary care office like CPC, the staff has to be flexible, understanding, patient, and extremely accurate with what we do,” Rhonda explains. To make sure things work as well as possible, she and the staff meet on a regular basis to identify areas that need improvement and to discuss practical ways to make things run as well as possible.

Rhonda says the quality of staff members who work for CPC make her job enjoyable. “We are fortunate to have a great team of caring people who like both their jobs and our patients,” she says. “We hope our patients have the same good feelings about us and the quality of care they receive at CPC.”

Filling Prescriptions: Knowledge is the Key to Minimizing Costs

Getting a prescription filled should be easy, but with the rising cost of prescription medications, insurance companies and employers are increasingly interested in controlling drug costs. Some of the steps they are taking to keep costs down are making it more confusing and complicated to get prescriptions filled.

In making informed decisions about prescriptions, it may help you to understand the terms you will encounter: formulary, co-pay, brand-name drug, generic drug, preferred drug, non-preferred drug, and lifestyle drug.

What is a formulary?

A formulary is a list of medications that your insurance company will help you pay for. This list is reviewed and changed by the company every few months. The drugs in a formulary are often listed in two or more groups, depending on how much of the cost you are expected to pay. The amount you’re expected to pay is called a co-pay. A typical formulary might include the groups (also called levels or tiers) shown in the table above.

What is the difference between brand-name and generic?

When a drug company develops a new drug, it gives it a brand name. Brand names are the names you usually see in ads on TV and in magazines – names like Amoxil (a brand name of amoxicillin) and Advil (a brand name for ibuprophen).

For several years after the drug is developed, laws prevent other drug companies from copying it. When other companies start manufacturing and selling the drug, their versions are usually known by a different name – the generic name. This is often the chemical name. For instance, amoxicillin is the generic name for Amoxil and ibuprofen is the generic name for Advil.

Generic drugs are chemically the same as brand-name drugs but are often less expensive. That’s why many insurance plans encourage you to use generic drugs.

What are preferred and non-preferred drugs?

Often two brand-name drugs are useful for the same problem. Your insurance company may be able to get one less expensively than the other. That drug becomes a preferred drug, and the other becomes non-preferred. That’s usually why you pay more for non-preferred drugs.

Sometimes an insurance company will move a drug from the preferred list to the non-preferred list. If this happens, your doctor might be able to prescribe a preferred drug that would work just as well at a lower cost.

What about drugs that are not in the formulary?Formularies include a limited number of drugs. Many do not include medications that the insurance companies do not want to pay for. These are sometimes called lifestyle drugs. Drugs for weight loss and hair growth are examples of lifestyle drugs. Your insurance company usually will not help you pay for a drug that is not part of its formulary.

More information about how to simplify the prescription process will be featured in the next newsletter

Source: Family Practice Management Patient Handout Reproduced (revised) with permission of the American Academy of Family Physicians, 2002.