Direct Care

Direct primary care practices offer a membership-based approach to routine and preventive care that can dramatically reduce health care costs for individuals, families and businesses. At the core of a direct primary care facility is a medical practice dedicated to providing routine, everyday care, essential for the well-being and ongoing maintenance of a patient’s health. This is where patients go for check-ups, vaccinations, sprained ankles, or frequent headaches. Direct primary care providers know their patients. They have talked with their patients in detail, gotten to know them, treated past conditions and know what recurring problems are experienced. If a patient has a chronic illness, like arthritis or diabetes, their primary care provider is already a partner in management every step of the way. And, in the unlikely event of a life-threatening accident or disease, the provider serves as the patients advocate, coordinating care across multiple providers, facilities, and prescriptions. Direct primary care practices serve as a patient’s primary care medical home where they go for all routine primary, preventive and chronic care management types of care. Patients pay one low monthly fee to their direct primary care facility for all of their everyday health needs. Like a health club membership, this fee gives patients unrestricted access for visits and care, so patients can use the services as much or as little as they want. Many direct primary care practices are open seven days per week and offer same-day or next-day appointments. At many clinics, physicians are on call 365/24/7. There is none of the paperwork and expense required today by insurance reimbursement - no procedure or billing approval, deductibles or co-payments. With a lower business overhead and dramatically less paperwork, primary care providers are no longer forced to squeeze in an unmanageable number of patients and can instead take the time necessary with each patient to deliver high-quality, personalized care. Accidents and the unexpected do happen, so the typical patient in a direct primary care practice keeps an insurance plan to cover emergencies and serious illnesses. Because this insurance does not need to cover routine care, many patients choose a less comprehensive plan with a higher deductible and lower premium. With insurance-paid primary care, where each and every part of the medical care is billed to a third party payer, reimbursement costs consume more than 40 cents of each dollar. Eliminating insurance from primary care makes those 40 cents available for actual health care - more time with each patient, more extensive office hours, more on-site services and diagnostics, and more patient-provider support technology. The patient and dire provider are responsible for the overall wellness. Any time have a health concern, the first visit should be to the primary care provider, who knows all of the medical history and can help make the best decision about the health. With most health issues, the primary care provider can diagnose and heal the problems thee experiencing. Specialist and hospital care should be for serious, complex illnesses and life-threatening emergencies. If one is severely injured in an accident, for example, an ambulance takes to the emergency room. Or, if thee diagnosed with cancer, may need hospital care such as surgery, radiation, or other treatments. Insurance is an important part of specialist and hospital care. Similar to automobile insurance, our health insurance system was originally designed to pay for rare, unpredictable, and extremely expensive problems. It is essential when patients need emergency care or an operation and chemotherapy treatments, care provided by specialists and hospitals. Primary care is frequent, highly predictable, and relatively inexpensive. It doesn’t make sense to pay for primary care using insurance. Paying for primary care with insurance has caused the cost of primary care and the downstream specialist/hospital care to rise considerably, and has made health care cost-prohibitive for millions of Americans. Direct primary care practices eliminate insurance overhead, which can extend health care to more Americans.

Gynecology

Obstetrics and gynecology are the two surgical–medical specialties dealing with the female reproductive organs in their pregnant and non-pregnant state, respectively, and as such are often combined to form a single medical specialty and postgraduate training program. This combined training prepares the practicing OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patients. Gynecology is a branch of medicine specializing in the disorders of the female reproductive system. Modern gynecology deals with menstrual disorders, menopause, infectious disease and development of the reproductive organs, disturbances of the sex hormones, benign and malignant tumor formation, and the prescription of contraceptive devices. A branch of gynecology, reproductive medicine, deals with infertility. It utilizes artificial insemination and in-vitro fertilizations, a human egg fertilized in a test tube, and then implanted into the womb. Some gynecologists also practice obstetrics. Surgical gynecology began to make progress in the 19th cent., when the introduction of anesthesia and antisepsis (see antiseptic) paved the way for many advances. The American physician J. M. Sims was largely responsible for gaining acceptance of gynecology as a medical and surgical specialty. Until then there had been opposition to it on moral grounds from midwives, the clergy, and the medical profession. Obstetrician/gynecologist is a physician specialist who provides medical and surgical care to women and has particular expertise in pregnancy, childbirth, and disorders of the reproductive system. This includes preventative care, prenatal care, detection of sexually transmitted diseases, Pap test screening, and family planning. An obstetrician is a medical doctor who specializes in the management of pregnancy, labor, and birth. They also receive specialized education in the health of the female reproductive system and surgical care. Much of their education focuses on the detection and management of obstetrical and gynecological problems. An obstetrician/gynecologist, commonly abbreviated as OB/GYN, can serve as a primary physician and often serve as consultants to other physicians. OB/GYNs can have private practices, work in hospital or clinic settings, and maintain teaching positions at university hospitals. OB/GYNs may also work public health and preventive medicine administrations. OB/GYNs have a broad base of knowledge and can vary their professional focus. Many develop unique practices, providing high-quality health care for women. OB/GYNs may choose to specialize in the following areas: An obstetrician closely monitors their patient's health during pregnancy and delivery. They diagnose fetus abnormalities or health issues of their patient and offer healthy living advice and treatment. They see their patients on a regular basis for health consultations, ultrasounds, and any of their patient's prenatal medical needs, including forming a birth plan. The frequency of a patients' check up often depends on risk factors and resources.

Epiderme

Epiderme is the one-stop for skin care. Moisturizers help keep skin youthful with elasticity. The epidermis is the outer layer of the skin. The epidermis helps the skin to regulate body temperature. The epidermis with the dermis forms the cutis. The epidermis is composed of four to five layers of skin, depending on the region of skin. The epidermis contains no blood vessels and nourishment of cells is by diffusion in the deepest layers from blood capillaries extending to the upper layers of the dermis. The amount and distribution of melanin pigment in the epidermis results in skin color variation in Homo sapiens. Melanin is in the small melanosomes, particles formed in melanocytes from surrounding keratinocytes. The size, number and arrangement of the melansomes varies between racial groups, but while the number of melanocytes can vary between different body regions, the number of melansomes remain the same in individual body regions in all human beings. In white and oriental skin, the melansomes aggregate but are small in size. Comparatively, in black skin, the melansomes are larger and distributed more evenly. The number of melansomes in the keratinocytes increases with UV radiation exposure, while their distribution remains largely unaffected.

Implant Material

Breast implants alter the size and shape of the breasts. There are two primary types of breast implant material: saline-filled and silicone gel-filled implants. Saline implants have a silicone elastomer shell filled with sterile saline liquid. Silicone gel implants have a silicone shell filled with a viscous silicone gel. Saline and silicone breast implants both have an outer silicone shell. The implants differ in material and consistency. The doctor fills saline into the implants often at the time of surgery. Some criticize implants have for feeling hard or unnatural, but improved surgical techniques such as placing the implant behind the chest muscle and slightly overfilling it have lessened these complaints. Saline breast implants are available to women age 18 and older for breast augmentation, or women of any age for breast reconstruction. Pre-filled silicone implants contain a silicone gel. A thick sticky fluid closely mimics the feel of human fat. Some women feel that silicone breast implants look and feel more like natural breast tissue. Silicone breast implants are available to women age 22 and older for breast augmentation, or women of any age for breast reconstruction. Implants are named according to what fills them. In other words, fill saline implants with saline and fill silicone implants with liquid silicone gel, which has the consistency of molasses. Regardless of what breast implants filling are, they all have a solid silicone shell. Implantation of solid silicone, or silastic, is used in millions of people with pacemakers, artificial joints, heart valves, penile implants, and artificial lenses for the eye. Solid silicone is a very different substance than silicone gel, which fills silicone gel implants. It might be helpful to think of breast implants as being similar to balloons. Fill a balloon with water, helium, or air, but it still has the same pliable plastic outer layer regardless of what is placed inside. There are currently two main options — silicone breast implants and saline breast implants. Both have their own set of advantages and disadvantages. In general, silicone gel-filled implants are smoother and softer than their saline-filled counterparts are. Silicone implants feel like a semisolid gel, while saline implants are more like water balloons. Many women prefer the softer, more natural-feel of silicone implants to saline breast implants, especially those with little breast tissue such as women undergoing breast reconstruction following breast cancer. Silicone-gel implants are also less likely to ripple than saline breast implants. A breast implant can be filled with saline or silicone gel. Both silicone and saline implants have an outer shell made of silicone-rubber material. Breast implants also come in a variety of sizes, shapes and profiles. Another important variable is texture. Implants can be smooth or textured. Gummy bear breast implants are also made of cohesive silicone gel, but the gel has the consistency of a gummy bear, meaning if cut it in half, it will not leak. These implants are only available to women who enroll in a clinical trial. An implant is a medical device manufactured to replace a missing biological structure, support a damaged biological structure or enhance an existing biological structure. Medical implants are manmade devices whereas transplants are transferred biomedical tissue. The surface of implants that contact the body might be made of a biomedical material such as titanium, silicone, or apatite, depending on what is the most functional. In some cases, implants contain electronics, as found in artificial pacemakers and cochlear implants. Some implants are bioactive like subcutaneous drug delivery devices--implantable pills or drug-eluting stents. Among the most common types of medical implants are pins, rods, screws and plates that anchor fractured bones as they heal.