T.J. Samson | Destination Health | February 2018

2 DESTINATION HEALTH Eric Fisher, MD T.J. Samson Family Medicine Center Almost everyone recognizes varicose veins when they see them. They’re the swollen, twisted veins that bulge from just under the skin, usually in the legs. Here are three key facts you should know about these veins: 1 They’re common. At least 20 million Americans have varicose veins. Women are more prone to get them than men. Risk factors include hav- ing multiple pregnancies, getting older, being overweight or obese, standing or sitting for long periods of time, having a family history of vari- cose veins, and having a personal history of blood clots in the legs. 2 They might not cause problems. Despite their appearance, varicose veins often have few signs or symptoms. When they do, they may cause: ●  ● Mild swelling of the ankles or feet. ●  ● Pain, aches or a heavy feeling in the legs. ●  ● Throbbing or cramping. ●  ● Itchy legs, especially on the lower part of the leg or on the ankle. ●  ● Discolored skin in the area around the vari- cose vein. In severe cases, varicose veins can trigger hard- to-heal sores near the ankle and increase the risk of blood clots. 3 They’re treatable. Doctors usually recom- mend lifestyle changes as a first step for treating varicose veins.These changes often can reduce pain or other bothersome symptoms and keep the veins from growing or getting worse. Lifestyle changes include losing weight, exer- cising, wearing compression stockings, and taking regular breaks from sitting or standing. If lifestyle measures don’t work, medical proce- dures may be needed. For instance, the veins may be closed by chemical injection, or they may be zapped closed with a laser.They can also be re- moved surgically. Treatments are usually done as outpatient procedures. Frequently more than one treatment is needed. Talk to your doctor if you’re concerned about varicose veins or want more information about treatments. Sources: National Institutes of Health; Vascular Disease Foundation Varicose veins 3 key facts to know now Great care: We’re proud of our team approach For Eric Fisher, MD, the ultimate aim of a patient-centered medical home is this: “Better care that results in healthier, happier patients.” Dr. Fisher is the Assistant Medical Director of the T.J. Samson Fam- ily Medicine Center. And he’s talking about the patient-centered medi- cal home (PCMH) recognition that his practice recently earned from the National Committee for Quality Assurance (NCQA). Several primary care practices that fall under the T.J. Health Pavilion umbrella also earned PCMH recognition from the NCQA. A medical home isn’t a place. It’s a way of delivering health care. Among other things, the PCMH model seeks to improve patient care and patients’ experiences, says Michael Taylor, Physician Operations Director for T.J. Health Pavilion. Each patient’s care is overseen by care teams. And patients are partners in their own care. EARNING YOUR TRUST To receive recognition (which is good for three years), both the Family Medicine Center and the T.J. Health Pavilion had to show they are prepared to fulfill key elements of a patient-centered medical home. “PCMH creates processes within your clinic that make sure patients get the attention they need beyond that one-on-one clinic visit,” Dr. Fisher says. Some of the ways practices do that include: Highly coordinated care. For instance, that might be when a primary care provider works closely with other specialists who are involved in your care. It’s also when your provider fol- lows up with you if you’ve been admitted to the hospital. And it can mean putting you in touch with other health care services that meet a wide range of your needs. Communicating. For instance, if you’ve not been able to have a recommended blood draw, a nurse may reach out to you as a helpful reminder. “Studies show that only about 50 percent of providers’ orders for recommended tests actually get completed,” Dr. Fisher says. Increasing access to care. This can include offering earlier or later appointment hours. “We have instituted additional hours in several of our clinics,” Taylor notes. A team approach. During an office visit, more than one provider may be involved in your care. For instance, a nurse might work with you while you’re waiting for the doctor. ACTION-ORIENTED CARE The PCMH model is a proactive approach to medicine, Dr. Fisher says. You might notice that the clinic reaches out to you to ask you about your health or to remind you of an upcoming medical screening test. “People spend most of their time outside this clinic, so a medical home pushes us to engage patients even more when they’re not here,” Dr. Fisher says. PCMH also emphasizes prevention and health education. For example, providers may of- fer additional resources to help people better manage chronic conditions such as high blood pressure or diabetes. Or a nurse may meet with patients to help them establish preventive health goals. “PCMH recognition is a testament to the dedication of our providers,” Taylor says. “Our teams and our physicians work together to reach the goal. And that’s always to provide the best quality care that we possibly can.”