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Dr. Scott Beach

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Heart & Vascular Care

Dr. Scott Beach talks vascular disease.

Dr. Scott Beach

On this week’s show I sat down with interventional cardiologist, Dr. Scott Beach, of Heart & Vascular Care, with offices in Johns Creek, Cumming, and Canton, GA.  I’ve known Dr. Beach for several years through the practice I was working for (Hyperbaric Physicians of Georgia).  Our physicians have worked with him on numerous patients’ cases, both sending him folks who needed to have their blood flow to their lower extremities evaluated, as well as providing specialized wound care for patients he and his colleagues occasionally see in their practice.

Dr. Beach share how he enjoys the fact that his relationship with his patients and their loved ones tends to extend over years rather than being short and limited to a procedure or two.  We talked about vascular disease and some things both patients and doctors need to think about to get problems identified and treated early.

Scott explained how often, symptoms of developing vascular disease are mild and gradually reduce the patient’s tolerance to activity.  In many instances, the patient and their family merely chalk the changes up to “getting older”.  That’s dangerous, because it means the blockage of blood flow that’s causing the symptoms continues to grow until a major event occurs such as a heart attack, stroke, or possibly a limb amputation.

We discussed the fact that there are simple, non-invasive studies that can reveal early vascular disease when it’s easier and more-likely-successful to treat with more options to choose from.  Additionally, we talked about the fact that having pulses that can be felt on a patient’s foot is NOT an accurate means of determining whether a patient has vascular disease that needs attention in many patients.

Additionally, when patients have a wound on their foot or leg that is healing slowly or not at all, it is very important to know whether blockage of blood flow is contributing to the inability to heal.  Too often, these patients go for amputation that could have been readily prevented with one of those non-invasive or minimally-invasive studies he described.  For patients with a wound that’s not healing, it is important for them to have a multiple-specialty team of doctors who help with different facets of the non-healing wound.  Scott and his colleagues certainly subscribe to this approach and get their patients with limb threatening wounds access to all available experts who can help save their foot/leg.

The value in this multi-specialty approach cannot be overstated when you consider that in diabetics (one of the largest groups who experience vascular disease), the 5 year mortality rate for patients undergoing a below-the-knee amputation is just under 50%.  Most patients and many doctors are not fully aware of this risk.

Special Guest:

Dr. Scott Beach, MD, Heart & Vascular Care  facebook_logo_small3  linkedin_small1

Heart & Vascular Care

 

Telemedicine

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Sidney Welch

Healthcare attorney, Sidney Welch

Telemedicine

We sat down with legal expert on healthcare matters, attorney, Sidney Welch, of the Polsinelli law firm on our monthly episode with Medical Association of Georgia.  What is it?  How is it utilized?  And, what are the licensing, regulatory, and legal concerns around it?

Georgia Composite Medical Board (GCMB) has stressed that it is essential for telemedicine patients in the state to receive the same high standard of care they would in a traditional office setting.  GCMB adopted a number of telemedicine rules in 2014 that “allow the Composite Board to take disciplinary action against licensed physicians and allied health professionals who practice telemedicine if they do not provide the minimum standard of care.”

Georgia’s rules require physicians and other allied health care professionals who deliver care by way of telemedicine to…

  • Be the ones who provide all of the treatment and/or consultations via telehealth.
  • Have access to the patient’s medical history if they are providing the services.
  • Have personally seen and examined the patient if they are referring the patient to a telehealth provider.
  • Maintain records on the patient’s evaluation and treatment if they are providing a service via telehealth and to provide a copy of those records to the referring physician.
  • Provide telehealth services only within their specialty.
  • Give their name, credentials and emergency contact information to the patient when they provide a telehealth treatment or consultation.
  • Provide the patient with “clear, appropriate, accurate instructions” on follow-up care.

Controlled substances for pain or chronic pain treatment cannot be prescribed through telehealth – but a physician or a nurse practitioner or a physician assistant can order appropriate labs or other diagnostic tests.

The physician who provides the care via telemedicine must make a “diligent” effort to ensure that the patient is seen and examined in person at least once a year by a Georgia-licensed physician or other appropriate health care professional.

Special Guest:

Sidney Welch, JD, of Polsinelli  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3  

Sidney Welch

Radiation Oncology

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Radiation Oncology

On this week’s show I sat down with Radiation Oncologist, Dr. Chad Levitt. We talked about how he decided he wanted to go into radiation oncology as his chosen field of practice. He shared how he enjoyed the fact that the specialty allowed him to call on his liberal arts schooling, helping him to be able to be perceptive to his patients’ needs and concerns, and allowing him to communicate effectively with them in a period of significant stress.

Chad explained how important it is for oncology physicians to make time to insure their patients’ questions are answered and that their concerns have been addressed. He believes the patient needs to be well-informed so they can hopefully experience less anxiety and allow them to make educated choices about their care. He stated the patient should be the “Captain of the Ship” and the health team the crew that helps them get to where they want to go.

We talked about the importance of getting 2nd and even 3rd opinions when facing life-changing illnesses such as cancer. Chad shared that it is vital to do so before engaging in treatments that cannot be undone. Given the political and personal alliances that can be present in a given hospital ecosystem, it is wise to seek 2nd opinions in hospitals or systems that are outside that of the primary physician to allow for likelihood of a more objective opinion.

Special Guest:

Dr. Chad Levitt, MD, of Radiotherapy Associates of Forsyth

Radiotherapy Associates of Forsyth

International Medical Graduates

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 TDR 12-9

International Medical Graduates

In our ongoing series with Medical Association of Georgia, we discussed International Medical Graduates on this episode.  Today, we continue to extend the age to which we humans live. This, coupled with the large post-war baby boomer population that is now entering the elderly population, compounds the effects of the period 2-3 decades ago where it was thought we possessed a surplus of physicians. During that time the creation of new medical colleges and expansion of residency programs was limited. These factors combined to bring us to the situation we find ourselves in today: an expanding shortage of physicians in the US.

The ECFMG (Education Commission for Foreign Medical Graduates) reports that since its inception in the 1950’s it has examined and certified over 320,000 foreign-trained physicians for acceptance to train in US medical colleges and residency programs.  Recent statistics show as many as 25% of practicing physicians in the US are foreign-trained graduates.  And they play a vital role in the delivery of healthcare in our country.  I sat down with Kate Boyenga, Director of Membership and Marketing with Medical Association of Georgia and current MAG president, Dr. Manoj Shah, himself a foreign medical graduate.

We learned about some of the reasons why Medical Association of Georgia is experiencing its largest membership with over 7500 members statewide.  And Dr. Shah shared excellent information about the steps required to study in medical school abroad with the ultimate goal of practicing medicine in the US.  He talked about the tests one can expect to take, challenges they may face while making application to schools/residencies in the US, and possible solutions for them.

Special Guests:

Kate Boyenga, Director of Membership and Marketing for Medical Association of Georgia 

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boyenga

  • BA Communication, College of Charleston
  • Under her leadership MAG Membership is at an all-time high
  • 14 years with MAG

Dr. Manoj Shah, MD, of Physicians for Women and president of MAG  linkedin_small1

  shah

  • MAG’s first President from Warner Robins
  • MAG’s first president of East Indian descent
  • Doctor of Medicine, Baroda, India
  • Residency, Henry Ford Hospital in Detroit
  • Has delivered more than 7,000 babies

Dr. Khusrow Niazi

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Emory Healthcare

Dr. Khusrow Niazi

This week I sat down with Emory School of Medicine’s Dr. Khusrow Niazi, Interventional Cardiologist and Director of Peripheral Vascular Interventions.  Dr. Niazi is a cardiologist but is different from many other cardiologists as he treats disease from the head to toes. He specializes in blockages of the artery which may involve coronary arteries around the heart which may cause chest pain or heart attack, carotid arteries which may cause TIA or strokes, arteries to the leg which may cause leg discomfort or slow wound healing. In addition he is one of the few cardiologists who also treat veins of the legs which may cause leg cramps, swelling, heaviness or varicose veins. He has lectured nationally and internationally and has helped many patients from getting their legs amputated.

Dr. Niazi appeared with the goal of providing the folks in the community with a cardiologist’s perspective on what they need to know about vascular disease which can affect the arteries that supply the brain, heart, and limbs.  We talked about things we can do to reduce our risk of disease in the vascular system.  He also shared recommendations on the types of tests and studies that folks who are at greater risk for vascular disease should consider having conducted.  Many of these tests are quite basic and can be performed at their local primary care physician’s office.  Persons who should consider regular monitoring for the presence of vascular disease include those who are over-weight, have diabetes, high cholesterol levels, hypertension, as well as those who have close relatives with a history of vascular problems.

Dr. Niazi advised our listeners to not ignore symptoms that might indicate a vascular problem exists such as chest tightness/pain, dizzy spells or changes in vision, speech, or ability to walk, pain in the lower legs when walking, shortness of breath at rest or with mild activity, etc.  These can be signs that vascular problems exist that could potentially be corrected with early intervention.  He also spoke about the fact that persons who have a wound on their lower leg or foot need to be evaluated for the presence of correctable vascular disease.  Many of these people go on to have amputations when they may have been prevented by intervention by a vascular specialist.

Special Guest:

Dr. Khusrow Niazi, MD, of Emory University School of Medicine facebook_logo_small3  twitter_logo_small  youtube logo  linkedin_small1

 

Emory Healthcare

  • Doctor of Medicine, King Edward Medical College, Lahore, Pakistan
  • Residency, Cardiology, Kettering Medical Center
  • Fellowship William Beaumont Hospital
  • Multiple published research articles