Primary care physicians (PCPs) hold the key to better health for you and your family. These physicians are on the front lines of health care and they get to know you, your family and medical history. It’s important to have a PCP that you like and have a good relationship with to get the best care possible.

Your PCP is like the quarterback on a football team calling the plays, or in this case, making the plans to address your health concerns and guiding your plan of care. Primary care can handle 85 percent of the problems that patients have, and can coordinate care needed for other problems as well.

It’s so important to get good primary care that many health care systems, including Johns Hopkins Medicine, are creating a new approach to primary care called “medical homes.”

Vice President of Population Health and Advancement at Howard County General Hospital, Elizabeth Edsall Kromm, Ph.D., offers some important insights on the benefits of primary care.

Broad Knowledge and Skills
While PCPs are not specialists, they have a special skill set, which allows them to be adept at spotting a broad, underlying condition responsible for a range of symptoms. Depression or a chronic inflammatory disorder, for example, can manifest in any number of ways: stomach discomfort, joint pain or problems with multiple organs.

There is a growing emphasis today on preventive medicine and maintaining overall wellness to ward off problems before they occur, if possible. Helping preserve and protect your health helps you save money on health care costs and also reduces costs for the health system overall.

For example, cardiovascular disease, diabetes and other chronic conditions are preventable. The effect of healthy habits on a person’s life can be enormous. Recent preliminary evidence shows a 5 percent reduction in weight in an overweight person can reduce their risk of diabetes by 65 percent.

Your Primary Care Team
To help ensure care is delivered most effectively and efficiently, health care systems are creating the “patient-centered medical home.” In short, the medical home transforms a primary care clinic or other facility into a home base, where most of what a person needs for better health is located and available.

Though the primary care physician remains at the center of providing care, emphasis on a team is paramount. These teams typically include nurse practitioners, physician assistants, health coaches, community health workers and more.

Technology Makes It More Personal
Electronic medical records are another component of the medical home that seamlessly weave together detailed notes from every care provider who sees the person, lab and imaging results, and the like. This way the primary care team can get reports on which patients are facing gaps in their care.

For more information about the benefits of primary care and selecting the best physician for you and your family, read Four Reasons Why You Should Have a Primary Care Physician.

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Primary Care Physician Consulting Patient

[Credit: monkeybusinessimages]

If you’re healthy and feeling good you’re probably wondering why you would need a primary care physician. According to William Saway, M.D., an internal medicine physician on staff at HCGH, “Even if you’re totally healthy, a primary care physician plays a very important role in keeping you healthy.”

Several benefits for having a primary care physician include:

  1. Gaining a Medical Home
    “Your primary care physician’s office is your medical home—they know you and your medical history to treat you best when you are feeling sick,” says Dr. Saway. They also ask you about your family’s medical history and use that information for preventative care and to determine any screening or testing you may need. “Patients who are otherwise healthy may have a family history of a condition that they in turn are susceptible to and they need to be monitored,” notes Dr. Saway. An emergency room visit can often be avoided by establishing a relationship with a primary care physician. Some local primary care practices also have extended hours or operate urgent care centers.
  2. Early Detection
    While you may feel perfectly fine, Dr. Saway warns, “You can have high blood pressure, diabetes and/or high cholesterol, which are silent killers. Pain brings you to the doctor and bleeding brings you to an emergency room but these conditions don’t give you a clue that you need to see the doctor. An annual visit to your doctor for screenings can provide insight before a condition can become serious.”
  3. Access to an Educational Resource
    A physician’s job is also to educate. For example, it is important to understand the consequences of high blood pressure or cholesterol or untreated diabetes. Your physician is your resource. Use your wellness visit to ask questions and get answers. If the need arises for you to seek the care of specialists, your physician can recommend specialists specific to your needs. Furthermore, they can provide collaboration between specialists and guide you to the appropriate resources. Specialists and patients should keep the primary care physician informed so care can be effectively managed.
  4. Electronic Tracking of Your Health Care
    Most physicians offer an electronic medical record that tracks test and screening results and generates reminders when you are due for a follow-up appointment, exam or test. This tool can be extremely helpful for managing a chronic illness. Your physician’s online website portal can provide education and an option for you to communicate with your doctor.

Internal medicine and family practice physicians serve as primary care physicians. Internal medicine physicians provide health care to adults and are skilled in preventing, diagnosing, treating and managing adult diseases as well as encouraging disease prevention and screening and promoting well-being. Family practice physicians provide ongoing, comprehensive health care for patients of all ages and genders. They also emphasize disease prevention and screening.

If your access to care is limited because of cost or insurance, Chase Brexton Health Care offers solutions as a Federally Qualified Health Center that serves underserved populations in the community as well as insured patients. “Our health care team is focused on helping patients stay healthy and providing care for urgent and chronic diseases. I enjoy working with my patients and their families to provide them with a comprehensive, team-oriented approach,” says Sarah Connor, D.O., a family medicine physician on staff at HCGH.

To find a primary care physician, visit Howard County General Hospital’s Find a Doctor webpage.

William Saway, M.D., specializes in internal medicine with Columbia Medical Practice in Columbia. For an appointment, call 410-964-5300. 
Sarah Connor, M.D., specializes in family medicine with Chase Brexton in Columbia. For an appointment, call 410-884-7831.

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Introducing Acute Care for Elders (ACE)- a Program to Meet the Evolving Needs of the Community

Specialized Program Changes to Meet Evolving Needs: Acute Care for Elders (ACE)

Geriatrician Anirudh Sridharan, M.D. with geriatrc nurse practitioner Francie Black, CRNP.

Geriatrician Anirudh Sridharan, M.D. with geriatrc nurse practitioner Francie Black, CRNP.

Caring for the ever-growing elderly population is a challenge faced by health care systems across the country. Responding to the need for improved hospital-based geriatric care, Howard County General Hospital launched the Acute Care for Elders (ACE) Program in November 2011, providing the community’s aging population with the specialized care needed to help minimize complications from hospitalization.

A national effort, the ACE model is designed to help elderly patients avoid inactivity that can lead to physical and cognitive decline during a long-term hospital stay. Patients admitted to HCGH’s ACE Program, must be at least 70 years of age, admitted through the Emergency Department from home and be considered at risk for functional decline.

Anirudh Sridharan, M.D., a geriatrician who specializes in hospital-based care and medical director of the ACE Program, explains that the program has benefited elderly patients by giving them the attention necessary to make their hospitalizations safer. “Howard County, like the rest of the country, is facing a shift in demographics. The fastest growing part of our population is people over the age of 65,” says Dr. Sridharan. “Treating an elderly patient is different than treating a younger patient; they are more likely to get confused in the hospital and more likely to suffer side effects from medications. It is vital that these vulnerable patients be given specialized attention that addresses these challenges.”

Since the program was launched, Francie Black, CRNP, a nurse practitioner with HCGH’s ACE Program, says the nursing staff is more keenly aware of the need to prevent deconditioning of elders in the hospital with a focus on getting patients up and out of bed. “Elders are mobilized as soon as day one, but definitely by day two of their admission to the hospital,” explains Francie. “The nurses and care technicians automatically add getting out of bed as a daily goal. There is a greater incentive for patients to walk in the hallways, and the solariums on the unit give our patients a destination as well as more daylight. We want our patients to function here as they do at home.”

Francie Black helps a patient stay mobile during a hospital stay, one of the goals of the ACE Program.

Francie Black helps a patient stay mobile during a hospital stay, one of the goals of the ACE Program.

Coordination of care between the patient and their primary care physician, hospital doctors, nurses, nutritionists, case managers, pharmacists

and the patient’s family is an integral component of the ACE Program. Through a multidisciplinary approach to care, HCGH’s ACE team ensures that admitted patients remain mobile, well-nourished and have ample opportunities to exercise their bodies and minds.

“The ACE Program has heightened awareness of the need to collaborate with caregivers in the hospital, with the family, and the community to safely discharge an elder from the hospital, keep them from coming back to the hospital, and to improve their quality of life,” adds Francie.


Via Howard County General Hospital’s Wellness Matters



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Being Schooled in Medicare

If you are like me, your eyes glaze over when Medicare is mentioned in the news.  I know I should learn more about it.  I’m still pretty far away from using it myself, but planning for my future should include more than projecting my income and savings, it should include projecting my future expenses, shouldn’t it?  Besides, my parents use Medicare, and it would be a good idea to understand what the heck Part A, Part B and Part D have to do with medical costs and reimbursement. (And what exactly is a Single Payer Health Care Plan as opposed to Medicare Advantage?) 

A quick search turns up the alarming statistics that the typical senior household has $66,900 in savings, and the average man needs $124,000 to cover health care during retirement. (The average woman needs $152,000- not because we’re weaker, but because of that whole life expectancy thing.)  Those are startling statistics!

Recently, my out-of-state aunt fell and broke her hip and had to be transferred to a facility that could provide the skilled care needed to get her back on her feet, but, because she stayed only 2 and one-half days in the hospital, Medicare could not cover the cost of that two week nursing home stay.  Unfortunately, the family learned about the rule the hard way.

How can we make what seems to be an incredibly complex system easier to understand?  The Senior Health Insurance Assistance Program (SHIP), the Howard County Office on Aging and Howard County General Hospital are hosting a free two-part lecture on the Medicare system.  What to Expect From Medicare is the first seminar on September 17, and will address the benefits, costs and how the plan works.  On October 1, Medicare Isn’t Enough will focus on the gaps in Medicare and how to protect yourself from Medicare fraud.  Although the classes are free, you’ll need to register as space is limited.

If you can’t make the free seminars, be sure to check in with SHIP directly as they are a terrific resource and, for a little light reading, check out this book currently on the shelves at the Howard County Library: Social Security, Medicare & Government Pensions: Get the Most Out of Your Retirement & Medical Benefits by J. L. Matthews. It was published in 2012 and is highly rated. 

After all, being wise is an essential part of being well!


Mary Catherine Cochran works as a Senior Communications Project Manager at Howard County General Hospital: Johns Hopkins Medicine where, among other things, she manages and writes for the Well & Wise blog.


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May is National Stroke Awareness Month and according to the NSA (National Stroke Association) strokes kill more than 137,000 Americans annually. A stroke (or brain attack) occurs when the blood flow to an area of the brain is disrupted. Some of the general symptoms of a stroke include a weakness or numbness of the face, arm, or leg, especially on one side of the body, as well as sudden vision changes, trouble speaking, or walking. You can read more about the many varied symptoms of a stroke here and stroke risk here. Your primary care physician is the best resource to talk about your risk factors for a stroke and what you can do to decrease those risks. Strokes can cause several types of disabilities and stroke patients may need to relearn skills and new ways to perform tasks. Any rehabilitation program will need to be individualized for the patient, but you can read about the general treatment components here.

Strokes can happen at any time to anyone. The stress of an emergency situation like this makes even the simplest tasks more difficult, so I encourage you to take a moment to plan for and practice what you would do in case of a possible stroke using NSA’s campaign Act FAST:

F- Face drooping. Ask the person to smile and check to see if their smile is uneven.
A – Arm weakness. Ask the person to lift both arms at the same time and check to see if one arm drifts downward.
S – Speech difficulty. Ask the person to repeat a simple sentence and check to see if they can do it correctly.
T – Time to call 9-1-1. Even if the symptoms go away it’s important to call 9-1-1.

Knowing how to Act FAST can truly save lives.

Nancy Targett is an Instructor & Research Specialist at the Miller Branch. She lives in Columbia and is the proud mom of three boys and a girl and a Siamese cat.

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Heart disease is the leading cause of death in men and women in the United States, according to the Centers for Disease and Prevention (CDC). Unfortunately, you may not realize that you are at risk of having a heart attack until it’s too late.

While there is very little you can do to change your family medical history, you can make lifestyle changes to lower your risk. First, learn about the behaviors that increase the risk of heart disease, and then start taking preventive steps.

Behaviors that Increase Heart Disease Risk

Preventive Steps

Eat a heart-healthy diet

Add these following foods to your diet. They are considered to be the main ingredients of a heart-healthy diet.

  • Vegetables – greens (spinach, collard greens and kale), broccoli, cabbage and carrots
  • Fruits – apples, bananas, oranges, pears, grapes and prunes
  • Whole grains – plain oatmeal, brown rice and whole-grain bread or tortillas
  • Fat-free or low-fat dairy foods – milk, cheese or yogurt
  • Protein-rich foods – fish high in omega-3 fatty acids, lean meats, poultry, eggs, nuts, seeds, soy products and legumes (lentils and some bean types)
  • Oils, butters, nuts and seeds – canola, corn, olive, safflower, sesame, sunflower and soybean oils; nut and seed butters; walnuts, almonds and pine nuts; and sesame, sunflower, pumpkin and flax seeds

Aim for a healthy weight 

Body mass index (BMI), a measure of weight relative to height, is commonly used for determining weight category (underweight, healthy weight, overweight and obese). Adults are typically considered to be at a healthy weight when their BMI ranges from 18.5 to 24.9.

Use Johns Hopkins Medicine’s BMI calculator to help determine your BMI.

Lower stress

Improve your emotional and physical health by learning to manage stress and practice stress-reducing activities, including:

  • Seeing a mental health care provider
  • Joining a stress management program
  • Meditating
  • Being physically active
  • Practicing relaxation therapy
  • Speaking with friends, family and community or religious support systems

Increase physical activity

Routine physical activity can lower bad (LDL) cholesterol and increase good (HDL) cholesterol levels, control high blood pressure and help with losing excess weight.

The National Heart, Lung and Blood Institute recommends the following:

  • Moderate-intensity aerobic exercise – at least 2 hours and 30 minutes per week
  • Vigorous aerobic exercise – 1 hour and 15 minutes per week

Before starting a new exercise program, you should first ask your doctor how much and what physical activities are safe for you.

Quit smoking

Speak with your doctor about programs and products that can help you quit smoking, and try to avoid secondhand smoke. If you are having trouble with quitting on your own, consider joining a support group.

Visit your doctor

According to David Jackson, M.D., a cardiologist on staff at HCGH, one of the critical steps to keeping your heart healthy is seeing your doctor for a routine physical exam. Your doctor checks your blood pressure, cholesterol and blood sugar – the big three indicators for heart attack and stroke.

“If your numbers start to become abnormal, you may not feel different or experience symptoms, so it’s important to have them checked periodically and more frequently as you age,” says Dr. Jackson. “Having a primary care physician monitoring your care to identify trends in your numbers is important.”

Learn more about why primary care physicians are important to your health.

More Information

For more details on heart-healthy living, view the National Heart, Lung and Blood Institute’s Heart-healthy Lifestyle Changes.

Share Your Thoughts

Do you have any heart-healthy tips – recipe, exercise, stress reducing or other tips? We’d love to hear them, and our readers will appreciate them too. Share them in the comments area.


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