By: Anika Goodwin, MD, FACS, EYEmergencyMD.com
You’re young, healthy, and invincible. Life is hectic. Who has time for an appointment with the eye doctor?
You visit your doctor if you’re sick and you get a physical about once a year, so you’re covered, right?
Wrong.
A physical examination and lab work can tell your doctor the status of your body, but not the status of your eyes.
To be such a small organ, the eyes are gloriously complex and responsible for the way you and your body interact with everything around you.
I can read your mind right now. “Yes, but only older people get eye problems.”
Wrong again!
There are a number of eye conditions that can occur at any age. Trauma and pink eye are two of the most commonly known, however, there is quite a list of other eye conditions that impact younger people.
How many of these are you familiar with?
Dry eye
Retinal holes or tears
Uveitis (inflammation inside the eye)
Color blindness
Amblyopia
Proptosis
Strabismus (crossed eyes)
Herpes simplex keratitis
Corneal ulcers
Retinitis pigmentosa
There are even people under the age of 40 who are legally or completely blind. The American Foundation for the Blind estimates that 35-40% of those who are blind or visually impaired are working age.
Loss of vision affects quality of life, your economic situation, your independence, and your mental health. The economic impact for those under 40 years of age is estimated to be $14.5 billion.
With the huge shift and focus on making health care more accessible and convenient, it seems only natural that care of an organ that performs such a vital function should offer no less.
That’s why The Doctor has partnered with EYEmergencyMD, a leading telemedicine company for eyes, to provide a convenient option to access high quality medical care right here at The Doctor, the place you love and with people you know and trust.
Starting in February, ask any of the friendly staff at The Doctor about having the following tests performed:
Visual acuity check
Intraocular pressure check
Examination of the front of the eye
Examination of the back of the eye
If needed, the team at The Doctor can even get you in front of a board certified eye physician when you have an acute eye problem. No more urgent care and long emergency room waits for you!
So, what are you waiting for? The next time you visit your primary care doctor, ask about getting your eyes examined that same day!
Life is much too full of awesome things to see, so start taking charge of your vision now.
We care, because vision matters. Go here to learn more about eye services The Doctor will offer starting in February.
If you’re not already having frank conversations with your doctor, some of these might make you blush—especially 3, 4, & 5—but it’s critical to your health to be fully open, honest, and out with your doctor. Start talking about these 9 things with your primary care provider right away.
#1: Your financial situation.
Wait. That’s not really anybody else’s business, right? And certainly has nothing to do with your primary care doctor, right?
Wrong.
If you’re gong through financial difficulty, those financial pressures may be contributing to some of your symptoms. Or they may lead to arguments with your significant other which could cause an impact to your health.
Similarly, if you’re having amazing financial success, that, too, could cause financial pressures that impact your health and relationships.
It’s important to tell the doctor everything about you, including stressors like your financial situation.
#2: You’ve lost interest in sex.
You may be more inclined to talk about your physical ailments, and less inclined to talk about your sex drive. But don’t fall victim to shyness.
You need to talk openly about emotional and sexual health because these topics could help your doctor hone in on symptoms of a physical problem.
Chronic stress, anxiety, depression, an eating disorder, or an imbalanced hormone level could be the cause of your lower sex drive.
In order to provide the best treatment plan for you, your doctor needs to know right away if you’ve lost your desire for sexual activity.
#3: You’re having a whole lot of sex.
On the flip side, let’s say you’re hooking up with a different catch each night. Your doctor needs to know that too.
Having a lot of sex with multiple partners can put you at risk for STDs like ghonnorhea, clamydia, syphillis, HIV, and more, and may (or may not) be a symptom of emotional distress.
It’s important to discuss your sexual history with your provider and be totally upfront about how often you have sex.
#4: You get paid to have sex.
If you’re involved in paid sexual activity, whether as a sex worker or in porn films, your doctor needs to know.
Our number one goal at The Doctor is to keep you healthy, safe, and sane.
The best way for our dedicated providers to do that is for you to raise the curtain on your life.
Whatever you say is protected and held to the highest standard of confidentiality. Remember—we can’t help you if we don’t know the full story.
#5: All the kinky secrets about your sexual activity.
Okay this one is a biggie guys. Again, this is a judgement free zone, so let’s keep it real.
If you enjoy inserting toys like large dildos in your anus, your doctor needs to know.
If you get into fisting, your doctor needs to know.
If you engage in unprotected sex, your doctor needs to know.
This activity may be perfectly fine for your body, or it may be causing damage. Our providers at The Doctor will work to understand your sexual proclivities, educate you on how to engage with those desires safely, or advise you against unhealthy behaviors.
Be warned: A judgment free zone doesn’t mean your doctor won’t ever encourage you to stop engaging in certain types of activity that could be harmful to you and your body. It just means they’ll do it with care and compassion, which is what you want from a primary care provider.
#6: You take over-the-counter meds, steroids, or any unprescribed drugs.
A best practice we always recommend is to keep a list of ALL drugs you take—prescribed or unprescribed—and bring it to your doctor each time you visit.
During visits, tell your provider EVERYTHING you take—even if it’s Tylenol, Benadryl, or any other over-the-counter medication, and especially if you’re taking a recreational drug or unprescribed steroids.
The combination of any of these types of drugs along with a prescription drug can produce serious side effects and could even lead to an overdose.
Make sure your list of drugs includes multivitamins, herbal supplements for sleep, and even powders like BC for headaches. And if you see a specialist who prescribes a new medication, make sure you let your primary care provider know about the prescription right away.
#7: You noticed blood in your stool.
If you have blood in your stool, you probably already know that’s a problem. But if you don’t look, you won’t know! So take a peek, and if you see something strange, say something.
Now some of you may be thinking, “Is this really something I need to talk about with my doctor?”
Definitely! It could save your life.
Blood in the stool could be a symptom of colorectal cancer, which can be completely cured if it’s caught early enough.
So be sure to mention any change in your bathroom habits to your doctor right away, including constipation.
#8: You think you’re depressed.
If you’ve been feeling down lately or for a prolonged period of time, make an appointment with your doctor and come have a conversation about how you feel.
Never be embarrassed to ask a doctor about depression. Emotions can impact your physical and mental health just like physical ailments.
Depression can make you feel fatigued, have aches, and lose you appetite and sex drive. The sooner a medical professional knows about how you’re feeling, the quicker you can get on a path toward feeling better.
At The Doctor, our providers are trained to assess and treat depression, and they can either prescribe treatment or refer you to an appropriate specialist if necessary.
If you’re not comfortable mentioning details about how you feel at the appointment, get help. Reach out to a friend or family member and get them to agree to join you in the appointment and speak up about how you’re feeling.
#9: You quit your meds.
First of all, let’s get this out of the way. Your doctor PROBABLY already knows if you aren’t taking your meds.
Blood work, your body’s progress, and your current symptoms could easily let your provider know that you aren’t following the prescribed treatment regimen.
Often, doctors aren’t surprised when you tell them you’ve stopped taking your meds, because by the time you muster the courage to tell them, your symptoms have progressed from bad to worse.
Don’t let it get to this point. Tell your doctor RIGHT AWAY if you stop taking your meds for any reason.
Perhaps your meds create an undesired or unexpected side effect. Let your doctor know. There may be alternative treatments, or your doctor may be able to reassure you that the side effects are worth it for the benefits of treatment.
Or maybe you’ve decided you don’t need the meds anymore, or a friend, family member, or other medical professional encouraged you to stop taking your meds. Tell your primary care doctor right away.
Stopping your meds before you’ve completed the treatment plan and not telling you doctor about it can be very dangerous.
The medicine your doctor prescribes is designed to keep you healthy. If you trust that doctor enough to keep coming for visits, trust the treatment plan too, or your better off finding another provider whose words you’ll honor.
So if you’re having problems with medication, talk to your provider right away.
Ready to start talking?
That’s right guys (and gals), we’re talking about those pesky sexually transmitted infections, gonorrhea and chlamydia. And you read that right…it can end up in your mouth and your butt.
So listen up to learn about the only way to test for these two serious infections, because your previous provider may not have done it correctly.
What is 3 site testing for gonorrhea and chlamydia?
When testing for these STDs, 3 site testing refers to testing for the presence of the infection in these three locations:
Urethra—by collecting a urine sample (Site 1, and the most commonly tested)
Throat—by collecting a pharyngeal sample (Site 2)
Anus—by collecting a rectal sample (Site 3)
Who should get 3 site testing?
Anyone who engages in oral and anal sex, male or female, should test at all three sites. Testing only by urinalysis is a very heteronormative approach to managing potential risk for STIs.
MSM in particular are at high risk for exposure to gonorrhea and chlamydia in the throat and anus, and should seek out locations that test through urinalysis as well as throat and anal swabbing.
If I have these infections in my throat or anus, can I get the same results from a urinalysis only?
No. If you’ve tested only urine for gonorrhea and chlamydia, the results will not identify the presence of those infections in the throat or anus. That means if you engage in receptive anal or oral sex, you could have these infections in locations that a urinalysis alone cannot identify.
Is the risk significant if I don’t get 3-site testing?
Absolutely. If you happen to have one (or both) of these infections in your urethra and you receive treatment, that treatment will kill the infection if it is present in your throat or anus. Good news, sure, BUT if you have the infection in your throat or anus and you’ve only received a urinalysis that comes back negative, you could still have an infection living inside of you that goes untreated.
How do we test at The Doctor?
At The Doctor, we get to know you. We encourage patients to be honest, upfront, and out about all issues from sexuality, to mental disposition, to sexual activity. We want to know you so that we can help you stay healthy and active.
We run a “no judgement zone” type of clinic where you can be yourself, own your sexuality, and feel comfortable telling us how you engage sexually.
Based on that sexual history, we’ll identify the type of STI testing you need to make sure we test and treat appropriately. That’s the kind of approach that only comes from a practice that truly understand you and your lifestyle.
Do you need an STD test?
At The Doctor, we emphasize the importance of routine healthcare. We encourage everyone to make an annual checkup a part of your healthcare plan, especially LGBT individuals.
Here’s what we recommend:
HPV. The virus that is more common than any other STI. HPV can cause cervical cancer in woman and anal cancer in gay men. Everyone needs to be checked annually for HPV, and gay men specifically need an anal PAP smear to check anal warts (condyloma) and anal cancer.
If you have precancerous cells or anal warts, you need a specialized treatment with a laser called an IRC. The Doctor performs this procedure in house at our office, so we screen, detect, and treat early-stage anal cancer all right here here in one comfortable place.Anal cancer. The HPV virus causes anal cancer in men and cervical cancers in women. We can screen, detect, and treat early-stage cancer right here in our office.
Colon and prostate cancer. Annual screenings for our patients start at age 40, unless you have a history of colon polyps or colorectal, breast, ovarian or uterine cancers in your family. Those with such a history need to get screened earlier, so be sure to let your provider know if you have a family history of cancers.
HIV. At The Doctor, we follow the CDC’s HIV testing guidelines that recommend that all adults ages 13-64 get regular screenings. Our rapid HIV tests allow readings within 20 minutes onsite from our onsite lab. As always, we use up-to-date testing methods to provide the best care possible—a rapid 4th generation test that detects HIV after only 10 days of exposure.
Screening for other sexually transmitted infections. It is important for everyone, and especially LGBT men and women, to be tested frequently for STIs. The frequency of your specific testing regimen is determined based on your sexual history.
Some clinics only test for STIs through urine, but The Doctor takes a more comprehensive approach. For our LGBT population, we test for Gonorrhea and Chlamydia at three sites—the throat, penis or vagina, and anus because we understand how you have sex.
Other things we check during an annual exam:
Cholesterol. You should have it checked every year.
Blood pressure. Should be checked at least once every year.
Immune system. We include Vitamin D testing, which is a signal marker for the health of your immune system.
Diabetes. A simple blood test called Hemoglobin A1C allows us to diagnose pre-diabetes or diabetes so that we can help you keep your blood sugar levels under control.
Body Fat. We measure percent of body fat/lean muscle and body mass index.
Heart Disease. Our office staff will take an EKG (electrocardiogram) to test for all kinds of heart conditions.
After we complete your screenings, your provider will discuss the results, treatment plan, and follow up needs with you.
Most of your results are available on site within a few minutes after your testing. For results that require more time, we’ll get you scheduled for a follow up exam either in person or virtually with our convenient telemedicine option that allows you to go through your results whenever and wherever you prefer.
Schedule your specialized annual checkup at The Doctor now and start your year on a good note.
As part of our ongoing effort to offer you the latest in quality health care, we are excited to formally launch our telemedicine platform.
As some of you know, we’ve been offering telemedicine at our clinic since December 2018, but we kept it on the down-low while we worked out the kinks. We’re now ready to come out fo the closet and reveal your new options in healthcare from The Doctor. :)
Lab result follow ups
You know the drill…you come in for a series of labs and head home. You wait a week or so until it’s time to learn your results, and you have to drag your ass back into the clinic for a 15 minute consultation to review your results. No more! The Doctor now offers convenient, secure telemedicine appointments with our providers to review your lab results. It’s just one of the ways we honor our commitment to reinventing primary care to get you your results faster and with less hassle.
General follow ups
Did you know that we can handle follow ups for many common issues by telemedicine? When your provider can confirm that a treatment regimen is working to achieve the desired medical result by video, you don’t have to come back in…unless you just want to! Of course we’re always happy to see your face in our clinic, but if you’re eligible for a telemedicine follow up and you’d prefer to connect that way, we’ll get you setup!
Urgent/Acute appointments
Wake up with pink eye? Have a cold and need flu meds? The Doctor can treat several common acute issues through a video appointment. Of course, if one of our providers feels that it’s best for you to come in, we’ll let you know, but if they can treat you effectively without an in person visit, they will. If meds are medically necessary, they can easily shoot a prescription over to your pharmacy of choice.
PrEP for HIV prevention
Would you like to learn more about PrEP for HIV prevention? In 2019, we introduced a video-based opportunity to learn more about HIV prevention and to secure a prescription for Truvada (currently the only medication that can prevent contracting HIV) all from the comfort (and privacy!) of your own home. Go here to learn more about our Tele-PrEP program to see if this medication may be right for you.
Traveling or emergency prescription refills
If you’re traveling or need to replace a lost or expired prescription, our providers may be able to help you without an in person visit!
NOTE: Controlled substances cannot be prescribed or refilled by telemedicine. If you request an appointment that cannot be appropriately handled by telemedicine, your provider may end the appointment and convert it into an in-person appointment.
Ready to book your next appointment with The Doctor virtually?
What does it mean to be paperless?
In medicine, a paperless office refers specifically to how an office handles your medical chart.
In a traditional office, providers write out medical notes after your visits and store them on paper in a filling cabinet or some sort of physical storage system. When a patient needs a copy of medical records, they often need to visit the office for printed copies.
In a paperless office, your providers input notes after each visit electronically, into an Electronic Health Record software. Providers can securely email patient records or invite patients to review lab results and medical notes in a secure patient portal online.
How does an office’s choice about paper impact my health and sanity?
Beyond the complications that arise when you want to access your medical records, offices that work with paper miss out on the benefits of technology in providing medical care. Here’s a scenario:
A patient with a chronic illness like HIV or diabetes comes to an office several times for ongoing treatment and management. After several visits, the patient’s chart grows significantly. A few months later, the patient learns that they have an allergic reaction to a certain type of treatment or medication and informs their primary care office. The provider adds a note to the patients growing file, now up to 150 pages. Do you really trust your provider, or anyone, to remember 150 pages worth of material when you come back in? Or to spend the time needed to review your extensive file each time?
Good patient care means that the provider needs to stay up on your medical chart and recall key issues like allergies, treatment regimens and more. Electronic health records help busy providers stay on top of your medical chart.
These softwares provide critical alerts to providers and work intuitively and interactively to help keep your current and future providers up to date on your medical treatment and profile. Providers are also more likely to add notes to your chart promptly after each visit when stored electronically, because an electronic record allows for added accountability that traditional paper charts can’t match.
And even better, whenever you want to access your medical record, a simple login to your patient portal will allow you to review your records, treatment plan, and more from any internet connected device.
How we treat paper at The Doctor.
At The Doctor, we value your health, your sanity, and your time. That’s why our founder decided three years ago that the office would be paperless, with all of your medical records securely stored in the cloud. We offer you 24/7/365 access to your patient chart through our online patient portal, and our providers keep your chart updated by promptly adding notes to your chart after each visit.