Executive Medicine Directory

Executive Medicine Directory The complete directory of Executive Medicine in the United States is online. Executive Medicine goes by many names, boutique medicine, retainer medicine, executive health, VIP medicine, and personalized medicine. Finding the right Concierge Doctor is the most important step for patient considering the best care. Concierge Doctor is a new style of practice with old roots, in which doctors limit their patient base in order to provide patients with personalized service, high quality care, 24-7 availability, and other amenities. In exchange for this enhanced personal attention, patients pay physicians an annual fee. This concierge fee enables physicians to increase their compensation while managing their workload. In addition to receiving an annual fee, most Executive Medicine Physicians continue to receive reimbursements from health plans and private pay clients. Executive Medicine is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design. The practice is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine. While all Executive Medicine practices share similarities, they vary widely in their structure, payment requirements, and form of operation. In particular, they differ in the level of service provided and the amount of the fee charged. There are an estimated 5,000 concierge, or membership medicine doctors throughout the U.S. Executive Medicine care for fewer patients than in a conventional practice. All generally claim to be accessible via cell phone or email at any time of day or night or offer some other special service beyond the normal care provided. The annual fees vary widely, from $600 to $5,000 per year for an individual, with the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services. Some concierge practices do not accept insurance of any kind. These are as cash-only or direct primary care practices. By refusing to deal with insurance companies, these practices can keep overhead and administrative costs low, thereby providing affordable healthcare to patients. They become concierge only if the practice assesses an annual or monthly fee instead of or in addition to a fee for each medical service. Other concierge practices do take insurance, even Medicare, but ask for an annual fee for additional services exclusive of insurance plans. This annual fee is not a substitute for medical insurance, and generally does not cover consultations outside the practice, laboratory procedures, medicines, hospitalizations, or emergency care from other providers.

Eyelid Complication

Eyelid complications related to patient dissatisfaction may be preventable before or correctable after surgery. To avoid aesthetic eyelid complications, it is important for a patient to understand the procedure and what kind of results to expect. Patients may complain of being unable to close their eyes completely. If the surgeon removes too much skin during the initial surgery, the surgeon may harvest tissue from the mouth to elevate the tissue on the inside of the eyelid. Alternatively, the doctor may decide to use skin from behind the ear, which closely resembles eyelid skin. Some patients end up unhappy with the results of eye surgery and require corrective cosmetic procedures as well as functional surgery. Revision surgery can be complex in nature. Tissue around the eyes and lids is extremely sensitive and surgery can cause several issues. On many occasions, eye surgery alters the shape of the eye: the rounded shape of the eye corners appears instead of the natural shape. In many cases, the natural shape of the eyes is also not symmetrical. Misshapen eyelids can cause irritation when blinking and often patients complain of dry eyes. Eyelid complications are the potential risks associated with eyelid surgery. The risk of eyelid complications is relatively rare, though when they do occur they can be quite injurious. There are a number of different types of blepharoplasty complications. Patients may be dissatisfied with the results because of unrealistic expectations, poor surgical choices by an inept surgeon who performed an under correction, or resulted in asymmetry. There are also significant medical complications associated with eyelid surgery. Eyelid complications may be associated with the actual surgery or be problems that develop during the recovery period.

FDA Medical Device Registration

Owners or operators of places of business that are involved in the production and distribution of medical devices intended for use in the United States must register annually with the FDA, which is a process known as establishment registration. Congress has authorized FDA to collect an annual establishment registration fee for device establishment registrations. A detailed list of all those establishment types that have to pay the registration fee is available at "Who Must Register, List and Pay the Fee." There are no reductions in annual establishment registration fees for small businesses or any other group. Most establishments that are required to register with the FDA are also required to list the devices made there and the functions of those devices. If a device requires pre-market approval or notification before marketed in the U.S., then the owner/operator should also submit the FDA pre-market submission number. The amendments to the Medical Device User Fee Modernization Act require that after September 30, 2007, all businesses submit registration and listing information electronically. Registration and listing provides the FDA with the location of medical device establishments and the devices manufactured at those establishments. This information augments the ability of the United States to prepare for and respond to public health emergencies.

Adjustable Gastric Band

A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device that a surgeon places around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Adjustable gastric band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater, or between 35 to 40 in cases of patients with certain co-morbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, high blood pressure or metabolic syndrome, among others. Gastric banding is the least invasive surgery of all bariatric surgeries. Gastric banding using laparoscopic surgery usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. The patient can continue to absorb nutrients from food normally. Gastric bands are made entirely of biocompatible materials, so they can stay in the body without causing harm. However, not all patients are eligible for laparoscopy. Patients who are extremely obese, who have had previous abdominal surgery or have complicating medical problems may require a more open surgery approach. The surgeon creates a small incision near the belly button and pumps carbon dioxide into the abdomen to create a workspace. Then the surgeon inserts a small laparoscopic camera through the incision into the abdomen. The camera sends a picture of the stomach and abdominal cavity to a video monitor. It gives the surgeon a good view of the key structures in the abdominal cavity. The surgeon makes more small incisions in the abdomen. The surgeon watches the video monitor and works through these small incisions using instruments with long handles to complete the procedure. The surgeon creates a small, circular tunnel behind the stomach, inserts the gastric band through the tunnel and locks the band around the stomach. Clinical studies of laparoscopic bariatric surgery patients found that they felt better, spent more time doing recreational and physical activities, benefited from enhanced productivity and economic opportunities and had more self-confidence than they did before surgery. The placement of the band creates a small pouch, or stoma, at the top of the stomach. This pouch holds approximately one half cup of food. A typical stomach holds about six cups of food. The pouch fills with food quickly, and the band slows the passage of food from the pouch to the lower part of the stomach, causing the sensation of being full. As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full, and this sensation helps a person to be hungry less often, feel full more quickly and for a longer period, eat smaller portions, and lose weight over time. As patients lose weight, their bands will need adjustments, or "fills," to ensure comfort and effectiveness. The surgeon can adjust the gastric band by introducing a saline solution into a small access port just under the skin. There are many port designs and a surgeon may place them in varying positions, but they always connect to the muscle wall in and around the diaphragm via sutures or staples.