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Diaphragms have been used as a method of birth control for nearly a century. Over that time, they have evolved in order to improve efficacy, comfort, and convenience. Today, there are several types of diaphragms on the market to choose from to meet your contraceptive needs. Let’s explore the different types of contraceptive diaphragms.
Diaphragms are often made of latex, but more recently, silicone versions have become available. Silicone is considered a hypoallergenic material, less likely to cause skin irritation. Newer silicone versions open up the diaphragm as a contraceptive option for women who have a sensitivity to latex.
Related: Why You Might Want to Ask Your Online OBGYN about Diaphragms
There are four traditional diaphragm types that are available today:
Wide seal rim
Arcing spring
Coil spring
Flat spring
The basic concept of a traditional diaphragm is to create a physical barrier that blocks the cervical opening. Latex or silicone material is stretched over a metal spring that forms a circular, flexible rim. The rim can be temporarily pinched and distorted for insertion and removal of the diaphragm. Once inserted, the springs open into proper placement, blocking the cervical opening.
Traditional diaphragms generally come as a set of different sizes of varying diameters that your doctor will use to find the proper fit. Sometimes there are as many as eight different sizes to choose from. That means that traditional diaphragms require an in-person doctor visit.
If you want to use a traditional diaphragm, your doctor will help select which type, from wide-seal to arcing spring, that will work best for your anatomy. Factors to consider include variances in pelvic muscle tone. A proper fit requires that the diaphragm stays in place as you change positions or move around. Discomfort and trouble with urination are also signs that you have an improper fit.
Traditional diaphragms are an effective method of contraception, with only 6 in 100 women becoming pregnant with perfect use and 12 in 100 for typical use, according to CDC studies.
Traditional diaphragms have become more difficult to find and come with the uncomfortable requirement of getting an in-person fitting from a physician. In today’s fast-paced society, there’s no wonder women decided they don’t have time to deal with that process anymore. In 2013, a new one-size-fits-most option was introduced as an alternative to the traditional diaphragms: it’s called the SILCS diaphragm, more commonly branded as “Caya.”
Caya is a uniquely designed diaphragm that is shaped to fit a woman’s contours. Looking much different from the traditional versions of diaphragms, Caya includes additional features such as a removal dome, contoured rim, and grip dimples. This new type of diaphragm still features the basics of a traditional diaphragm, including a spring rim and barrier material made of silicone. Ergonomic improvements make this contoured diaphragm stand out from the older versions.
The best part about Caya is that it comes only in one size–that means that no in-person fitting is required from your physician. Caya has been found to fit 99% of women who try it. A prescription is still required, along with patient education about how to properly use the diaphragm in pregnancy prevention. Caya’s effectiveness rates are at about 14 pregnancies in 100 women per year if used perfectly.
Both traditional diaphragms and the new contoured options are valid non-hormonal contraceptive methods. If you’re relying solely on a diaphragm and spermicide for pregnancy prevention, you may prefer to stick with a traditional diaphragm, which has slightly higher effectiveness. For convenience, most women might opt for the contoured diaphragm solely because it doesn’t require an awkward fitting at the OBGYN’s office, and it has more ergonomic features.
If you’re considering trying a diaphragm or upgrading your current one, My Virtual Physician has gynecologists available to meet with you virtually and discuss your options. We have partnered with Caya to get your contoured diaphragm to you as simply as possible.
The Covid-19 pandemic and technological advancement in healthcare delivery have introduced telemedicine in prenatal care. It might seem that telemedicine is here to stay and in a few years, will become a major approach in delivering health care to pregnant women.
With telemedicine, expecting mothers receive consistent and necessary care via videoconferencing, at-home monitoring, and consultation with remote specialists. These were said to improve health outcomes while allowing for less frequent antenatal visits.
However, certain challenges may affect the use and outcome of telemedicine to provide care to patients. Below are perceived barriers to telemedicine in prenatal care.
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Several factors affect the use and health outcomes of telemedicine. Patients and healthcare providers alike play a significant role in the provision and delivery. However, other non-human factors exist which may affect the successful outcome of virtual visits and at-home monitoring.
The following are perceived barriers to telemedicine in prenatal care:
Poor internet connection and slow speed result in loss of connection, poor audio and video quality, hence affecting the smooth interaction between patients and providers. Due to poor signal, online consultations can experience multiple interruptions leading to frustration, low patient satisfaction, and reduced use of the virtual approach to healthcare delivery.
In some cases, factors such as weather conditions, living in rural areas, and home interior can affect the network service in homes and workplaces, hence reducing the frequency, duration, and efficiency of virtual visits for healthcare delivery.
Lack of technological knowledge and skills is a challenge to the use and success of telemedicine in prenatal care. Unfamiliarity with communication technology is common to both patients and providers.
Healthcare providers who have little to no knowledge on how to use communication technology may not want to take up online consultations.
Likewise, patients may find it difficult to install and navigate the telemedicine software on their digital devices. In other cases, patients lack knowledge and training on how to use certain monitoring devices. Hence, they may find it difficult or impossible to interact and provide adequate information during online consultations.
The lack of certain equipment and instruments poses a challenge to the success of telemedicine in prenatal care. Some patients may not have certain instruments such as a fetoscope, weighing scale, sphygmomanometer, amongst others, resulting in non-availability of data to work with.
Consequently, this can lead to poor monitoring which may affect health outcomes of prenatal care via telemedicine.
While patients may enjoy convenience at home, they may be faced with discussing health concerns at the risk of being heard by family members and friends.
In-person visits provide the privacy of the doctor's office which may not be possible with audio and video calls from the homes of patients. This may affect the use of telemedicine in providing and accessing prenatal care.
In other cases, the patient may feel their conversations are being recorded and hence, lose trust in both the service and the healthcare provider.
Telemedicine switches up the order of the conventional hospital visit. The presence of family members, children, colleagues, and other persons may make engagement difficult. Activities in the background may cause distraction during virtual visits.
On the other hand, certain patients may feel disconnected due to a lack of social presence and physical contact with their healthcare provider. The online interaction may be alien to some patients and affect their ability to bond with their healthcare provider.
Nonverbal communication is as effective as verbal communication and in some cases, more. Virtual visits limit communication with body language and facial expressions. Healthcare providers can read these cues during in-person visits and act accordingly.
While telemedicine might be said to save cost, it does not come cheap. Patients may lack the financial ability to buy smartphones, airtime and data, and instruments and equipment.
Unfortunately, patients may not have insurance, or their insurance companies may not cover telemedicine healthcare services.
Healthcare providers are not left out as they also need airtime and data to call and interact with patients.
Telemedicine is a novel approach to access and delivery of prenatal care. Like the conventional in-person approach of care, it has its pros and cons.
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At My Virtual Physician, our team is committed to ensuring that patients get the best of health care as needed. We provide virtual care at any point in your pregnancy while you await your appointment with your local OB doctor. We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare, and Blue Cross.
Prenatal care (or antenatal care), remains one of the most accessed preventive health services in the United States. Accessed by 4 million women yearly, the COVID-19 pandemic has made healthcare less accessible and unsafe for both healthcare providers and patients.
In the U.S., patients with low-risk pregnancies are expected to have 12 to 14 office-based visits. However, the COVID-19 pandemic has made it increasingly difficult for pregnant women to meet up with the recommended visits. Hence, the shift to telemedicine.
Telemedicine is a relatively new approach to prenatal care. However, through telemedicine, pregnant women can access several healthcare services including certain emergency services, specialist consultations, and psychotherapy.
Below are the benefits of telemedicine to both patients and their healthcare providers.
The following are advantages of telemedicine in prenatal care for patients and providers.
Improves access to care
Telemedicine makes you gain access to care while bypassing the time and distance it usually takes for an in-person visit.
With telemedicine, you do not need a day off for a 15 to 60-minute appointment. Likewise, patients with disabilities, those geographically isolated, or with one ailment or the other can easily get care from wherever they are.
Telemedicine helps you save costs from transportation, consultation, childcare, and time spent in the hospital. You can attend your appointment with a doctor from anywhere, including your home and workplace.
Research shows that using telemedicine helps save up to 30% from healthcare costs.
An in-person prenatal care appointment means you get in close contact with people who may be sick.
Pregnant women may be particularly susceptible to COVID-19, as they are more susceptible to respiratory pathogens. They made also be prone to other infections as the immune system undergoes several changes during pregnancy to accommodate mother and child.
With telemedicine, there is reduced risk and spread of infection, especially for pregnant women with underlying conditions or weak immune systems.
Improved access makes it easier for doctors to provide care to their patients. Patients and healthcare providers can easily connect via a voice or video call.
Telemedicine bypasses the somewhat tensed atmosphere of a doctor's office. Patients can relax in a more familiar environment and discuss their symptoms and concerns. This helps improve the care provided.
Additionally, research shows that telemedicine helped provide equal or better care to women with high-risk pregnancies.
Telemedicine allows you to book and have a visit from the comfort of your home or anywhere you may be.
It cuts off the need to leave your home or workplace, arrange childcare, take some time off work, drive through traffic or get a bus or cab to access care.
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Telemedicine helps providers cut down on overhead expenses such as paying for a big office space or facility, front desk support, etc.
Telemedicine allows healthcare providers to care for more patients outside of the hospital. Hence, telemedicine may serve as an additional stream of income.
Telemedicine eliminates physical or close contact with several patients. Hence, providers are less exposed to illnesses and infections.
Patients experience greater satisfaction with care rendered via telemedicine visits. Reasons include being able to involve their families, improved access to and delivery of care, lower costs, and at their convenience.
Doctors also appreciated that they were able to spend more time with their patients, and at their time. They could also give follow-up calls.
Study shows that telemedicine visits helped improve health outcomes. These included patients quitting smoking and gaining access to necessary high-risk obstetrical services.
You may enjoy the advantages of telemedicine with My Virtual Physician. At My Virtual Physician, our team is committed to ensuring that patients get the best of health care as needed.
We provide virtual care at any point in your pregnancy while you await your appointment with your local OB doctor. We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare, and Blue Cross.
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Every woman desires to have a healthy pregnancy and birth without complications. Prenatal care helps improve an expecting mother's chances of a healthy pregnancy and birth. In prenatal care, a pregnant woman visits a health care provider at intervals to assess and monitor her health and that of the growing baby.
Prenatal care, also known as antenatal care, is the health care a woman receives during pregnancy. Accessed by 4 million women every year, prenatal care is one of the most common preventive health services in the United States.
Prenatal care involves regular checkups with your healthcare provider and routine testing to ensure you are healthy throughout your pregnancy and have a complication-free birth and a healthy baby. During these appointments with your healthcare provider, you get to ask questions and report any complaints you may have. A doctor, nurse, or midwife provides answers to these questions, advice, and possible treatments for whatever complaint you report.
Appointments during prenatal care depend on the age of your pregnancy and your risk for complications.
Telemedicine is simply the use of technology to access and provide health care remotely. The Covid-19 pandemic made healthcare less accessible and unsafe for both healthcare providers and patients. However, with telemedicine, pregnant women and their families could access healthcare without being physically present. Information such as readings and test results could be exchanged via videoconferencing, voice calls, text messaging, and other formats on mobile devices and computers.
Hence, telemedicine has made healthcare more accessible, cost-effective, and convenient with patients receiving care from the comfort of their homes. Consequently, telemedicine has reduced the number of ER visits and the workload at hospitals.
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Although telemedicine is not new to the healthcare system, its use in prenatal care is low. In prenatal care, telemedicine provides an avenue for pregnant women to keep appointments and receive care via apps and other software on digital devices. These apps provide opportunities for home monitoring of vital signs including temperature and blood pressure, fetal heart rate, blood sugar, and weight amongst others. Besides having routine appointments with their general physician, pregnant women can book consultation sessions with specialists such as Obstetricians, Psychiatrists, Genetic Counselors, and Lactation Consultants.
With telemedicine, you can have your appointment from the comfort of your home. The physicians at My Virtual Physician are there when you have concerns, issues, and questions that do not require hands-on physical examination. Hence, we supplement the care you will receive from your local Obstetrician.
You can book an appointment or call for an appointment with our Obstetric and Gynecology specialists. To book your appointment, we will collect some data such as your name, address, and date of birth. You will be asked to specify the reason for your visit, your preferred day of the week, and your preferred time frame.
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During the video call, we will collect confidential medical, obstetric, and gynecology history. Privacy is very important and we adhere to all ethical rules binding that. We will ask you to agree or "consent" to the terms and conditions of the telemedicine visit.
During the video visit, we will ask you for other data such as vital signs including weight, temperature, and blood pressure. We will ask about medications you're using, allergies, diet and food cravings, complaints, and other important information. The data collected inform what action of care will be provided.
A visit to us helps you get your prenatal care started while you await your appointment with your local OB doctor. Your virtual physician can help to electronically order prenatal care labs and/or send an order to the nearest radiology facility for you to get an ultrasound.
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At My Virtual Physician, we are available to help guide you through your pregnancy and answer any questions that may arise. We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare and Blue Cross.
Many women enjoy the feel of soft-shaven skin. But the red, itchy patches that come after can be a real pain. Razor bumps in sensitive areas like the bikini line are annoying. So how can men and women deal with razor bumps down there?
Razor bumps, technically called pseudofolliculitis barbae, are a common skin complaint. Fortunately, they are preventable to some degree. By protecting skin before, during, and after hair removal, men and women can minimize the effects of razor bumps.
If you're wondering how to save your skin, check out these tips to steer clear of painful razor bumps.
Razor bumps are an uncomfortable sign of skin irritation. For those who already have them, the first step is to keep them from getting worse.
A compress made with salt water can also help soothe the skin. Saltwater cleans and heals the skin by osmosis. To make a "saline soak" at home:
Consider adding a couple of drops of an essential oil, like tea tree oil, to the saline solution for more relief.
When bumps don't go away or become more painful, it may be best to see a doctor.
A physician can tell if the problem is razor bumps or may be something else. Some doctors use antibiotic gels, steroids, or retinoids to treat severe cases.
They say an ounce of prevention is worth a pound of cure. When it comes to razor bumps, it's very true.
Here's how you can lower your risk of getting razor bumps from shaving.
Find more tips on how to prevent razor bumps here.
Taking care of skin before, during, and after hair removal can go a long way in preventing razor bumps.
If you've tried to treat pseudofolliculitis barbae yourself but find the situation getting worse, it may be time to check with a doctor.
Are you looking for a doctor near you to treat your sensitive issues? My Virtual Physician has board-certified physicians who can address gynecological and primary care problems via video visits.
If you would like to talk with a board-certified doctor, you can schedule your appointment online now. My Virtual Physician offers health screening, lab tests, and counseling to meet all of your healthcare needs.
Every 13 minutes, a woman dies from breast cancer. Unfortunately, many women with the disease do not show symptoms. So, regular screening for breast cancer is critical for early detection and diagnosis.
Breast Cancer screening typically occurs as a part of routine preventative care. Individuals do not have to have any signs or symptoms to have a screening performed by their doctor. Manual exams, ultrasound, thermography, and mammography are a few ways patients are screened for abnormalities. A doctor can explain screening options and when it is time to consider certain tests.
To find out how breast cancer screening aids in the diagnosis of the disease, read on.
Breast cancer can be asymptomatic. In other words, it may have no symptoms. In fact, cases may show different symptoms and examination findings. That is why screening should be individualized for each patient.
Screening means looking for or testing for something when there are no signs.
Many people think that only someone with a family history should worry. Yet, about 85% of breast cancers occur in women who do not have any family history of breast cancer. Rather, genetic mutations that occur as women age increase their risk. The most significant risk factors for breast cancer are being a woman and growing older.
Doctors are trained in the latest research and guidelines. They can tell their patients about the options. And doctors help women decide when it is a good idea to be tested.
Breast cancer is typically diagnosed in one of the following ways:
Mammography is the most common screening method used today. Other testing methods include Digital Breast Tomosynthesis (DBI) and thermography, although these are not widely used.
According to a recent article, doctors are seeing later-stage cancer cases in younger women. This is worrisome because cancers detected in younger women in their 20s and 30s are more aggressive. And they may lead to poorer outcomes.
Doctors are seeing later-stage cancer cases in younger women. This is worrisome.
Early detection is key in cancer treatment. The cost of treatment, risks of complications including death, and length of treatment go down with earlier detection.
If not caught early, cancers can grow and spread. When cancer cells move to other organs, this is called metastasis. Thus, cancer is harder to treat.
The best way to catch cancerous changes early is through regular check-ups with a doctor and routine screening tests to help detect changes early. Online doctors or virtual gynecologists can order mammograms or other imaging tests, and tailor screening plans for women who do not usually see a primary care physician.
Medical researchers continue to look for ways to help doctors with better and more accurate tests.
In 2019, the National Cancer Institute presented a new study that showed Doctors could detect breast cancer up to five years before any clinical signs appear, using a blood test for tumor-associated antigens (TAAs).
Newer research from Johns Hopkins University School of Medicine paired blood tests with other screening tests to determine whether finding and treating cancers identified by blood tests reduced mortality rates. Researchers said that “some screening may actually cause more harm than good.” And so, they used bloodwork with standard imaging procedures.
Results were promising. Researchers concluded that there is hope for a blood test that could eventually reduce deaths from cancers that typically go undetected until late stages. But “any blood test needs to complement and add to standard-of-care screening because standard-of-care screening works.”
Current recommendations encourage most women to have a mammogram beginning at age 40. Here are the most recent guidelines on screening.
My Virtual Physician can offers virtual gynecology services in many states. Women can talk with experts about individualized screening plans. Don’t worry about your risk. Talk to the doctor now.
My Virtual Physician is now accepting new patients.
My Virtual Physician has great news to share. Nevada’s favorite telemedicine provider is now in-network with Anthem Blue Cross Blue Shield (BCBS). Nevada residents looking for an online doctor may be able to book an appointment now with little to no out-of-pocket expense.
Anthem leads the health insurance industry with a strong desire to make healthcare easier and change lives. Anthem health plans serve more than 42 million families. That is why My Virtual Physician (MVP) is proud to join the Anthem Nevada provider network.
BCBS is known for offering members value-added services.
Anthem Nevada’s member support services are unmatched.
And when Anthem Nevada members need to see a doctor, that’s where MVP comes in. Their board-certified, expert doctors care for Nevada patients from the convenience and safety of home.
MVP offers Obstetrics/Gynecology (OB/GYN) and primary care services to residents of Nevada. Whether using insurance or paying out-of-pocket, My Virtual Physician’s pricing is competitive, and the patient care is unmatched.
Take a look at a few of the current online physician services they treat for Nevada residents:
Patients who need to see an online doctor can book now through a secure patient portal. My Virtual Physician is excited about the new Anthem Nevada partnership and is now accepting new patients. Virtual doctor visits are now easier than ever.
Residents of Nevada can find more information about Anthem BCBS in Nevada at www.anthem.com.
To meet our book an online doctor appointment with our physicians, simply click “Book Appointment Now” to book your visit. Or visitors can contact the office for questions about their virtual/online doctor benefits. My Virtual Physician is standing by to help.
Telemedicine is a great choice for women with gynecologic concerns. The My Virtual Physician founder, Dr. Howard, recently joined a call to explain the value of telemedicine in gynecology. So how can virtual gynecology address women's health concerns?
Irregular periods are one of the most common reasons that women see gynecologists. Here's a look at what Dr. Howard shared.
One of the most common questions about Virtual Gynecology is, "how much of gynecology can be dealt with through telemedicine?" How can diseases or conditions be dealt with through a video visit?
One of the most common reasons women see their gynecologist is irregular periods.
Some women have regular but heavy periods, which are abnormal periods. Abnormal or irregular periods are one of the most frequent reasons why a woman will go to the gynecologist. In young or premenopausal women, the most common reason for irregular periods is a hormonal imbalance. In other words, they're not ovulating regularly. Other times, the lining of the uterus is dysfunctional.
One of the most common ways in young women to fix irregular periods is to manage hormones through a trial of hormonal contraception. To be clear, this is through the use of birth control pills.
For a young woman who visits a doctor for irregular periods, the doctor will take a good history. He or she will make sure that there is not a specific reason for the irregularity. For example, if the young woman has previously had an ultrasound that showed she has fibroids, or other specific structural pathology in the uterus, that could explain the abnormal periods.
An online physician can take a thorough patient history through a video visit and prescribe birth control pills. This is one of the most common things that gynecologists do for young women: start a trial of birth control pills.
Young women with irregular periods do not need a pelvic exam initially.
However, if birth control pills fail to regulate periods, then a woman may need imaging. In some cases, a doctor may even need to look inside the uterus with a camera to see if there is any pathology. And before any invasive procedure, the doctor must do an exam to see how big the uterus is and which way it points because that will guide any surgery.
But initially, when a woman first presents with irregular periods, a video visit is appropriate because a pelvic exam is not needed up front. The doctor needs a good history followed by a trial of hormonal management. Birth control pills can be prescribed electronically, and the entire visit can be be done virtually.
After a few months, if the patient's periods are still irregular, then it may be time for a pelvic ultrasound. This test can be ordered electronically.
The patient will go to a radiology facility for an ultrasound and the report will be faxed to the physician. In some cases, the doctor will have electronic access to the images if the radiology site has a provider portal. Many facilities do. They may provide referring doctors with usernames and passwords they can use to log in and view the ultrasound results. Depending on what the imaging shows, the doctor may move forward with certain treatments.
Although many people would stereotypically think, "oh, I've got to go in," for irregular periods in a young woman, this problem can actually be dealt with through a video visit, at least initially. Depending on ultrasound results, there may ultimately be a time when a patient must go into a gynecology office. But initially, the assessment and management of abnormal periods can be done entirely through a video visit.
"A lot of people would stereotypically think, 'oh, I've got to go in,' ... you can see that actually, abnormal bleeding can be dealt with through a video visit."
- DR. DAVID HOWARD
Now consider the opposite extreme, a woman who is postmenopausal, having bleeding or spotting, the first thing the OB/GYN might do is get a pelvic ultrasound. If the uterine lining is less than five millimeters thick, a biopsy is not indicated. Current evidence shows that.
This transcript was exported on Sep 16, 2021
Still, a patient who has postmenopausal spotting should be evaluated. Since a pelvic ultrasound is not necessarily needed on a first visit, a woman can choose a video visit.
However, if bleeding is heavy, they should go to an emergency room (ER). An ER doctor can assess why the bleeding is heavy. They can assess the amount of bleeding.
If a woman has one episode of postmenopausal spotting but is worried, they can book a video visit. Through a virtual consultation, the doctor can take their history. Then a pelvic ultrasound can be ordered for the physician to review. After this, the doctor will schedule a follow-up visit by video to discuss results with the patient.
If the lining of the uterus is less than five millimeters thick, then the doctor does not have to do a biopsy. The chances of a patient having endometrial or uterine cancer then is very low.
On the other hand, if the lining of the uterus is thick, more than five millimeters, then a woman does need to go into the gynecologist's office for an exam and possibly a procedure such as a biopsy. Yet, the initial part of the assessment and management of postmenopausal bleeding can be done through video visits.
In summary, medical management for abnormal bleeding can be thought of as a three-step process:
As discussed, the first steps can be done through a video visit. At step three, that is when a woman needs to go in office to see a provider.
In short, abnormal uterine bleeding is a common condition that many women would go in to see their gynecologist for. And a lot of people would think, "how can you deal with that through a video visit?"
It is clear that a doctor can start off with a history through video and order a pelvic ultrasound electronically. In some cases, a young patient in their 20's with irregular periods can start with a trial of birth control pills. Postmenopausal women with irregular bleeding can also be treated through a video visit. In the best case scenario, the case can be managed entirely through video visits.
The uncomfortable truth is that doctors probably do too many pelvic exams. Many times they are not necessary. Sensitivity and specificity of pelvic exams, in many cases, is actually really low. Gynecologists should probably be doing a lot less pelvic exams. And when it is really necessary, physicians should be doing them in a very targeted manner.
History, imaging, and blood work, that is the trifecta that accounts for the overwhelming majority of the diagnostic process in gynecology.
"A careful history, imaging, like a pelvic ultrasound, and sometimes blood work. The combination of those three things, that's what really makes the diagnosis overwhelmingly the majority of times in gynecology."
- DR. DAVID HOWARD
Hopefully, eyes are opened as to how abnormal uterine bleeding can be managed through a video visit. A lot of people would not think that it could. Many still don't realize the value of telemedicine in gynecology.
Connect with Our Board-Certified Gynecologists online now. MVP’s founder Dr. Howard is a board-certified physician practicing in Las Vegas, Nevada. He is passionate about medicine and research. He has authored/co-authored several publications and is among the top 10% of scientific reviewers in the United States. Dr. Howard and his team are now accepting new patients.
This transcript was exported on Sep 16, 2021
One in five Americans face poor access to medical care. In some parts of the country, there are serious shortages of doctors and healthcare services. And this is the case for many women living in Georgia.
Georgia has been greatly affected by a nation-wide healthcare shortage. The need for care, specifically women’s healthcare, has increased dramatically over the past decade. Especially in the rural areas outside of major cities, Obstetrical and Gynecological (OB/GYN) services can be hard to find. Fortunately, My Virtual Physician (MVP) has been able to fill the need for some.
Why is there such a need for OB/GYN services in Georgia? And what can be done about the problem? Here's a closer look at the problem.
According to the Georgia Board for Physician Workforce, the state has:
Hence, the lack of doctors is part of the issue. Some women have no choice but to travel to other cities for care. And others even go without.
In many rural areas, there are no OB/GYNs. And in other parts of Georgia, facilities are closing. According to Becker’s Hospital Review, over 100 hospitals have closed during the past decade. Georgia ranked third for most hospitals closed, behind Texas and Tennessee.
To sum it up, a lack of doctors and hospitals is one piece of the puzzle.
Finding a doctor is one problem. But paying for services is another. Many women in Georgia do not have health insurance. Notably, Georgia's insured rate is ranked 48th in the nation.
Another problem is the state's low high school graduation rate. Lack of education is a barrier for access to healthcare. Women struggling with their health may not know where to go for answers.
Speak to one of our board certified OB/GYN virtual doctors today:
Birth control, sexual health, and menopause are sensitive topics. Women need doctors they can trust. OB/GYNs help women through complicated health changes.
OB/GYNs can treat common problems such as:
In addition to new or worrisome symptoms, gynecologists also provide preventative health services.
For example, OB/GYNs encourage women to have breast cancer screenings after age 45 and bone density scans every two years following menopause.
Without regular checkups, women may face major health concerns as time goes on.
Despite the dismal circumstances, care for women in Georgia and other states is changing.
Telemedicine providers offer a new solution. Board-certified OB/GYNs are treating women in Georgia virtually.
According to the American College of Obstetricians and Gynecologists (ACOG), patients can get the same quality care via telemedicine as they would in person. In some cases, patients say their online doctor experience is even better.
Online doctor appointments are affordable and easy to schedule. As well as that, virtual gynecology visits provide a greater sense of safety and security from the comfort of home.
It is getting easier for the women of Georgia to see top-rated doctors for the virtual gynecology care they need. Dr. Howard of MVP treats patients across the U.S., including Georgia. MVP is a multi-state, multi-specialty telemedicine provider that is quickly becoming the preferred choice for many.
Women who want an online gynecology appointment can text the office at 725-228-8277 or visit the patient portal to set up self-scheduled appointments.
My Virtual Physician offers comprehensive virtual gynecology services to address women’s healthcare needs. Our caring doctors can talk with you about your concerns and provide the experience you've been looking for.To talk with one of our expert physicians near you, book an appointment today.
Have you been looking for a Nevada healthcare provider that is in your Prominence Health Plan network? Look no further.
My Virtual Physician (MVP) is excited to announce a new partnership with Prominence Health Plan. Prominence is a respected plan provider that offers a broad network of hospital and healthcare services to its members. Together, MVP and Prominence are serving more individuals with the high quality online healthcare services they need.
Here’s what this new relationship can do for you.
Prominence Health Plan is a subsidiary of Universal Health Services (UHS), which was recognized by Fortune and Forbes as a top company in 2021.
Prominence focuses on providing their members with options for quality, convenient, cost-effective care close to home.
Prominence Health Plan began in Reno, Nevada as a commercial Health Maintenance Organization (HMO) in 1993. Since then, they have expanded to include Preferred Provider Organization (PPO) and Medicare Advantage (MA) service lines in multiple states including Nevada, Texas, and Florida.
What Does Prominence Cover?
Prominence Health Plan, like most insurers, offers different types of medical plans. Health insurance plans are similar because they cover many of the same services. Yet they can be different when it comes to:
If a plan is called a Health Maintenance Organization (HMO), the insurance plan gives members a list of doctors that are in the network. Choosing a provider that is not on the list may mean that the insurance will not cover any of the visit costs. Members are encouraged to choose an in-network provider so the services will be covered by the plan.
On the other hand, if a plan is called a Preferred Provider Organization (PPO) the member has more options. They can pick any doctor. But choosing an in-network doctor makes services more affordable because of discounts or additional coverage for using in-network providers.
It is easy to see why it is best if your doctor is in-network with your insurance plan. This is one reason why MVP is excited to announce that they have joined the Prominence Health Plan network.
MVP and Prominence have a lot in common.
They both started in Nevada.
They are both well-respected companies.
And both work to provide options for quality, convenient, cost-effective care close to home.
Prominence Health Plan and MVP are a perfect match.
MVP is a multi-specialty telemedicine team, treating patients across the US. They provide comprehensive online doctor visits to treat patients of all ages with care for obstetrical-gynecological, primary care, and pediatric services.
Virtual physician appointments are affordable and easy-to-schedule. Plus, they offer the safety and security of being seen from your home or workplace in convenient after-hours and weekend appointment times. Now with more in-network insurance coverage, MVP’s online physician services are better than ever.
MVP’s online doctors treat gynecological issues including:
As well as primary care concerns such as:
If you need to see a doctor and you’ve been looking for the best care at an affordable price, your search can stop here.
Many health concerns can be solved with a simple online consultation. The team at MVP is available now to meet with you.
Did you know My Virtual Physician is offering a promotion for September? Book now to get a free home blood pressure kit for new patients who complete an online consultation in the month of September. Don’t wait, grab your appointment spot now!
MVP’s founder Dr. Howard is a board-certified physician practicing in Las Vegas, Nevada. He is passionate about medicine and research. He has authored/co-authored several publications and is among the top 10% of scientific reviewers in the United States. Dr. Howard and his team are now accepting new patients.
Women looking for a great Obstetrics and Gynecology provider (OB/GYN) in Las Vegas, Nevada, may have trouble. There is an OB/GYN physician shortage in Las Vegas. And the situation is getting worse.
Factors such as physician burnout, population growth, and competition from other parts of the country have created a shortage of OB/GYNs in Las Vegas, Nevada. As a result, some may have difficulty finding the perfect provider to care for their reproductive health.
Women and their partners want an OB/GYN they can trust. Issues like birth control, childbirth, and menopause are delicate matters. Unfortunately, a shortage means there are not enough providers to meet Las Vegas’ needs. Thus, those doctors who are available may be overworked or stretched thin.
Here is why it’s hard to find a good OB/GYN in Las Vegas and what to do about it.
When there are too few doctors to meet a city's demands, it can be hard to find a provider to respond to each patient’s needs. According to NBC News, America is facing an OB/GYN shortage.
Las Vegas, overall, has the most severe OB/GYN workforce shortage.
Other parts of Nevada face an even more serious situation. Some counties lack even one OB/GYN provider. Hence, patients face delays in care. In some cases they are forced to look far away to find a doctor.
Here’s why it is hard to find OB/GYN care in Las Vegas.
And while Las Vegas OB/GYNs may have it rough, the patients suffer too.
OB/GYNs offer services that women need. They provide health counseling, sexually transmitted infection (STI) testing, and more. From puberty to menopause, women need a health expert they can trust. Many patients depend on OB/GYN advice.
Fortunately, Las Vegas residents can now find the best OB/GYNs, right in their neighborhood.
My Virtual Physician has an answer for the physician shortage crisis. Two of the best board-certified OB/GYNs in the nation are on staff and available for appointments near you in Las Vegas.
My Virtual Physician offers OB/GYN visits in Las Vegas with flexible scheduling through telemedicine. While most providers are busy and feel the pressure to treat many patients quickly, My Virtual Physician is different. Online video visits eliminate travel time and the feel of a busy waiting room. Virtual consultations provide a relaxed, personalized, and patient-centered care experience.
During the pandemic, many patients have had questions about staying safe. Some want to know if vaccination is right for them. Women in Las Vegas can now book a visit with My Virtual Physician to discuss their concerns and get real medical advice. Booking an appointment with an OB/GYN in Las Vegas has never been easier.
Are you looking for an OBGYN near you in Las Vegas? My Virtual Physician has two board-certified physicians licensed in Nevada who can address gynecological problems via video visits.
If you would like to talk with a board-certified OB/GYN, you can schedule your appointment online now. My Virtual Physician offers health screening, lab tests, and counseling to meet all of your healthcare needs.
Sexually transmitted diseases (STDs), also called sexually transmitted infections (STIs), are very common, with around 25 million new diagnoses made yearly in the United States. Young people, ages 15-24 years of age, appear to be the most prevalent group to acquire and spread STDs, accounting for about half of newly diagnosed cases in 2018 per the Centers for Disease Control (CDC). Notably, 1 in 5 people in the United Stated have had an STD.
Oral, vaginal and anal sexual encounters are the methods of transmission and these infections vary greatly in their symptoms, severity, curability and prognosis. Treatment has improved over the years and some lifelong conditions now do not preclude a good quality of life. However, some of these diseases can be quite quiet in terms of initial symptoms, and screening tests, or tests to check if a disease is present even when symptoms are not, are a critical way to help reduce transmission and consequences of these infections.
Bacterial Vaginosis, not categorized itself as a sexually transmitted disease, is a condition named for alterations in the normal balance of bacteria in the vagina, which can lead to an increased risk for susceptibility to STDs, as well as preterm labor. A fishy odor may be noted after vaginal intercourse, and pain, itching and burning in this area or during urination, as well as thin, grey-white vaginal discharge, are among associated complaints. Although many cases of bacterial vaginosis clear on their own, antibiotic treatment may be needed at times. Currently, there is no recommendation for routine screening for BV.
Two of the most predominant, but easily treatable STDs, include chlamydia and gonorrhea. Both can spread through oral, vaginal or anal sex. Though either condition may be asymptomatic, some suspicious findings include abnormal vaginal or penile discharge, burning while urinating and pain or swelling of the testicles. Chlamydia and gonorrhea can also reoccur if infectious sex continues, despite prior treatment. Also, having these infections increases a woman’s risk to develop pelvic inflammatory disease (PID), which is damage to the internal reproductive organs, making future fertility a challenge. If infected during pregnancy, risk for miscarriage, preterm labor, low birth weight or an infection in the fluid surrounding the fetus, called chorioamnionitis, increases. Newborns of untreated mothers may also suffer postnatal complications such as eye infections and pneumonia. Pregnant women < 25 years of age, or older pregnant women at increased risk of exposure to gonorrhea or chlamydia, are typically screened at their first prenatal visit. Similarly, it is recommended to screen all sexually active women < 25 years of age, yearly, for gonorrhea and chlamydia, and older women who have multiple sexual partners. All sexually active gay or bisexual men, should also be screened at least yearly, but more often depending on frequency of new sexual encounters/multiple partners. Testing for these diseases can be as simple as a urine sample ordered by a virtual physician, however it is prudent to discuss symptoms and history to determine the best course of screening.
According to the CDC, every 1 out of 6 people in the United States has herpes simplex virus (HSV) infection, oftentimes without knowing it. HSV can be divided into HSV 1, more commonly known as oral herpes, and HSV 2, known as genital herpes. Although designated as such, either can occur orally or genitally. Many people are infected with HSV 1 in their childhood, through non sexual mediated contact with infected saliva. Oral herpes results in cold sores or fever blisters, around the lip and mouth area. Genital herpes, likewise, can demonstrate sores throughout the genital region of infected individuals. Lack of active sores however does not negate infectious activity and the disease can still spread through unprotected oral, vaginal and anal routes. There is no curative treatment for HSV and the virus can go into a dormant phase where no symptoms occur for years, though patients are at risk for recurrent outbreaks, where an antiviral medication may be prescribed. Devastating effects can occur if left untreated during pregnancy, including life-threatening infection to the newborn. If there is history of infection or active infection at the time of labor, a Cesarean section may be indicated. The United States Preventive Services Task Force does not recommend routine screening for HSV in asymptomatic sexually active adolescents or adults, including pregnant women.
Syphilis is a bacterial infection spread through sexual contact, and is divided into distinct phases, first beginning as painless mouth/oral, genital or anal sore(s) several days to several months after initial exposure. This sore or sores will resolve after a few weeks, even without medication. Then a body rash develops, sometimes with swollen lymph nodes, general fatigue and a fever, later. There can be a long period of “latency”, or no symptoms, followed by the last stage classified by neurological, ocular and cardiac symptoms. This is a curable condition, but can cause life-long consequences if untreated, including dementia and blindness, and can lead to death. Screening is indicated for sexually active individuals on a yearly basis, but more often such as every 3-6 months for high risk features, such as multiple partners. This can be performed through a blood test, which may be ordered through a virtual physician’s visit.
Although there are other methods of transmission, typically hepatitis B may be acquired through the sexually transmitted routes mentioned above. Hepatitis C is less commonly sexually transmitted, but spreads through exposure of infected blood, such as in activities like sharing needles in illicit IV drug abuse. Both conditions, though incited by different viruses, have the same impact on the liver and symptoms can overlap, with fever, fatigue, yellowing of the eyes and skin, abdominal pain and changes in urine color. With the exception of individuals living in extremely low prevalence areas, it is recommended that hepatitis C screening be given to a person at least once after the age of 18 years. Additionally, although hepatitis B is a vaccine preventable illness, the USPSTF recommends screening by blood test, those individuals at high risk such as those who inject drugs or share needles, men who have sex with men and immunocompromised patients, such as those with HIV, as well as those living in areas with a 2% or higher prevalence of the hepatitis B surface antigen, regardless of vaccination status. This is especially important given that hepatitis B is a chronic illness that will need lifelong treatment and both viruses present a higher susceptibility to liver cancer.
HIV, or human immunodeficiency virus, eventually progresses to acquired immunodeficiency syndrome (AIDS). Fortunately, through screening and early detection, appropriate prophylactic and supportive agents can be provided to help maintain CD4 counts and stable immune status in order to prevent, or at least slow, this advancement. It is generally recommended that adolescents beginning at 13 years, through adulthood, into the 60s, be screened via blood test, at least once as part of routine health maintenance. For those in higher risk categories, such as individuals with multiple sexual partners, men who have sex with men and those who share needles, screening may be advised yearly or with more frequent intervals depending on individual circumstances. Once again, this is a blood test that may be ordered through a virtual doctor visit.
While prevention of any illness is optimal through regular visits with a physician, screening tests have proven to be useful in early detection of otherwise asymptomatic diseases, allowing for quicker treatment. In particular, sexually transmitted diseases are relatively easy to screen for through blood or urine samples. If you have questions or concerns regarding your need to be screened for these conditions, it is quite simple to schedule a virtual visit with one of our physicians at My Virtual Physician, and we can help determine which testing is right for you. In addition, depending on the results, oftentimes follow up guidance or medication can also be provided! Schedule a visit today!
This past year tested many young businesses. Telemedicine is not new. But the My Virtual Physician (MVP) business model is. The virtual doctor practice offers the best in online doctor services as a direct-to-consumer multi-specialty provider licensed in multiple states. Regardless of 2020's challenges, the MVP virtual doctor team didn't slow down. They focused on their path to becoming the #1 online doctor and forged ahead.
Over the last 12 months, MVP worked hard to bring high-quality medical care into homes in 15 states. They now offer online pediatric, gynecologic, and primary healthcare services for patients of all ages. Plus, they provide same-day scheduling for online physician appointments, some in-network insurance benefits, and five-star customer service.
As the #1 online healthcare provider, MVP doctors get to know their patients. Quality care is emphasized, and they aim to provide the best patient satisfaction in telemedicine. Here’s what patients are saying about MVP's online doctors:
“I would give My Virtual Physician more stars if I could”
“Dr. Howard has the best personality and is very friendly.”
“The future of medical visits; what better way to social distance.”
“A+ would recommend to everyone.”
Since their launch, MVP has opened new offices and added service lines such as nutrition and diabetic care. The practice has partnered with more online doctors and added office staff. Just this Spring, MVP enhanced their patient portal for self-scheduling, and integrated a program to trend patient reviews.
This one year anniversary milestone is cause for celebration. It is exciting, and this is only the beginning. Despite any challenges that lie ahead for this medical practice, their progress shows that the future is very bright for My Virtual Physician.
Congratulations to Dr. Howard, Dr. Masghati, Dr. Ayyagari, and all of the My Virtual Physician Staff.
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
Welcome to Talk Tuesday. We are continuing our weekly educational series, talking with our expert physicians, exploring some common healthcare concerns, and hopefully answering some questions you may have.
Today our physician expert is Dr. Salome Masghati, a practicing gynecologist and minimally invasive surgeon who is one of our telemedicine providers. We are talking about a complaint our doctors commonly see or treat, and that is URINARY TRACT INFECTIONS or UTIs.
Dr. Masghati, thank you for joining us today.
Stefanie:
So let’s cut to the chase Dr. Masghati, can cranberries cure a UTI?
Dr. Salome Masghati:
Many people believe that cranberries or cranberry juice can treat a UTI, and the answer is it's complicated.
There have been many studies on cranberries as a UTI treatment, and research has shown that an active ingredient in cranberries called “proanthocyanidins,” or PCAs for short, is effective in preventing E. Coli bacteria, the most common cause of UTI infections, from attaching to the bladder wall lining and colonizing or creating an infection.
So PCAs or cranberries may help prevent a urinary tract infection but once there is already an infection, that treatment may not be effective.
A cup of cranberry juice may only contain a small amount of this active ingredient with a lot of sugar! Cranberry tablets or pills may be another option for prevention.
Stefanie:
So if someone wants to try cranberry juice for prevention of a UTI, how much should you drink?
Dr. Masghati:
A recent article in Pharmacy Today recommends at least 36 mg of PAC daily.
For the prevention of UTIs, 300–500 mL of cranberry juice cocktail (26% cranberry juice) daily and 400–800 mg cranberry extract twice daily.
Or 36–72 mg of cranberry PAC equivalents per day, found in about 360–720 mg of cranberry extract, has been shown to be effective.2
The research shows some evidence that cranberry products may reduce the incidence of UTIs but the most effective amount and concentration of PACs that must be consumed and how long they should be taken are unknown.
Stefanie:
So cranberry juice and cranberry extract tablets together may help prevent infections but what about someone who already has a UTI?
Dr. Masghati:
Truly if someone has an infection, either their body will be able to fight off the infection, or they may need an antibiotic medication to kill the bacteria that is causing the infection.
Stefanie:
That’s interesting, so you say in some cases a UTI can go away on its own because the body is able to fight off the infection?
Dr. Masghati:
Yes, in some cases. Approximately 25-42% of the time these uncomplicated UTIs may resolve without any medical treatment.
Stefanie:
Ok, so when would it be time for someone to see a doctor about their UTI?
Dr. Masghati:
Untreated infections can spread and become serious. You should talk to your doctor as soon as you suspect a UTI.
Also for signs such as fever, chills, flank pain, or abdominal pain with nausea or vomiting. These can be signs of a serious infection.
Stefanie:
For someone who is going to make an appointment but has not yet, is there anything that they can do to manage the UTI?
Dr. Masghati:
There are some things you can do for relief, or even after you have seen your doctor while you are waiting for an antibiotic to work.
It is important to stay hydrated, drinking plenty of water flushes out the bladder.
When going to the bathroom it is important to try to empty the bladder completely. Some adults with UTI have a frequent urge to urinate or sensation of pressure in the low abdomen which can make it feel as though you need to urinate. Going to the bathroom frequently to empty the bladder can help.
If there is pain in the low abdomen a heating pad may provide some relief.
Over the counter pain relievers such as Motrin or Tylenol can also be taken to help with discomfort.
Stefanie:
Dr. Masghati you have shared some great information today. I appreciate you joining us for Talk Tuesday and helping us understand more about UTIs and cranberry juice. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to connect with one of our board certified OB/GYNs, or for more information you can check out our website at www.myvirtualphysician.com. We look forward to seeing you again and we hope you have a great week.
Starting a family is a goal for many couples. Unfortunately, one in ten couples may have some difficulty getting pregnant and require medical treatment. If you've been affected, you might be wondering about infertility: when is it time to see a doctor? My Virtual Physician has board certified physicians who specialize in infertility and are available for virtual doctor visits.
Infertility is a diagnosable medical condition in which a couple cannot conceive a pregnancy despite unprotected intercourse. It can be caused by many factors.
In women, most often, abnormal ovulation causes infertility. In men, usually problems with sperm cells, such as sperm count or function, cause difficulty conceiving.
Aside from these physiological causes, factors affecting a couple's fertility include their age, health status, and lifestyle factors such as stress, diet, or smoking.
According to the American College of Obstetricians and Gynecologists, women who are overweight, underweight, or exercise too much may have difficulty getting pregnant, and men who are heavy drinkers or smoke marijuana since these are known to lower sperm count and movement.
In some cases, doctors cannot determine the cause and refer to these cases as unexplained infertility.
Generally, it is time to consult your physician about getting pregnant if you are under the age of 35 and have been unable to conceive after one year of unprotected sex. Women over the age of 35 and those who have irregular menstrual cycles or have known abnormalities with their reproductive system, should talk with their doctor much sooner, after six months.
Infertility affects both people in the relationship. There is a 30% chance the infertility is related to male factors in a traditional couple, 30% related to female factors, and a 30% chance a combination of both factors. Therefore, anyone in the relationship may need to discuss options for starting a family. Here are some reasons to see a virtual doctor:
When you consult your physician about infertility, you can expect that they will begin your care with a complete history and physical exam. They may order blood testing, urinalysis, hormone tests, or other diagnostics to check for abnormalities. It may be necessary to have your partner undergo an exam and diagnostic testing also. Your physician may order an ultrasound or an X-ray as well.
After all of the tests, you will meet with your physician to discuss the results and go over treatment options and recommendations. After you decide on the treatment plan that is best for you, you will receive support and guidance in your process to get pregnant.
Medical treatment and new technologies can increase your chances of getting pregnant. One or both partners in a couple may undergo treatment.
Medications may be taken by mouth or injected. There are drug therapies for both men and women aimed at increasing egg production or sperm count. A list of medicines frequently prescribed for infertility treatment can be found here.
In some cases, blockages, scar tissue, or abnormal growths require surgical intervention. Procedures may be laparoscopic: meaning performed through small incisions in the abdomen for a minimally-invasive procedure.
Today, the two most common infertility treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF).
IUI is a procedure during which a physician injects sperm into the uterus at the ovulation time. This method is least invasive and most cost-effective but has lower success rates. The estimated success rate is 10-20% for a single cycle of IUI, but additional rounds increase chances, and in three to six cycles, the success rate is up to 80%.
IVF is a complicated procedure requiring surgical retrieval of a woman's eggs, fertilization in a laboratory, and then transferring the fertilized eggs back into the uterus. Women under the age of 35 can expect a 50% success rate for IVF treatment, but this process requires intense testing and monitoring and can cost $20,000 to $50,000.
Starting a family can be challenging, and your physician may offer options to guide you through the process. Infertility is a medical condition that affects many couples, and there are treatments available.
Need to talk to a physician now? My Virtual Physician has Board-Certified OB/GYN's that are available for virtual doctor appointments and are able to answer any questions you have and guide you in the right direction. The online doctors at My Virtual Physician, not only address infertility and reproductive endocrinology, but also irregular periods and painful periods, and many more gynecological conditions.
If you still have questions or you would like to discuss your problem with our board-certified OB/GYN specialists, click below to schedule an appointment. My Virtual Physician treats conditions, including infertility, irregular periods, sexually transmitted infections, and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to check out our podcasts for more and follow us on social media.
Speaker 1:
The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not a diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own health care professional about all topics address on Talk Tuesdays or for any other medical problem.
Speaker 1:
Welcome, everyone. Thank you for joining us today. My name is Stephanie and I'm part of the team here at My Virtual Physician. We are a direct to consumer multi-specialty telemedicine provider operating in multiple States. It is Talk Tuesday and we are continuing our weekly educational series to talk with our experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is dr. Coleman. She is a general surgeon, and today we are going to talk about breast cancer screening and breast cancer surgery. So thank you for joining us today. Thanks for having me. Yeah. And welcome
Speaker 2:
Back October was breast cancer awareness month. So we're going to be doing
Speaker 1:
Again a blog and an episode or two of Talk Tuesday on breast cancer screening. When would someone go in to get a mammogram or if they feel something or they have any history of breast cancer in their family, what's kind of the age range,
Speaker 2:
What to look for. Okay. So there's actually three organizations, probably more, but there's at least three organizations that have opinions on breast cancer screening, depending on which organization you listen to, it could be 40 years old, 45 years old or 50 years old, either way. Everyone agrees that by the age of 50, you should be getting a screening mammogram, most people, uh, and I believe most insurance companies go with the age of 40 breast cancer. Under the age of 40 is pretty rare. If, if you have
Speaker 1:
Breast cancer under the age of 40, usually it's associated
Speaker 2:
With some sort of genetic predisposition. There's the BRC mutation that predispose people to, to breast cancer at a younger age. But there's some other things that can, can run in families. Some other genetic diseases that predispose you at a younger age and typically cancer at a younger age is more aggressive and more advanced when it's found, because who in their thirties thinks that they're going to have breast cancer. So what we learned in residency was at the age of 40, you started getting your screening mammograms, and that's just, you have no symptoms. You have nothing going on. You're 40 years old. It's time to get a mammogram. Just like when you turn 50, you got to get a colonoscopy. It's just a way of life. Some people will come in. Well, I feel a mass I'm worried. And this also kind of depends on your age.
Speaker 2:
If you're younger, the chances of you having a mass that's breast cancer is pretty low. You, you may have these little hard nodules called fibroadenomas. They're pretty common in younger people and they grow and shrink in size with your menstrual cycle. And that's something that people usually will point out like, Oh, I noticed this, I know I was on my period last week and now I don't really feel it so much. And so that's, that's pretty common and we can actually do ultrasounds in clinic. I mean, not everyone, but if you're, if the clinic has an ultrasound, we can do an ultrasound because sometimes it's just breast cyst that can feel like a lump and they can hurt. And if it is a cyst, they can drain it in the office and, and hopefully give you some relief. So when you turn 40, get a mammogram, if you feel something that's concerning, you would need to go into your doctor, talk to them about getting an ultrasound or a mammogram.
Speaker 2:
And again, depending on your age, it may dictate what screening that they do. If you have a family history of breast cancer, then that would be something to coordinate with your doctor to get a screening done earlier. They usually recommend doing screening before 40, uh, it may be an MRI and mammogram alternating every six months starting at the age of 25 30. It just kind of depends on when your family member had breast cancer and what genetic mutation it is that you have. So I've had my screening mammogram and I got called back in for more images, do I have cancer? So not necessarily, this is something we actually deal with quite a lot. It really kind of depends on your age and your breast tissue density. It can be really hard to evaluate the breast tissue on a screening mammogram. If you have really dense breast tissue, there's actually, uh, States that have a requirement when they report on your mammogram, that they disclose to you that there are certain regions, depending on the density of your breasts, that they may not be able to see.
Speaker 2:
So they have to give you that information because then if you end up having breast cancer, but you've, you've had a screening mammogram, you know, why wasn't it caught well, and it, it can just really depend on the density of your arrests. So sometimes you'll get a call that you need to come back in and it's for a more formal or what we call a diagnostic mammogram. The difference in that is with a screening mammogram, you kind of just, you go into a facility, they do the mammogram and you go home. And in a couple of days, they either call you with the results or you go into your doctor's office and they give you the results, a diagnostic mammogram, you go into a facility, but the radiologist is, is physically there. And when they do the mammogram, they try and focus on that area that was questionable in your screening mammogram.
Speaker 2:
And so the radiologist can actually look at it in real-time and determine, okay, well, we need a different view here, or we need to zoom in here and take a better look at that so that you don't get called back in for even more. This is, I'm a little bit better idea of, of what they're looking at. And if it, if it is something that looks suspicious for cancer or not, some patients may actually end up needing an ultrasound to go with their mammogram or an MRI. It's all pretty personalized. So it all just depends on what your breast tissue looks like and what, what exactly it is, that's going on, what was seen, or if you're having symptoms and things like that. So it could just be that you have dense breast tissue, and it does not look abnormal when they do the more focused imaging, or could be something that, that is concerning for breast cancer. But being called back does not mean that you have cancer. You could, but they just need to get better pictures. Yeah.
Speaker 1:
Since so, after I got called in my mammogram showed an area concerning for breast cancer and I need a biopsy. Can you explain what that is?
Speaker 2:
Yeah. So when you need a biopsy, it doesn't necessarily mean that it's cancer again. So, so don't panic, but chances are, they saw something that are concerning and suspicious for cancer, and chances are it is, but I need a tissue sample to say for sure what it is. There's different types of breast cancer, there's DCIS, which maybe you've heard of, or there's invasive cancers by doing the biopsy. It gives you a little sample of tissue to be able to determine what type of cancer it is, what hormone receptors it has if it has any. And, and that helps you tailor your treatment, not only for surgery, but if you need chemo or other things, or even additional surgery, when you meet a bias, it can be done a couple of ways, the most common way, or at least the way that I'm used to it being done from when I was in residency is if you have a mask that can be felt if you came in because you had an that you found and you get a mammogram and they, they say, we need to biopsy.
Speaker 2:
If they can see it, then you can get a biopsy done with an ultrasound and you don't have to go through a mammogram again. If you can't see it on an ultrasound, then you got to get a mammogram again. So not, not super fun for everybody when they do it with under a mammogram, it's done by a radiologist typically, and it's called a stereotactic biopsy. So essentially you lay down on this table and you lay face down and there's, there's a little opening in the table. And the breast with the concerning area goes through this little hole in the table and kind of hangs blue so that the arm on this machine can get in the right position and orientation to access the delusion that the arm on the mammogram machine has a needle on it. And once the area is targeted, the needle goes in, they take a sample of the breast tissue that comes out, but there's also a clip that gets placed in the area that they biopsied.
Speaker 2:
So that on later imaging, you can say, okay, well, we already biopsy this area and everything was normal. Or this is where they had a biopsy before we don't see anything different. Or, you know, now there's something there that, that wasn't there before. And we need to re-investigate it. Sometimes you can't do the stereotactic biopsy and that's for reasons, you know, maybe you can't lay flat, maybe it's too uncomfortable, or you can't breathe. There are weight limitations. And depending on your age, I mean, it may just not be something that you're very capable of laying there because it's not, it's not a five-minute procedure. I mean, it's a 20-minute procedure or so. And it depends on where the lesion is. If it's really close to your chest wall, like the muscles underneath your breasts, they don't usually do the stereotactic biopsy. They can still do a biopsy under a mammogram. It's just done a little bit differently. This is all kind of targeted and oriented and one process. Whereas if they have to do it with, without the stereotactic part, it's done a little bit differently. Now there are some stereotactic biopsy machines where you can actually sit up. I don't know how many places have those. Like I don't, I'm not real familiar with how prevalent they are, but they do exist. So that maybe something that they could do.
Speaker 1:
Thank you so much, Dr. Coleman. I know it's a really hard topic to talk about. Cancer is always something that's a pretty scary word. I appreciate you joining us for Talk Tuesdays and telling us what we need to know about breast cancer screening for everyone else. This has been Talk Tuesdays with My Virtual Physician. You can schedule a consultation with one of our doctors by visiting our website: www.myvirtualphysician.com. We look forward to seeing you again, and we hope you have a great week.
Speaker 1 :
Information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not a diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics addressed on Talk Tuesdays or for any other medical things.
This week on Talk Tuesdays from my Virtual Physician, we have Dr. Daniel Kessler, a Family Practice Doctor.Before a manufacturer can introduce a new drug to the public, a lot of money goes into the research, development, testing, and marketing. Companies can patent their new medications, and are guaranteed exclusivity to make and sell them for five years. This allows manufacturers to recoup some of the cost associated with getting their new brand name drugs to market. After that time, the patent expires. This means other companies can come along and make and sell the same medication under a different name. This “copy-cat” medication is considered a generic medication.
In many ways a generic medication is like the brand name version. To be approved as a generic drug, the pharmacologic characteristics must be the same as the brand name. Generic medications are the same as the brand name when it comes to:dosages and strengthintended useeffects and side effectsroute of administration active ingredientsBy contrast, generic medications can be approved with different inactive ingredients. So different colors, additives, and fillers may be used to help with binding, flavoring, coloring, transporting, or preserving. That means that your generic medication will likely look different. Trademark laws in the U.S. prevent manufacturers from creating a generic that looks exactly like the brand name. The Federal Drug Administration (FDA) regulates generic drugs that are approved for sale in the United States. It provides a process that ensures the medications are safe, effective, and of sufficient quality. Keep in mind that the FDA also investigates complaints about generic and brand name medications including side effects. They can issue a recall any time there is a concern for safety. There are always risks and benefits associated with any medication. Everybody is different and some more sensitive to differences in the drugs.Because the inactive ingredients are not identical, some individuals may experience differences when taking a generic medication vs, a brand name, but this is not always the case. There have been reports of medications affecting patients differently. For instance, when they feel the onset of effects, how long the medication effects last, and even incidence of side effects. It is important to talk to your physician if you are concerned about a generic medication affecting you differently. Generic medications often cost substantially less than the brand name. Again, the company making the generic medication did not have to pass along the cost associated with getting a new drug to market. When a patient is going to be on a drug long term or even for a lifetime, choosing a generic medication can save thousands of dollars a year in medical expenses. Lower cost may mean better compliance for some patients.
The savings to the individual are important but it doesn’t stop there. When multiple manufacturers are able to make and sell a medication the competition can drive the cost down and makes healthcare more affordable for the public. Generic medications save our healthcare system millions of dollars every year. To learn more, schedule a consultation today!
MedPage Today published an article stating the following:
1. Medicare is still seeing a high and leveling use of telehealth among medicare beneficiaries.
2. Although Medicare is going down the direction of permanently increasing access to Telemedicine, private payors are actually going in the opposite direction.
3. Confirms that people who adopted telemedicine during the shutdown, and liked it, are likely to make it a permanent part of the way they see their doctors moving forward.
To read the rest of the article, click here.
MedPage Today published an article about the rise of telemedicine services in relation to the COVID-19 pandemic and why more people are favoring virtual doctor's visits. To read the rest of the article, click here.
The journal, Female Pelvic Medicine & Reconstructive Surgery, published a study comparing video visits to in-person office visits for postoperative care. To read the study, click the link below!
Dr. David Howard was a guest speaker on The Accad & Koka Report last week. To listen to the full podcast, click here.
Researchers at the University of California, San Francisco have been evaluating hundreds of pregnant women who tested positive for coronavirus, and the impact it has had on themselves and their babies during pregnancy. The study aims to better understand the correlation between pregnancy and coronavirus. They also want to evaluate a diverse population for a more thorough grasp of the findings. The study is open for women 14 years or older who have tested positive for coronavirus or are experiencing symptoms. In addition, it will examine the impact of the virus on African American and underprivileged women who are more susceptible due to a lack of health care.
As of May 15th, 2020 The Pregnancy Coronavirus Outcomes Registry, or PRIORITY, has registered 706 women to participate in the study. The year long evaluation includes how the virus impacts maternal health, fetal development, early delivery, newborn health, transmission between mother and child, and the correlation between underprivileged women and the risk of higher mortality. Participants are asked to answer questions about their health and pregnancy, permission to review their medical records related to their coronavirus diagnosis and treatment, and contacted up to 7 times within the next year for routine checkups. The PRIORITY website states that they will continuously update their data so all of the information is available to the public eye. For more information about PRIORITY, click here to navigate to their homepage, and click here if you’re a healthcare provider who wants to refer someone, or if you are personally interested in joining the study.
Everyday Health released an article about the importance of making and keeping your appointment to see your gynecologist during the pandemic. If you are interested in learning more, click here to read the article! Make sure to book your appointment with our virtual gynecologist today.
