Listening to patients is the meditation of medicine.   – Elane Shirar, MD – Founder and Medical Director

The doctor–patient relationship has been and remains a keystone of our care, the medium in which healing happens.

Comprehensive medical care:

Thorough review of values and goals of care   –   Our extensive experience shows that the only way to ensure high quality medical decisions are being made is for a fully informed patient and family to participate in a shared decision making process with their health care provider.  To this end, we strongly encourage family conferences (need bold here) between our patients, their families, caregivers and our team (bold) consisting of an MD plus Nurse Practitioner (NP) or Physicians Assistant (PA).

Comprehensive review of medical history –  The medical interview is the major medium of health care.  Increasing data suggest that patients activated in the medical encounter to ask questions and to participate in their care do better biologically, in quality of life, and have higher satisfaction.

Physical exams and ongoing diagnosis and treatment of medical conditions – Many of our patients are frail.  Timely and frequent assessments of changes in health status are critical to the wellbeing and quality of life of our patients.  Our highly trained staff is able to assess these changes during every visit.

Age appropriate preventive care, including flu shots and immunizations – We provide yearly flu shots.  We coordinate care with our  facility partners to provide other immunizations such as pneumococcal and shingles vaccines.

Review of medications, and management of refills – Did you know that the average 75 year old has three chronic conditions and uses five prescription drugs? Many of our patients come to us taking 15 or more medications!  A consequence of multiple medications is that we may be overmedicated and experience adverse reactions, such as depression, anxiety, confusion, grogginess and falls.  One of our primary aims is therefore a regular and careful review of all the medications, including prescription, over-the-counter, herbals and supplements our patients may be using.  Management of appropriate medications through timely refills is also our priority.

 

Diagnostics:  We collaborate with many mobile diagnostic services including:

labs, Xray, EKG, echo, sleep studies, oxygenation studies, PCLS Genetic testing

 

Care Coordination:

Medical Specialists – we communicate with your specialists, obtain recommendations for care and implement any medication changes.

We collaborate with many home based health services including:

PT/OT/ST

wound care services

foot care

eye care

hospice

medical equipment

psychiatry/psychotherapy

 

Counseling and Education  –    We provide counseling and education for patients, families and facility staff regarding a variety of issues including:   nutrition, function, safety, medications, diabetes, dementia

For patients and families:  We find that empowered patients and families make better decisions and are happier!  To that end, our doctors provide FREE talks at facilities on a variety of essential topics, such as medication side effects and risks of interactions.

We work closely with the Grillo Health Information Center whose well-trained volunteers and staff can work with patients and their families (as well as your staff!) to research any medical questions that may arise during our visits.

For facility Staff :  We provide free in-service trainings to staff at facilities for their continued education and to support them in providing competent care with greater confidence.

 

Holistic Care:

Integrative Medicine Consults – holistic approaches to stress reduction and wellbeing – Healing touch, massage, herbs, chinese medicine, ayurveda, mindfulness

 

Continuation of care

Rehabilitation or Skilled Nursing –  We are expanding our services to provide continuity of care for many of our patients when they receive rehabilitation or skilled nursing care post hospitalization or due to increased need for personalized care.

 

Ongoing assessment of patient and facility satisfaction –  In an ongoing collaboration to improve patient care, our staff and administration works with our assisted living facility partners to assess effectiveness of our service including ease of communication, timeliness of orders, and level of compassion in our care.  Family conferences with our team also provide us with an ongoing understanding of the effective delivery of our care according to our mission.

 

Liaison with Community Resources:  We actively support, and promote the use of these valuable, free community resources

Grillo Health Information Center – http://healthquestionresearch.com

Colorado Drug Card – http://www.coloradodrugcard.com/index.php

Senior Resource Center – http://www.srcaging.org

 

Other important resources:

american academy of family physicians  – http://www.aafp.org/home.html

Informed Medical Decisions Foundation:  http://www.informedmedicaldecisions.org

American Geriatrics Society – http://www.americangeriatrics.org

American Academy of Home Care Physicians – http://www.aahcm.org

National Institutes of Health  – http://www.nih.gov

 

In Development:

Group Medical Visits- We are exploring how to provide service to patients in groups.  Research has shown that this approach may be empowering and normalizing for many patients.