Q: My doctor wants me to join a group appointment for my diabetes checkups and another before I head into knee-replacement surgery. Is this a scam to generate more income for the docs and less one-on-one time for me? -- Gregory F., San Bernardino, California
A: Quite the opposite! Shared medical appointments are a growing trend that’s good for YOU. Dr. Mike’s Cleveland Clinic is the leader in this innovation, and 70 percent of the patient visits in his Center for Lifestyle and Integrative Medicine in the Wellness Institute are SMAs.
SMAs are used to manage chronic diseases, such as diabetes, heart disease, Parkinson’s disease -- even opioid addiction -- because they benefit the patient medically and emotionally, increase compliance and improve outcomes. You join seven to 15 people with the same or similar medical issues to meet with a doc and often a medical assistant, an expert in stress management, yoga or physical activity and/or a nutritionist/chef. They teach you techniques to manage your condition, and group members support and teach one another too.
SMAs also are used to help joint-replacement patients prepare for and recover from surgery more effectively. They have cut post-op pain medication use in half at the Cleveland Clinic! And every insurance plan to date has covered these without a co-pay.
Also, with an SMA you get to spend MORE time with your doctor. For example, your solo diabetes checkup might be 15-30 minutes every six months; a group session can run 120-180 minutes every three weeks. One patient who participated in the Cleveland Clinic’s diabetes SMAs credits the group with his 48-pound weight loss: “When I see my stats up there on the board during group, they’re my responsibility. I have to look at them and say, ‘What am I doing right, and what am I doing wrong.’”
Q: How were people in Flint, Michigan, exposed to super-high levels of lead in their water supply, and how serious is the health crisis? -- Jamie G., Detroit
A: It’s a very serious and completely man-made problem. We, along with the whole country, are concerned for the welfare of Flint’s citizens, especially the children.
In 2014, Flint’s municipal water system switched its supply to water from the Flint River in order to save around $2.5 million a year (about what a nearby Detroit Tigers shortstop makes annually). But that water contained higher-than-expected levels of salts. The salts corroded the city’s old pipes so that they leached lead into water supplied to homes, hospitals and businesses. Many children in Flint now have dangerously high levels of this neurotoxin in their blood.
The body can store lead for weeks in blood, months in soft tissue and years in bone. In the brain, especially a child’s developing brain, lead can cause widespread damage that triggers mental retardation, behavior problems, nerve damage and possible neurodegenerative diseases such as Parkinson’s and Alzheimer’s disease.
Unfortunately, while adults with mildly high lead levels often recover without problems, in children even mild lead poisoning can damage the brain and lower IQ permanently! Although children with lead levels above 45 mcg/dL can receive chelation therapy to remove lead from their blood, that process cannot remove it from the bones. Over time, it leaches back into the body and brain.
A simple blood test can ID a problem: A level higher than 10 mcg/dL is a definite worry, although some experts say 7.5 should be the threshold. And any level between 2 and 10 should be discussed with a doctor.
Anyone, anywhere -- if you have old pipes, flaking paint or think your child is at risk for exposure to environmental lead, get the blood test. And for more information, call 800-RID-LEAD and the National Lead Information Center at 800-LEAD-FYI.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at firstname.lastname@example.org.