I started at Blue Fish on Monday November 8th and things are going well so far.
Here are some answers to a few FAQ's:
1. Does Blue Fish take my insurance?
More than likely, the answer is yes.
If you want to make sure either call Blue Fish at 713-467-1741 or check directly with your insurance provider by Internet or telephone. Since we are in the process of changing my location with all insurances, use the name of one of the other doctors at the Blue Fish Memorial location (www.bluefishmd.com) to verify coverage because I will have the same insurance plan profile.
2. Which patients am I accepting?
See my profile at http://www.bluefishmd.com/about/blue-fish-memorial/dr-r-adrian-clarke/.
Feel free to call or email the office for further clarification.
Basically the current plan is to limit my panel to existing patients who wish to "follow me" to Blue Fish, existing patients of Dr. Eddings who do not wish to transfer to Blue Fish Cypress, any siblings of either of these first two groups, and infants 2 months and younger with commercial insurance.
3. What is the parking like?
There is free parking in Garage 3 on the Memorial Hermann Memorial City Hospital campus. The entrance to Garage 3 is easiest to find off Kingsride. The entrance is on Kingsride between Gessner and Frostwood, next to the Chase bank branch. There is usually ample parking the higher up you go in the garage. There is a pedestrian bridge from the 2nd floor of the garage directly into 915 Gessner (our building). There is paring on the ground floor of Garage 3, but it is intended for ER parking and costs $20 unless you are seen in the ER that day.
4. Will I be notified directly?
Official notice has already appeared in the Houston Chonicle, will appear in the Katy Times, and is posted at TCPA-Katy. Patients who have seen me at TCPA-Katy in the last few years will also receive a letter in the mail.
5. What do I do if I decide I want to transfer to Blue Fish?
The easiest way to do this is to check out the Blue Fish website (http://www.bluefishmd.com/new-patients/).
In order for any doctor's office to obtain a patient's medical records from any other doctor's office, the patient him/herself or his/her parent or guardian must give written authorization. Click on this link to get the Blue Fish Transfer of Medical Records Authorization form ( http://www.bluefishmd.com/files/Transfer_Medical_Records_Authorization.pdf).
Don't forget to fill out the child's name and date of birth clearly at the top of the form, complete the "From" section identifying the name of the office that you wish to have the records "released" from, fill in the date range that you want released and sign and date the bottom of the form. The form can then be faxed, mailed or hand delivered to the office that you wish to have the records sent from.
Thursday, November 11, 2010
Wednesday, October 27, 2010
Update
Wow. What a few days.
I have decided to join Blue Fish Pediatrics in the Memorial City area of West Houston.
Although this has been a difficult decision, I feel fortunate to have the opportunity to practice closer to home in another high-quality pediatric practice. This opportunity at Blue Fish is especially attractive since Drs. Jung and Pielop are trusted colleagues that I have known since we started pediatric residency training together at Texas Children's in 1999.
More information is available through my current practice upon request.
The notification process for patient families is underway.
I have decided to join Blue Fish Pediatrics in the Memorial City area of West Houston.
Although this has been a difficult decision, I feel fortunate to have the opportunity to practice closer to home in another high-quality pediatric practice. This opportunity at Blue Fish is especially attractive since Drs. Jung and Pielop are trusted colleagues that I have known since we started pediatric residency training together at Texas Children's in 1999.
More information is available through my current practice upon request.
The notification process for patient families is underway.
Monday, October 18, 2010
Flu Vaccine Update 10/18/10
There continues to be a good supply of both injectable and nasal flu vaccine in our office and at local pharmacies.
Please refer to earlier posts for details on which patients should get the flu vaccine, how many doses should be given, and which version of the flu vaccine is most appropriate for your child.
Please refer to earlier posts for details on which patients should get the flu vaccine, how many doses should be given, and which version of the flu vaccine is most appropriate for your child.
Wednesday, September 29, 2010
Flu Vaccine Update 9/29/10
There continues to be a good supply of both injectable and nasal flu vaccine in our office and at local pharmacies.
Please refer to earlier posts for details on which patients should get the flu vaccine, how many doses should be given, and which version of the flu vaccine should be given.
Please refer to earlier posts for details on which patients should get the flu vaccine, how many doses should be given, and which version of the flu vaccine should be given.
Wednesday, September 15, 2010
Highlighting a Few Health Care Reform Provisions
Six months after President Obama signed the Patient Protection and Affordable Care Act, three major provisions of health care reform are set to take effect on September 23, 2010.
However, insurance plans that were already in place when the Affordable Care Act was signed can claim "grandfathered" status. These grandfathered plans are not required to provide some of the new law's consumer protections.
Here is a summary of those provisions:
1. No co-pay for pediatric preventive care for children with private insurance.
All pediatric well-child visits, including services such as physical examination, immunizations, hearing and vision screening must be covered by non-grandfathered insurance with no co-pays or deductibles for families. Non-grandfathered insurance also cannot exclude any of these services from coverage.
2. Eligible young adults will be able to remain on their parents' health insurance up to age 26.
Young adults do not need to be living with a parent, be a student, or be listed as an IRS dependent in order to be eligible.
3. The Patients' Bill of Rights takes effect.
Most annual and lifetime limits on insurance coverage are eliminated.
Insurers cannot deny care to children with pre-existing conditions.
The PBR applies to all new health insurance plans but not to grandfathered plans.
If you are interested in knowing whether your child's insurance plan will be following these and other provisions, I suggest that you contact your employer's benefits manager and/or call your insurance company directly.
The American Academy of Pediatrics (AAP) and other child advocacy groups have noted their concerns about the wide array of health insurance plans that are currently able to keep their grandfathered status. The AAP is lobbying to ensure that all plans, including those with grandfathered status, protect children's health.
However, insurance plans that were already in place when the Affordable Care Act was signed can claim "grandfathered" status. These grandfathered plans are not required to provide some of the new law's consumer protections.
Here is a summary of those provisions:
1. No co-pay for pediatric preventive care for children with private insurance.
All pediatric well-child visits, including services such as physical examination, immunizations, hearing and vision screening must be covered by non-grandfathered insurance with no co-pays or deductibles for families. Non-grandfathered insurance also cannot exclude any of these services from coverage.
2. Eligible young adults will be able to remain on their parents' health insurance up to age 26.
Young adults do not need to be living with a parent, be a student, or be listed as an IRS dependent in order to be eligible.
3. The Patients' Bill of Rights takes effect.
Most annual and lifetime limits on insurance coverage are eliminated.
Insurers cannot deny care to children with pre-existing conditions.
The PBR applies to all new health insurance plans but not to grandfathered plans.
If you are interested in knowing whether your child's insurance plan will be following these and other provisions, I suggest that you contact your employer's benefits manager and/or call your insurance company directly.
The American Academy of Pediatrics (AAP) and other child advocacy groups have noted their concerns about the wide array of health insurance plans that are currently able to keep their grandfathered status. The AAP is lobbying to ensure that all plans, including those with grandfathered status, protect children's health.
Flu Vaccine Update 9/15/10
We have injectable and nasal spray flu vaccine in stock.
Feel free to call the office to schedule a flu vaccine nurse visit for your child or we can usually give the flu vaccine at a minor ill visit or check-up visit.
Unfortunately, we can't accommodate walk-ins for the flu vaccine.
We have weekday appointments and we plan to have at least one Saturday flu clinic per month, starting with Saturday, September 18th.
Please note, certain patients should get 2 doses of this year's flu vaccine to adequately protect against the 2009 H1N1 flu strain (aka swine flu). For more details, please look at a previous post on this topic on this blog or check out www.cdc.gov/flu.
Feel free to call the office to schedule a flu vaccine nurse visit for your child or we can usually give the flu vaccine at a minor ill visit or check-up visit.
Unfortunately, we can't accommodate walk-ins for the flu vaccine.
We have weekday appointments and we plan to have at least one Saturday flu clinic per month, starting with Saturday, September 18th.
Please note, certain patients should get 2 doses of this year's flu vaccine to adequately protect against the 2009 H1N1 flu strain (aka swine flu). For more details, please look at a previous post on this topic on this blog or check out www.cdc.gov/flu.
Wednesday, September 8, 2010
Flu vaccine Update 9/8/10
We got our first shipment of injectable flu vaccine this afternoon.
As of today we have:
A. Thimerosal-free, individual dose injectable vaccine for children 6-35 months old.
We will use this version of the vaccine for children younger than 3yo who need injectable vaccine while supplies last.
AND
B. Multi-dose injectable vaccine (contains thimerosal) for approved for children 6 months and older.
This version can be given down to 6 mo, but will be used only for children 3 yo and older while we have thimerosal-free injectable in stock.
AND
C. Nasal Spray flu vaccine (thimerosal-free). Approved for children 2yo and older who do not have chonic medical conditions including asthma.
For more info on thimerosal, click on this link: www.cdc.gov/vaccinesafety/Concerns/thimerosal/index.html
We will schedule flu vaccine nurse visits by appointment, while we have adequate vaccine supply.
Please call the office to schedule the flu vaccine and/or to get more details.
See previous blog posts and/or visit www.cdc.gov/flu for more details on the 2010-2011 flu vaccine.
As of today we have:
A. Thimerosal-free, individual dose injectable vaccine for children 6-35 months old.
We will use this version of the vaccine for children younger than 3yo who need injectable vaccine while supplies last.
AND
B. Multi-dose injectable vaccine (contains thimerosal) for approved for children 6 months and older.
This version can be given down to 6 mo, but will be used only for children 3 yo and older while we have thimerosal-free injectable in stock.
AND
C. Nasal Spray flu vaccine (thimerosal-free). Approved for children 2yo and older who do not have chonic medical conditions including asthma.
For more info on thimerosal, click on this link: www.cdc.gov/vaccinesafety/Concerns/thimerosal/index.html
We will schedule flu vaccine nurse visits by appointment, while we have adequate vaccine supply.
Please call the office to schedule the flu vaccine and/or to get more details.
See previous blog posts and/or visit www.cdc.gov/flu for more details on the 2010-2011 flu vaccine.
Wednesday, September 1, 2010
Flu vaccine update 9/1/10
All children 6 months and older should get a flu vaccine each flu influenza season.
I agree with the CDC: "Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later."
Based on the information we have now, we should receive plenty of vaccine supply. However, so far we have only received a small portion of our flu vaccine order. Except for a limited supply from the state's VFC program (CHIP insurance patients or patients with no vaccine coverage), we still do not have any injectable flu vaccine at our office.
We do have the nasal spray flu vaccine (aka FluMist®).
Here is the 2010-2011 vaccine information statement for the nasal flu vaccine: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flulive.pdf.
In summary, children who have already turned 2yo and do not have any chronic medical conditions (such as asthma, diabetes, and other illnesses) are eligible to get FluMist®.
By definition, all of our high risk patients (children under 2yo and children of any age with underlying chronic illnesses such as asthma, diabetes and other illnesses) need to get the injectable flu vaccine and cannot get the nasal spray version.
Here is the 2010-2011 vaccine information statement for the injectable flu vaccine:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flu.pdf.
Both the injectable and the nasal flu vaccines protect against the same 3 virus strains (the 2010-11 vaccine contains the 2009 H1N1 (aka swine flu) and 2 seasonal strains).
Of note to some parents, FluMist® does not contain thimerosol (a mercury containing preservative). We order the thimerosol-free injectable flu vaccine to give to children less than 3yo.
I agree with the CDC: "Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later."
Based on the information we have now, we should receive plenty of vaccine supply. However, so far we have only received a small portion of our flu vaccine order. Except for a limited supply from the state's VFC program (CHIP insurance patients or patients with no vaccine coverage), we still do not have any injectable flu vaccine at our office.
We do have the nasal spray flu vaccine (aka FluMist®).
Here is the 2010-2011 vaccine information statement for the nasal flu vaccine: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flulive.pdf.
In summary, children who have already turned 2yo and do not have any chronic medical conditions (such as asthma, diabetes, and other illnesses) are eligible to get FluMist®.
By definition, all of our high risk patients (children under 2yo and children of any age with underlying chronic illnesses such as asthma, diabetes and other illnesses) need to get the injectable flu vaccine and cannot get the nasal spray version.
Here is the 2010-2011 vaccine information statement for the injectable flu vaccine:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flu.pdf.
Both the injectable and the nasal flu vaccines protect against the same 3 virus strains (the 2010-11 vaccine contains the 2009 H1N1 (aka swine flu) and 2 seasonal strains).
Of note to some parents, FluMist® does not contain thimerosol (a mercury containing preservative). We order the thimerosol-free injectable flu vaccine to give to children less than 3yo.
Tuesday, August 24, 2010
Does my child need 1 or 2 Flu vaccine doses?
Since the flu vaccine is starting to trickle in to many offices and pharmacies around the country (we don't have the injectable vaccine in stock yet in our office as of today), I thought I would take my first stab at answering this question.
Unfortunately, there is a complicated answer for the 2010-2011 season, especially since this season's vaccine has 2 seasonal flu strains and the 2009 H1N1 strain in it.
It is probably most easily explained in figure 3 at this link on the CDC website: http://www.cdc.gov/flu/professionals/acip/specificpopulations.htm#fig3
However, if you like words more than a diagram, this is how I summarize it:
1. Children who have already turned 9 years old only need one dose.
2. Infants aged less than 6 months cannot get the vaccine until they are 6mo.
3. Children 6mo-8yo who did not get (or it is unsure if they got) any 2009 H1N1 flu vaccine should get 2 doses of 2010-2011 vaccine at least 4 weeks apart.
4. Children 6mo-8yo who have never (or it is unsure if they ever) received seasonal flu vaccine should get 2 doses of 2010-2011 vaccine at least 4 weeks apart.
5. Children 6mo-8yo who got the seasonal flu vaccine for the 1st time during the 2009-2010 flu season AND did not get 2 doses of seasonal flu vaccine during the 2009-2010 should get 2 doses of the 2010-2011 vaccine at least 4 weeks apart.
6. Otherwise, only one dose of flu vaccine is recommended by the CDC during the 2010-2011 season to protect against both seasonal flu and 2009 H1N1 flu.
Lastly, to add a bit more confusion, according to the CDC "children who had laboratory-confirmed 2009 pandemic H1N1 virus infection... are likely to be immune to this virus". These children may not need 2 doses of the 2010-2011 flu vaccine. However, "laboratory-confirmed" H1N1 testing is not the same as the office, ER, or urgent care-based rapid flu swab. This term refers to a PCR or viral culture H1N1 positive result.
Unfortunately, there is a complicated answer for the 2010-2011 season, especially since this season's vaccine has 2 seasonal flu strains and the 2009 H1N1 strain in it.
It is probably most easily explained in figure 3 at this link on the CDC website: http://www.cdc.gov/flu/professionals/acip/specificpopulations.htm#fig3
However, if you like words more than a diagram, this is how I summarize it:
1. Children who have already turned 9 years old only need one dose.
2. Infants aged less than 6 months cannot get the vaccine until they are 6mo.
3. Children 6mo-8yo who did not get (or it is unsure if they got) any 2009 H1N1 flu vaccine should get 2 doses of 2010-2011 vaccine at least 4 weeks apart.
4. Children 6mo-8yo who have never (or it is unsure if they ever) received seasonal flu vaccine should get 2 doses of 2010-2011 vaccine at least 4 weeks apart.
5. Children 6mo-8yo who got the seasonal flu vaccine for the 1st time during the 2009-2010 flu season AND did not get 2 doses of seasonal flu vaccine during the 2009-2010 should get 2 doses of the 2010-2011 vaccine at least 4 weeks apart.
6. Otherwise, only one dose of flu vaccine is recommended by the CDC during the 2010-2011 season to protect against both seasonal flu and 2009 H1N1 flu.
Lastly, to add a bit more confusion, according to the CDC "children who had laboratory-confirmed 2009 pandemic H1N1 virus infection... are likely to be immune to this virus". These children may not need 2 doses of the 2010-2011 flu vaccine. However, "laboratory-confirmed" H1N1 testing is not the same as the office, ER, or urgent care-based rapid flu swab. This term refers to a PCR or viral culture H1N1 positive result.
Monday, August 23, 2010
How to Eat for Good Health and Other Weight Control Tips
1. All in the Family
Approach food choices and exercise as a family project and set an example of healthy eating and exercise habits
-Read food labels looking for calorie, sugar and fiber content in particular.
-Avoid isolating or singling out the child (or children) with weight issues
2. Call a TV timeout and stay on the move
-Take the stairs, walk the dog, ride bike, and formal athletic activities (when possible)
-Keep total daily "screen time" to less than 2 hours/day
3. Eat more slowly and monitor portion size
- Take 20 minutes or more until second servings.
- Be aware of the USDA daily calorie recommendations for children. The recommended calorie intake in children depends on age, gender, and activity level. Summary of approximate calorie goals: 2-3yo 1000-1400; 4-8yo 1200-2000; 9-13yo girls 1400-2200/boys 1600-2600; 14-18yo girls 1800-2400/boys 2000-3200.
4. Limit sugar intake, in particular fructose
-Encourage your child to drink milk, water and max of 4-6 oz/day of fruit juice. Avoid or at least minimize soft drinks (12oz non-diet soda = 150cal & 10 tsp of sugar)
- High Fructose Corn Syrup (HFCS) was introduced to the U.S. market in the mid-1970’s. HFCS is used as a sweetener (cheaper than cane sugar) and preservative (extends shelf life) in processed foods, bread, condiments, and soft drinks.
-There is conflicting research on HFCS's health effects, but some of the research shows an association with obesity.
-Fructose acts biologically like fat and is toxic to the liver in large doses; it also delays satiety (feeling full).
5. Encourage a high fiber diet
-The fiber goal (> 2yo) in grams per day = age in years plus 5-10 grams per day (max of 30-35g/day).
-Promote fresh fruit, veggies, beans, and whole grains (see websites below to get list of high fiber foods).
-Fiber health benefits: slows the absorption of fructose (see above), helps control blood cholesterol levels, decreases the risk of type 2 diabetes and heart disease, and promotes general colon health.
6. Useful Internet Resources:
www.healthychildren.org; www.mypyramid.gov; www.uptodate.com/patients; www.mayoclinic.com
Approach food choices and exercise as a family project and set an example of healthy eating and exercise habits
-Read food labels looking for calorie, sugar and fiber content in particular.
-Avoid isolating or singling out the child (or children) with weight issues
2. Call a TV timeout and stay on the move
-Take the stairs, walk the dog, ride bike, and formal athletic activities (when possible)
-Keep total daily "screen time" to less than 2 hours/day
3. Eat more slowly and monitor portion size
- Take 20 minutes or more until second servings.
- Be aware of the USDA daily calorie recommendations for children. The recommended calorie intake in children depends on age, gender, and activity level. Summary of approximate calorie goals: 2-3yo 1000-1400; 4-8yo 1200-2000; 9-13yo girls 1400-2200/boys 1600-2600; 14-18yo girls 1800-2400/boys 2000-3200.
4. Limit sugar intake, in particular fructose
-Encourage your child to drink milk, water and max of 4-6 oz/day of fruit juice. Avoid or at least minimize soft drinks (12oz non-diet soda = 150cal & 10 tsp of sugar)
- High Fructose Corn Syrup (HFCS) was introduced to the U.S. market in the mid-1970’s. HFCS is used as a sweetener (cheaper than cane sugar) and preservative (extends shelf life) in processed foods, bread, condiments, and soft drinks.
-There is conflicting research on HFCS's health effects, but some of the research shows an association with obesity.
-Fructose acts biologically like fat and is toxic to the liver in large doses; it also delays satiety (feeling full).
5. Encourage a high fiber diet
-The fiber goal (> 2yo) in grams per day = age in years plus 5-10 grams per day (max of 30-35g/day).
-Promote fresh fruit, veggies, beans, and whole grains (see websites below to get list of high fiber foods).
-Fiber health benefits: slows the absorption of fructose (see above), helps control blood cholesterol levels, decreases the risk of type 2 diabetes and heart disease, and promotes general colon health.
6. Useful Internet Resources:
www.healthychildren.org; www.mypyramid.gov; www.uptodate.com/patients; www.mayoclinic.com
Sunday, August 15, 2010
Recommended pediatric health websites for parents
TCPA Katy
www.texaschildrenspediatrics.org/katy
Includes office hours, patient forms, physician biographical information, and other office info.
TCPA Health Library
www.texaschildrenspediatrics.org/healthlibrary/default.aspx
The TCPA health library is an excellent resource of health information on a variety of topics.
American Academy of Pediatrics' Website for Parents
www.healthychildren.org
The AAP’s parent-oriented webpage has up to date information on a variety of pediatric health topics.
TCH Center for Vaccine Awareness and Research
www.texaschildrens.org/vaccines
Includes info on vaccine education, safety and schedules for parents and health professionals.
Children’s Hospital of Philadelphia’s Vaccine Education Center
www.vaccine.chop.edu
Includes informational videos and tear sheets. Parents can also sign up for a monthly email newsletter on vaccine science, safety and schedules.
UpToDate.com patient information
www.uptodate.com/patients
Includes free patient-level health information that is continually updated with evidence-based medical information on both pediatric and adult health topics.
Mayo Clinic
www.mayoclinic.com
Includes comprehensive guides on hundreds of diseases and conditions.
Centers for Disease Control and Prevention- International Travel
www.cdc.gov/travel\
Includes info to assist travelers and their health-care providers in deciding the vaccines, medications, and other measures necessary to prevent illness and injury during international travel.
Texas Department of State Health Services Immunization Branch
www.dshs.state.tx.us/immunize/default.shtm
Includes info for the public on topics such as school and daycare minimum immunization requirements, schedules, and the Texas Vaccine for Children program (VFC).
www.texaschildrenspediatrics.org/katy
Includes office hours, patient forms, physician biographical information, and other office info.
TCPA Health Library
www.texaschildrenspediatrics.org/healthlibrary/default.aspx
The TCPA health library is an excellent resource of health information on a variety of topics.
American Academy of Pediatrics' Website for Parents
www.healthychildren.org
The AAP’s parent-oriented webpage has up to date information on a variety of pediatric health topics.
TCH Center for Vaccine Awareness and Research
www.texaschildrens.org/vaccines
Includes info on vaccine education, safety and schedules for parents and health professionals.
Children’s Hospital of Philadelphia’s Vaccine Education Center
www.vaccine.chop.edu
Includes informational videos and tear sheets. Parents can also sign up for a monthly email newsletter on vaccine science, safety and schedules.
UpToDate.com patient information
www.uptodate.com/patients
Includes free patient-level health information that is continually updated with evidence-based medical information on both pediatric and adult health topics.
Mayo Clinic
www.mayoclinic.com
Includes comprehensive guides on hundreds of diseases and conditions.
Centers for Disease Control and Prevention- International Travel
www.cdc.gov/travel\
Includes info to assist travelers and their health-care providers in deciding the vaccines, medications, and other measures necessary to prevent illness and injury during international travel.
Texas Department of State Health Services Immunization Branch
www.dshs.state.tx.us/immunize/default.shtm
Includes info for the public on topics such as school and daycare minimum immunization requirements, schedules, and the Texas Vaccine for Children program (VFC).
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