Learn more: How to Best Communicate with your Care Team

By: ARIEL J. WARDEN-JARRETT, MD, FAAFP

Maryland continues to have one of the longest wait times for patients to be evaluated in the emergency department. At one point, wait times in some hospital systems were as long as 16-24+ hours. I think most of us can agree that this is ridiculous, but that does not change the reality.

Our hospital systems and state legislators are looking in depth as to why this is the case. In the meantime efforts were made to pass legislation that would allow qualified immigrants to apply for certain hospital positions in order to help decrease staffing shortages. Only time will tell if this proves to be an effective measure. I think the root of the problem exceeds hospital staffing issues. We need more access to primary care physicians.

As a board-certified family physician, I have some tips to share with you that may help you and your family avoid the emergency department in the first place. I believe one of the possible root causes of prolonged wait times is that individuals are not utilizing the primary care setting appropriately. Health issues that could be optimally addressed in this setting are getting pushed to the understaffed and overwhelmed emergency department settings. This won’t be solved overnight, but here are 10 things you can do to decrease your need for an emergency department visit, because we want to keep you out of the emergency departments, and utilize them for true emergencies…

1. Establish a relationship with a primary care physician. Someone needs to know you and care about your specific needs. You are important and special!
2. Schedule your annual physical. This gives you an opportunity to discuss your health, identify potential concerns and place a treatment/prevention plan in place. After all, healthy people tend to not need the emergency room on a regular basis, if at all.
3. Schedule regular interval visits with your provider to maintain/control your chronic health conditions. For example, If you have asthma, COPD, diabetes, heart disease or other significant condition, you should have an action plan — this will help to decrease your chances of needing the ER.
4. Do not wait until the last minute to call your doctor’s office when you have an urgent need. Yes, we have staffing issues too, but we are here to serve you. Let the trained staff help guide you to seeing an available provider who can evaluate you ASAP rather than “waiting” to see your preferred provider who may be booked up. At MPCP, we consider you our family. Yes, you have a preferred provider, but during an emergency, if your preferred provider is not available, it’s ok to see another provider in the office.
5. Do not let your medications run out. If cost is a concern, let your provider know, as we have access to some programs that may be able to assist you. We do not want your health to deteriorate because you did not have access to your medication(s). We want to help you stay as healthy and robust as possible.
6. When in doubt, call us. Our trained staff can triage your needs to guide you as to prioritizing the setting where your health concerns should be addressed (office, after-hours telemedicine, urgent care or the emergency department).
7. Make your health a priority! Years ago, a patient told me that when they became sick at work, their employer refused to let them leave for a doctor’s visit and told them to go to the ER after work. Sadly, that is what happened, but it is wrong! You have employee and patient rights. Become familiar with them, exercise them and advocate for yourself.
8. Ensure that you are building a robust immune system. Get adequate sleep (7-8 hours/night), exercise 45-60 min at least 3-5 days per week, avoid excessive caffeine, limit stress, eat balanced and healthy meals, limit alcohol intake, spend time outdoors (with sunscreen), spend time with family/friends.
9. Know your medications and take them as prescribed. Review them at each visit with your provider. Let your provider know about supplements or other medications you may take. This will help to decrease medication-related emergencies.
10. Read number 6 again.

At MPCP, we strive to create the best healthcare experience for you. Thank you for allowing us to be a part of your patient-centered medical homes.

By: ARIEL J. WARDEN-JARRETT, MD, FAAFP

Physicians, legislators, insurance company leaders and the general public may have different educational or socioeconomic backgrounds and legislative agendas, but at the end of the day, we share a common denominator: WE ARE ALL PATIENTS.

As we embark on a new election year, know your value. Our country may be divided politically, but that should not stop us from aiming to unify, especially on healthcare issues.

Here are some key strategies for you to engage in health advocacy:

1. Identify your top health issues that align with your personal core value system.
2. Educate yourself on the subject matter from trusted resources instead of falling prey to the propaganda of click bait as a source.
3. Meet with your legislators. Share your stories and experiences, so lawmakers can make decisions with YOU in mind.
4. Exercise your right to vote, and encourage your network of family and friends to do the same.

Have you reached out to your legislators? Believe me, they want to hear from you! Each of us adds value to the pool of wisdom, but only if we share our stories in settings that have power to influence change.

2024 is not the year to be a diminished chord waiting for the resolve. Rather, come out of the gate to form a united major chord. Be the change you wish to see! Know your value and stand strong!

By: Ariel J. Warden-Jarrett, MD, FAAFP

“Doc, you really have to help me lose weight!”

Your doctor smiles at you and states, “Sure, let’s go over your options.”

You ask about Semaglutide because you saw TikTok video, and you have a colleague that lost 50 pounds on the injections. After an in-depth discussion, you and your provider agree to try Wegovy® (Semaglutide). You are so excited! But the excitement is short lived. When you go to pick up your prescription, you learn from the pharmacist the following:

1. Your insurance won’t cover it and it will cost you $1,200 per month out of pocket.
2. There is a back order as the demand has exceeded the supply.

You feel helpless, defeated and lost all over again. What do you do?

It is important to understand that your employer selects your benefits, but the insurance company also selects the medication formulary. They indirectly work together. Therefore, you cannot assume that individuals with the same insurance plan that work for different companies will have the same coverage.

1. If the medication is not covered on the insurance formulary or by the employer, check to see what needs to be done to see if you qualify for an “exception.” This process is often called a prior authorization. In this case, the treating provider appeals to the insurance company to cover the requested medication due to a specific medical necessity. Unfortunately, the process can take time, and with many medical offices experiencing staffing shortages, the process can take even longer.
2. Next, reach out directly to the pharmaceutical company to see if they have programs/coupons that you may qualify for in order to bring your out-of-pocket costs down.
3. Reach out to your employer to see if there are plans to cover weight loss medications. Maybe you are not the only one needing the medication. Perhaps if enough employees reach out, the employer may recognize the potential need and include the option during the next open enrollment.
4. Last but not least, reach out to your elected official and share your frustrations with trying to obtain access to medication that your provider prescribed. They may be able to use their influence to urge pharmaceutical companies to increase their production of certain medication based on the demand.

I have had several patients that went through steps 1 and 2. We were able to get the medication approved through a prior authorization. Each circumstance is different, but together we can work to help you reach a more desirable health outcome.