dr. sheldon m. permack md ccfp medical director family ... sheldon permack slides.pdf · 5 ( )...
TRANSCRIPT
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Dr. Sheldon M. Permack MD CCFP Medical Director Family Medicine Primary Care WRHA
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MD training with post graduate residency training in Family Medicine
International Medical Graduates who have completed training and Family Medicine certification
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Principles of Family Medicine: ◦ Relationship based care ◦ Skilled clinician ◦ Community based ◦ Resource to a defined community ◦ Adaptable professionals ◦ Collaborative professionals
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Advocacy Communication
Education Service
Coordination and Navigation
Prescriptions-polypharmacy
avoidance
Interprofessional Patient Team Leadership
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Anger
Loss
Stress
Coping
Continuity and Accessibility
Waiting for Tests Consults Services Paneling
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Assessment
Diagnosis Diagnostics Referral
Examination
General CNS and Mental Health
History
Patient Family
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Mental Status
Labwork
Diagnostics
•Mini Mental Status
•CT •MRI
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Orientation 5 ( ) What is the (year) (season) (date) (day) (month)? 5 ( ) Where are we (state) (country) (town) (hospital) (floor)? Registration 3 ( ) Name 3 objects: 1 second to say each. Then ask the patient all 3 after you have said them. Give 1 point for each correct answer. Then repeat them until he/she learns all 3. Count trials and record. Trials ___________ Attention and Calculation
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5 ( ) Serial 7’s. 1 point for each correct answer. Stop after 5 answers. Alternatively spell “world” backward. Recall 3 ( ) Ask for the 3 objects repeated above. Give 1 point for each correct
answer. Language 2 ( ) Name a pencil and watch. 1 ( ) Repeat the following “No ifs, ands, or buts” 3 ( ) Follow a 3-stage command: “Take a paper in your hand, fold it in half, and put it on the floor.” 1 ( ) Read and obey the following: CLOSE YOUR EYES 1 ( ) Write a sentence. 1 ( ) Copy the design shown. _____ Total Score ASSESS level of consciousness along a continuum ____________
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Complete blood count Thyroid stimulating hormone serum levels ◦ electrolytes ◦ calcium and ◦ glucose
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Early pharmaceutical treatment Early referral to medical specialists and
community resources Early family support and intervention Early lifestyle/risk factor modification “First Link”
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Delerium •Delerium-acute
Substance abuse •Substance abuse
Hydrocephalus •Hydrocephalus (csf increase)
Blood clots around the brain
•Blood clots around the brain (subdural)
B12 Deficiency •B12 Deficiency
Low Thyroid •Low thyroid
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What are the new developments in community Primary Care for dementia
patients and their families?
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2015 promise Every Manitoban will have access to a
family physician by 2015! Primary Care Home Primary Care Teams
Networks Home Care Shared Care
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Patie
nt S
afet
y •Drug interactions
• Information transfer
Qua
lity •Handwriting
•Guidelines
Popu
latio
n ca
re
• Identifying those at risk
•Drug and program trials
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New regional efforts to enhance process inform families and patients
http://www.wrha.mb.ca/acp/files/Workbook.pdf
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Bring services into Family Physician Practices
Share expertise between ◦Family Doctors
◦Medical Specialists ◦Nurses
◦Allied health