no pain, total gain - lifestyle matrix · 2018-11-28 · avoid addictive sub-stances (e.g. alcohol,...
TRANSCRIPT
Improve the health of your patientswith meaningful information
• Easy to implement
• Cost-effective
• Time-efficient
• Insurance-friendly
FOR ADDITIONAL GROUP VISIT RESOURCES, VISIT LifestyleMatrix.comFOR ADDITIONAL GROUP VISIT RESOURCES, VISIT LifestyleMatrix.com
No Pain, Total Gain
GROUP VISIT TOOLKITGROUP VISIT TOOLKIT
LT-Guide-Healthy Weight GVT
This toolkit educates patients on the lifecycle of pain, where and how we feel pain, and why pain persists and doesn’t resolve for many. By exploring the underlying factors causing pain, patients will recognize patterns and long-term e�ects of unhealthy behaviors. Understanding the pitfalls of medication dependency and how poor nutrition, lack of exercise, high stress and inadequate sleep all contribute to poor healing and chronic pain, patients will embrace lifestyle choices that create lifelong, optimal health and chronic pain prevention. Use for patients with these issues:
THIS GROUP VISIT TOOLKIT INCLUDES:
© Living Wellness, LLC 2015. All rights reserved.
Visit Forms:Patient intake forms are designed to capturekey information to create e�cient, insurance-friendly patient encounters.
Patient Handout(s):Patient-friendly handout(s) assist you and improvethe implementation of key lifestyle tips necessaryto correct underlying causes of illness.
Multi-Media Education:Choose the best format to suit your presentation style• Video + audio version• Presentation slides for custom educationIdeal use for a Group Visit or one-on-one setting
Shilpa P. Saxena, MD is a Board-Certi�ed Family Practice physician whose passion and purpose come to life through sharing her innovative patient education and practice manage-ment solutions in her classic ‘keep it simple’ style. She serves as Faculty with the Institute for Functional Medicine, the Arizona Center for Integrative Medicine, the University of Miami, Miller School of Medicine, the Metabolic Medical Institute at George Washington University and most recently, joined the Lifestyle Matrix Resource Center serving as the Clinical Expert for the CM Vitals Program. Dr. Saxena is an expert in the Group Visit medical model, creator of Group Visit Toolkits, and co-author of The Ingredients Matter: India.
• Sciatica or leg pain• Low back pain• Neck or shoulder pain
• Headaches & migraines• Sports & accident-related
injuries• Tendonitis
• Autoimmune arthritis• Osteoarthritis• Fibromyalgia
Your patients want to change…now you have the toolsYour patients want to change…now you have the tools
Patient Name: Date of visit:
(initial) I understand as a participant in this Group Visit/Shared Medical Appointment, that I and other patients will discuss medical information in the presence of other patients, family members, staff, and the clinician. If I have medical concerns that are of a very private nature, I will request to discuss with the clinician in a private setting or will schedule an individual office visit. I will also respect the confidentiality of the other members of the group by not revealing medical, personal, or any other identifying information about others in attendance after the session is over.
CC: Pain Associated with Chronic Issue(s): 1. 2.
Location of Pain
Left, Right, Both
(circle all that apply)
Intensity(0=none;
10=horrible)
Better, Worse or Same
(in last 30 days)(circle all that
apply)
Better, Worse or Same
(in last 90 days)(circle all that
apply)
Things that make it better
(e.g. rest, moving, Rx, ice, etc.)
(to be completed by provider)
PHYSICAL EXAM(circle all that apply)
R-red; S-swollen; D-deformed; W-warm
Head L R B B W S B W S
Neck L R B B W S B W S
Shoulder(s) L R B B W S B W S
Elbow(s) L R B B W S B W S
Wrist(s) L R B B W S B W S
Hand(s) L R B B W S B W S
Back L R B B W S B W S
Hip(s) L R B B W S B W S
Knee(s) L R B B W S B W S
Ankle(s) L R B B W S B W S
Foot L R B B W S B W S
[ Insert Logo Here ] No Pain, Total Gain
© 2018 Living Wellness, LLC GVT-8 No Pain, Total Gain
Review of Systems (check all that apply):
Fatigue Malaise Unexplained Fevers Nausea Constipation Dizziness Weakness Rash Joint Swelling Joint Redness Joint Warmth
Past Medical History:
History of motor vehicle accident? Yes No If yes, how many?In general, do anti-inflammatories (e.g. aspirin and ibuprofen) make your pain better? Yes No More often than not, are narcotics (e.g. codeine) what you need to resolve pain? Yes No Depends
Family History (check all that apply in your family): Autoimmune disease (e.g. rheumatoid, lupus, psoriasis, ankylosing spondylitis, etc.) Gout Osteoarthritis (“old age” arthritis) Dependence/Addiction tendencies (e.g. smoking, alcohol, pain medications, illegal drugs of abuse)
SOAP Note
a Insurance-friendly
a Can be scanned into EMR
a Patient completes all
non-gray box sections
ASSESSMENT (to be completed by office):
Chronic pain syndrome Osteoarthritis: Knee Shoulder Spine (Lumb, Thor, Cerv) Other Autoimmune arthritis (specify) Other Overweight Obese BMI Other
PLAN OF CARE (to be completed by office):
Educated on pain physiology, impact of anti-inflammatory lifestyle signals to reduce pain syndromes and improve quality of life
Refill specified medications as previous: Follow-up for routine pain management appointment in/on PATIENT REQUESTS additional information on personalized anti-inflammatory lifestyle support for pain and/or
medication usage reduction.
Provider Signature/Date:
© 2018 Living Wellness, LLC GVT-8 No Pain, Total Gain
No Pain, Total Gain
Are you ready for a pain-free life?Register for our upcoming patient Group Visit:
Are you ready for a pain-free life?Register for our upcoming patient Group Visit:
Did you know that pain a�ects more Americans than diabetes, cancer and heart disease combined? Occasional aches and pains often turn into frequent pain, driving patients to turn to medications for relief. If the underlying factors contributing to chronic pain are never addressed, patients risk getting caught in the trap of pain pill dependency.
Join us to learn how to aviod getting trapped in a life of pain and understand the lifestyle factors that create lifelong, optimal health and prevent chronic pain.
Date/Time/Location
[ Insert Logo Here ]
Event Flyer
a Market to office patients
a Market to the greater
community
a Customizable
Word format
PowerPoint Slides
a Concepts reviewed in
video
a PPT slide files for
clinician to present
and modify as needed
a Handouts for patients
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Able
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Jogg
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ing
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Patient Handouts
a Reference concepts learned
from group session
a Reinforce plan of care
a Customizable with clinic
name/logo
Con
cen
trat
ed P
rote
in 3
-4oz
, 150
cal
orie
s
• 2 w
hole
egg
s or
3 w
hite
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1 w
hole
• Egg
Sub
stitu
te (2
/3 c
up)
• Fis
h or
she
llfish
• Pou
ltry:
chi
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key,
whi
te m
eat
• Lam
b: le
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eef:
very
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buf
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pric
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ries:
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raw
berr
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loup
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ium
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(15)
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rape
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t (1
who
le)
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pes
(15)
• Hon
eyde
w (¼
med
ium
)• M
ango
(½ m
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/nec
tarin
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sm
all)
• Pea
r (1
med
ium
)• P
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mm
on (½
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)• T
ange
rines
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mal
l)
Fats
40
calo
ries
• Oils
:-
Cold
pre
ssed
, ext
ra-v
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oliv
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coco
nut,
avoc
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arth
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ance
(1½
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larifi
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lives
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Legu
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ry &
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45 c
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quas
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baby
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wee
t pot
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(½ m
ediu
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old
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ssel
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rout
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bage
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liflo
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• Cel
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ves/
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ucum
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plan
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enne
ll
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• Mus
hroo
ms
• Okr
a• O
nion
, Lee
ks• S
alsa
• Let
tuce
(all
type
s)• T
omat
oes
• Sno
w p
eas
• Spi
nach
• Spr
outs
• Squ
ash
zuc
chin
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ello
w s
pagh
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• Gre
ens:
bee
t gre
ens,
bok
cho
y, co
llard
s, e
scar
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kal
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pina
ch, S
wis
s ch
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mus
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ins
(lim
it to
1 s
ervi
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aily
) 75-
110
calo
ries
• Who
le w
heat
bre
ad (1
slic
e)*
• Who
le w
heat
tort
illa
or p
ita (½
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hole
whe
at p
asta
(½ c
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• Ryv
ita o
r Was
a cr
acke
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larg
e)*
• Bar
ley
(½ c
up c
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d)*
• Bul
gur c
rack
ed w
heat
(½ c
up)*
• Who
le o
ats
(½ c
up c
ooke
d)
Glu
ten
Free
Opt
ions
:• B
uckw
heat
gro
ats
(½ c
up)
• Ric
e, b
row
n or
wild
(½ c
up)
• Qui
noa
or q
uino
a pa
sta
(½
cup)
• Udi
’s g
lute
n-fr
ee b
read
(1
slic
e)*
Dep
endi
ng o
n yo
ur c
ondi
tion
your prac
titio
ner m
ay re
com
men
d av
oidi
nggl
uten
-con
tain
ing
food
s
Nut
s &
See
ds 1
00 c
alor
ies
• Alm
onds
, haz
elnu
ts (1
2 w
hole
)• C
ashe
ws
(8 w
hole
)• P
eanu
ts (1
8 w
hole
)
• Wal
nuts
, pec
ans
(8 h
alve
s)• N
ut b
utte
r (1
Tbl)
• Chi
a Se
eds,
gro
und
flax
seed
s
• Oth
er n
uts/
seed
s- P
ista
chio
, pum
pkin
, sun
flow
er, s
esam
e, p
inen
uts
Goo
dNES
S: A
nti
-In
flam
mat
ory
Nut
riti
on
My GoodNESS Self-Evaluation & Strategy
Mental
Common thoughtpatterns?
Too manyToo fastAll over the placeToo intenseConfused or slow
Emotional
Common types offeelings?
Worried or anxiousSad or blueMad or irritableJoyful or giddyPeaceful or content
Fulfilling relationships in my life??
FriendsFamilyPetsWork
Social
What gives sacrad meaning to my life?
God/spiritualityGratitudeService to others
Spiritual
Good
Nutrition
Up my waterStop sugary drinksLimit sweetsAvoid fake foodsUp the veggiesUp the fiber
Exercise
Move once hourlyWalk more oftenYoga or stretchingCore StrengtheningImprove postureStrength training
Meditate/prayBreathe (in 4, out 7)Avoid addictive sub-stances (e.g. alcohol, cigarettes, Rx/illegal drugs)
Stress Management
Avoid caffeine after lunchAvoid electronics & eating 3 hours before bedtimeCreate a bedtimeritual you love
Sleep
NESS
Other Beneficial Things I Am Learning Today That I Want To Implement:
The 3 C’s of Life: You must make the Choice to take the Chance if you want anything in life to Change.
Patient Name: Age: Date of visit:
Group Visit Presenter:
Please rate the value of today’s Group Visit (1=low/10=high): 1 2 3 4 5 6 7 8 9 10
What are the 3 most important things you learned or changes you plan to make from today’s Group Visit?
1.
2.
3.
Suggestions for Improvement:
Optional Testimonial:
We are seeking support to help other patients understand the benefits of the Group Visit model. Please tell us why you think other patients should attend a Group Visit.
(initial) I, give permission to (name of practice) to use my testimonial (using initials, age and hometown only) to help other patients understand the benefits of Group Visits and our practice.
[ Insert Logo Here ] No Pain, Total Gain Patient Feedback Form
Patient Feedback Form
a Patient feedback allows you to
improve your Group Visit
experience
a Collect Testimonials to help you
promote the Group Visit
experience with other patients
a Gives you important items the
patient plans to change so you
can hold them accountable
This toolkit educates patients on the lifecycle of pain, where and how we feel pain, and why pain persists and doesn’t resolve for many. By exploring the underlying factors causing pain, patients will recognize patterns and long-term e�ects of unhealthy behaviors. Understanding the pitfalls of medication dependency and how poor nutrition, lack of exercise, high stress and inadequate sleep all contribute to poor healing and chronic pain, patients will embrace lifestyle choices that create lifelong, optimal health and chronic pain prevention. Use for patients with these issues:
THIS GROUP VISIT TOOLKIT INCLUDES:
© Living Wellness, LLC 2015. All rights reserved.
Visit Forms:Patient intake forms are designed to capturekey information to create e�cient, insurance-friendly patient encounters.
Patient Handout(s):Patient-friendly handout(s) assist you and improvethe implementation of key lifestyle tips necessaryto correct underlying causes of illness.
Multi-Media Education:Choose the best format to suit your presentation style• Video + audio version• Presentation slides for custom educationIdeal use for a Group Visit or one-on-one setting
Shilpa P. Saxena, MD is a Board-Certi�ed Family Practice physician whose passion and purpose come to life through sharing her innovative patient education and practice manage-ment solutions in her classic ‘keep it simple’ style. She serves as Faculty with the Institute for Functional Medicine, the Arizona Center for Integrative Medicine, the University of Miami, Miller School of Medicine, the Metabolic Medical Institute at George Washington University and most recently, joined the Lifestyle Matrix Resource Center serving as the Clinical Expert for the CM Vitals Program. Dr. Saxena is an expert in the Group Visit medical model, creator of Group Visit Toolkits, and co-author of The Ingredients Matter: India.
• Sciatica or leg pain• Low back pain• Neck or shoulder pain
• Headaches & migraines• Sports & accident-related
injuries• Tendonitis
• Autoimmune arthritis• Osteoarthritis• Fibromyalgia
Your patients want to change…now you have the toolsYour patients want to change…now you have the tools
LT-GUIDE-MSKGVT-A