Behavioral Health Services

Our clinical staff understand mental health is as important as physical health. Family clinicians are often first line to help review and identify many psychologic diagnoses such as Depression, BiPolar, Substance Abuse, PTSD, and Anxiety. In the situation that your needs exceed the resources available in our practice, we will work with local community resources to get you established with psychologist, counselors, or psychiatry care.

Blood Pressure Monitor

What is Blood Pressure?

Blood pressure is the force of the blood on the artery walls as the heart pumps blood through the body. The arteries are the blood vessels that carry blood from the heart to the rest of the body. The heart pumps blood through the blood vessels by contracting. Each time the heart contracts, the blood pushes harder against the walls of the arteries than it does when it rests between beats. This means that the pressure of the blood on the artery walls is greatest each time the heart contracts.

Normal, healthy blood pressure is less than 120/80 (“120 over 80”).  Blood pressure can rise and fall with exercise, rest, emotions, or pain. However, if you have several measurements over 120/80, you probably have pre-high (pre-hypertension) or high blood pressure (hypertension).  The higher your blood pressure, the greater your risk of having a stroke and other serious medical problems.

We monitor blood pressure at every visit and also offer 24-hour ambulatory diagnostic tools to assist with hypertension monitoring. If your blood pressure is normal, check it once a year. If it’s above normal, follow the schedule for checkups recommended by your health care provider.

Try to reduce the amount of stress in your life by learning techniques to help you relax and cope with stress better. If you take medicine for high blood pressure, always follow your health care provider’s instructions. Don’t take less medicine or stop taking medicine without talking to your provider first. It can be dangerous to suddenly stop taking blood pressure medicine. Also, do not increase your dosage of any medicine without first talking with your provider.

Bone Density Study/Dexa Scan

What is bone mineral density testing?

A bone mineral density (BMD) test, also called a bone mass measurement, is a way to see if your bones are healthy and strong and is used to measure bone density and determine fracture risk for osteoporosis. It may also be used to determine how effective an osteoporosis treatment is.

Why is this test done?

Your health care provider orders a bone mineral density test to check your bone health. It may be done for several reasons.  The National Osteoporosis Foundation recommends BMD testing for the following individuals:

• All women aged 65 and older regardless of risk factors.
• Younger postmenopausal women with one or more risk factors.
• Postmenopausal women who present with fractures (to confirm the diagnosis and determine disease severity).
• Estrogen deficient women at clinical risk for osteoporosis.
• Individuals with vertebral abnormalities.
• Individuals receiving, or planning to receive, long-term glucocorticoid (steroid) therapy.
• Individuals with primary hyperparathyroidism.
• Individuals being monitored to assess the response or efficacy of an approved osteoporosis drug therapy.
• As a routine screening test.
• When your risk for having weak bones is high.
• After you have broken a bone to see if weak bones were a cause of the break, which could mean you are at risk for more broken bones.

Your bones naturally lose some density as you get older. The loss of density weakens the bones. If your bones are somewhat less dense than normal, you have osteopenia. If your bones have lost a lot of density, you have osteoporosis.

Each year there are approximately 700,000 spine fractures and 250,000 hip fractures in the US. Most of these fractures occur in people who have osteoporosis. To help prevent such fractures, it is important to diagnose osteoporosis. Osteoporosis can then be treated with diet, exercise, and sometimes medicines to help make the bones strong again.

Bone mineral density tests are much more sensitive than normal x-rays. Normal x-rays do not detect bone loss until at least 30% of the bone mass has been lost. Bone mineral density tests allow health care providers to diagnose weakening bones at earlier stages. The test helps your health care provider decide if you need treatment for osteoporosis.

How do I prepare for this test?

• You don’t need to fast, stop taking any medicines, or limit your activity in any way before the test.
• Don’t wear clothing with buttons, snaps, or zippers from the waist down on the day of the test. If you wear pants with an elastic waistband or cloth tie, you won’t need to get undressed for the test.
• If you have recently had x-ray tests using barium or any nuclear medicine tests, you should have your bone density test at least a week after those tests.
• Tell your health care provider if you are or might be pregnant.

Complete Physical Exams

The Complete Physical Examination defines the Preventive Visit as an exam specifically focused on promoting health and wellness. The exam includes counseling, anticipatory guidance and risk factor reduction. A preventive service exam is for a healthy individual who presents with no acute problems (asymptomatic). Your lab work for an annual exam will not be done in advance of your exam.

This is done because our screening questions may change the types of lab work that’s needed to diagnose specific issues your clinician may determine.

Although a discussion of different problems sometimes arise during your visit, this discussion is usually considered counseling and is considered a component of the preventative medicine examination unless significant time is spent on the care of that particular problem.

If a treatment plan is required to be changed based on an acute problem, your PCP (Primary Care Provider) is required to bill a consult visit with your Preventive Physical Exam. This can result in a co-pay for your visit.

This office will then bill for a Preventive Exam and a sick visit on the same day which may result in two co-pays for that visit. This is an acceptable insurance practice.

Note: Complete Physical Exams are a specific type of check up, which aids in identifying problems that may occur in the future based on your results.

Complete Physical Exams and Annual Wellness Exams are not the same. Annual Wellness Exams are a yearly appointment to create or update a personalized prevention plan. This plan may help prevent illness based on your current health and risk factors. Annual Wellness Exams are not a head-to-toe physical.

At your Annual Wellness Exam, your Clinician may:

• Check your weight and blood pressure
• Update the health risk assessment you completed
• Update your medical and family history
• Update your list of current medical providers and suppliers
• Update your written screening schedule
• Screen for cognitive issues
• Provide health advice and referrals to health education and/or preventive counseling services

For further reading on what’s covered at an Annual Wellness Exam and if you qualify, please visit Medicare Interactive and Medicare Made Clear.

Hearing Tests

In the United States, there are over 31 million people, or 10% of the population, suffering from hearing loss.  More than 80% of these individuals remain undiagnosed and untreated.  Left untreated, hearing loss is connected to depression, social isolation, lower self-esteem and decreased earning power.  The incidence of hearing loss is expected to increase significantly as a result of an aging population and unprecedented exposure to environmental, vocational and recreational noise.

We are committed to providing advanced, patented technologies to improve early detection of hearing loss, increase access to diagnostics, and facilitate the ease and convenience of personalized treatment.

When should I see a health care provider about my hearing? See your provider if:

• Spoken words are hard to understand.
• Another person’s speech sounds slurred or mumbled, especially if it gets worse when there is background noise.
• Certain sounds are overly annoying or loud.
• You hear hissing or ringing in the background.
• TV shows, concerts, or parties are less enjoyable because you can’t hear much.

Home Sleep Testing

We partner with community resources to provide home diagnostic services.

Types of Sleep Apnea

1 in 5 individuals have mild OSA. Another 1 in 5 have severe OSA.

Signs and Symptoms

Sleep Lab vs Home Treatment

Immunizations

Southwest Orlando Family Medicine, P.L. offers comprehensive immunization services for ages 6 and older. We are able to offer the following vaccines for our patients:

• Diphtheria, Tetanus, and Pertussis (called the Tdap vaccine)
• Flu/Influenza
• Hepatitis A and B
• Human Papilloma Virus (HPV) for young women
• Measles, Mumps, Rubella (the MMR vaccine)
• Meningococcal disease (meningitis)
• Pneumococcal
• Polio
• Varicella (chickenpox) and Shingles

Ideally, people should be fully vaccinated against these diseases by the age of 11 or 12. But because new vaccines are constantly being developed (the HPV vaccine was only approved in 2006), there’s a chance teens may have missed getting at least one of these. The good news is that, in most cases, you can still get a shot if you’ve missed it.

Going out of the country?

Visit the CDC Yellow Book for what vaccines are recommended for the area you are traveling to. These vaccines can be found at the Seminole County Department of Health and Orange County Department of Health, or the Orlando Health Passport Clinic.

We unable to provide traveler’s vaccines, including Typhoid, Japanese Encephalitis, and Yellow Fever.

Why Do I Need Shots?

Missing a shot may not seem like a bad thing — nobody wakes up in the morning thinking they’d love to go out and get a jab in the arm. But missing out on shots puts you at more serious risk than you might think. That one little “ouch” moment protects you from some major health problems.  For example, older teens and adults who get diseases like mumps may not feel too sick — but they could still be at risk for side effects of the illness, such as infertility (the inability to have children).

People sometimes mistakenly think that vaccinations are only for kids or that they are for diseases that only kids get. But many of the diseases that we are vaccinated against when we’re kids — like Hepatitis B or Tetanus — actually affect more adults than kids. And those “kid diseases” like chickenpox? Anyone can get them — and they are far more dangerous to teens and adults than they are to kids.

The best reason to get shots is because they could save your life. Hepatitis B attacks the liver and can eventually kill. The new HPV vaccine can protect girls from certain types of cervical cancer. And another great reason to stay current on your shots is because scientists are constantly working on new vaccines against diseases like HIV.

Are Vaccinations Safe?

Like any medicine, vaccines may cause side effects, but receiving one is far safer than getting the disease it prevents. The most common reactions include soreness, redness, and swelling in the area of the shot or a low-grade fever. Usually acetaminophen or ibuprofen will take care of these side effects. It’s rare to have any kind of bad reaction to a vaccine. If you’ve had reactions to vaccines in the past, let your doctor know.

Remember, you’re not alone; no one likes shots. But the good news is that the shot itself only lasts for a second, but you’ll be protected for a long, long time after that!

Laboratory Services

Traditional diagnosis is based on symptoms.  But uncovering the underlying causes of symptoms opens a world of preventative medicine that can better the lives of all.

We offer blood drawing for standard blood tests, routine blood tests and wellness screening tests for individuals who desire to stay healthy and fit.

Schedule your blood test as early in the morning as possible if you’re required to fast for 8 hours. You can stop eating at 6 p.m. or 7 p.m. the night before of your appointment. And then wake up the next morning and go right to the lab to have your blood drawn.

Instructions for Fasting Blood Work:

Your provider has ordered a test that requires a 8-hour period of fasting before your blood is drawn.

• Do not eat or drink anything except plain water for 8 hours before having your blood drawn.
• Avoid smoking, breath mints and gum chewing prior to having your blood drawn.
• Take any medications ordered by your provider but do not follow any food-related instructions for the medication. Refer to these instructions instead.
• Bring any written information or laboratory slips the provider gave you when reporting for the tests.
• We are only able to facilitate and process laboratory studies by our clinical staff. Please contact your insurance provider’s lab center (Quest or LabCorp) for outside testing from other clinical providers.
• If you need more information about any other test please contact our office.

We offer optional blood drawing services at our offices that are not covered by insurance. The cost for blood draws is $10 in-house convenience fee and $2 mail results fee.

We notify our patients via the Patient Portal on results of labs and procedures done.

Minor Emergencies

We offer friendly care for you and your family for minor medical emergencies and other services.

We are available to help you with cuts, bruises, minor injuries and illnesses such as like:

• Allergies & Allergic Reactions
• Asthma attack, Shortness of breath
• Back Pain, Kidney stones, etc
• Triage for Closed Bone Fractures and Dislocations
• Cuts & Minor Burns
• Ear aches, Ear infections
• Fever, Cold & Flu, Pneumonia
• Insect Bites & Rashes, Poison ivy
• Minor Eye injuries, Pink eye, Sinus Infections
• Nasal bleeding
• Soft tissue Injuries, foreign bodies
• Sprains, Strains
• Vomiting & Diarrhea, Dehydration, IV Infusions

Office Surgery

What is Minor Surgery?

A minor surgical procedure involving an incision with instruments that can be performed in a brief period of time–usually in less than 1 hour under local anesthesia, does not–under normal circumstances—constitute a major hazard to life or function of organs or body parts.

Minor Surgeries does not generally require hospitalization and may be performed electively.  Some conditions can be treated by cryosurgery (warts destruction) or simple excision (mole biopsy) which just requires a little local anesthetic and a few minutes of your time.

Which conditions can be treated under local anesthesia?

• Biopsy of growths
• Excision of benign skin nenus
• Foreign Body Removal from skin and soft tissue
• Hairy moles
• Incision and Drainage of an Abscess
• In-growing toe nails
• Laceration and Incision Repair of Skin & Soft Tissue
• Molluscum warts
• Pre-cancerous and cancerous skin lesions
• Skin tags/Skin Biopsy
• Skin cyst, Abscess
• Verruccae warts

and many more conditions…

Any other surgical procedure that involves anesthesia or respiratory assistance as a major surgery is not performed in our office.

Pediatric Care (6 years and older)

We offer medical care of children 6 years and older, and adolescents. Childhood is the period of greatest growth, development and maturation of the various organ systems in the body. Congenital defects, genetic variance, and developmental issues are of greater concern to our physicians.

Pediatric Care for children 6 years and older includes access to Immunizations, School Physicals, Sick Visit, and more.

School Physical Exams

Some schools require a physical exam and proof of up-to-date immunizations before children can enter certain grades or participate in sports. Check with your school district to see what’s required. This typically includes a well-child visit every other year for school age children. Your family’s health insurance may also affect the number and timing of these visits. Be sure to make an appointment specifically for a School Physical Exam, since they are not offered during a normal sick visit to our offices.

The doctor will check your child’s:

• Height and weight
• Blood pressure and heart rate
• Teeth, gums, tongue and throat
• Reflexes
• Eyes, vision
• Ears, hearing
• Nose and skin
• Heart, lungs and abdomen
• Fine-motor development, such as the ability to pick up small objects or tie shoes
• Gross-motor development, such as the ability to walk, climb stairs or jump
• Spinal alignment for signs of curvature (scoliosis)
• Genitalia, confirming a normal level of maturation and checking for hernia, infection and other possible problems

Immunization update:

Every checkup is an opportunity to make sure your child is up-to-date on immunizations. Ask for a copy of the immunization dates for your child – many schools require that information. Also keep an immunization record at home.

A value-added proposition

Well-child checkups can reveal problems early and reinforce healthy behavior. In addition, they establish a relationship with your child’s doctor. With up-to-date information at hand, your doctor can assess your child’s condition more readily.  Finally, your child’s trusting relationship with his or her doctor may help establish a lifelong pattern of healthy habits and appropriate utilization of medical care.

Shared Medical Appointment

What is a Shared Medical Appointment? A Shared Medical Appointment, also known as a group visit, occurs when multiple patients are seen as a group for follow-up care or management of chronic conditions. It allows patients to learn from each other, ask questions, and share experiences. Patients are seen one-on-one by the doctor and then by a team that includes a Registered Nurse, Registered Dietitian, Certified Diabetic Educator, and Medical Assistant.

What are the BENEFITS of a Shared Medical Appointment? Patients have more time with the provider. You will receive a combined 90 minutes with your provider, which includes some individual time and some group time. The visits also include a multidisciplinary care team and the shared experience, concerns, and support of other patients. Patients leave with more information and answers to questions they may not have known to ask.

Is the Shared Medical Appointment a Seminar? No. Although patients receive a lot of information and they do get more time with their doctor and care team, it is not a seminar. Patients will receive many of the same services they receive in a regular appointment; such as medication review, review of results, referrals, and medications needed. However, they will also learn from other patient’s questions and experiences. They may also participate in activity demonstrations, sample healthy food alternatives, view cooking demonstrations, and receive additional education and handouts not normally included in a regular visit.

If I attend a Shared Medical Appointment, do I always have to see my doctor in a Shared Medical Appointment? No. The shared medical appointment is an additional visit and health care choice available to you. Most patients who try a shared medical appointment want to return, but you can always also schedule regular individual office visits with your doctor.

What about Privacy? If you participate in Shared Medical Appointment, you will be asked to sign a privacy and confidentiality agreement. All patients that participate have to sign this agreement. The confidentiality and privacy agreement assure that any information patients share during these appointments remains private and confidential. Once patients participate, many have reported reported feeling much more comfortable with sharing information and grateful for the information others share with them in return.

Does my insurance pay for a Shared Medical Appointment? Yes. Shared Medical Appointments are covered just like regular office visits. It will be billed exactly like a regular office visits. Patients are normally just responsible for their co-payment and or co-insurance.

Can I get my medications in a Shared Medical Appointment? Yes, everything available to you at a regular office visit can be done as part of the Shared Medical Appointment. You can do everything at a shared medical appointment that you would a regular medical visit. The doctor can give you prescriptions, referrals, test results and a plan for ways to improve your health.

Can I bring a family member or friend with me? Yes. We encourage you to bring a spouse, family member or friend. It is your appointment but may be helpful to you to have someone with you. Anyone that attends with you will be required to sign a privacy and confidentiality agreement.

How can I join a Shared Medical Appointment? Please speak with your doctor at your next appointment and ask for more information. You may also speak with any member of our Patient Care Team.

Sick Visit

Feeling Sick? Southwest Orlando Family Medicine, P.L. offers a variety of acute care services for issues like flu, cold, cough, and a variety of symptoms. You can schedule an appointment to visit us during our office hours, visit us during our Saturday Hours (8am – 12pm) or call our offices after hours for medical assistance. In the case of an emergency, please call 911.

Ultrasounds

Please review the chart below for some example screening exams:

Well Woman Care

We provide well-women care in all phases of life. This includes menopause consultations, annual gynecological exams, pap smears, incontinence evaluation, sexually transmitted infection education and screening. Annual well women exams are important to address concerns which include but are not limited to: health, cancer, and sexually transmitted infections screenings, birth control and concerns about sex, issues with menstrual periods, and preconception counseling.

What is Cervical Cancer Screening?

A sample of cervical cells are taken and sent to the lab to be tested to see if abnormal cells are present (Pap test), or if there is infection with HPV types linked to cancer (HPV test). Co-testing is the preferred strategy of the American Cancer Society for cervical cancer screening where both the Pap and HPV test is performed.

Who should have Pap Smears and when?

The American College of Obstetricians and Gynecologists (ACOG) recommends women aged 21-29 years old to get their Pap test every 3 years. Co-testing, which is the Pap test plus HPV test, is recommended every 3-5 years for women aged 30 years and older. You should stop having cervical cancer screening after age 65 if you do not have a history of moderate or severe dysplasia or cancer and you have had either three negative Pap test results in a row or two negative co-test results in a row, with the most recent test performed within the past 5 years.

Women younger than 21 years, women older than the age of 65 who have been screened regularly, and women who have had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer or pre-cancer, should no longer be screened. Women 65 years and older do not need screening if there is no history of cervical changes and either three negative Pap test results in a row or two negative co-test results in a row within the past 10 years, with the most recent test performed within the past 5 years.

Women can and should still see their doctors more often than every 3 or 5 years – just not for a Pap test. Doctor visits should be scheduled for general wellness, with Pap tests and HPV tests given according to guideline.