Services

Here at Boca Raton Family & Pediatric Center we share a passion and that is improving the lives of our patients. Our mission is to provide affordable high quality patient oriented care. To do this we utilize available technologies and strategies to adapt to an ever changing healthcare environment. We feel it is important to have a trusting relationship with your physician and this includes good communication and an ability to relate well with others.

It is very important to have one doctor who knows all your medical history. Many people have complicated problems that require specialists, but still need one physician who can help coordinate your health care needs.

About our Services

Specialists play an important role in your health care.

In fact, many people see several specialists.

It essential to have a primary care doctor help you manage all of your medical issues. A doctor that knows you, your problems and your medications.

For example, your ophthalmologist can take excellent care of your eyes; but if you have a question about your high blood pressure medicine or about an influenza vaccine, it is not their area of expertise.

It is the job of you primary doctor to help you manage your health.

Dr. Luis Alvarez works in close partnership with his sister Dr. Sandra Alvarez. Both physicians see all ages of patients and if one doctor is unavailable the other is happy to accomodate your needs.

Another advantage of choosing a Family Physician is that when several members of the same family are sick, they can all be evaluated and treated at the same time. There is no hassle of trying to arrange appointments with three or four physicians. We treat patients of all ages. We also treats acute and chronic problems and is on staff at West Boca Medical Center.

Annual Physical Exam: The Basics

The physical exam is an essential part of any doctor's visit. Surprisingly, though, there are no absolutes in a routine physical. A good doctor may be thorough or brief, but they will spend time listening to your concerns and providing counseling for your particular complaints and risk factors. Annual exams usually check your:

History

This is your chance to mention any complaints or concerns about your health. Your doctor will also likely quiz you about lifestyle behaviors like smoking, excessive alcohol use, sexual health, diet, and exercise. The doctor will also check on your vaccination status and update your personal and family medical history.

Vital Signs:

These are some vital signs checked by your doctor:

• Blood pressure: Less than 120 over less than 80 is a normal blood pressure. Doctors define high blood pressure (hypertension) as 130 over 80 or higher.
• Heart rate: Values between 60 and 100 are considered normal. Many healthy people have heart rates slower than 60, however.
• Respiration rate: From 12 to 16 breaths per minute is normal for a healthy adult. Breathing more than 20 times per minute can suggest heart or lung problems.
• Temperature: 98.6 degrees Fahrenheit is the average, but healthy people can have resting temperatures slightly higher or lower.

General Appearance:

Your doctor gathers a large amount of information about you and your health just by watching and talking to you. How is your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk?

Heart Exam

Listening to your heart with a stethoscope, a doctor might detect an irregular heartbeat, a heart murmur, or other clues to heart disease.

Lung Exam:

Using a stethoscope, a doctor listens for crackles, wheezes, or decreased breath sounds. These and other sounds are clues to the presence of heart or lung disease.

Head and Neck Exam:

Opening up and saying "ah" shows off your throat and tonsils. The quality of your teeth and gums also provides information about your overall health. Ears, nose, sinuses, eyes, lymph nodes, thyroid, and carotid arteries may also be examined.

Abdominal Exam:

Your doctor can use a range of examination techniques including tapping your abdomen to detect liver size and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness.

Neurological Exam:

Nerves, muscle strength, reflexes, balance, and mental state may be assessed.

Dermatological Exam:

Skin and nail findings could indicate a dermatological problem or disease somewhere else in the body.

Extremities Exam:

Your doctor will look for physical and sensory changes. Pulses can be checked in your arms and legs. Examining joints can assess for abnormalities.

Services: Male Physical Exam

An annual physical exam for men might also include:

• Testicular exam: A doctor can check each testicle for lumps, tenderness, or changes in size. Most men with testicular cancer notice a growth before seeing a doctor.
• Hernia exam: The famous "turn your head and cough" checks for a weakness in the abdominal wall between the intestines and scrotum.
• Penis exam: A doctor might notice evidence of sexually transmitted infections such as warts or ulcers on the penis.
• Prostate exam: Inserting a finger in the rectum lets a doctor feel the prostate for its size and any suspicious areas.

Services: Female Physical Exam

A woman's annual exam might include:

• Breast exam. Feeling for abnormal lumps may detect breast cancer or benign breast conditions. The doctor will also check the lymph nodes in the underarm area and look for visual abnormalities of the breasts and nipples.
• Pelvic exam: The pelvic exam allows examination of the vulva, vagina, cervix, uterus and ovaries. Routine checks for sexually transmitted infections are often done. A Pap test and HPV test can screen for cervical cancer and help assess risk.

For a full and complete comprehensive guide please refer directly to the Florida Department of Eduction's website:

Resources:

FLDOE.GOV

Downloads:

Physical Education Toolkit (PDF, 211 KB)

School Physicals: The Basics

School & Sports Physicals are taken by appointment & walk in.

The comprehensive school physical is $100.00 - which includes the required blue and yellow forms.

It is a complete history and physical exam. If immunizations are required, please bring records. Vaccines price is not included as required vaccines depend entirely the patient's immunization status. Please inquire during your visit. The school physicals are for children entering daycare, preschool, VPK Kindergarten and all grades thereafter. If you have specific questions please call the office for more details.

Services: School Sport Physicals

Sports physicals: The Basics

Sports physicals are usually a part of registering youths for participation in a sport. Schools generally require an evaluation for children to participate, with regulations varying according to the rules of the respective state, school or a sport's governing body. A sports physical helps to assure that the student is healthy and physically ready for their chosen activity such as baseball, football, soccer or track. Before registering, check with the school about their eligibility requirements. The purpose is to help minimize the risk of injury while your child plays.

Physicals for participants in School Sports are $100.00

Other Instructional and Professional Resources:

United States Department of Agriculture (USDA) Team Nutrition Resources
I Can Do It! Program
President's Council on Fitness, Sports and Nutrition
Sample On-hold Wellness Messages (Word)
Sample "Tip of the Day" Messages for Grades K-5 (Word)
Sample "Tip of the Day" Messages for Grades 6-12 (Word)
Palm Beach County Schools Physical Activity Lessons (Word)
Florida's Pedestrian and Bicycle Safety Resource Center
Sunshine State Games
Get Outdoors Florida!
Florida High School Athletic Association (FHSAA)

For the latest forms and updated information on Immigration Physicals please refer directly to the USCIS website:

Resources:

USCIS.GOV

Immigration Physicals: The Basics

The doctors at Boca Raton Family and Pediatric Center have been designated Civil Surgeons by the USCIS and can perform immigration physicals.

Immigration Physicals are done by appointment only.

It is important to bring all your medical records with you including vaccination records. - Please bring your passport and vaccination record. Also, if you want to fill out paperwork ahead of time, you can print and fill out the forms to the right and bring with you to your appointment.

A complete physical examination is required. Several laboratory tests are required. If during your history and physical evidence of any additional illness arises, further tests may be required.

Immigration Physicals: Forms

Please have the following forms ready, when you arrive for your appointment:

Form I-693 Report of Medical Examination and Vaccination Record
New Patient Form (completed)
Office Policies

Forms and Document Downloads:

Form I-693 (PDF, 637.91 KB)
Instructions for Form I-693 (PDF, 340.95 KB)
Office Policies (PDF, 340.95 KB)

These forms were downloaded from the US Citizenship and Immigration.gov.

Please always be sure to use the latest forms. You can do so by checking the USCIS.gov website for further information.

If you need further information or help please do not hesitate to contact us: Contact

General Medicine: The Basics

Internal medicine or general internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Physicians specializing in internal medicine are called internists, or physicians.

Also called family doctors or internists, general practitioners often develop an ongoing relationship with you, providing continuity of care. They treat common medical conditions and perform routine exams. They refer you to other medical services or doctors if you need urgent or specialized treatment.

A general practitioner focuses on your overall health: physical and mental. They serve an important role in a much wider healthcare system. One of their main goals is to keep you healthy and out of the hospital.

In an emergency, a general practitioner can provide life-saving treatment until emergency services arrive.

General practitioners work as a part of a larger team — including nurses, pharmacists, psychiatrists, and others — to support your holistic ( whole-body) care. They’re an essential part of preventative medicine and health education.

The general practitioner’s duties are broad. Some examples of the care they provide include:

• Immunizations
• Routine exams
• Mental health checks
• Chronic (long-term) illness care
• References to specialists
• Follow-up care

Reasons to See a General Practitioner:

General practitioners can help you with many routine and serious conditions. There are several reasons to visit your general practitioner, including:

Wellness Exams and Preventative Medicine

One of the general practitioner’s most important roles is performing routine screenings for health conditions. You may benefit from visiting a general practitioner to check for conditions, such as:

• High blood pressure
• Risk factors for heart disease
• Risk factors for diabetes
• High cholesterol
• Cancer
• Sexually transmitted diseases
• Depression

General practitioners can be instrumental in the early detection of health conditions as well as preventative medicine. If you have a family history of chronic illness, are at-risk for a chronic condition, or are experiencing symptoms, a screening by your general practitioner will benefit your health and peace of mind.

Beyond this, general practitioners are a great resource for staying updated on all necessary immunizations and preventative care.

Urgent Care for Illness or Injury

An equally important duty of the general practitioner is treating illness and injuries. Visit your general practitioner when you’re sick, injured, or experiencing concerning symptoms.

A general practitioner can use lab tests to diagnose illness, prescribe medication as treatment, assess your overall health, and connect you with a specialist if needed.

General practitioners can treat acute (short-term) conditions, such as:

• Minor wounds
• Asthma attacks
• Migraines
• Urinary tract infections
• Colds and flu
• Fever
• Dehydration
• Minor broken bones
• Skin infections or rashes
• Muscle strains and sprains

In the case of a mental health crisis, your general practitioner can connect you with a mental health specialist.

Chronic Conditions

General practitioners can provide prescriptions, lifestyle recommendations, and follow-up care for chronic conditions like heart disease, diabetes, asthma, high blood pressure, and some mental health conditions.

What to Expect at the General Practitioner

A general practitioner appointment typically lasts 10 to 30 minutes. Your general practitioner may:

• Assess your health
• Discuss your medical history and symptoms
• Run diagnostic tests
• Develop a treatment plan
• Advise you about ongoing lifestyle changes
• Give you thorough information about your condition and treatment
• Prescribe medication
• Refer you to a specialist or arrange a follow-up appointment

Healthy Eating for a Healthy Weight

An eating plan that helps manage your weight includes a variety of healthy foods. Add an array of colors to your plate and think of it as eating the rainbow. Dark, leafy greens, oranges, and tomatoes—even fresh herbs—are loaded with vitamins, fiber, and minerals. Adding frozen peppers, broccoli, or onions to stews and omelets gives them a quick and convenient boost of color and nutrients.

According to the Dietary Guidelines for Americans 2020–2025, a healthy eating plan:

• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products
• Includes a variety of protein foods such as seafood, lean meats and poultry, eggs, legumes (beans and peas), soy products, nuts, and seeds.
• Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars
• Stays within your daily calorie needs

Fruit:

Fresh, frozen, or canned fruits are great choices. Try fruits beyond apples and bananas such as mango, pineapple or kiwi fruit. When fresh fruit is not in season, try a frozen, canned, or dried variety. Be aware that dried and canned fruit may contain added sugars or syrups. Choose canned varieties of fruit packed in water or in its own juice.

Vegetables

Add variety to grilled or steamed vegetables with an herb such as rosemary. You can also sauté (panfry) vegetables in a non-stick pan with a small amount of cooking spray. Or try frozen or canned vegetables for a quick side dish—just microwave and serve. Look for canned vegetables without added salt, butter, or cream sauces. For variety, try a new vegetable each week.

Calcium-rich foods:

In addition to fat-free and low-fat milk, consider low-fat and fat-free yogurts without added sugars. These come in a variety of flavors and can be a great dessert substitute.

Meats:

If your favorite recipe calls for frying fish or breaded chicken, try healthier variations by baking or grilling. Maybe even try dry beans in place of meats. Ask friends and search the internet and magazines for recipes with fewer calories ― you might be surprised to find you have a new favorite dish!

Comfort Foods:

Healthy eating is all about balance. You can enjoy your favorite foods, even if they are high in calories, fat or added sugars. The key is eating them only once in a while and balancing them with healthier foods and more physical activity.

Some general tips for comfort foods:

• Eat them less often. If you normally eat these foods every day, cut back to once a week or once a month.
• Eat smaller amounts. If your favorite higher-calorie food is a chocolate bar, have a smaller size or only half a bar.
• Try a lower-calorie version. Use lower-calorie ingredients or prepare food differently. For example, if your macaroni and cheese recipe includes whole milk, butter, and full-fat cheese, try remaking it with non-fat milk, less butter, low-fat cheese, fresh spinach and tomatoes. Just remember to not increase your portion size.

Downloads:

Dietary Guidelines for Americans 2020–2025 (PDF, 31,404 KB)
My Food Diary (PDF, 106 KB)

Overview:

An electrocardiogram records the electrical signals in your heart. It's a common and painless test used to quickly detect heart problems and monitor your heart's health.

Electrocardiograms — also called ECGs or EKGs — are often done in a doctor's office, a clinic or a hospital room. ECG machines are standard equipment in operating rooms and ambulances. Some personal devices, such as smart watches, offer ECG monitoring. Ask your doctor if this is an option for you.

Why it's done:

An electrocardiogram is a painless, noninvasive way to help diagnose many common heart problems in people of all ages. Your doctor may use an electrocardiogram to determine or detect:

• Abnormal heart rhythm (arrhythmias)
• If blocked or narrowed arteries in your heart (coronary artery disease) are causing chest pain or a heart attack
• Whether you have had a previous heart attack
• How well certain heart disease treatments, such as a pacemaker, are working

You may need an ECG if you have any of the following signs and symptoms:

• Chest pain
• Dizziness, lightheadedness or confusion
• Heart palpitations
• Rapid pulse
• Shortness of breath
• Weakness, fatigue or a decline in ability to exercise

The American Heart Association doesn't recommend using electrocardiograms to assess adults at low risk who don't have symptoms. But if you have a family history of heart disease, your doctor may suggest an electrocardiogram as a screening test, even if you have no symptoms.

If your symptoms tend to come and go, they may not be captured during a standard ECG recording. In this case your doctor may recommend remote or continuous ECG monitoring. There are several different types.

For a full and complete comprehensive guide please refer directly to the CDC's website, for the latest information on Flu Vaccines:

Resources:

CDC.GOV



Downloads:

Vaccine Information Statements (VIS) (PDF, 131 KB)
A Strong Defense Against Flu: Get Vaccinated (PDF, 579 KB)

What is a flu vaccine?

Influenza (flu) vaccines (often called “flu shots”) are vaccines that protect against the four influenza viruses that research indicates most common during the upcoming season. Most flu vaccines are “flu shots” given with a needle, usually in the arm, but there also is also a nasal spray flu vaccine.

Is there more than one type of flu shot available?

Yes. There are different flu vaccine manufacturers and multiple influenza vaccine products licensed and recommended for use in the United States.

CDC recommends use of any licensed, age-appropriate influenza vaccine during the 2021-2022 influenza season. Available influenza vaccines include including quadrivalent inactivated influenza vaccines [IIV4s], recombinant influenza vaccine [RIV4], or live attenuated influenza vaccine (LAIV4). No preference is expressed for any influenza vaccine over another.

Quadrivalent flu vaccines include:

• Standard-dose quadrivalent influenza shots that are manufactured using virus grown in eggs. These include Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent. Different influenza shots are licensed for different age groups. These four vaccines are approved for people 6 months of age and older. Most influenza shots are given in an arm muscle with a needle. One quadrivalent influenza shot (Afluria Quadrivalent) can be given either with a needle (for people aged 6 months and older) or with a jet injector (for people aged 18 through 64 years only).
• A quadrivalent cell-based influenza shot (Flucelvax Quadrivalent) containing virus grown in cell culture, which is licensed for people 4 years and older. This vaccine is egg-free.
• Recombinant quadrivalent influenza shot (Flublok Quadrivalent), an egg-free vaccine, approved for people 18 years and older.
• A quadrivalent flu shot using an adjuvant (an ingredient that helps create a stronger immune response), Fluad Quadrivalent, approved for people 65 years of age and older.
• A quadrivalent high-dose influenza vaccine Fluzone High-Dose, which contains a higher dose of antigen to help create a stronger immune reseponse, licensed for people 65 years and older.
• A live attenuated influenza vaccine (FluMist Quadrivalent), which is given intranasally. This vaccine is approved for people 2 through 49 years of age. Live attenuated influenza vaccine should not be given to people who are pregnant, immunocompromised persons, and some other groups.
• There are many flu vaccine options to choose from, but the most important thing is for all people 6 months and older to get a flu vaccine every year. If you have questions about which vaccine is best for you, talk to your doctor or other health care professional. More information on approved flu vaccines for the 2020-2021 flu season, and age indications for each vaccine are available in CDC’s Table: U.S. Influenza Vaccine Products for the 2020-2021 Season.

Who should and who should not get a flu vaccine?

Everyone 6 months of age and older should get an influenza (flu) vaccine every season with rare exception. CDC’s Advisory Committee on Immunization Practices has made this recommendation since the 2010-2011 influenza season.

Vaccination to prevent flu and its potentially serious complications is particularly important for people who are at higher risk of developing serious flu complications.

Different influenza (flu) vaccines are approved for use in people in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to flu vaccine or its components.

How effective is the seasonal flu shot?

Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, it is possible to measure substantial benefits from flu vaccination in terms of preventing flu illness and complications. However, the benefits of flu vaccination will still vary, depending on characteristics of the person being vaccinated (for example, their health and age), what influenza viruses are circulating that season and, potentially, which type of flu vaccine was used.

There are many reasons to get an influenza (flu) vaccine each year. Flu vaccination is the best way to protect yourself and your loved ones against flu and its potentially serious complications.

Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits:

• Flu vaccination can keep you from getting sick with flu.
• Flu vaccination prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020 flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
• Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.
• A 2021 studyexternal icon showed that among adults, flu vaccination was associated with a 26% lower risk of ICU admission and a 31% lower risk of death from flu compared to those who were unvaccinated.
• A 2018 studyexternal icon showed that among adults hospitalized with flu, vaccinated patients were 59 percent less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.
• Flu vaccination can reduce the risk of flu-associated hospitalization.
• Flu vaccination prevents tens of thousands of hospitalizations each year. For example, during 2019-2020 flu vaccination prevented an estimated 105,000 flu-related hospitalizations.
• A 2014 studyexternal icon showed that flu vaccination reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74 percent during flu seasons from 2010-2012. A 2017 study found that during 2009-2016, flu vaccines reduced the risk of flu-associated hospitalization among older adults by about 40 percent on average.
• A 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent.
• Flu vaccination is an important preventive tool for people with certain chronic health conditions.
• Flu vaccination has been associated with lower rates of some cardiac eventsexternal icon among people with heart disease, especially among those who have had a cardiac event in the past year.
• Flu vaccination can reduce the risk of a flu-related worsening of chronic lung disease (for example, chronic obstructive pulmonary disease (COPDexternal icon) requiring hospitalization.
• Among people with diabetesexternal icon and chronic lung diseaseexternal icon, flu vaccination also has been shown in separate studies to be associated with reduced hospitalizations from a worsening of their chronic condition.
• Flu vaccination helps protect pregnant people during and after pregnancy.
• Vaccination reduces the risk of flu-associated acute respiratory infection in pregnant people by about one-half.
• A 2018 studyexternal icon showed that getting a flu shot reduced a pregnant person’s risk of being hospitalized with flu by an average of 40 percent from 2010-2016.
• A number of studies have shown that in addition to helping to protect pregnant people from flu, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when he or she is too young to be vaccinated.
• Flu vaccine can be lifesaving in children.
• A 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from flu.
• Getting vaccinated yourself may also protect people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions.

Despite the many benefits offered by flu vaccination, only about half of Americans get an annual flu vaccine and flu continues to cause millions of illnesses, hundreds of thousands of hospitalizations and tens of thousands of deaths. Many more people could be protected from flu if more people got vaccinated.

What are the side effects that could occur?

Common side effects from a flu shot include soreness, redness, and/or swelling where the shot was given, headache (low grade), fever, nausea, muscle aches, and fatigue. The flu shot, like other injections, can occasionally cause fainting.

Can severe problems occur?

Life-threatening allergic reactions to flu shots are very rare. Signs of serious allergic reaction can include breathing problems, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat, or dizziness. If they do occur, it is usually within a few minutes to a few hours after receiving the shot. These reactions can occur among persons who are allergic to something that is in the vaccine, such as egg protein or other ingredients. While severe reactions are uncommon, you should let your doctor, nurse, clinic, or pharmacist know if you have a history of allergy or severe reaction to influenza vaccine or any part of flu vaccine.

There is a small possibility that flu vaccine could be associated with Guillain-Barré syndrome, generally no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine.

What should I do if I have had a serious reaction to seasonal flu vaccine?

Call a doctor or get to a doctor right away.

Tell your doctor what happened, the date and time it happened, and when you got the flu shot.

Why do some people not feel well after getting a flu shot?

Flu vaccine side effects are generally mild and go away on their own within a few days. Some side effects that may occur from a flu shot include soreness, redness, and/or swelling where the shot was given, headache (low grade), fever, nausea, muscle aches, and fatigue. The flu shot, like other injections, can occasionally cause fainting.

What about people who get a seasonal flu vaccine and still get sick with flu symptoms?

• One reason is that some people can become ill from other respiratory viruses besides flu such as rhinoviruses, which are associated with the common cold.  These viruses can cause symptoms similar to flu, and also spread and cause illness during flu season. Flu vaccines only protect against flu and its complications, not other illnesses.
• Another explanation is that it is possible to be exposed to flu viruses, shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This exposure may result in a person becoming sick with flu before protection from vaccination takes effect.
• A third reason why some people may experience flu symptoms despite getting vaccinated is that they may have been exposed to a flu virus that is very different from the vaccine viruses. The ability of a flu vaccine to protect a person depends largely on the similarity or “match” between the vaccine viruses chosen to make vaccine and those spreading and causing illness. There are many different flu viruses that spread and cause illness among people.
• The final explanation for experiencing flu symptoms after vaccination is that flu vaccines vary in how well they work and some people who get vaccinated still get sick with flu. When that happens, though, vaccination has been shown in several studies to reduce severity of illness in those people who get but still get sick.

What protection does a flu vaccine provide if I do get sick with flu?

Some people who get vaccinated may still get sick. However, flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick:

• A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients.
• Another study in 2018 showed that a vaccinated adult who was hospitalized with flu was 59% less likely to be admitted to an intensive care unit (ICU) than someone who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.
In addition, it’s important to remember that flu vaccine protects against three or four different viruses and multiple viruses usually circulate during any one season. For these reasons, CDC continues to recommend flu vaccination for everyone 6 months and older even if vaccine effectiveness against one or more viruses is reduced.

Special Consideration Regarding Egg Allergy

People with egg allergies can receive any licensed, recommended age-appropriate influenza vaccine (IIV4, RIV4, or LAIV4) that is otherwise appropriate. People who have a history of severe egg allergy (those who have had any symptom other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions. Two completely egg-free (ovalbumin-free) flu vaccine options are available: uadrivalent recombinant vaccine and quadrivalent cell-based vaccine.

For a full and complete comprehensive guide please refer directly to the CDC's website, for the latest information on Immunizations:

Resources:

CDC.GOV



Downloads:

adult-combined-schedule (PDF, 159 KB)
adult-schedule Black and White (PDF, 151 KB)

Recommended Adult Immunization Schedule for ages 19 years or older, United States, 2021

¶ = Recommended vaccination for adults who meet age requirement, lack documentation of vaccination, or lack evidence of past infection
§ = Recommended vaccination for adults with an additional risk factor or another indication
± = Recommended vaccination based on shared clinical decision-making
⇒ = No recommendation/Not applicable

For a full and complete comprehensive guide please refer directly to the CDC's website, for the latest information on Immunizations:

Resources:

CDC.GOV



Downloads:

0-18yrs-child-combined-schedule (PDF, 543 KB)
0-18yrs-child-combined-schedule Black and White (PDF, 727 KB)

Recommended Child and Adolescent Immunization Schedule for ages birth to 15 months or younger, United States, 2021

¶ = Range of recommended ages for all children
†= Range of recommended ages for catch-up immunization
§ = Range of recommended ages for certain high-risk groups
± = Recommended based on shared clinical decision-making or *can be used in this age group
• = No recommendation/Not applicable

For a full and complete comprehensive guide please refer directly to the CDC's website, for the latest information on Immunizations:

Resources:

CDC.GOV



Downloads:

0-18yrs-child-combined-schedule (PDF, 543 KB)
0-18yrs-child-combined-schedule Black and White (PDF, 727 KB)

Recommended Child and Adolescent Immunization Schedule for ages 18 Months to 18 Years or younger, United States, 2021

¶ = Range of recommended ages for all children
†= Range of recommended ages for catch-up immunization
§ = Range of recommended ages for certain high-risk groups
± = Recommended based on shared clinical decision-making or *can be used in this age group
• = No recommendation/Not applicable

What is medication management and who should consider it?

Medications play a critical role in the treatment of various mental health issues. The right medication can reduce or eliminate symptoms and significantly improve a patient’s quality of life.

However, mental health professionals are keenly aware that the efficacy of medications vary from patient to patient. Although it may seem random, trained professionals know how to account for various factors, including medical history and medication plan.

Medication management is a level of outpatient treatment that involves the initial evaluation of the patient’s need for psychotropic medications, the provision of a prescription, and ongoing medical monitoring related to the patient’s use of the psychotropic medication by a qualified physician/prescriber. Medication management includes monitoring, reconciling medications, and ensuring patients get the desired outcomes. It requires a thorough review of prescribed drugs and their possible side effects to create treatment plans and monitor their safety and efficacy.

Better Health And Health Care For Older Adults

In 2018 the US population ages sixty-five and older numbered 52.4 million, with older adults representing 15.6 percent of the population. By 2030, 20 percent of Americans will be age sixty-five or older. The most striking aspect of this population is its heterogeneity. In 2017, 23 percent of older Americans were members of racial and ethnic populations, and this percentage will increase by an estimated 135 percent between 2017 and 2040, compared with 36 percent for the non-Hispanic White population.2 And although stereotypes portray older people as frail, disengaged, and cognitively impaired, many are industrious, creative, and intelligent into the tenth decade of life.

Because of momentous advances in science and technology, the knowledge and skills exist to provide excellent preventive and clinical care to this cohort. What is now needed is the policy, and the will, to take collective action to ensure that all older adults are engaged in health promotion and disease prevention and receive equitable, person-centered, high-quality care. Effective policies are needed that can bridge the gaps between public health, health care, and other sectors of the economy, focusing on social determinants of health and preventive measures to reduce the burden of chronic disease while also providing person-centered care to those with serious illness.

Blood testing and why its important:

Here are some reasons that you may need your blood drawn:

As part of a wellness physical (which screens for a number of different things like thyroid and metabolic issues).

• complete blood count (CBC)
• chemistry (basic metabolic) panel
• thyroid panel
• nutrient tests for levels of vital nutrients, such as iron or B vitamins
• If your doctor wants to check your cholesterol levels
• To test for diabetes
• To see if you have allergies to foods or any other substances
• To check for the Mono or Epstein-Barr virus
• To find out if you have a vitamin or mineral deficiency

Some other tests that you may want include:

• enzyme markers if you’re at risk for cancer or other conditions like liver cirrhosis, stroke, or celiac disease
• sexually transmitted disease (STD) tests if you have multiple sexual partners or a new partner

Even if you have to come back for the draw, such as when you are required to fast for more accurate results, at least you can come back to a location that you are familiar with and comfortable in. No going to a lab where you’re just another person waiting for a blood draw. Here, you’re family. Regular blood testing is one of the most important ways to keep track of your overall physical well-being.

Getting tested at routine intervals can allow you to see the way your body changes over time and empower you to make informed decisions about your health.

How often should I get routine blood work?

We will typically recommend that you get routine blood work at least once a year, around the same time as your yearly physical.

But this is the bare minimum. There are several major reasons you may want to get blood tests more often than that:

• You’re experiencing unusual, persistent symptoms.These could include anything from fatigue to abnormal weight gain to new pain.
• You want to optimize your health. Knowing levels of various blood components, such as HDL and LDL cholesterol, can allow you to tweak your diet or fitness plan to minimize unhealthy habits (that you may not even realize are unhealthy). This can also maximize the nutrients you put in your body and more.
• You want to reduce your risk of disease or complications. Regular blood tests can catch the warning signs of almost any disease early. Many heart, lung, and kidney conditions can be diagnosed using blood tests.

Talk to your doctor first if you want to get certain tests more often than once a year.

Services: Urinalysis:

Urinalysis: Overview

A urinalysis is a test of your urine. A urinalysis is used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes.

A urinalysis involves checking the appearance, concentration and content of urine. Abnormal urinalysis results may point to a disease or illness.

For example, a urinary tract infection can make urine look cloudy instead of clear. Increased levels of protein in urine can be a sign of kidney disease. Unusual urinalysis results often require more testing to uncover the source of the problem.

Why it's done

A urinalysis is a common test that's done for several reasons:

• To check your overall health. Your doctor may recommend a urinalysis as part of a routine medical exam, pregnancy checkup, pre-surgery preparation, or on hospital admission to screen for a variety of disorders, such as diabetes, kidney disease and liver disease.
• To diagnose a medical condition. Your doctor may suggest a urinalysis if you're experiencing abdominal pain, back pain, frequent or painful urination, blood in your urine, or other urinary problems. A urinalysis may help diagnose the cause of these symptoms.
• To monitor a medical condition. If you've been diagnosed with a medical condition, such as kidney disease or a urinary tract disease, your doctor may recommend a urinalysis on a regular basis to monitor your condition and treatment.

Other tests, such as pregnancy testing and drug screenings, also may rely on a urine sample, but these tests look for substances that aren't included in a typical urinalysis. For example, pregnancy testing measures a hormone called human chorionic gonadotropin (HCG). Drug screenings detect specific drugs or their metabolic products, depending on the purpose of the testing.

How you prepare

If your urine is being tested only for a urinalysis, you can eat and drink normally before the test. If you're having other tests at the same time, you may need to fast for a certain amount of time before the test. Your doctor will give you specific instructions.

Many drugs, including nonprescription medications and supplements, can affect the results of a urinalysis. Before a urinalysis, tell your doctor about any medications, vitamins or other supplements you're taking.

What you can expect

Depending on your situation, you may collect a urine sample at home or at your doctor's office. Your doctor will provide a container for the urine sample. You may be asked to collect the sample first thing in the morning because at that time your urine is more concentrated, and abnormal results may be more obvious.

To get the most accurate results, the sample may need to be collected midstream, using a clean-catch method. This method involves the following steps:

• Cleanse the urinary opening. Women should spread their labia and clean from front to back. Men should wipe the tip of the penis.
• Begin to urinate into the toilet.
• Pass the collection container into your urine stream.
• Urinate at least 1 to 2 ounces (30 to 59 milliliters) into the collection container.
• Finish urinating into the toilet.
• Deliver the sample as directed by your doctor.
• If you can't deliver the sample to the designated area within 60 minutes of collection, refrigerate the sample, unless you've been instructed otherwise by your doctor.

The urine sample is sent to a lab for analysis. You can return to your usual activities immediately.

Results

For a urinalysis, your urine sample is evaluated in three ways: visual exam, dipstick test and microscopic exam.

About Preventive Medicine

Preventive medicine is a medical specialty recognized by the American Board of Medical Specialties (ABMS), which focuses on the health of individuals and communities. The goal of preventive medicine is to promote health and well-being and prevent disease, disability and death.

Preventive medicine specialists are licensed medical doctors (MD) or doctors of osteopathy (DO) who possess expertise in a broad range of health care skills, including biostatistics, epidemiology, planning and evaluation of health services, management of health care organizations, research, and the practice of prevention in clinical settings. They apply their knowledge and skills in medicine, social, economic, and behavioral sciences to improve the health and quality of life of individuals, families, communities and populations through disease prevention and health promotion.

Preventive medicine has three sub-specialty areas: public health and general preventive medicine, occupational medicine, and aerospace medicine.

Urgent Care Guide

In a recent survey conducted with the Urgent Care Association, we found that patients were waiting an average of 24 days for appointments with their primary care provider. In a world of instant gratification, consumers demand more. They demand now. If you want to watch a movie, you download it in minutes or stream it instantly. If you need groceries, you can pick up your phone and have them delivered to you within the hour. If you need restaurant reservations, you find one with availability, book online, walk in minutes later and sit right down. Healthcare shouldn’t be any different.

That’s why urgent care has been growing at a faster pace than any other healthcare service in the United States. And it is why healthcare consumers search for “urgent care” more than 5x more than “primary care” or “family doctor,” combined. These consumers are highly actionable, searching with high intent terms like “urgent care near me.” They want same day access to quality healthcare providers when they are sick or injured - after hours, one weekends and on holidays - without the cost and inconvenience of the emergency room.

Urgent care centers typically treat minor illnesses like the flu, sinus infections and strep throat, as well as injuries like bone fractures and sprains, cuts, scrapes and burns, making these clinics ideal for diagnosing and treating non-emergent healthcare needs. And at a growing rate urgent care clinics are offering preventative care services including annual physicals and well visits, flu shots and other immunizations and vaccines, taking on the role of primary care provider for the tens of millions of consumers that don’t have one.

For kids there we also specialize in pediatric urgent care centers, for patients between the ages of 1 and 18.

Services & Pricing

Urgent care centers, which are part of the walk-in clinic healthcare category, are a convenient resource for consumers needing treatment for minor illnesses and injuries. Services that you would normally receive at your primary care office are usually available at an urgent care including annual and school physicals, flu shots and immunizations, treatment for illnesses including colds, flu stomach pains, sinus and ear infections and more. You can also be seen for injuries such as burns, bites, sprains and breaks - things that you might first thing to go to the emergency room vs urgent care; but you’ll have a shorter wait and smaller bill at the urgent care. As for cost, without insurance, you should expect between $100-140 for your visit, plus the cost of any labs, tests or images. With insurance, urgent care will be similar to seeing a specialist with applicable co-pay.

Insurance & Payments

Nearly all urgent care centers take commercial insurance and many (if not most) will take medicare. As such if you have insurance coverage, you can expect the financial experience to be similar to visiting a specialist where you have a co-pay, usually $35-50, due at the time of the visit. Any additional lab work, x-rays or other tests performed will be billed against your insurance first and any supplemental balance due will be invoiced to you after the fact. Without insurance, you’ll pay a visit fee between $100-140 at the time of your visit. This is typically 25-50% more than your primary care provider, but usually the convenience is well worth the additional cost. If you are interested in a telehealth or video visit, your cost could be as much as 50% less than an urgent care, you could be diagnosed and prescribed medication and you’ll never have to leave your home.

Hours & Wait Times

Wait times varies; if you have an appointment then your wait time will be based off of the scheduled date/time. If you are a walk-in, we schedule you based off of the charts for the day.

Our hours of operations is:

What to Expect During Your First Well Woman Exam

The annual well woman exam often makes women feel nervous or uncomfortable, especially if it’s your first one. If it’s time to schedule your first well woman exam, it can help to know exactly what to expect to help you feel prepared and at ease during your appointment.

Why Do You Need an Annual Well Woman Exam?

It’s completely understandable to feel anxious before your first well woman exam, but it’s important not to delay scheduling your appointment. You should schedule your first well woman exam when you become sexually active or when you turn 21. You should also schedule an exam if you experience any menstrual irregularities or pelvic pain.

A well woman exam is the only way to detect early stages of cervical cancer, and it’s the first line of defense against diseases of the female reproductive system. That’s why it’s so important to be diligent with scheduling your annual exam.

What to Expect During Your First Well Woman Exam

A well woman exam will start like any other doctor’s appointment. You will be asked to fill out paperwork with questions about your family medical history, any medications you’re taking, general demographic information, your menstrual cycle, whether or not you’re sexually active, and if you’ve been pregnant before. A nurse will take your height, weight, and blood pressure and may ask follow-up questions about your intake forms. They will then give you a dressing gown and leave the room so you can change.

There are four parts of the well woman exam: the physical exam, breast exam, pelvic exam, and pap smear.

Physical Exam

The physical exam is much like what your general practitioner would do during an annual physical, but it can be more convenient to get your physical done at the same time as your well woman exam. Your gynecologist will review your medical history and ask about any current issues. They will check your vital signs, heartbeat, lungs, head, neck, abdomen and reflexes. Sometimes they will ask for blood work or a urine sample.

Breast Exam

Breast exams help detect early signs of breast cancer. During the breast exam, your gynecologist will look for lumps or irregularities in your breasts. They will also teach you how to perform a self-examination, which you should do once every month.

Pelvic Exam

The dreaded pelvic exam helps detect early stages of cancer, sexually transmitted diseases, and any causes of inflammation. During the pelvic exam, your doctor will ask you to lie down with your feet elevated on leg rests. Your gynecologist will examine the outside of your vagina for redness, irritation, discharge, and any signs of other conditions. Then, they will examine the size and position of your ovaries, uterus, cervix, and vagina by inserting the fingers of one hand into the vagina while the other hand presses down on your abdomen from the outside. Women 21 and older should get a pelvic exam once per year. If you are under the age of 21, you should get a pelvic exam if you experience menstrual irregularities, vaginal discharge, or pelvic pain.

Pap Smear

A pap smear helps to detect early forms of cervical cancer. Your gynecologist will insert a small brush or spatula to gently scrap a tissue sample from the cervix while the speculum is in place. A pap smear shouldn’t be painful, but you will likely feel a brief pinching sensation. If you are 21 or older, or are sexually active, you should have a pap smear test done every other year.

Schedule Your First Well Woman Exam

We know that many women feel anxious about their annual well woman exams, especially if it’s your first. At Walnut Hill OB/GYN, we try to make your first well woman exam comfortable and easy, so we can detect irregularities and concerns as early as possible. Contact us today at (+1) 561-477-2862 to schedule your annual well-woman exam.

Pediactric Medicine

Routine well-child visits are scheduled with that doctor. However, there may be times when a family requires advice or an acute office visit and the primary doctor is unavailable. Because the doctors, nurses and office staff work as a team they can offer assistance. The physicians frequently collaborate with each other and every patient's record is available to the other medical staff members. They can easily review ongoing medical problems, prescription medications, lab results and previous consultations.

This site will give you a lot of information about our practice but don't hesitate to contact us by phone if you have unanswered questions.

The Pediatrician

A pediatrician is a medical doctor who treats children. They provide:

• Preventive health maintenance and ongoing monitoring for healthy children.
• Medical care for children who are acutely or chronically ill.
• Coordination of care for children after hospital discharge

Pediatricians manage the physical, mental, and emotional well-being of children. This is in every stage of development, in good health or in illness.

Generally, pediatricians focus on babies, children, teens, and young adults from birth to about age 21 to:

• Reduce infant and child mortality.
• Control infectious disease.
• Foster healthy lifestyles.
• Ease the problems of children and teens with chronic conditions.
• Make sure that kids have the correct development and preventive health screenings.

Pediatricians advise on, diagnose, and treat many different diseases, including:

• Infections
• Injuries
• Genetic defects
• Malignancies
• Organic diseases and dysfunctions

Pediatricians are concerned with more than physical health. They also are involved with the prevention, early detection, and management of other problems that affect children and teens. These include:

• Behavioral problems
• Developmental disorders
• Functional problems
• Social stresses
• Mental health disorders, such as depression or anxiety

Ear Piercing

Ear piercing is something a lot of children want to have done. And sometimes parents want to have their child’s ears pierced when they are infants. The reasons behind ear piercing in children can be cultural or cosmetic, but it is not medically necessary. However, that doesn’t mean it isn’t something your pediatrician can take care of. If you’re thinking about getting your child’s ear pierced, you should have it done in the pediatrician’s office.

Risks of Ear Piercing for Kids

There are risks associated with ear piercing for kids, with infection being the most common. Allergies are also sometimes an issue, and in rare cases, piercings can tear.

• Infection:There is a risk of all ear piercings getting infected, but with children, the risk can be greater, especially when they are very young. If a child is not old enough or responsible enough to care for their own ear piercings, then it falls on parents to keep them clean and healthy.

Also, in very young infants, the risks associated with infections are greater. If an infection develops in a piercing and presents with a fever, babies younger than three months may have to be admitted to the hospital, depending on protocols. For this reason, many pediatricians will not pierce a baby’s ears until later, usually around 4 months. At the very least, the baby should have received their first round of vaccinations before having their ears pierced.

• Allergies: Sometimes children will have an allergic reaction to the materials used in earrings. That’s because some metals contain nickel, a common allergen for a lot of people. It’s recommended that one use only earrings made of either a precious metal like gold or another nickel-free metal like titanium or surgical steel.
• Tearing: People of all ages are at risk of tearing the piercing site if the earring gets pulled or snags on something. This is mostly an issue with long, dangling earrings. Children should only wear stud earrings that don’t dangle until they are older. After studs, a type of earring called a “huggie” that is more like a hoop, but stays close to the earlobe is recommended.

Why a Pediatrician Should Pierce Kids’ Ears

While there are risks for ear piercing in kids, they can be minimized by having your pediatrician do it instead of having it done at a retail jewelry store. Many pediatricians offer pediatric ear piercing as a regular service. Your insurance won’t cover ear piercing, but the fee is usually minimal and will include the earrings and the piercing itself.

Here are some good reasons to have your child’s ears pierced by a pediatrician:

They Know Your Child: If you take your child to their regular pediatrician to have their ears pierced, then the doctor will already be familiar with your child and their medical history. They’ll be able to see your child’s vaccination history to ensure they have received the recommended immunizations before piercing.

Also, your child may be more comfortable with a doctor or nurse practitioner they know than a stranger at a jewelry store. The more relaxed they are, the easier the process will be.

• You Know You’re in a Safe Environment: You can be confident that a pediatrician’s office is a safe and clean place for the piercing to take place. The staff of a doctor’s office takes great care to make sure everything is sanitized and all equipment used is sterilized properly.
• They Use the Best Equipment and Materials: Another reason ear piercing for kids should be done by a pediatrician is because of the equipment used. The pediatrician will be able to use medical-grade piercers rather than a standard piercing gun you’d see at the mall or other retail stores. Also, medical providers will use earrings made of the right materials to reduce the risk of an allergic reaction. Most doctors use earrings made of titanium, surgical steel, or precious metal.
• They’re Medical Professionals: Bottom line is that the pediatrician is trained to give your child the best care in all areas, including ear piercing. They can also offer clear and comprehensive aftercare instructions and are there to follow up if there are any problems like infection after the piercing is done.

Ear Piercing Safety and Care

After your child’s ears are pierced, you should carefully follow the instructions your pediatrician gives you to care for the new piercings. The American Academy of Pediatricians has comprehensive guidelines on how to avoid infections after ear piercing, but here are the basics.

• Leave earrings in for at least 6 weeks after the piercing. This is the standard length of time a piercing takes to heal and if earrings are removed before this point, then the hole may close.
• Stick to post or stud earrings for the first several months after piercing. Very small children should wear studs until they get older.
• Don’t touch a piercing unless you are cleaning it.
• Wash hands before touching a piercing to clean it.
• Regularly clean ear piercings two to three times a day. Use alcohol on a cotton swab and clean the front and back of the piercing. Make sure to get to the actual piercing under the earring.
• Ensure the back of the earring is on and secure (but not on too tight) during cleaning.
• Rotate the post of the earring gently during each cleaning.
• Take care not to pull on earrings when washing or brushing hair to prevent tears.
• Try to keep your child out of hot tubs, pools, and natural bodies of water during healing if possible. A lot of people swim with newly pierced ears and are fine, but exposure to the water may increase the chance of infection. If children do go swimming, make sure to clean the piercings afterward.
• Keep an eye out for symptoms of infection like itchiness, redness, pain or sensitivity, and discharge. Take your child to see the doctor if those symptoms appear.

Resources:

The American Academy of Pediatricians