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Pre-Existing Conditions Update:
Jennifer Delaney, MD

 Attorney General Josh Hawley has joined a law suit with 18 other Attorneys General seeking to make the Affordable Care Act unconstitutional. If the law suit succeeds, then all provisions of the Act will be void, including the provision that bans insurance companies from excluding people with pre-existing conditions from obtaining insurance.  This means that the 27 percent of the Missouri population that has pre-existing conditions might lose their health insurance, be charged higher premiums or have coverage for the pre-existing condition excluded from their benefits.  If you have significant pre-existing conditions, this may have a major impact on the cost of your insurance.

Also, if you are enrolled in supplemental insurance for Medicare, if you switch between plans, your co-insurance and copayments for pre-existing conditions may not be covered for 6 months, depending on the plan.  Please take care when switching plans to avoid significant out of pocket costs.
Aspirin-Yes or No?
David Katzman, MD

While it has been clearly established that a daily aspirin is beneficial in preventing heart attack or stroke in those who have established vascular disease, doctors have also recommended it as a preventative measure in those over 50 or who have risk factors for vascular disease (hypertension, tobacco use, diabetes, high cholesterol or family history).  This practice has recently been challenged in a study published in the New England Journal of Medicine.

In this study, 19,000 patients over age 65 without established vascular disease were randomly assigned to aspirin or placebo and then followed for 5 years.  Surprisingly, those who took aspirin had a slightly higher mortality rate than those taking placebo.  This unexpectedly stemmed from a slightly higher rate of cancer death in those taking aspirin than placebo.  Moreover, there did not seem to be a mortality benefit in those with the traditional risk factors for vascular disease noted above.

This is a pretty convincing practice-changing study.  Aspirin clearly has risks such as bleeding or stomach ulcers, and possibly cancer now too, although this potential side effect needs further evaluation.  It clearly benefits those who have had heart attacks, cardiac rhythm issues, strokes and established vascular disease in the legs or carotid arteries, and certainly should be continued in this group.

In summary, most people should not take a daily aspirin for prevention of heart attack or stroke.  If you have multiple risk factors for heart or vascular disease, or have excessive plaquing in your arteries seen on any x-rays, it may be worthwhile as a preventative measure.  Please feel free to discuss this with us at your next visit!



News Blast:
Medicare Advantage is an HMO.
This means that you will have restricted access to physician networks and we may be unable to get the prior authorization you require for testing as we are not in the network for Medicare Advantage.

Gardasil, the HPV vaccine that protects against cervical cancer, anal cancer and head cancer is now approved for women and men up to 45 years of age.  HPV is spread through intimate contact with a sexual partner.  Please let us know if you are interested in receiving the vaccine.

FLU VACCINE is here! Please call the office to schedule your flu shot! We have the High Dose vaccine recommended for people 65 years and older and the Quadrivalent vaccine that contains 4 inactivated influenza strains for greater coverage.

Welcome the newest member of our team!

Welcome Jane Kozlowski, BSN. Jane will be working part time in our office as the new office manager. Jane grew up in the St. Louis area and is a graduate of St. Louis University School of Nursing. She has worked the past 10 years at Missouri Baptist Medical Center in community health and education.  

I will continue my work at BJC in Community Health and also enjoy the extra day off during the week to spend with my family! I will miss talking with and seeing the many of you that were "regulars" in the office on my Monday and Friday work days. I wish I could of had more time to get to know every one of you! Jane will be a great addition to the team!

Thank you!
Lauri Slyman, RN

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