Blue Care Network Best Practices
Detroit physician says cholesterol screening benefits all patients
Not only do all of Dr. Barry Braver’s patients with cardiovascular conditions get the recommended LDL-C screening; all of his patients are screened.
“By doing a thorough exam that includes blood work, we can find problems before they become acute,” says Dr. Braver. “We see every visit as an opportunity to evaluate the patient clinically.”
Dr. Braver stresses to his patients the importance of proper education about cholesterol and a healthy diet. “It’s important for the patient to understand what we’re doing and why we are doing it, so the patient can be an active participant in their care and we can expect better outcomes.”
Every patient is required to do a baseline cholesterol screening. Dr. Braver notes that ischemic heart disease can start in childhood. “In an era where McDonald’s is pervasive, it’s more incumbent on health care professionals to educate patients about healthy lifestyles,” he said. He also notes that hyperlipidemia is not uncommon in young children.
There are benefits to screening every patient. “We look for the things that don’t always jump out at you,” says Dr. Braver. “When we evaluate patients, we are proactive in their care and can find things that will become a problem for them so we’re not playing catch-up.”
Patients with high cholesterol levels and heart disease require more regular follow-up visits. They may also have other conditions, Dr. Braver says. “I don’t see coronary artery disease as an end result. Patients usually don’t just have coronary artery disease; patients usually have arterial vascular disease.”
Patients have their blood drawn at the office. When results come back from the lab, patients are notified immediately. Dr. Braver may recommend follow-up care and lifestyle changes. In some instances, patients undergo further evaluation.
Demonstrating the importance of testing all patients, Dr. Braver recounts an example of a 50-year old female patient with elevated LDL cholesterol and no symptoms. Dr. Braver says he recommended a diet and exercise program. “Before recommending an exercise program, I wanted to make sure she could tolerate the exercise,” he said. “So I did an EKG and it showed she had i phasic T-waves in the anterior leads. I questioned if she was having shortness of breath and chest pain. I evaluated the patient further after she said no. After the evaluation, I ordered a CTA, and found she had 90 percent occlusion in her heart. When the cardiologist called me, we had the patient go directly to the hospital to have a stent inserted. That further evaluation saved her life.”