Frequently Asked Questions

Procedures

Quantitative Sensory Nerve Conduction Studies

Procedure Description:
See Dr. Zebley Home Page

What To Expect:
This test does not use sharp needles or electrical current. Painless it does require your full active participation

Preprocedure:
Discuss payment options with Dellie prior to scheduling this test which may last as long as 45 mins and cost up to $400.00 for a full diabetic nerve conduction analysis.

Postprocedure:
Dr. Zebley will analyse the test and ask that you come in for a consultation to discuss the results. In some simple cases a written report, e-mail, or phone report will be sufficient. There is usually, however, need to review the results in depth and plan a treatment regimen or arrange a further consultation to a specialist or surgeon for resolution of the nerve conduction deficit.



Physical Therapy

Procedure Description:
Neuromuscular Re-education

What To Expect:
This procedure is for acute and chronic pain. It uses electrodes strategically placed over certain points on the body.

Preprocedure:
No grease or oils on the areas to be treated. Bring a book as the treatments last 30 to 45 minutes.

Postprocedure:
A treatment course consists of 5 to 10 treatments (see Dr. Zebley's home page for more details)



Staff Information


I have transitioned this practice to an MDVIP practice. See my web site for details.

Mrs. Dahlia Payne remains in charge of referrals. Mark continues to "man" the desk in the mornings from 0800 to 1400 hrs. Heather and Dellie provide the clinical services and Mrs. Zebley handles chart extractions and transfers.

Laboratory studies for the MD VIP physical will be performed at Quest labs at no charge to you. We will absorb that expense aspart of your MDVIP benefit.

The rest of the year it is however very important to check your health insurance requirements as the lab request process becomes more and more complicated. Careful attention to this on your part should also avoid the occasional sample going to the incorrect facility (Quest vs LabCorps
vs Calvert Labs). Such an administrative error cna end up costing you hundreds of dollars if
your insurance refuses to pay for the laboratory services!

We have a dedicated phlebotomist (Harold) on Tuesday and Thursday mornings. We will ask you (other than for emergency labs) to come in on those days.

Our top notch team is here to help you and to make the often uncomfortable doctor's visit as pleasant as possible. Please help them with your patience and good will...JWZ


Procedures

Procedure Description:
A test for damage to nerves

What To Expect:
This test is painless but takes time and requires your full alert participation. It may take from ten minutes to as long as forty five minutes depending on the number of nerves tested and the difficulty you have in recording the sensation of pressure from the probe.

Preprocedure:
The test is performed fully clothed without needles or electrical current. It depends entirely on your ability to feel the pressure of a blunt thin metal probe placed against the skin at one
point, two points, still, or moving. For carpal tunnel syndrome you may also be asked to squeeze or pinch a handle. This test helps the doctor decide if you have diabetic nerve
damage or damage to the nerves from a neck or back injury or a metabolic disorder. Carpal tunnel,ulnar nerve entrapment, tarsal tunnel, and a number of other nerve entrapment
syndromes can be diagnosed this way.Most insurances will pay for the procedure which costs $70.00 per nerve or about $420.00 for a full diagnostic evaluation for peripheral diabetic neuropathy in the legs and feet.

Postprocedure:
Dr. Zebley will analyse the report and recommend appropriate referral or treatment based on the findings. This may include more careful treatment of diabetes, thyroid disease, or other
metabolic condition, physical therapy, massage therapy or other alternative therapy (CAM), or possibly referral to a surgeon such as Dr. Lee Dellon for diabetic nerve release.



Procedures

Spirometry

Procedure Description:
A test of your maximal lung capacity

What To Expect:
This is a simple test, performed fully clothed in which you must exhale forcibly as long and as hard as you can. The procedure is repeated three times to make sure the results are consistent.
Spirometry is covered by most insurance plans.

Preprocedure:
You should bring any and all inhalers with you. If you use a broncholdilator such as Alupent, Brethaire, or Albuterol (Proventil, Ventolin), we can also test how effective your medicine is in opening up a tight airway. This is called a Pre and Post pulmonary function test.

Postprocedure:
Dr Zebley will go over your results immediately after the test to help plan your treatment or to discuss risks for future lung problems depending on the test results.



Neuromuscular Re-education

Procedure Description:
Neuromuscular Re-education

What To Expect:
This is a technique that reduces pain and increases range of motion (R.O.M.) using small electrodes placed exactly over certain strategic points. It is covered by Medicare and many
Third Party Payors although you may have to be referred to a Physical Therapist in some plans (MD-IPA Alliance etc..)

Preprocedure:
Wear loose clothes that can be easily removed to expose the area to be treated. DO NOT USE oils, grease or other chemicals on this area. Your treatment will last between 30 and 45
minutes. Bring a book, your iPod (if not treating your head or upper neck area) or be ready to take a nap!

Postprocedure:
You may not notice much after the first two or three sessions. We begin with a series of five (5) sessions. If there is improvement by then I recommend five more treatments. Most problems, if
they respond, are solved in ten treatments applied daily or every other day.



Audiometry

Procedure Description:
Audiometry/Hearing test

What To Expect:
When you have your comprehensive physical exam we can offer you an audiometric hearing screening.We use an ear muff automatic pure tone audiometer. If you score poorly on this test I may recommend you see an audiologist for further study

Preprocedure:
No preparation is required

Postprocedure:
We will review the results immediately upon completion of the study and make appropriate recommendations based thereon.



Care Philosophy

MD VIP is a company that helps physician practices reduce their patient load and volume while they
increase the quality of medical, health maintenance, and personal services.MD VIP charges a yearly membership fee of $1500 per adult member ($125 a month). Children to age 25 receive
services at no charge other than the usual and customary insurance payments.

I have set a 500 person limit to the practice. Contact me if you are interested in this plan and staying with we me at GMA!


Staff Updates


Mr. Mark Laughlin and Ms. Elviria (Ella) Scott handle the front desk and Ella will now handle most all referrals

We have daily early morning phlebotomy services for blood drawing. The most crowded morning is
Wednesday as Ella is by herself. I will continue to ask most of our dear patients who do not need urgent lab work to go to a commercial lab for phlebotomy whenever possible to take some of the
stress off the staff .

Dellie continues to work for us as a part time M.A. handles the Neural Scans as well as electrical stimulation and pain managment. She continues her massage practice in Towson as well.

Kathy McCoy has now been with us for three months and is the main medical assistant for the comprehensive physicals.

We have reopened the practice to new patients as we go into our third year with MDVIP


ONLINE CONSULTATION


Remember you can save time and hassle using the ONLINE CONSULTATION service.Try the Family Practice Link on the web page and check the patient hand outs. Then come back to Medem and
contact me through the CONSULTATION page.

Taking time off from work, or scheduling between conflicting levels of priority, can be difficult. Driving and parking take up time, especially if you leave extra travel time to arrive a few
minutes before the scheduled appointment and account for traffic.

If time to you is a valuable resource, let's try to use 21st century technology to save on this commodity through a "virtual office visit". While most appointments still require you and me
to sit face to face in the same room (sorry no virtual prostate checks or Pap smears ... yet!), there will be many instances where I can provide you with as much, if not more, individualized
information through an electronic meeting. Some specific examples include advice on medication therapies, dosage changes, hormonal treatments, literature resources, and interpretation of abnormal test results with suggestions for further evaluation or therapy. There appears to be
increasing interest in expanding these services to the entire practice. All MD VIP patients and patients who are already established at Greenspring Medical, on whom we still have an active chart are eligible for this service.

"Will there be a charge?" you ask. Yes. The usual and customary rate will be $30.00/visit. This is in line with national norms. ONLINE CONSULTATION is a covered service paid for by insurance in
only a few test markets, but not in Maryland. It does qualify for reimbursement by your Flexible
Medical Benefit Plan or HSA. Make sure to use these pre-tax dollars as offered by your insurer or your H.S.A. We will invoice you so you have documentation of your expenses and we now have on
line credit card availability for payment at time of service. Face to face personal care will howoever always remain our primary activity. Electronic consults are for those busy individuals and when you are of town when this service, and its time saving convenience, is of a higher priority
then an office consultation or at those times when a hands on physical exam is not necessary.

In addition we can now offer you world wide web based medical record retrieval through both iHealth and MDVIP. You must log in and enter your data in the specific fields (follow the prompts) in either system. These services are offered at no additional charge (iHealth is free) and allow
you to access your information wherever you can access the web. This would be in addition to your MDVIP CD ROM.

How do I log on to these wonderful services? Easy, in MEDEM go to "new user" LOG ON and follow the prompts. Read the waivers and terms. These are very important as they deal with medical
liability and your rights under these electronic communication conditions. If you agree, accept and set up the medical messaging account, your electronic iHealth record, and then the ONLINE CONSULTATION account.

Remember if you want some easy self care flow charts, go to my AAFP web page. This is the FAMILY PRACTICE Link. Click on Patient Handouts, and check out these AAFP approved patient
resources!

Hope to hear from you soon...JWZ


GMA News Bulletin


I am updating this News Bulletin on the 21st of February, one month before the first day of Spring.

By now you have all experienced the benefits of the MDVIP plan and hopefully are sticking to your Wellness plan. With people moving and with with individuals going to nursing homes or passing away we have now reopened the practice to new patients. Let your friends and family know if they assumed we re closed!

Check the updated Family Practice Link on the home page for self help information and also the MDVIP library for articles on health issues of concern. In addition to the CD ROM you receive after the comprehensive physical, you can use the free iHealth function on this Medem site to set up a
web based electronic record.We also still use the Medem disease adherence programs which will send you an automatic e-mail reminder about lab tests and office visits. It is regularly updated and all the articles represent peer reviewed evidence based medical opinions.

Let me wish you a pleasant upcoming Spring Season! Get to the Ball Park Catch the O's or the Nats. Get the winter sludge out of the joints and do some yard work. Get a 1/2 hour of sun a day for good bone health and work on the waist and the weight!

In good health...JWZ


Adherence Programs


Medem now offers a service that will send you automatic reminders and updates regarding your specific disease state (diabetes, cholesterol, high blood pressure, etc..).You can sign up for the adherence program through the web page or our staff can set you up through the secure
messaging or ONLINE CONSULTATION services.

This fall look for a secure, portable, pesonla internet based medical record service as well!!

Exciting e-times!! JWZ


 



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