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June 18, 2018

Health Care Trends - Around Florida

Health Care Highlights

» The Cough Doctor

For most people, a cough is just a temporary nuisance that comes on quickly because of a common cold or other viral infection and goes away within a week or two. But for others, a cough can become a chronic problem that lingers for months or years and interferes with their daily life.

“It’s a debilitating problem. These patients, when we interview them, say, ‘I’m depressed. I’m anxious. I don’t want to go out or attend church or go to the theater because I’m afraid I’ll cough.’ So this isn’t just a nuisance — it really has significant consequences,” says Dr. Mandel Sher, who has expanded his practice by creating a niche treating patients suffering from chronic cough and throat clearing.

A specialist in asthma, allergy and immunology as well as pediatric rheumatology, Sher says he uses an interdisciplinary approach to treating patients who come to his Center for Cough in Largo. He says he can do virtually all the same tests that a pulmonologist, gastroenterologist or ENT would do in trying to diagnose a chronic cough patient.

Sher says chronic cough is usually caused by one or two underlying problems, the most common of which are asthma, postnasal drip, gastro-esophageal reflux disease and ACE inhibitors, which are a type of blood pressure medication. Some people — women, in particular, he says — are also “hardwired for coughing” because they have a heightened cough reflex. Identifying the causes and treating each one, he says, is the key to getting long-term relief. Depending on the cause, treatment can range from medication to diet changes, other lifestyle changes and voice exercises.

Sher says he sees several patients each month at his Center for Cough, housed within his allergy practice, but says it’s gaining traction primarily through the internet and word of mouth. Most important, he says, his patients are seeing results. Most report a cure, or at least significant improvement, within one or two visits, he says.


» Domestic Violence Screening

There were 111,681 reported domestic violence offenses in Florida last year. It’s estimated, however, that more than 25% of all cases of domestic abuse go unreported.

“Most of the time, the patients who are victims are not telling because they are afraid and you can see it in their body language,” says Ademola Adewale, an emergency medicine physician at Florida Hospital, which has partnered with Harbor House of Central Florida, an Orlando shelter for victims of domestic abuse, in launching a domestic violence screening app that will help health care personnel identify people in danger or at risk of being harmed.

The R3 app uses four screening questions to assess whether a patient may be a victim of abuse. Adewale says Florida Hospital plans to incorporate the app into the triage process in the ER when medical personnel are taking down a patient’s history and that it will eventually be built into the hospital’s electronic medical record system.

Patients who are identified as being at-risk can then be referred to the appropriate community advocacy services for help.


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