A friend emailed me a few days ago. She was frustrated that her pediatrician couldn’t offer pre-travel care because the large group practice didn’t offer travel vaccines. I think her pediatrician missed an important opportunity to provide good care for her patient.
Maybe your practice was consolidated with others as part of an Accountable Care Organization. Or maybe you are part of a large healthcare system.
At any rate, you’ve lost control of the formulary and the types of vaccines offered, all in the name of group efficiencies.
This doesn’t mean you can’t help your patients who travel. Or that you can’t get them their needed travel vaccines.
It just requires a new way of thinking.
Did you know that travel medicine is much more than travel vaccines? Immunizations are only one component of pre-travel care.
No matter where you practice, you can offer pre-travel services
Your patients need you. Many are traveling abroad: some for short vacations to the tropics, others ‘home’ to visit their friends and families, and still others on mission trips around the world.
Yet over half do not get appropriate pre-travel healthcare. You may not think this is part of your job, but you need to re examine that.
Patients have unmet needs and they are in your office regularly for healthcare. Don’t miss the opportunity to keep them healthy at home and abroad.
Millions people travel abroad every year, many to high-risk destinations. Over 40% of those traveling to high risk destinations become ill while traveling. You can put an end to this by provided much needed advice.
Help your patients feel better and get more done when traveling by offering travel services within your general medical practice.
Most people think of vaccines when they travel abroad, yet what most people need is sound anticipatory guidance (and a few vaccines).
How do you address the expectation of vaccines in your travelers? Not surprisingly the principle of ‘common things happen commonly’ applies here:
–The most important vaccines are the ‘routine’ vaccines, the ones you offer in your office everyday. They are routine because they protect against disease that are prevalent everywhere.
–When you see your travelers you can use the visit as an opportunity to catch them up on their routine vaccines and discuss which ‘travel’ vaccines they might need.
–Studies show that the most common vaccine-preventable disease in travelers is influenza. It’s really no surprise since flu is ubiquitous and present year-round in tropical climates.
But what if you are recommending typhoid, yellow fever, rabies or Japanese encephalitis and your healthcare ‘system’ doesn’t offer them?
Simply write a prescription. Many of the pharmacies that offer ‘routine’ vaccines give these vaccines too.
It’s that simple.
Your patient is headed to the pharmacy anyway to get their prescriptions filled; they can get the vaccines at the same time.
Granted, writing prescriptions for immunizations is a new way to go. But adult medicine has been doing this for a while with the Zoster vaccine. And many people like to get their flu shots at their pharmacies. So why not their travel vaccines too?
–You will still want to see your patients prior to vaccination, to review your recommendations and discuss any health problems.
–Don’t forget to mention that their insurance may not cover the cost of the travel vaccines. They simply pay the pharmacy when they get their shots.
Why do pharmacies offer vaccines? It’s good business. And it’s accessible healthcare. Convenience is good medicine.
When healthcare is easy for patients they are more likely to take your advice.
Of course it would be better if you could offer the travel vaccines yourself. Why not ask the practice manager, someone who may not be familiar with your patients’ needs, if you can add them to the formulary.
While you wait for this to work through the system you can write prescriptions for your patients’ travel-related immunizations.
Vaccine strategy vs anticipatory guidance
We have been talking about vaccine strategy, how to actually get the vaccines. Remember, anticipatory guidance is the most important part of pre-travel care, even if it isn’t glamorous.
Good news, if you are in general medicine you already excel in this.
You know your patients really well, their problems, their preferences. They trust you and are counting on you to provide helpful guidance.
Sure there’s lots of information available on the web. Maybe even too much information. It’s confusing and often contradictory.
–You need to provide clear and concise instruction in how to stay healthy. Vaccine recommendations are only a small portion of the advice you will give.
–You are in the best position to offer meaningful advice and prescriptions that work with your patients’ lifestyle. You have access to their medical record and can make sure prescriptions don’t interfere with routine medications.
–When you take the time to learn travel medicine you’ll be able to help your patients stay healthy when they travel.
Isn’t travel medicine hard to learn?
It takes less time than most people think to get up to speed. Mostly because you already have a lot of the skills needed, such as vaccine counseling and anticipatory guidance.
Learning 4 new vaccines shouldn’t take much time either. Travel vaccines are manufactured in a similar fashion to every day vaccines. And you already know a lot about live, conjugate, and recombinant vaccines; every day you prescribe flu, measles, polio, tetanus, whooping cough, meningitis, hepatitis, and many more vaccines.
There are some nuances to adding travel medicine to your practice. It needs to fit in your workflow, you need effective patient education, and you need to learn how to bill for your services.
Are you ready to add the healthcare your patients need and want?
I’m happy to chat with you about how to add travel medicine services to your practice.
It’s time to take better care of your patients.