Cary Presant, MD, Oncology, Hematology/Oncology, 03:41PM Nov 30, 2013
Here in Los Angeles, I am constantly asked about addition of herbs and vitamins to anti-cancer treatment regimens. We are expected to answer these questions just as well as inquiries about diet and exercise.
Fortunately, there is a new tool that can help us answer these questions. Dr. Barrie Cassileth of Memorial Sloan Kettering Cancer Center has developed an app for iphones, ipads, and ipods (About Herbs can be downloaded from the App store).
I have used this app to help to identify proper doses of herbals, be aware of adverse effects, and review reported beneficial effects from peer-reviewed published studies. This helps me in recommending evidence-based medical interventions to my patients.
For example, we have heard that ginger has been useful in helping to control fatigue or nausea in some of our patients treated with chemotherapy. I recommend that you download the About Herbs app, review the use of ginger 1200 mg to 2000 mg daily in patients, and come to your own conclusions about who might benefit from use of ginger or other herbal therapies.
Also, making sure your patients report all over the counter drugs they are taking is very important in evaluating prescription drug choices. Your staff can help by advising each patient to report all OTC intake.
Getting this history and making such recommendations represents a higher level of care, and one that our patients often expect. Discussing such recommendations should be considered when coding your visit level.