SUN HEALTH MEDICAL CLINIC

PRIMARY HEALTHCARE

We fix most medical conditions under the sun.

We help you optimize health and happiness!

Excludes: controlled substances, obstetrics (instead referrals are coordinated)

SICK VISIT

Emergency, urgent, or routine symptoms, issues, and problems.

EXAMPLES

NONSPECIFIC

Pain (including back, abdomen, head, foot, chest, knee, wrist, arm, leg, neck, finger)

Fatigue, Dizziness, Fainting

Pink Eye, Ear Plugged, Runny Nose, Sore Throat, Cough, Fever, Chills, Shortness of Breath, Snoring, Abnormal Lump

DIGESTIVE

Acid Reflux, Constipation, Diarrhea, Gallstone, Nausea/Vomiting

MUSCULAR

Weakness

INTEGUMENTARY

Acne, Rash, Wound

LYMPHATIC

Allergies, Infection

ENDOCRINE

Diabetes, Thyroid

NERVOUS

Depression, Anxiety, Grief, Numbness, Weakness

SKELATAL

Fracture, Arthritis, Sprain

MALE REPRODUCTIVE

Erectile Dysfunction

FEMALE REPRODUCTIVE

Vaginal Discharge, Abnormal Menstruation

RESPIRATORY

Asthma, Chronic Obstructive Pulmonary Disorder

URINARY

Urine Infection

CIRCULATORY

Heart Failure, Abnormal Heart Rhythm

WELL VISIT

Routinely screens for and prevents problems based upon preventive guidelines.

Despite pandemic, don't postpone this.  We continue to remain open for both In Person and Telehealth (portal, telephone, video) visits.

United States Preventive Task Force (USPTF) guidelines

depending upon your age and risk factors

Since the Affordable Care Act in 2010, health plans usually fully cover the cost of this portion of the visit.

EXAMPLES

PSYCHIATRY

Unhealthy Drug

..opioid, cannabis, stimulant, sedative hypnotic

..tobacco

..alcohol

Depression (Lifeline 800.273.8255, text 998)

GENERAL

Healthy Diet + Physical Activity

CARDIOVASCULAR

Hypertension (annually: age 40+, African, hypertension, overweight/obese;  otherwise age 18-39 every 3-5 yrs)

Obesity

Lipid (age 35+ male, risk factors)

Abdominal Aortic Aneurysm (age 65-75 if ever smoker)

Statin for cardiovascular disease 10 year risk 10+%)

INFECTION

Sexually Transmitted Infection Prevention (safe sex: limit partner, verify status, use condom)

HIV (exposure, age 15-65 x 1+, pregnant, Man Sex with Man HIV+ partner, IV drug use, or transactional/commercial sex, inconsistent condom use when not in a mutually monogamous relationship, every 3-6 mo)

..Pre-Exposure Prophylaxis (PrEP): Man Sex with Man, HIV+ partner, inconsistent condom use, syphilis/gonorrhea/chlamydia within 6 mo) 

Hepatitis B (exposure, born Asia/Africa, IV Drug Abuse, Men having Sex with Men, pregnant)

Syphilis (exposure, Man Sex with Man, prostitute, HIV+ living partner)

Hepatitis C (age 18-79 x 1+, exposure, born 1945-65, transfuse/transplant, IV Drug Abuse, liver disease)

Chlamydia + Gonorrhea (exposure, female sexually active age <=24 or age 25+ with new/multiple partner(s), symptoms)

Latent Tuberculosis (former resident in country at risk, homeless, prison)

Immunizations (may obtain at pharmacy)

-Pediatric

-Adult 

  COVID x 2+ when to get a booster

  flu: annual (LIVE VERSION NOT RECOMMENDED FOR IMMUNOCOMPROMISED, inactive version recommended for immunocompromised)

  TDaP: every 10 years

  MMR (NOT RECOMMENDED FOR IMMUNOCOMPROMISED)

  VAR x 2 if no history of vaccination or disease (NOT RECOMMENDED FOR IMMUNOCOMPROMISED)

  HepB x 3 (if <age60, new CDC recommendation)

  PCV15 or PCV20 (if age >=age65 and no history of any pneumococcal vaccination, new CDC recommendation)

..Additional Immunizations for Specific Populations

  Pregnant: 1 TDaP each pregnancy week 27-36 (CONTRAINDICATED: LIVE FLU, MMR, VAR, HPV SO DO NOT GET)

  Immunocompromised: shingles RZV, pneumococcal (CONTRAINDICATED: LIVE FLU, MMR, VAR SO DO NOT GET)

  Chronic Liver Disease: hepA

  Healthcare Personnel: shingles RZV

  Men who have Sex with Men : shingles RZV age 50+, HPV <=age26, monkeypox if exposure https://myturn.ca.gov/

CANCER

Breast Cancer

..mammogram (biennial age 50-74) may consider biennial age 40-49, option for annual age 40+

..BRCA gene (also for Ovarian Cancer)

--known family BRCA mutation

--Ashkenazi Jewish woman: breast or ovarian cancer in 1st degree relative or two 2nd degree relatives

--1st degree relative(s) with breast cancer: two relatives or one relative with bilateral

--1st or 2nd degree relatives: three with breast cancer or comorbid breast and ovarian cancers or two with ovarian cancer

--male family member with breast cancer

..endocrine Rx  new including for

 --age 65+ with 1 first-degree relative with breast cancer

 --age 45+ with more than 1 first-degree relative with breast cancer or 1 first-degree relative who developed breast cancer before age 50

 --age 40+ with a first-degree relative with bilateral breast cancer

 --presence of atypical ductal or lobular hyperplasia or lobular carcinoma in situ on a prior biopsy

Cervical Cancer (every 3 yrs age 21-65;  every 5 yrs age 30-65 if Pap and HPV normal)

Colon Cancer (newly lowered age 45-75, especially black/native, family history, male, obese, diabetes, smoker, alcohol)

..Options

--high-sensitivity guaiac fecal occult blood test (HSgFOBT) or FIT fecal immunochemical test annually

--stool DNA-FIT (ColoGuard) every 1 to 3 years

--virtual colonoscopy (computed tomography colonography) every 5 years

--flexible sigmoidoscopy every 5 years

--flexible sigmoidoscopy every 10 years + annual FIT

--colonoscopy screening every 10 years (preferred)

Lung Cancer (age 55-80 + 1 Pack / Day x 30 yrs + smoker <=15 yrs)

Prostate Cancer (age 55-69)  option for annual blood/exam age 50+ (age 35+ if African or family history)

ABUSE

Intimate Partner Violence (childbearing age female)

ENDOCRINOLOGY

Diabetes (age 40-70 overweight/obese, Family History, ethnicity: African, Native, Asian, Hispanic, Pacific Islanders)

Osteoporosis (age 65+ female)

DERMATOLOGY

Skin Cancer if fair skinned (shade 10AM-4PM, cover, SPF 15+)

PREGNANCY PLANNING

folic acid 400-800ug daily