INNOVATIVE PRACTICE FORM

Innovative Practitioner: Melinda Joyce, Pharm D.

Address: Springhill Pharmacy
2305 Russellville Rd.
Bowling Green, Kentucky 42101

Phone #: (502) 796-3909

FAX #: (502) 796-4111

Description of innovation:

Dr. Melinda Joyce is a co-owner and a practitioner at Springhill Pharmacy in Bowling Green, Kentucky. She is also a key practitioner at an innovative practice site, located in an ambulatory care clinic. The program is called L.E.A.N. (Losing [weight] through Education and Nutrition). The L.E.A.N. clinic has been operating for about nine months and currently has more than three hundred patients enrolled. Dr. Joyce works with a psychiatrist and nurse at the clinic and can confer with a dietitian and exercise physiologist who are available on a consultant basis.

First time patients are assessed in detail. Their vital signs, height, and weight are recorded. They then complete a questionnaire concerning their dietary and exercise habits, medications taken, and the types of weight loss programs they have tried in the past. The physician will then meet with the patient to get a thorough medical history, give a physical examination, and order any laboratory tests that may be warranted. If the patient is a candidate, the physician will prescribe weight loss medication. Dr. Joyce spends about fifteen to twenty minutes counseling each patient about their weight loss medication. She explains each drug in detail and has each patient sign a consent form stating that he/she understands the potential adverse drug reactions that can occur with his/her medication. Beyond medication counseling, Dr. Joyce also counsels patients on nutrition and dietary changes, exercise programs, and behavior modifications. Each patient is given a one month supply of medicine and is required to return to Springhill Pharmacy for their additional two refills. At Springhill pharmacy their blood pressure is checked and weight loss results are documented. Any dosage adjustments are determined between Dr. Joyce and the physician using a team approach. The L.E.A.N. Clinic also provides additional support services to its patients such as fitness screenings and dietary consults. The L.E.A.N. program caters to the needs of each individual enrolled to obtain optimal results.

Payor: The patient is the payor. A bill is provided to patients which can be used if patients want to submit a claim on their own. The initial fee is one hundred and forty dollars, which includes a month’s supply of medication. The patient returns to the clinic after three months for a "Medcheck" which costs seventy-five dollars and also includes a one-month supply of medication. Additionally, patients can have a one-hour fitness screening for thirty dollars or a one-hour dietary consult for forty dollars. An exercise physiologist and a dietitian offer these services respectively.

Documentation is required. Documentation includes items such as:

• Adverse Drug Reaction consent forms
• "Consent to Treat"
• "Confidentiality"
• "Payment and Agreement of Terms"

Of course, all information concerning patient history and physical exam is documented as well.

Specialized training required?

Dr. Joyce did not receive any type of specialized training, but an extensive knowledge of weight management is essential. Dr. Joyce also uses her skills of physical assessment for monitoring vital signs.

Dr. Joyce uses no special software, other than the Springhill dispensing system.