Appointments & Scheduling

Primary Care Visit for New Patients

New patient visits focused on establishing primary care are essential for initiating comprehensive and continuous healthcare management. These visits are designed to thoroughly assess your health history and establish a personalized care plan.

What to Expect During Your New Patient Chronic Disease Visit:

·       Comprehensive Health Review: Your provider will thoroughly review your medical, surgical, family, and social history. Current medications, allergies, past medical conditions, and any acute concerns will be discussed in detail.

·       Physical Examination: A thorough physical exam including vital signs (blood pressure, heart rate, respiratory rate), and evaluation of the heart, lungs, abdomen, and other relevant body systems.

·       Laboratory and Diagnostic Testing:

o   Blood Tests: Tailored to your specific chronic conditions and general health needs.

o   Diagnostic Radiology Tests: X-rays, ultrasounds, or other necessary imaging.

o   Procedures: Appropriate minor procedures as required.

o   Vaccinations: Immunizations appropriate for your medical history and chronic condition.

·       Specialist Referrals: Coordination of referrals to specialists if your chronic condition requires advanced or specialized care.

Follow-Up and Treatment Planning:

·       A follow-up visit will be scheduled to review test results and refine your treatment plan based on these findings.

·       Follow-up frequency typically ranges from every 2–4 weeks for active or unstable conditions, to every 3–6 months for stable chronic conditions.

·       Adjustments to treatment plans are usually done at the follow-up visit unless there is an urgent issue. In such cases, the patient will be called for scheduling sooner than the already scheduled visit if necessary, or referred to the ER in case of a critical result requiring emergent management.

Important Information for New Patients:

·       It is crucial for us to receive previous medication records, significant diagnostic radiology results, and preventive screening results from at least the last five years prior to your visit. This helps us sort through and review your medical history to provide tailored, effective, and continuous care.

Test Results and Communication

·       Lab and diagnostic test results will typically be available in your patient portal within 7–10 days after your visit.

·       Your provider will review and comment on your results within an additional 72 hours (3 business days).

·       Necessary adjustments to your care plan based on these results will be promptly communicated, and further follow-up visits or specialist referrals will be coordinated accordingly.

Annual Preventive Visits

Annual preventive visits, commonly known as annual physical exams or wellness check-ups, focus on maintaining overall health, early detection of potential health issues, and preventive health measures. These visits are essential for proactive healthcare and help ensure you stay on top of your health.

What to Expect During Your Annual Preventive Visit:

·       Comprehensive Health Review: Your provider will review your medical, surgical, family, and social history. They will update and review your current medications, allergies, and immunizations. Additionally, they will discuss lifestyle, diet, exercise habits, and preventive care recommendations.

·       Physical Examination: This includes a general health assessment with vital signs (blood pressure, heart rate, respiratory rate), examination of heart, lungs, abdomen, and other areas as needed.

·       Laboratory and Diagnostic Testing:

o   Blood Tests:

-  Complete Blood Count (CBC): Evaluates overall health and detects disorders such as anemia or infection.

-  Basic Metabolic Panel (BMP): Assesses kidney function, electrolyte levels, and blood sugar.

-  Liver Function Test (LFT): Evaluates the health of your liver.

-  Hemoglobin A1c (HbA1c): Screens for diabetes or monitors blood sugar control.

-  Thyroid Function Test: Assesses thyroid gland function.

-  Cholesterol Panel: Evaluates risk for cardiovascular disease.

-  Urinalysis: Screens for urinary tract infections, kidney disorders, or other metabolic conditions.

o   Diagnostic Testing:

-Electrocardiogram (ECG): Evaluates heart function and detects abnormalities.

-  Spirometry: Measures lung function by evaluating airflow and lung capacity.

·       Age and Gender-Appropriate Screenings:

o   Cardiac Calcium Score Test: Evaluates the risk of coronary artery disease by measuring the amount of calcium in the heart’s arteries.

o   Mammogram Referrals: For breast cancer screening.

o   PSA Test: For prostate cancer screening.

o   Low-Dose CT Scan: For lung cancer screening (for smokers).

o   Referral to Gastroenterologist: For colorectal cancer screening.

·       Chronic Health Conditions Management: Existing chronic health conditions are usually addressed during your annual preventive visit. Medication refills for chronic conditions are typically provided during this visit. Pertinent labs and diagnostic testing will also be ordered in addition to the preventive labs and diagnostic tests.

·       New Symptoms or Acute Illness: If you have new symptoms or an acute illness at the time of your scheduled preventive visit, these issues will be addressed during the appointment. If you have a communicable illness, your preventive visit may need to be rescheduled for the safety of all patients and staff.

Important Notice About Insurance and Charges:

·       Annual Preventive Visits (preventive CPT codes) are typically covered by insurance at no charge. These codes are age-specific; please refer to our Billing and Coding page for more details.

·       Labs ordered with or for preventive visits may not be paid at 100% by your insurance. Deductibles may apply to labs and diagnostic testing, even if no chronic condition or acute illness is addressed.

·       Preventive visits cannot be scheduled solely to address acute problems or chronic disease management. If you are a new patient with chronic conditions, it is better to schedule an established primary care visit prior to the physical.

·       Annual preventive visits are recommended once per year.

·       At check-out, our staff will schedule recommended follow-up visits and your next annual preventive visit for the following year.

Test Results and Follow-Up:

·       Lab and diagnostic test results are available in your patient portal within 7–10 days after your visit.

·       Providers review and comment on results within an additional 72 hours (3 business days).

·       Recommended follow-up visits or specialist referrals should be scheduled during check-out or shortly after your visit.

Well Woman Exams

Well woman exams, also known as annual gynecological exams, are vital for maintaining women’s health through preventive care and early detection of potential issues.

Annual Well Woman Visit Includes:

·       Health History Review: Discussion of medical, surgical, family, and social history, including updates on medications, allergies, and immunizations. Lifestyle factors (diet, exercise, preventive care) are also addressed.

·       Physical Examination: Assessment of vital signs (blood pressure, heart rate, respiratory rate), heart and lung function, abdomen, thyroid, and overall wellness.

·       Breast Examination: Screening for lumps, changes, or other breast health concerns.

·       Pelvic Examination: Evaluation of reproductive organs and overall pelvic health.

·       Pap Smear & HPV Testing (When Indicated):

o   Ages 21–29: Pap smear every three years if previous results are normal.

o   Ages 30–65: Pap smear every three years, or HPV testing every five years, or Pap smear plus HPV co-testing every five years.

o   Referral to Gynecologist: Patients who are pregnant or have intrauterine devices (IUDs), a history of abnormal Pap smears, or complex gynecological concerns will be referred to a gynecologist.

·       Breast Cancer Screening: Mammogram referrals provided as age-appropriate.

Pre-Visit Preparation:

·       Scheduling: Aim to schedule your exam for a time when you are not menstruating, as this can affect test accuracy.

·       Avoid Before Visit: Refrain from intercourse, douching, tampons, and vaginal creams 24–48 hours prior to your appointment.

·       Attire: Wear comfortable, two-piece clothing to simplify changing; gowns are provided during the exam.

Insurance Coverage and Billing:

·       Coverage: Most insurance plans cover well-woman exams, Pap smears, and HPV testing at 100% under preventive care, in accordance with the Affordable Care Act (ACA).

·       Billing for Non-Preventive Services:

o   Addressing chronic conditions or new symptoms during a preventive visit may result in an additional office visit code and related charges.

o   Labs and diagnostics related to acute or chronic issues may incur extra charges subject to deductibles, copays, or co-insurance.

Test Results & Follow-Up:

·       Results: Typically available in the patient portal within 7–10 days after your visit.

·       Provider Review: Providers review and comment on results within an additional 72 hours (3 business days) of availability.

·       Next Steps: Any necessary follow-up appointments or specialist referrals should be arranged promptly.

Chronic Disease Management

At Sugarloaf Medical P.C., we provide comprehensive care and management for chronic medical conditions within the scope of primary care. This page explains why regular chronic care appointments are essential, whether scheduled at your request, at checkout, or following a review of your test results.

While our practice manages a variety of chronic medical conditions, there may be circumstances requiring referral to specialists for advanced management, complex issues, or specific procedures. Please note, our practice does not prescribe narcotics or any Schedule II medications, nor do we manage psychiatric conditions (such as ADHD, bipolar disorder, anxiety requiring tranquilizers, or similar conditions), advanced dermatological illnesses, significant trauma, or chronic pain requiring narcotics. Our services are strictly focused on primary medical care.

For patients experiencing work-related injuries, automobile accidents, or other traumatic injuries that are not urgent or life-threatening, we can provide an initial evaluation and referral to the appropriate specialist.

Acute Illness Visits

Sugarloaf Medical P.C. provides same-day or next-business-day appointments specifically for the evaluation and treatment of acute illnesses. Our dedicated Acute Care Team will manage only your acute medical issue during this visit to ensure timely and focused care for quick recovery. This team does not address chronic or existing medical problems. Those ongoing health concerns will continue to be managed separately by your regular assigned primary care physician and/or advanced practice provider. If chronic medical issues are present or require attention, please schedule an additional appointment with your primary physician.

Emergency and Life-Threatening Symptoms
If you experience severe or life-threatening symptoms—such as chest pain or pressure suggestive of a heart attack, acute neurological symptoms indicative of stroke, severe difficulty breathing, loss of consciousness, severe bleeding, severe allergic reactions, or significant heart rhythm disturbances—seek emergency care immediately by calling 911 or visiting the nearest emergency room.

Important: Communicable Respiratory Illnesses
If you have symptoms of communicable respiratory illnesses (flu, COVID-19, respiratory infections), we provide testing to ensure accurate diagnosis and treatment. Masks are required throughout your entire visit—from check-in until check-out.

Conditions Treated During Acute Illness Visits

Respiratory, ENT, and Allergy Symptoms

·       Symptoms: Cough, congestion, sore throat, ear pain, sinus pressure, fever, allergies, wheezing, mild difficulty breathing.

·       Conditions: Common cold, flu, COVID-19, bronchitis, pneumonia, sinus infections, strep throat, ear infections, allergies.

Gastrointestinal and Abdominal Issues

·       Symptoms: Nausea, vomiting, diarrhea, constipation, bloating, stomach pain, heartburn, loss of appetite.

·       Conditions: Food poisoning, stomach flu, acid reflux, ulcers, IBS flare-ups, diverticulitis, hemorrhoids, gallbladder issues.

Skin Issues, Rashes, and Minor Wounds

·       Symptoms: Redness, itching, swelling, painful bumps, blisters, insect bites, minor cuts, minor burns.

·       Conditions: Skin infections, abscesses, hives, insect bites, minor wounds.

Neurological Symptoms & Headaches

·       Symptoms: Headache, dizziness, vertigo, balance issues, mild weakness, numbness, tingling, memory concerns, confusion.

·       Conditions: Migraines, tension headaches, vertigo, Bell’s palsy.

General Symptoms & Unexplained Conditions

·       Symptoms: Fever, viral symptoms, general weakness, unexplained discomfort.

·       Conditions: Flu, viral infections, mild dehydration.

Chronic Condition Flare-ups

·       Conditions: Asthma attacks, COPD flare-ups.

Conditions Not Treated at Acute Illness Visits

The following conditions are not managed by our Acute Care Team and require evaluation elsewhere:

·       Trauma-related injuries (motor vehicle or workplace accidents, severe burns, fractures, major injuries)

·       Chronic pain management or narcotic pain medication prescriptions

·       Acute psychiatric emergencies

Follow-Up Care

If your symptoms persist or worsen, promptly schedule a follow-up visit for further evaluation and care.

Surgical Clearance and Preoperative Risk Stratification

Sometimes, a surgeon, specialist, or anesthesia team requests a preoperative risk assessment or clearance prior to a scheduled procedure. In certain cases, forms are faxed to our office or brought in by the patient without a dedicated appointment, or a patient may have recently been seen without notifying the physician that a clearance is required.

However, performing preoperative clearance or risk stratification without a proper evaluation is neither appropriate nor safe. This type of assessment must be done in a dedicated preoperative consultation, which should not be combined with other visits. Being established at our practice, having known medical history, and ensuring chronic conditions are stable are prerequisites for us to provide comprehensive clearance. Additionally, the request for surgical clearance must come from a legitimate, licensed physician in the United States, and anesthesia involvement may be required if necessary.

During a dedicated preoperative consultation:

·       We review any new or updated health information to ensure your records are up to date.

·       We determine if diagnostic tests or labs are needed to verify you are medically optimized for surgery.

·       We optimize any chronic conditions prior to surgery if adjustments are required.

If all necessary results or evaluations are not available at the time of consultation, your surgery may need to be delayed until you receive full clearance. This policy helps ensure the highest level of safety and care. If you have questions about scheduling a preoperative risk assessment, please contact our office directly to arrange an appointment.

Transition of Care and Hospital Follow-Ups

Transitioning from hospital to outpatient care can be a critical time for patients. Scheduling a follow-up visit after any hospital or skilled nursing facility discharge helps ensure a proper review of discharge instructions, medication changes, and ongoing treatment plans.

We recommend:

·       Scheduling a post-discharge appointment within 7–14 days (or sooner if instructed by your discharging provider).

·       Bringing any new prescriptions, hospital discharge paperwork, and a current list of all medications to this appointment.

·       Sharing updates about any new or unresolved symptoms you experienced during your hospital stay.

During this follow-up, we will:

·       Review all discharge instructions and verify that medications are correct.

·       Order or review any necessary labs or diagnostic tests to ensure a smooth recovery.

·       Coordinate with hospital-based teams or specialists if additional care is needed.

By proactively scheduling a post-discharge follow-up, we can help prevent complications, support your recovery, and keep our care team informed about your progress.

Ultrasound Procedures

Ultrasound imaging is a safe, painless diagnostic procedure that uses sound waves to produce detailed images of internal organs, tissues, and blood vessels. Sugarloaf Medical P.C. works with a certified sonographer from a third-party service to perform these exams. The resulting images are then reviewed and interpreted by specialist physicians at Emory University, who send a detailed report to our office. Your healthcare provider will discuss these results with you.

Please allow at least 7 business days for your final report to be available.

Exam Duration

·       Cardiovascular Ultrasounds (e.g., Echocardiogram, Carotid Ultrasound, Renal Artery Ultrasound, etc.) typically take 45 minutes to 1 hour, depending on your body habitus and the complexity of the exam.

·       General Ultrasounds (e.g., Abdomen, Kidney, Thyroid) usually take 30 minutes or less.

Insurance Information: Your insurance deductible may apply to these tests, and an estimated payment will be collected prior to your appointment.

Types of Ultrasound Exams Offered:

1.     Echocardiogram

o   Evaluates the heart’s structure and function, helping detect any heart disease or abnormalities.

o   Preparation: No special preparation is required.

2.     Carotid Ultrasound

o   Examines the carotid arteries in the neck for narrowing or blockages.

o   Preparation: No special preparation is required.

3.     Renal Artery Ultrasound

o   Assesses the arteries supplying blood to the kidneys, detecting possible narrowing or blockages.

o   Preparation: Fast for at least 8 hours before the test; water is permitted.

4.     Lower Extremity Arterial Ultrasound

o   Evaluates blood flow and circulation in the arteries of the legs.

o   Preparation: Wear comfortable clothing; no other special preparation is needed.

5.     Lower Extremity Venous Mapping

o   Identifies issues in the veins of the legs, such as varicose veins or blood clots, and helps map veins for surgical procedures.

o   Preparation: Wear comfortable clothing; no special preparation is needed.

6.     Abdomen Complete Ultrasound

o   Examines abdominal organs including the liver, gallbladder, pancreas, spleen, and kidneys.

o   Preparation: Fast for at least 8 hours; no food or drink except water.

7.     Kidney Ultrasound with Postvoid Volume Measurement

o   Evaluates overall kidney health and measures any urine remaining in the bladder (postvoid residual) after urination.

o   Procedure: You will undergo an ultrasound scan with a full bladder, then empty your bladder and have a second scan to measure residual urine volume.

o   Preparation: Fast for at least 8 hours before the test; no food allowed. Drink 1–2 liters of water starting 2 hours before your appointment, and do not urinate until instructed during the test.

8.     Thyroid Ultrasound

o   Examines the thyroid gland for lumps, nodules, or abnormal enlargement.

o   Preparation: No special preparation is needed.

Ambulatory Blood Pressure Monitor

1. Description: A small device worn for 24 hours that measures and records blood pressure regularly throughout the day and night.

2. Indications:

   • Evaluating high blood pressure (hypertension)

   • Diagnosing “white coat” hypertension (elevated blood pressure in medical settings)

   • Monitoring blood pressure medication effectiveness

3. Benefits: Provides a detailed profile of blood pressure over a full day, aiding in accurate diagnosis and treatment adjustments.

4. Preparation: Wear comfortable clothing; no special preparation required.

5. What Results Indicate: Helps determine true blood pressure levels, detect hypertension patterns, and guide medication or lifestyle modifications to lower the risk of heart disease or stroke

Bone Density Scan (DEXA)

• Description: A quick, painless imaging test that uses X-rays to measure bone mineral density.

• Indications:

  • Screening for osteoporosis

  • Evaluating risk of fractures

  • Monitoring bone health in conditions affecting bone strength

• Benefits: Early detection of bone loss, enabling proactive treatment to prevent fractures and maintain mobility.

• Preparation: Avoid calcium supplements for at least 24 hours prior to your appointment; wear loose, comfortable clothing without metal objects.

• What Results Indicate: Identifies normal bone density, osteopenia (low bone mass), or osteoporosis (significant bone loss), guiding appropriate treatments or preventive measures

Home Sleep Study

·       Description: A non-invasive, overnight diagnostic test performed in the comfort of your home to detect sleep disorders—most commonly obstructive sleep apnea (OSA).

·       Indications:

o   Suspected sleep apnea

o   Snoring accompanied by daytime fatigue

o   Concerns about sleep quality or sleep-related breathing issues

·       Benefits: Offers a convenient, private, and accurate alternative to in-lab sleep studies, allowing for evaluation in your normal sleeping environment.

·       Preparation:

o   Follow all setup instructions carefully, as provided by our team.

o   Go to bed at your usual time and aim to sleep for at least 6 continuous hours to ensure the device collects enough data for accurate results.

o   Avoid caffeine, alcohol, or heavy meals before bedtime to support restful sleep.

·       Device Return Policy:

o   The device must be returned to our office the next business day after use to allow for timely sanitization and availability for the next scheduled patient.

o   Handle the device with care and store it in a safe, dry place when not in use.

·       What Results Indicate:

o   Confirms the presence and severity of sleep apnea or other sleep-related breathing issues.

o   Informs appropriate next steps, including lifestyle modifications, CPAP therapy, or specialist referral.

Spirometry

• Description: A simple breathing test that measures lung function by evaluating airflow and lung capacity.

• Indications:

  • Asthma or COPD diagnosis and management

  • Assessing unexplained shortness of breath

  • Monitoring lung function over time

• Benefits: Quick and effective identification of respiratory conditions, assisting in targeted management to enhance breathing and overall health.

• Preparation: Avoid inhalers or respiratory medications as instructed by your physician prior to testing; avoid heavy meals immediately beforehand.

• What Results Indicate: Helps diagnose restrictive or obstructive lung conditions, assesses severity, and aids in tailoring effective treatments, including inhalers or other medications

Cerumen (Ear Wax) Removal

• Description: A safe, gentle procedure to remove excess or impacted ear wax using specialized techniques.

• Indications:

  • Ear discomfort or blockage

  • Hearing impairment

  • Preparation for other ear examinations or procedures

• Benefits: Provides immediate relief of symptoms, improves hearing, and prevents complications associated with ear wax impaction.

• Preparation: Apply ear wax softening drops as directed by your provider prior to the appointment.

• What Results Indicate: Clears the ear canal to restore normal hearing function and reduce the risk of infection or other ear-related complications.

Laboratory Services

Lab tests are an important part of managing your health and guiding treatment decisions. If you require fasting labs during an office visit but are not appropriately fasting, we will schedule you to return on a different day for labs only. For patients who wish to schedule labs themselves, an office visit with a provider is necessary to determine whether testing is medically indicated. Certain labs may also need to be collected early in the morning or follow special instructions from your physician.

Important Points about Lab Visits:

·       Scheduling: Patients cannot schedule lab-only visits on their own. A physician or advanced practice provider must order any labs, and you will be placed on our lab schedule if indicated.

·       Specialist-Requested Labs: If a specialist asks you to have labs done, you may choose to have them performed at our office. However, this still requires physician review and a nurse’s visit for proper documentation and follow-up.

·       Fasting Instructions: If your provider requests fasting labs, please refrain from eating or drinking anything except water for the specified time before your appointment.

By following these guidelines, we can obtain the most accurate test results and ensure that any treatment decisions are well-informed and safe.