| QUESTION: |
Is Dr. Barley Board Certified in Internal Medicine? |
| ANSWER: |
Dr. Barley has been Board Certified in Internal Medicine since completing his training in 1996. |
| QUESTION: |
Dr. Barley seeks to provide “preventative” medicine. What does that mean? |
| ANSWER: |
With all the advances in medical technology, it makes sense that this knowledge should be used to detect and treat diseases in their earliest stages or before they develop. More often than not, we only use our best technology to diagnose and treat people with diseases in more advanced states. Many serious illnesses, including cancers and heart disease, if found early, are treatable and even curable. |
| QUESTION: |
What forms of early detection and preventative medicine does Dr. Barley employ? |
| ANSWER: |
Since Dr. Barley is not confined by the financial limitations of managed care companies, he uses state-of-the-art technology to help identify people at greater risk for disease, and he is often able to intervene before the development or progression of disease. For example, special screenings exist for cancers of the lung, ovaries, and prostate, as well as advanced tests for heart disease, early diabetes, osteoporosis, and many other common illnesses. |
| QUESTION: |
What comprises a full yearly physical exam and why is it necessary? |
| ANSWER: |
Yearly physical exams are strongly recommended by Dr. Barley, particularly with advancing age. Dr. Barley spends approximately one hour on an annual physical exam. During this time, he takes a careful history of your current and past medical conditions, paying close attention to areas such as diet, weight control, alcohol and tobacco use, substance abuse, exercise, herbal / vitamin / supplemental intake, prescribed medicines, vaccination history, sleeping disorders, childhood illnesses, surgical history, cardiac and pulmonary history, allergies, and specific review of other body systems. Dr. Barley then performs a comprehensive head to toe exam with appropriate blood testing and other diagnostic exams. Additionally, Dr. Barley takes an extensive family history with particular attention given to possible genetic and familial diseases to help modify and suggest prevention and early detection of these diseases. There are many “silent” diseases that require screening in order to be detected. Lung cancer, heart disease, diabetes, cataracts, anemia, thyroid disease, colon cancer, prostate cancer, some forms of hepatitis, Lyme disease, osteoporosis, vitamin deficiencies, hormonal imbalances, glaucoma, and other serious illnesses are some examples that may be treated if caught early. |
| Question : |
Dr. Barley practices “travel medicine.” What does that mean? |
| Answer : |
Dr. Barley has access to the latest recommendations for country-appropriate vaccinations and prophylactic medications for diseases like malaria, diarrhea, tetanus, diphtheria, measles, mumps, rubella, hepatitis, polio, and typhoid, among others. Dr. Barley takes the time to educate patients about specific health concerns related to the area in which they are traveling. In addition, Dr. Barley has access to an extensive network of doctors around the world, and he can help arrange emergency air evacuation for patients, either back to America or to an appropriate major medical facility elsewhere for emergency treatment. |
| Question : |
What vaccinations, prophylactic medicines, or other medicines do I need for traveling in third world countries? |
| Answer : |
These recommendations change frequently, and Dr. Barley is always current on the latest prevention and treatment recommendations for infectious diseases in third world countries. He administers most vaccinations for foreign travel, prescribes prophylactic medicines to prevent illness, and offers disease information specific to the area of travel. |
| Question : |
Who needs medicine for malaria protection when traveling? |
| Answer : |
Patients traveling to most parts of Asia, Africa, and South or Latin America are strongly suggested to take some form of antimalarial medicine. Recommended antimalarial medicines include Malarone, Chloroquine, Mefloquine, and Doxycycline. Dr. Barley will review the available choices of these medicines and their potential side effects with patients. Additionally, patients traveling to areas with a higher risk of malaria will often require other vaccines to protect them from a range of infectious diseases. |
| Question : |
If a patient becomes ill in another country, what is Dr. Barley able to offer that distinguishes him from other doctors? |
| Answer : |
Having established a network through his work in national health care policy with CITTA (an organization with hospitals in several third world countries) and the Executive Registry and Corporate Care, Dr. Barley is able to locate the highest quality care for his patients in most parts of the world. When this is not possible, he works with companies that can airlift patients to areas with more advanced medical care. |
| Question : |
How much time does Dr. Barley spend with his patients? |
| Answer : |
Because Dr. Barley is not a member of any insurance plans, he has no mandate to see a high volume of patients. He typically spends one hour or more with new patients or patients receiving yearly physicals and 30 minutes with follow-ups and acutely ill patients. Dr. Barley attempts to work on schedule but will always endeavor to give as much time as is needed, depending upon special circumstances. |
| Question : |
If a patient is sick, how long does it take them to get an appointment with Dr. Barley? |
| Answer : |
Dr. Barley will always try to see current patients with serious problems the same day they call the office. If his schedule does not permit a same-day visit, he will then try to speak with them to establish the nature of the problem. Dr. Barley has same-day access to some of the finest specialists in the city and around the world should that be necessary. In addition, Dr. Barley tries to leave some time in his schedule to accommodate new patients each day. |
| Question : |
To whom does Dr. Barley refer patients when he needs specialists? |
| Answer : |
Dr. Barley attempts to refer his patients to the most qualified and respected specialists, regardless of hospital affiliation. Over the years, he has developed relationships with top specialists in New York City, around the country, and in many foreign countries. |
| Question : |
Does Dr. Barley make house calls? |
| Answer : |
Because of costs and liabilities, many doctors have abandoned this important service. When appropriate, Dr. Barley will visit patients who cannot leave home, feeling that valuable insight can be gained during such visits. Dr. Barley works with other specialists who share this philosophy that it is important and necessary at times to provide competent care to those unable to leave home. |
| Question : |
What happens if a patient has a medical problem during off-hours? |
| Answer : |
Dr. Barley has 24 hours-a-day, 365 days-a-year coverage, which means that a call to his office at any time will be answered promptly. Patients may often expect a call back from him directly. On some weekends, his practice is covered by a doctor who is part of a small group of physicians, all having admitting privileges at New York Presbyterian Hospital, which is located at 68th Street and York Avenue. The “call group” is made up of highly experienced doctors who communicate frequently with each other about their patients’ care. |
| Question : |
Is it important what hospital your physician is affiliated with? |
| Answer : |
Your physician’s hospital affiliation is an important aspect of what his/her practice has to offer. When asked with which hospital their doctor is affiliated, many patients don’t know. This may not seem like an important issue when you are healthy; but treatments of some serious illnesses can only be administered in a hospital setting. Dr. Barley is affiliated with the New York Presbyterian Hospital, one of the world’s finest medical institutions. |
| Question : |
What is the nature of Dr. Barley’s affiliation with New York Presbyterian Hospital? |
| Answer : |
Dr. Barley is a voluntary teaching professor at The Cornell Weill School of Medicine at Cornell University, which is affiliated with the New York Presbyterian Hospital, where he has admitting privileges. The hospital has close ties to Memorial Sloane Kettering and the Hospital for Special Surgery, as well as the highest quality nursing and medical staff, training the brightest young doctors in the medical field. Having done his internal medicine residency training at NY Presbyterian Hospital and as an ongoing teacher of medical students and young doctors there, he is well known to a large percentage of the administrative and medical staff. These relations are very important to patients when hospital care is needed. |
| Question : |
What does Dr. Barley do as a professor at the NYP Hospital/Cornell Weill Medical Center? |
| Answer : |
It has always been very important to Dr. Barley to teach medical students and young doctors in the art of physical diagnosis. There are few better academic institutions to teach this than the New York Presbyterian Hospital and Cornell/Weill School of Medicine. His class, Physical Diagnosis, is taught at bedside without the aid of high tech equipment and diagnostic tests, encouraging young doctors to use their eyes, hands, and ears to diagnose and treat patients. Additionally, Dr. Barley often has medical students working closely with him in his office and in the hospital. Dr. Barley has been recognized by both the medical student classes as well as the institution for his high quality of teaching with the honor of Excellence in Teaching as well as an award from the Alpha Omega Alpha Honor Medical Society. |
| Question : |
In the event of serious illness, who takes care of Dr. Barley’s patients in the hospital? |
| Answer : |
Dr. Barley has an arrangement with the New York Presbyterian Hospital that, in the best interest of his patients, makes it possible to have a highly trained hospital physician or “hospitalist” involved in all his cases. During hospitalization, Dr. Barley frequently makes visits and gives appropriate recommendations when needed, often bringing in some of the best specialists in the city to advise and help care for his patients. While Dr. Barley is ultimately in charge of his patients’ care, he views the team of hospitalists, specialists, doctors in training, medical students, nurses, and medical staff as his partners in his patients’ hospital care. |
| Question : |
How does Dr. Barley stay up-to-date on the latest medical treatments and advances? |
| Answer : |
Dr. Barley attends conferences and lectures, fulfills his work on continuing medical education, teaches medical students and oversees medical residents, as well as complying with the American Board of Medical Examiners’ re-accreditation process. |
| Question : |
Is Dr. Barley open to non-traditional and alternative treatments? |
| Answer : |
Dr. Barley recognizes the growing interest patients have in non-traditional and alternative treatments, and he attempts to remain up-to-date with developments in this area. He has identified specialists in these areas who are well-trained, competent doctors who can work in harmony with traditional medical practices. There are several well-known alternative health care facilities whose staff Dr. Barley works with closely. |
| Question : |
Does Dr. Barley see patients with known or suspected heart disease? |
| Answer : |
Dr. Barley has a large number of patients with early or undiagnosed heart disease as well as many who have come for treatment once diagnosed with heart disease. Dr. Barley uses the latest heart imaging technologies, blood testing, as well as traditional clinical acumen and the assistance of top cardiologists to determine who has coronary disease, who is at greatest risk, and how best to intervene before heart disease begins or before it progresses to a more serious illness. Dr. Barley may use the latest Ultrafast Cardiac Cat Scan imaging and MRI Cardiac imaging for early detection of silent coronary disease. When appropriate, he also uses the newest blood testing techniques available to help predict those who are at greatest risk for coronary plaque buildup. |
| Question : |
Does Dr. Barley have experience with patients who have a diagnosis of diabetes, hypoglycemia, thyroid problems, hypo-testosterone, or other endocrine and hormonal diseases? |
| Answer : |
Dr. Barley routinely screens his patients who are at risk for various endocrine and hormonal problems. Abnormalities in many of these hormones can have very subtle symptoms and findings, which Dr. Barley attempts to identify early on before they progress to serious illness. |
| Question : |
Does Dr. Barley treat patients with sore throats, bronchitis, sinusitis, and pneumonia? |
| Answer : |
Sore throats may simply signal the onset of a common cold or may be an early symptom of a more serious illness. Patients frequently misunderstand symptoms of respiratory illnesses and ignore treatments that help avoid more serious infections that sometimes follow the common cold or other viral illnesses. While not all cold sufferers need an office visit, a conversation with their physician can determine if one is necessary. Dr. Barley is well-versed in most illnesses of the respiratory tract and their treatments and feels that early diagnosis and treatment is an important part of the health of his patients. |
| Question : |
Does Dr. Barley see patients with orthopedic injuries, back pain, muscle injuries, and joint pain? |
| Answer : |
Joint, back, and muscle injuries are very common, and Dr. Barley oversees care for many of them, working closely with the best orthopedists, chiropractors, sports medicine doctors, and physical therapists in the city in the treatment of injuries involving back, knee, elbow, ankle, and shoulder. Dr. Barley feels that early and proper diagnosis, treatment, and consultation with specialists is key to the cure and prevention of future injuries. |
| Question : |
What about urinary and prostate problems? |
| Answer : |
Patients with urinary and prostate problems are common to the practice of internal medicine. Dr. Barley is able to help treat most common urinary and prostate conditions such as urinary tract infections, kidney infections, sexually transmitted diseases, prostate enlargement, prostatitis, urinary frequency, urinary burning, and penile or vaginal discharge. When necessary, he consults with top urologists in New York City. |
| Question : |
What about the Lasik procedure for corrective vision? |
| Answer : |
Many patients are now requesting Lasik procedures for nearsightedness and farsightedness. Dr. Barley believes it is very important that his patients who request this procedure be appropriately screened by top eye surgeons. There are currently a large number of ophthalmologists performing this procedure, and some are more deft at choosing who the best candidates are for this surgery. Dr. Barley works closely with the city’s best eye surgeons to insure the safety of his patients’ vision, as well as obtain the best possible results. |
| Question : |
Does Dr. Barley administer flu shots? |
| Answer : |
Dr. Barley recommends the flu shot to any patient who has or is living with someone with a chronic illness, such as diabetes, heart disease, lung disease, kidney disease, blood disorders, people with compromised immune systems, and HIV/AIDS. Also, women who may become pregnant during the flu season, health care workers, and all those over 65 should be vaccinated. Depending on the year and the vaccine availability, Dr. Barley will administer the flu vaccine in a younger, healthier population, as well. He also administers the flu vaccine to companies and corporations on-site, as part of their preventative medicine programs. |
| Question : |
Does Dr. Barley test for sexually transmitted diseases in his patients? |
| Answer : |
Dr. Barley screens appropriate patients for most sexually transmitted diseases, including syphilis, gonorrhea, chlamydia, herpes, HIV, giardia, hepatitis and many others. HIV test results can be available in as little as 20 minutes in his office. Dr. Barley also attempts to educate his patients about proper precautions to help avoid these diseases, as well as vaccinate his patients against some forms of hepatitis and genital herpes. |
| Question : |
Is Dr. Barley able to perform bone density testing for patients in his office? |
| Answer : |
Dr. Barley has a state-of-the-art Lunar Bone Densitometry machine that he uses in his office, and he is able to perform and interpret your results immediately. |
| Question : |
Does Dr. Barley treat patients with osteoporosis? |
| Answer : |
Dr. Barley is very familiar with treating osteoporosis and, as a result, is able to intervene in the early stages before the disease worsens. With proper screening, a patient’s bone thinning may be caught at an early stage long before true osteoporosis sets in and when intervention is still effective. When significant bone thinning is found, Dr. Barley will perform other testing of the blood and urine to ensure there is not a secondary cause of this condition, such as vitamin D deficiency, celiac disease, abnormal calcium regulation, kidney disease, thyroid disease, testosterone, and other hormonal imbalances. Whether the osteoporosis is due to the normal aging process or to another cause, Dr. Barley is familiar with all the recent and most effective treatments available. In rare instances, complex cases may be referred to top osteoporosis specialists. |
| Question : |
Does Dr. Barley see a large amount of Lyme disease in his practice? |
| Answer : |
Dr. Barley sees many patients with Lyme disease and has a long experience recognizing the often complicated presentation of both early and late infections. It is very important to screen those at high risk for exposure to Lyme disease, as well as to intervene early in the disease before serious effects set in. |
| Question : |
How do I know when it is appropriate to have a diagnostic test, such as a colonoscopy, mammography, PAP smear, PSA testing, coronary artery screening, pelvic ultrasound, or other screening tests? |
| Answer : |
Factors such as age, family health history, and lifestyle affect decisions concerning diagnostic testing. Basic recommendations for each of these tests are best discussed with Dr. Barley in the course of routine treatment, such as yearly physicals or on the first visit as a new patient. |
| Question : |
Why has Dr. Barely chosen to have no contracts with managed care plans? |
| Answer : |
It is the view of physicians like Dr. Barley that managed care plans, in their focus on high patient volume, compromise the quality of medical care delivery. He decided early in his practice that he never wanted to compromise a medical decision for his patients or take the cost-effective routes favored by insurance companies. |
| Question : |
How does a patient get reimbursed from their insurance company? Does such reimbursement include the cost of labs, radiology, and specialists? |
| Answer : |
Because Dr. Barley does not maintain contracts with managed care plans, some patients may have concerns about insurance reimbursement. All but the most restrictive HMOs will reimburse patients who visit doctors outside their plan. Dr. Barley and his staff make every effort to ensure that patients receive maximum reimbursement from their insurance plans. Physician fees are usually just a small fraction of overall medical costs; all other services are coordinated by the practice with the goal of the greatest efficiency and affordability. |
| Question : |
What is IDNY, and why is Dr. Barley a member? |
| Answer : |
The Independent Doctors of New York (IDNY) is a group whose mission is to deliver the highest quality of care to all its members’ patients. In order to achieve this, physicians in IDNY maintain no contracts with health care insurance companies. This allows these doctors to make decisions entirely independent of restrictive agreements. Dr. Barley has been an active member in IDNY, as well as a board member and co-vice president. |
| Question : |
What type of political health care work does Dr. Barley do, and how has his work in health care policy with both local and national politicians helped in the delivery of health care to his patients? |
| Answer : |
Dr. Barley has been involved on many different levels in advising city, state, and national political figures. These experiences have helped keep Dr. Barley aware of the changes in the delivery of health care nationally, in insurance issues for his patients, the complexities of Medicare, and prescription drug benefits. He was National Health Care Policy Advisor to Congressman Dick Gephardt for his Presidential campaign in 2004. |
| Question : |
What is CITTA, and what does Dr. Barley do in third world countries to help their health care systems? |
| Answer : |
CITTA is an organization that delivers health care to some of the most impoverished populations in the world. Dr. Barley is involved in the delivery of health care facilities in India, Nepal, and Mexico. Through not-for-profit hospitals and accompanying schools, women’s centers, and small businesses, CITTA helps lead these regions out of poverty and aids in the preservation of their unique cultures. Dr. Barley has served as vice president of the organization and has visited several of CITTA’s facilities, where he has worked closely with local physicians and helped coordinate, teach, and work alongside many visiting American medical students and doctors. |
| Question : |
Where is Dr. Barley’s office located? |
| Answer : |
Dr. Barley’s office is in a high-end medical building at 110 East 55th Street, 9th floor. Our office is conveniently located near all major forms of public transportation and is just blocks from Central Park. |
| Question : |
Where did Dr. Barley go to medical school and receive his training to become a doctor? |
| Answer : |
Dr. Barley went to medical school at George Washington University School of Medicine in Washington, DC. This program is known for its emphasis on clinical training and boasts a diverse patient population in various hospitals throughout the Washington area. Dr. Barley completed his training in Internal Medicine at the New York Presbyterian Hospital, where he rotated between the New York Presbyterian Hospital, the Hospital for Special Surgery, and Memorial Sloane Kettering. |
| Question : |
Where are his hospital affiliations? |
| Answer : |
Dr. Barley is affiliated with the New York Presbyterian Hospital, as well as the Cornell/Weill School of Medicine. |
| Question : |
Is there any benefit from the fact that Dr. Barley trained in Internal Medicine at New York Presbyterian Hospital, Memorial Sloane Kettering Hospital, and the Hospital For Special Surgery? |
| Answer |
Dr. Barely has the unique advantage of three years of training in one of the finest cancer centers in the world, one of the best rheumatology and orthopedic centers, and one of the leading medical residency training programs in the country. The exposure and ongoing connections to the top physicians, researchers, and facilities is something unique and special Dr. Barley can offer his patients. |
