Prevention of Cardiovascular Disease

Consumer Reports Letter Submitted to the Editor


Dear Editor

It is with great interest that I read your Consumer Reports article, “Take Charge of you Heart Health.” Let me preface the following words with the confession that I AM NOT A CARDIOLOGIST.

I am an adult medicine doctor who takes an intense personal and professional interest in the PREVENTION OF CARDIOVASCULAR DISEASE.

IN 2014, 24 years into my career as a physician, I was grieving the senseless loss of my father due to cardiovascular disease and frustrated that I could not achieve compliance with my patients to take the medications which would help decrease the nation’s number one cause of death and disability.

After much complaining to the universe I, fortuitously, landed a seat at the HASPA (Heart Attack and Stroke Prevention Alliance) conference. That day I learned about ALL the different technologies which would help me care for my patients’ vascular health. The cardiopulmonary exercise test, however, was the winner by far. Interestingly, there are 2 groups which use the test. Cardiologists who care for persons with congestive heart failure and athletes to improve their functional capability. The bike test tells the VO2 max which is each person’s capability to use oxygen maximally.

Prior to the bike test we were attempting to achieve compliance by discussing risk factors. This was like trying to mix water and oil. A fair number of patient’s, if they had no OBVIOUS SYMPTOMS of cardiovascular disease, would tell me, “ All I need to do, Dr. B, is exercise and eat healthy.” Every year they would return heavier, transitioning fully into diabetes or have a heart attack.

Prior to the bike test we looked at cholesterol, blood pressure, sugar levels, family history, calculated risk scores and other risk factors. More than 50% of the time I would hear this, “Dr. Baksh, My strong personal philosophy is to do this naturally.” I have actually had patients pay THOUSANDS of dollars for supplements, spas, purging and other ‘natural remedies’ while resisting medical recommendations.

With the bike test, the answer is personalized and clear cut. This is YOUR VO2 max. You use oxygen optimally ..great. You use oxygen poorly…let’s fine tune the different areas where oxygen plays a role and recheck you in 6 months. Your level is <70%. Is that because of airway inflammation, anemia, cholesterol plaque buildup OR ALL OF THE ABOVE? Let’s find out the specifics, the details and then let’s sit down and discuss what exactly is going on. NOT SURPRISINGLY, THIS makes SENSE to each person. Not all patients “get it” and some, for whatever reason, decide not to have the tests. That’s okay too because, at the end of the day, we offer excellence of care and the patient decides if that fulfills their philosophy.

Other reasons it makes sense from a self care standpoint is that I am not sending patients to a cardiologist to have nuclear medication injected and then exposed to radiation (a test that is wrought with false positives and negatives) and you will not need to get an invasive procedure unless my ultimate evaluation (a CT angiogram) shows that you have a blockage. This is a very rare step. I have had to do this 2-3 times in the last 3 years.

Further, this makes great sense not only from a personal care standpoint. It resounds with wisdom from the viewpoint of national medical debt control.

It is well known that most of medical care costs is due to specialist care. Keep all the evaluation in the hands of the internists or family practitioners, strive for prevention, strive for longevity AND quality… superior quality of life based on fine tuning microvascular changes..then we truly have a multiple win situation.

Once again, I humbly confess, I am not a cardiologist. The person who has guided us through the studies and the science of this is Dr. Sundeep Chaudhry. When I have questions and concerns… I quickly reach out to him and his exercise physiologist Nick Menasco. It would be great if you could reach out to him if you wanted the specific scientific information surrounding this practical, sensible and cost effective testing

Though not a cardiologist I am a physician who has seen the inability of the current system to successfully achieve compliance in prevention of cardiovascular disease AND many forms of disease. I strive every day to understand how I can capture my client’s attention, develop compliance and RETAIN that interest and proactivity.

I invite you to take part in our Prevention of Cardiovascular Disease Program. See for yourself how these tests inspire and energize us to achieve cardiac health.

Best Regards,

Husna R. Baksh, M.D.

Healthy Steps: Office of Internal Medicine

Portal de Pacientes

¡BIENVENIDO a nuestro Portal de Pacientes de Healthy Steps en línea!

En julio de 2011, Healthy Steps se cambió a los sistemas de registros médicos electrónicos a AthenaHealth en línea. Esta nueva tecnologia de RME (Records Medicos Electronicos) nos ha permitido ofrecer a nuestros pacientes un mayor nivel de control y acceso al manejo de la salud y la información.

En Healthy Steps, creemos que el logro de sus metas de atención médica debe ser un esfuerzo de grupo y el uso del Portal de Pacientes nos ayuda a hacer precisamente eso.


Puede acceder a su cuenta en cualquier momento para:

Revisar sus registros médicos / resultados de laboratorio / imágenes
Solicitar citas que no sean de EMERGENCIA (sin necesidad de hacer una llamada!)
Pagar una factura
Solicite rellenos de medicamentos
Envíe a nuestro personal mensajes de rutina / consultas …. ¡Y MUCHO MÁS!
Haga clic en el siguiente enlace para crear su cuenta de portal SEGURO y empiece hoy mismo.

Patient Portal

WELCOME to our online Healthy Steps Patient Portal!

Our Electronic Medical Records system through AthenaHealth allows us to provide our patients with a greater level of control and access to their healthcare management and information. At Healthy Steps, we believe that achieving your healthcare goals should be a TEAM effort and the portal helps us do just that!

You can access your account anytime to…
1. Review your healthcare records/lab/imaging results
2. Request and schedule NON EMERGENCY appointments (without picking up your phone!)
3. Pay a bill
4. Request medication refills
5. Send our staff routine messages/concerns …. AND MUCH MORE!

Click on the link below to create your SECURE portal account and get started today!

Inclement Weather Policy

At Healthy Steps, our primary concern is the safety and well being of our patients and staff. In the event of inclement weather, we will follow the Montgomery County Schools Administrative Offices policy. If the administrative offices are closed, we will be closed. If they have a delayed opening, we will delay our opening the same number of hours. A 2-hour delay would mean we will open at 10 AM.

If you are unsure of the status of an appointment, please call the office. 

Patient Forms

If you are a new patient who has an upcoming appointment scheduled with us please print the form below, fill it out and bring to your visit. This will make your first office visit go more efficiently!

Don’t forget to bring your insurance card, picture ID and copay to your appointment as well.

Si usted es un nuevo paciente y tiene una cita con nuestra oficina, por favor imprima el siguiente formulario y traigalosa su cita. Esto ayudara que su primera visita se conduzca mas eficientemente.

También, no se olvide de traer su tarjeta de seguro, una forma de identificación con foto y su copay designado.

Insurance & Fees

We accept most insurance, but if you are not sure whether we participate with your insurance plan, please contact your insurance company for more information. We thank you for the trust you have put in us by choosing us as your healthcare provider. We are committed to providing you with the best possible care and to your treatment being successful. Your clear understanding of our financial policy, however, is important to our professional relationship. Please understand that payment of your bill is considered part of your overall treatment.