Narrow networks… keep premiums lower but…..

A recent Associated Press vignette noted: “MIAMI — The first thing Michelle Pool did before picking a plan under President Barack Obama’s health insurance law was check whether her longtime primary care doctor was covered. Pool, a 60-year-old diabetic who has had back surgery and a hip replacement, purchased the plan only to find that the insurer was mistaken.”

“Pool’s $352 a month gold plan through Covered California’s exchange was cheaper than what she’d paid under her husband’s insurance and seemed like a good deal because of her numerous pre-existing conditions. But after her insurance card came in the mail, the Vista, California resident learned her doctor wasn’t taking her new insurance.”

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If you do not buy health insurance you will get billed by the doctor, ER, and hospital

Choosing not to buy health insurance as required by Obamacare will result in IRS penalties withheld when you file your income tax returns. But you will still get billed by your doctor, the ER and the hospital – which could affect your credit rating, and in the case of an expensive emergency hospital admission put you into enormous long term debt if not bankruptcy.

Recently NPR published FAQs on “Understanding The Health Insurance Mandate And Penalties For Going Uninsured”. For example:

“Do I have to carry health insurance? Yes, just about everyone is required to have insurance as of Jan. 1, 2014, or else they’ll be liable for a tax penalty. That coverage can be supplied through your job (including COBRA or a retirement plan), public programs such as Medicare, Medicaid or the VA, or an individual policy that you purchase.

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Are Sure You Know What Kind of “Doctor” is Treating You?

If you are not certain who is treating you, ask!!!

We are familiar with M.D. and D.O. (physicians). Many other clinicians are called doctor such as your dentist (D.M.D.), podiatrist (D.P.M.), optometrist (O.D.) and chiropractor (D.C.).

Read this from the New York Times:

“Hi. I’m Dr. Patti McCarver, and I’m your nurse,” she said. And with that, Dr. McCarver stuck a scope in Ms. Cassidy’s ear, noticed a buildup of fluid and prescribed an allergy medicine. It was something that will become increasingly routine for patients: a someone who is not a physician using the title of doctor. Dr. McCarver calls herself a doctor because she returned to school to earn a doctorate last year, one of thousands of nurses doing the same recently. Doctorates are popping up all over the health professions, and the result is a quiet battle over not only the title “doctor,” but also the money, power and prestige that often come with it.”

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Rosacea: myths, reality and treatment

What is rosacea?

Rosacea is a skin condition in which your face tends to appear red and inflamed with periods of worsening and improvement over months to years. Individuals with rosacea may flush easily or develop what looks like acne breakouts. It can occur in all ages or ethnicities but tends to be most common in white, middle-aged adults.

How common is rosacea?

Rosacea is extremely common with an estimated 14 million Americans suffering from the condition. Some notable sufferers include former President Bill Clinton, J.P. Morgan, W.C. Fields, Rembrandt and Rosie O’Donnell — not to mention Santa Claus and, most likely, Rudolph!

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Evidenced Based Medicine

In my health care management career, medical education has advanced from apprenticeships (“see one, do one, teach one”) to differential diagnosis (The process of weighing the probability of one disease versus that of other diseases possibly accounting for a patient’s illness) to…..Evidenced Based Medicine

“The most common definition of Evidence-Based Practice (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”

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Why Don’t Patients Remind Medical Professionals to Wash Their Hands?

I ask this question to every clinician examining me, doing a procedure on me, or drawing blood from me. Physicians. Dentists. Phlebotomists. Radiology techs. PTs.

And I prefer they wash their hands in front of me. Proper hand washing is the single most effective preventive medicine measure.

Recently a Bloomberg News article explained why it is important to remind clinicians to wash their hands. “Physicians shouldn’t take offense. We all can benefit from reminders about the basics. Years of education and expertise don’t mean that medical professionals aren’t human, and may sometimes forget a step in even routine procedures.”

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Don’t Behave Emotionally When Asking for Hand-Washing Compliance

Recently a Fox Business story noted: “When Cari Shane requested that her four-year-old’s pediatrician wash her hands before starting the exam, the doctor complied, but was upset. But Shane, who is a public relations executive, says if she were in the same position, she’d do the same thing all over again. “What was more important? Having the doctor mad at me or protecting the health of my child?”

“Strict hand hygiene is the gold standard for reducing infections associated with health care-associated infections (HAIs), experts say. And when doctors, nurses and health care workers fall short, it’s important for patients to feel confident enough to speak up.”

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Achieving the “Triple Aim”

“—providing the highest quality of care at the lowest cost possible while improving patient outcomes—is becoming more and more difficult…” One strong option to help the medical community achieve these aims is physician-led team-based care.”

A recent AMA Wire story story noted: “In a physician-led team, physicians collaborate with nurse practitioners, physician assistants and other health professionals, supporting team members in performing to the height of their training and building on each professional’s strengths and perspectives. At the 2012 AMA Interim Meeting, a joint report (AMA login required) of the Councils on Medical Education and Medical Service established principles to guide the interactions between physician team leaders and non-physician practitioners. The Councils noted that this care delivery approach can help improve access to care, enhance quality and enable greater continuity of care.”

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Does Your Physician Use an Electronic Medical Record (EMR)?

There are many advantages of electronic medical records. Electronic medical records (EMR) help health care providers better manage patient care by:

  • Getting accurate and complete information about their patient’s health
  • Better coordinating the care they give to their patients and families
  • Securely sharing information with patients electronically about their personal health record
  • Accessing information to help diagnose patients, reducing medical errors, and providing safer care at lower costs
  • An EMR contains patient health information, such as: Administrative and billing data; Patient demographics; Progress notes; Vital signs; Medical histories ; Diagnoses; Medications; Immunization dates; Allergies; Radiology images; Lab and test results

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