HealthPoints

Life's Health Risks

by Mark E. Schlussel
I was reading an article on Medscape.com entitled "No Safe Limit: Even One Drink a Day Increases Risks." This article focuses on research being done that establishes alcohol consumption may substantially increase the risk of diseases like cancer, coronary artery disease, tuberculosis and obviously road injuries. The article states, "Alcohol has long been recognized as a leading risk factor for disease burden and has been linked to 60 acute and chronic diseasthe radom beeres via all multitude of mechanisms, both through cumulative consumption and acute intoxication." The article further states, "Studies have suggested that low-level alcohol consumption may [protect] against Ischemic heart disease and diabetes, among other conditions. However, such findings have been challenged by recent analyses."
 
As I thought about the implications of the findings in this article, there was no question that alcohol consumption leads to terrible tragedies on our roadways daily. However, it was the other findings that were most intriguing as they brought to mind all of the continuing research advice we as laypeople get from the research component of our medical community about our eating habits and our lifestyles. To this day, I remain confused as to whether eating whole eggs or food prepared with whole eggs including the yolk are unhealthy or are now on the continuum of "not so bad for us". I feel the same about beef and the implication of the potential adverse health effects of interspersing meat in your diet. I wonder about my vitamin regimen - Is it helping me stay healthy or am I just enriching the pharmaceutical companies who manufacture the vitamins and minerals that I take. I would hate to think that I'm merely passing all of this cash through my kidneys.  
 
The truth is, during my lifetime,the advice given to us as healthcare consumers about what we should eat, what we should drink, how much exercise we should receive, how much sleep we need and generally what we should expect at each stage of our life is a set
Are all the foods bad?
of fluid criteria. We can find opinions and research on all sides of the various eating and lifestyle experiences. We can also do our own research and find that advice of 25 years ago which was subsequently determined to be misdirected, is now, once again, in vogue as reasonable behavior.
 
What do we learn from these changing analyses of our lifestyles? The fundamental take away from the changes in advice and direction is that moderation should be the cornerstone of our lifestyles. We all know that drinking too much leads to alcoholism. That is a distinct illness as a standalone. We do not need researchers to tell us of the profound health risks associated with being an alcoholic. Not only does it abuse the body of the alcoholic, but it puts at risk their immediate family from levels of abuse that are directly attributable to drunken behavior. Further it puts the public at risk when an alcoholic chooses to drive.
 
We all see the statistics on the health risks of obesity; yet in our society, food consumption has largely become a drive-through experience. The idea of a family dinner with its balance between fatty foods and healthy vegetables and fruits is largely a thing of the past.

When it comes to the vitamins, I still intend to take mine every morning whether it serves as a psychological palliative or it really helps. It feels much the same as my perception of chicken soup; which, for many decades, has been a remedy for all sorts of medical issues. It may help or it may not help, but it won't hurt you.   
 
As we head into Labor Day weekend, many of us will be thinking about how fast the summer has gone by. For each season of the year, our life balance changes. At Curus, this is a metaphor for the aging process. As we age, our health becomes a greater priority. When we are young, we have a sense of invincibility; and as we age, we recognize our growing limitations. Our company is committed to enhancing the quality of our members' lives as they experience the transitions through the seasons of life.   Check out what Curus has to offer

Filed Under: changes in healthcare, alchohol

Concierge Medicine Pros and Cons and a Little History

The Great Society

If you remember the time when physicians made house calls it was a period in American healthcare where the relationship between doctor and patient was both medical and economic. During the era of house-calls you received your services directly from your doctor and you paid for those services directly to your doctor. Along came the presidency of Lyndon B. Johnson and his “Great Society”. 

 

 Closeup portrait, overwhelmed, busy unhappy stressed female health care professional, funny looking doctor holding big clock running out of time exhausted, isolated red background. Healthcare reformThis aspirational vision began the disconnect on payments for physician services t patient and doctor. In this new emerging aspirational society, everyone was going to have comparable healthcare and both the government and private insurance would be the payment intermediary between patient and doctor. The patients purchased health insurance or if they were senior citizens they purchased Medicare insurance to cover the costs of their healthcare needs. As this phenomenon emerged and expanded, a total disconnect occurred between the patient and the physician. The patient no longer understood the cost or the value of the service being received.

As we fast-forward decades from the Great Society to today, we have a new emerging unique relationship being developed between physicians who provide primary care services such as internists or family doctors and their patients. This new relationship is occurring within the more affluent socio-demographic who seek to have preferred status with their primary care doctor to ensure immediate access and physician availability. We are in a time of increasing physician scarcity and access to a doctor can be weeks or more away from the time the services are sought.  These physicians are experiencing a reduction in the reimbursements provided by the third-party payer (insurance companies) for the services they have historically provided. As a result, the physicians have begun to look for alternatives to seeing more patients and reducing the amount of time available to each patient. 

 

New call-to-actionThe alternative that is emerging is that increasing numbers of well-trained primary care physicians are adopting a concierge medicine model. In this model, the physician caps the number of patients in his/her practice and receives an additional direct payment, in addition to the insurance reimbursement, from the patient. The norm for the average full-time primary care provider is to see between 1500-2200 patients annually. In concierge medicine, the number of patients seen by the physician is a sliding scale tied to the concierge payment made directly by the patient to the doctor. So what does concierge medicine cost? There are significant national groups that charge an additional patient payment, approximating $1800 annually, and the physician agrees to limit the number of patients in the practice to 600 patients. From this benchmark, there are practices that limit the number of patients to 50 patients annually and they are paid an additional $20,000 per year to have this very exclusive limited practice. Between these two extremes, there are a number of price points and patient numbered caps all along the continuum of concierge medicine. 

 

In a unique way, you can think of concierge medicine as a throwback to the doctors who made house calls. Photo of retired man on private medical consultation
The doctor provides much more hands-on direct access and the patient remunerates the doctor with an additional annual direct payment to have this accessibility. Do you really get good medical access with concierge medicine? The limiting factors that occur in this emerging concierge medicine model result from the fact that healthcare delivery has become much more complicated and specialized over the last five decades. Many of the illnesses that the traditional primary care doctor handled previously are now referred to specialist and sub-specialists. In this scenario, the exclusive access that exists with the PCP dissolves when the patient moves on to the specialists. The specialists, not being tied to a patient cap, has a full waiting room and the patient is again thrown in with the masses seeking, this time, a specialized physician. Further, the PCP develops a referral pattern that may result in the specialists recommended not being uniquely qualified for the specific medical issue or event, but more, a result of familiarity or network connections. Further, the complications of the billing processes in medicine and the document known as Explanation of Benefits (EOB) still remain within the purview of the patient as most concierge physicians continued to bill their patient’s insurance company.   When you decide that you are in the market for a concierge doctor, you need to focus on the doctor’s skill sets, referral patterns, and ability to navigate with you through the complex healthcare system we have. Just purchasing access for primary care in the complex healthcare world may not satisfy the experience your parents and grandparents had with their doctor who made house calls. 

 

 

There is a difference between concierge healthcare and concierge medicine. Which one are you really wondering about?

Click to Download a PDF on the Concierge HealthCare Management Model 

Filed Under: Insider, concierge medicine, concierge healthcare, why don't doctors do housecalls, changes in healthcare, lyndon by johnson, great society, pros and cons of concierge medicine