By Ancestral Apothecary
By Ancestral Apothecary
By Ancestral Apothecary
By Paula & Oro Cas
Catch-22: A dilemma or difficult circumstance from which there is no escape because of mutually conflicting or dependent conditions.
I sit looking at this document wondering how to write about the craptastic Catch-22 that has appeared in my husband’s life. My husband is one of the millions of people who suffer with chronic pain. His journey to where he is today began 35 years ago when he worked for a traveling carnival. While working to repair a ride, the clutch holding the ride’s car opposite the repairmen failed sending the cars around the track. Hubby and two other workers fell 50 feet resulting in multiple fractures and life threatening injuries. Combine those injuries with 30 years of commercial truck driving, a near fatal lightning strike resulting in damage to his nerve sheaths and joints, along with degenerative disk disease, stenosis, scoliosis, and osteoarthritis … We have a perfect storm of chronic pain.
by Oro Cas
How many people do you know who have never taken an antibiotic in their lifetime ? Probably not very many. The fact is a large majority of people in this country and around the world have been prescribed an antibiotic at one point or another.
Would you have been willing to take that pill or injection if someone told you beforehand that there was a good chance your entire body make up would be changed ?
The lady who wrote the story I’m sharing is an incredible person with an inner strength that can only be understood by myself and others who are living with the physical effects of this problem.
If your body seems to be breaking down quicker than normal then you will want to check Amy’s post out because she has shared a wealth of information on the subject.
This is the link to Amy’s story. >>>
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Treatments for head and neck cancers include surgery, chemotherapy, and radiotherapy, used either alone or in combination. Used to treat inoperable tumors, radiotherapy can cause radiation-induced dermatitis, which is treated with steroidal, nonsteroidal, and metallic topical medications. Researchers have studied the use of skin care products containing aloe vera (Aloe vera, Asphodelaceae) in patients undergoing radiotherapy. Aloe vera has been shown to have anti-inflammatory properties and researched for its use in treating a variety of skin ailments including eczema, psoriasis, burns, wounds, and ultraviolet (UV)-induced skin erythema. These authors conducted a single-center, investigator-blinded, randomized, clinical study to evaluate the efficacy of a topical aloe vera-based cream (AVC) in preventing radiation-induced dermatitis in patients undergoing therapeutic radiation for head and neck cancers.
The study was conducted between July 2012 and December 2012 in the Department of Radiation Oncology at Mangalore Institute of Oncology in Pumpwell, Mangalore, India. Eligible patients were…
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It’s the time of year, where more often than not we are turning to our medicine cupboard to support our bodies and our families. An abundance of tea herbs, honey, and lemon, fresh herbs like ginger, turmeric, cayenne, and garlic are all great to have on hand throughout the winter. A few herbal tinctures also play useful roles and are key ingredients in the medicine cabinet.
Elderberry | Elderberry is an excellent superfood-like ally safe to take in large quantities. With elderberry and plenty of rest, our body’s natural response kicks in–that’s why elderberry syrups and tea have long been used to help support optimal immune function. All these amazing herbs come in handy when our resources are low: elderberry helps our body maintain its normal immune response. Because it’s so much like food, it’s incredibly safe for kids, and happens to taste divine when combined with honey–hence the elderberry syrup! This one…
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March 19, 2017
Dr. Bryan Hill spent his career working as a pediatrician, teaching at a university, and working at a hospital. But in March 2016, he decided he no longer wanted a boss.
He took some time off, then one day he got a call asking if he’d be up for doing a house call for a woman whose son was sick. He agreed, and by the end of that visit, he realized he wanted to treat patients without dealing with any of the insurance requirements.
Then he learned about a totally different way to run a doctor’s office. It’s called direct primary care, and it works like this: Instead of accepting insurance for routine visits and drugs, these practices charge a monthly membership fee that covers most of what the average patient needs, including visits and drugs at much lower prices.
That sounded good to him. In September, Hill opened his direct-primary-care pediatrics practice, Gold Standard Pediatrics, in South Carolina.
Hill is part of a small but fast-growing movement of pediatricians, family-medicine physicians, and internists who are opting for this different model. It’s happening at a time when high-deductible health plans are on the rise – a survey in September found that 51% of workers had a plan that required them to pay up to $1,000 out of pocket for healthcare until insurance picks up most of the rest.
That means consumers have a clearer picture of how much they’re spending on healthcare and are having to pay more. At the same time, primary-care doctors in the traditional system are feeling the pressure under the typical fee-for-service model in which doctors are incentivized to see more patients for less time to maximize profits.
Direct primary care has the potential to simplify basic doctor visits, allowing a doctor to focus solely on the patient. But there are also concerns about the effect that separating insurance from primary care could have on the rest of the healthcare system – that and doctors often have to accept lower pay in exchange for less stress.
Courtesy Lauren Clark
For Brent Long and his family, paying for healthcare is now like paying a cellphone bill. Since they joined Black Bag Family Healthcare in Johnson City, Tennessee, about two years ago, the family has paid about $150 a month to belong to the practice.
Long joined around the time he was shifting his insurance to a high-deductible health plan. There were two reasons he decided to switch and start paying for all six members of his family to get direct primary care: the cost-effectiveness of not having to deal with copays or urgent-care visits, and the fact that it could easily fit his family’s busy lifestyle that doesn’t jibe with spending hours in waiting rooms.
Included in that monthly fee are basic checkups, same-day or next-day appointments, and – a big boon to patients – the ability to obtain medications and lab tests at or near wholesale prices.
Direct primary care also comes with near-constant access to a doctor – talking via FaceTime while the family is on vacation, or taking an emergency trip to the office to get stitches after a bad fall on a Saturday night. Because direct primary care doesn’t take insurance, there are no copays and no costs beyond the monthly fee.
Skye Gould/Business Insider
When Blythe Fortin went in for a recent visit at sparkMD, a direct-primary-care practice in Boise, Idaho, Dr. Julie Gunther spent an hour chatting with her before getting to the results of her blood test, which showed elevated blood-sugar levels.
“She listened when I said I can manage with diet,” rather than starting her on medication, Fortin said.
Fortin, who pays $60 a month for sparkMD, had used a different kind of subscription healthcare called concierge medicine. It has some similarities to direct primary care but often costs thousands per month and still incorporates health insurance. She says she prefers direct primary care because the quality of care she has received is better than concierge medicine, and she likes that it’s available to a wider base of patients.
At the 17 direct-primary-care practices Business Insider spoke with, the percentage of members who still had insurance varied. At some practices, all but a handful had some form of insurance, while at others a little more than half didn’t have insurance.
Courtesy of Dr. Julie Gunther
To describe how coverage functions under direct primary care, doctors use the example of car insurance: You don’t use your car insurance for small transactions like oil changes, but it’s there for you if you get in a car accident. Likewise, health-insurance plans – especially those with high deductibles – can be there if you require healthcare beyond primary care.
For those who have insurance, the choice to pay for both makes financial sense, even if they can’t use it at their doctor’s office.
Fran Ciarlo has coverage through Medicare but decided to pay for sparkMD as well. One of the ways she’s seen an advantage is in prescriptions – like many direct-primary-care practices, sparkMD can provide prescriptions at wholesale prices, adding a 10% fee. On a recent visit, Ciarlo estimated she had saved at least $100 on prescriptions for standard steroids and antibiotics that in total cost her $6.
And for those with high health-insurance costs, it’s occasionally a choice between paying a monthly premium or the monthly membership fee for a direct-primary-care practice. For Rebekah Bennett, paying for direct primary care at sparkMD made more sense for her and her children than opting for insurance through the Affordable Care Act marketplace, since for roughly the same cost, if not less, her family could see their doctor without any copays.
Philip Eskew, who has tracked the movement through his website, Direct Primary Care Frontier, said direct primary care began at the end of the 1990s and early 2000s. Around that time, three doctors had the idea to go insurance-free, charging monthly fees instead and freeing up time to enjoy practicing medicine. This way, patients who might not have insurance could have a clear idea of how much going to the doctor would cost.
One of the three founded Qliance, a direct-primary-care system based in Washington state that got its start in 2007. The company was backed by Amazon CEO Jeff Bezos and Dell founder Michael Dell before the company leadership bought it to run it privately, without investor pressure. Qliance now has about 25,000 members visiting a handful of clinics around Puget Sound.
Cofounder Dr. Erika Bliss sees this movement growing in the future from its grass roots, rather than becoming big and national.
“It keeps the resolve and the drive toward independent primary care,” she said, which she described as a critical element. She says she envisions independent practices with maybe 10 to 20 providers at three to five locations being about as big as they’d get.
Dr. Matthew Abinante opened his practice in Huntington Beach, California, in September. Since then, he has had two people call his office to find out more about his practice. When he explained the system, he said, the callers thought it had to be a scam.
It’s one of the biggest hurdles doctors face when starting direct primary care – the “too good to be true” factor, the learning curve that comes with the understanding that “No, you won’t be using insurance here.” Even so, Abinante has signed up about 150 patients.
Going into direct primary care often means ditching the reliability of a salary. Because the practice relies on membership fees, the more patients who sign on, the more money that can be made. Practices cap their number of patients at anywhere from 300 to 1,000.
And it’s not exactly cheap to get started. Dr. Vance Lassey, who runs Holton Direct Care in Holton, Kansas, took out a loan to start his practice and spent time renovating a 750-square-foot space he rented from a friend at an industrial park. He picked up a lot of old equipment from a nearby nonprofit hospital and surplus stores. For his in-house pharmacy, Lassey took mismatched cabinets and refinished them so they matched.
Courtesy Dr. Vance Lassey
Keeping his costs low helped Lassey break even within four months of opening his practice. Still, he’s not earning as much as he used to when he worked at a hospital and had only five to 10 minutes with a patient – a lot less time than he gets to spend with his patients now.
“I am making a profit, I have more free time, and I can practice properly,” he said. “It’s worth it to me.”
Others, like Dr. M. Chad Williamson in Fort Payne, Alabama, went upscale – he offers his patients a 24-hour gym as part of his practice’s $60 monthly membership fee. Williamson, who opened his practice in August, a few months after finishing his residency, currently has 215 members. He wants to bring that up to between 600 and 1,000 people, ideally.
And it’s not just building the office space – direct-primary-care doctors are also responsible for building referral relationships with other doctors in the area.
While doctors and patients using direct primary care might praise the model – it was hard to get anybody to suggest a group, geographic or otherwise, that they thought wouldn’t benefit from direct primary care – not everyone is sold just yet.
Carolyn Long Engelhard, a public-health expert and professor at the University of Virginia School of Medicine, broke down the main concerns with direct primary care:
Engelhard worries about the direct-primary-care model becoming the norm. Generally, she said, “I do think it has a place in our healthcare system.” Instead, though, she’d like to see more adoption of the “patient-centered medical home,” a model in which primary care is more of a team effort.
Medical organizations have had mixed reactions to the movement as well. The American Academy of Family Physicians supports it, while the American College of Physicians, which represents internal-medicine doctors, has chosen not to take a stance on direct primary care.
There are also logistical hurdles that present challenges. For example, Eskew said that in the eyes of the Internal Revenue Service, having a health savings account is illegal if you’re a member of a direct-primary-care practice. The IRS views the monthly fees as insurance payments, making the person ineligible for an HSA, he said. Patients also can’t use the funds from an HSA, flexible savings account, or Medicare savings account to pay their monthly membership bills.
But politicians have shown support for the business model. Libertarians see direct primary care as a free-market solution to healthcare, and legislation at the state level has gained support from Democrats and Republicans alike. And direct primary care is on the radar of Department of Health and Human Services Secretary Tom Price, who while he was a member of Congress introduced a plan that would allow HSA funds to pay for direct primary care.
“Whoever is in power tries to take credit,” Eskew said. The ACA contains a paragraph about direct primary care that allows for the business model. It’s unclear what would happen to direct primary care under the American Health Care Act, the proposed bill to replace the ACA.
Courtesy of Dr. J. Bryan Hill
As one of the first pediatricians to go into direct primary care, Hill has had the additional challenge of figuring out how the service works with children. Unlike many direct-primary-care physicians, he offers one-time visits to nonmembers. He said he also spends a lot of time listening to what parents want and sets his prices accordingly, offering discounts to families with three or more kids.
Doctors who are part of the movement tend to be the first in their area to have a direct-primary-care practice, and patients the first of their friends to use direct primary care. But all said they had positive experiences with the model.
“This is a niche, but a niche that makes sense,” Long said.
If direct primary care continues to gain traction, it could lead to new kinds of insurance plans – ones that don’t necessarily factor in primary care. Already, patients with high-deductible healthcare plans are using this. But direct-primary-care doctors also said they’d prefer to recommend catastrophic health insurance plans, which have deductibles as much as $10,000 or $30,000 and aren’t allowed under the ACA.
Even with the growth in the last few years, Bliss said the market is still slow, and a lot of unknowns would come with the AHCA should it become law. And it will be hard to get fully insured employers to use it in the same way self-insured employers and unions have picked it up.
Either way, those in direct primary care are optimistic about the movement’s future.
“In 10 years, we’re going to be an overnight success,” Eskew said jokingly.
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