Are Family Physicians an Endangered Species?
Dr. William T. Chushing, M.D., J.D, MBA
June 9th, 2010
I had breakfast last week with another Family Physician who, after 14 years of practice, had to close his family medicine practice because, during the last two years, he could not make enough money to pay himself. He could only make enough money to pay the rent and the salaries of the staff.
The burdens imposed by government and insurance companies on Family Physicians will make it impossible for Family Physicians to survive. The extinction of Family Practice physicians will bring the U.S. healthcare system to its knees. Family Physicians have been the front line of the healthcare system.
A Family Physician has to maintain an office, support it with equipment and supplies, staff it with personnel and obtain insurance. Now, the federal government is increasing the costs of maintaining a family medicine practice by mandating that electronic medical record systems be installed and used in these practices.
Electronic medical record systems have been shown to reduce the number of patients a family physician can see by 25 to 30 percent. This is even more devastating when taken in the context of the government and the insurance companies paying the physician less and less for caring for patients. Physicians are being paid less per patient visit and the government is guaranteeing that physicians can see fewer patients. It is a recipe for more Family Physicians to go out of business.
On top of this, the government is demanding more specific and tedious coding and administrative requirements for physicians. This will also add to the costs of doing business.
The costs, direct and indirect, of electronic medical record systems, decreased payments for patient care, more administrative demands by government and insurers, increased costs of maintaining a family medicine practice, increased medical malpractice insurance costs and increased medical malpractice litigation will guarantee the extinction of the Family Physician.
Something has to be done to save the Family Physician.
Dr. Cushing's blog
Rest and Renewal Tips for Caregivers
Cargiving is not only hard work, it's sacred work and caregivers need to get their share of rest to renew their energy. Here are some tips to help you find additional rest and renew your energy.
Hire a non-medical home care assistant for occasional events or on a regular basis.
Arrange for other family members or friends to provide care.
Consider a nursing home or assisted living facility for planned vacations. Call ahead to make sure you have the time to complete the paperwork and assessment.
Consider an adult day center to provide care during the day.Often transportation can be arranged.
Ask a trusted family member or friend to take on some responsibility regularly, such as paying bills, taking your loved one for a daily walk, giving a bath and shampoo or even running errands such as grocery shopping or preparing a meal.
Change your expectations, being a caregiver is your priority, not housework. Instead of doing chores every week, it may be a little less often.
Plan some time in your day for yourself - perhaps it's a long bath, or talking to a friend or reading a book, do something you enjoy that is just for you!
Join a support group - either a local group or an online group. Just talking to someone who understands can offer you additional support and sometimes a new way to handle different situations.
Recognize that for some people, nursing homes or assisted living facilities are the best option.
Don't try to guess what your loved one needs - Ask. Ask the doctors and nurses: What will my loved one need? What help is available in the community?
Consult a social worker or case manager, especially to understand Medicare and Medicaid rules and what facilities and services might be available should you need them.
Get information from the relevant national organizations. All kinds of good information is posted on the Internet, and a librarian can help you get it if you don't have access. Some groups also have toll-free phone numbers.
Do some research, either in the library or on the Internet. Try to become something of an expert on the particular illnesses affecting your loved ones.
There is help out there — don't do it all alone.
Saving Lives - One Story at a Time
It is important to capture not only the stories of our elderly loved ones, friends and neighbors, but also our own, for when we are gone from this good earth our stories will die with us... unless we record them now.
One of my most treasureed memories of my maternal grandfather is a written story he left behind for us to find after he was gone. It was a story of his youth, of growing up "tough". To read his account, he was quite a scrapper in his day. We know him differently but we also loved his stories, his trips down memory lane that he shared with us. These memoir's have the power to entertain but they also are able to convert experiences into wisdom and personal growth for those who came after them.
The time to capture these stories is now. Put it on your calendar, your "to do" list and do it. Make it a priority. If you can, video tape these stories.
Some tips about writing life stories from the Association of Personal Historians can be found here -
Are you a Military Veteran?
For more information please visit their web site - http://www.personalhistorians.org/
The Association of Personal Historians is a proud partner of the Library of Congress: Veterans History Project. As partners, we help collect first-person accounts of military service in World War I, World War II, the wars in Korea, Vietnam, and the Persian Gulf, and the conflicts in Afghanistan and Iraq. They also collect stories of civilians who supported these efforts, including men and women who worked in defense-related industries, as USO entertainers, and as Red Cross workers.
Sleep Apnea
This is a link to a resource for discount CPAP supplies and it has articles about how important it is to get a good fitting CPAP mask and to replace it on a regular basis.
http://www.apneamask.net/
Expenses you might be able to eliminate in retirement
From Yahoo Financials -
Although retirement can mean the cessation of some forms of income such as earned compensation, it can also mean the elimination of certain types of expenses. Although some studies have indicated that the cost of living for retirees is just as high as it is for younger taxpayers, there are still many everyday expenditures that may disappear at some point. Here are the expenses you might be saving once you hit your golden years.
See the list here
People who move into retirement communities more likely to live fully and age successfully
FACT: People who move to retirement communities tend to be “planners” and want to take the right actions so they can continue to live fully and age successfully.
Making the move to a reirement community is often not a decision that is quickly made, many people spend years trying to decide when the time is "right" to make this MAJOR MOVE.
The most successful transition moves are those moves that happened when the older adult felt they had control over the process and the decisions they made.
Almost everyone who has made the transition will tell you, "Too soon” is better than “too late.” As we age, the older we get, the harder it is to make the tranistion. Additionally, as you age, you will need more support in the process and afterwards.
Move while you are still together as a couple, before major health issues happen so you are able to move together... it's much easier than moving alone.
Remember, moving sooner rather than later, gives you the opportunity to make decisions that feel right to you, not decisions that feel right to your adult children. It's your life and by moving sooner you have control over it.
Plan ahead... clean out the attic, learn to recognize what things you truly love and want to take with you and what things you can give away or live without. Make a list and revise it as you go forward with your plans to downsize.
Visit retirement communities often, walk through them, talk to the people who live there.... they will tell you, over and over, they are so glad they made the move! If you ask them for advice, most likely they will say -"Move now while you are still able, don't wait until your kids have to move you, we wish we had made the move sooner!"
If you think you might want to move there, ask about the process of putting your name on their waiting list - as a rule, that doesn't obligate you, it just lets them know you are interested and when one becomes available they let the people on the list know about it first. If you are not interested, the next person on the list is called... and you'll remain on the list to hear about other openings as they become available.
At Brethren Retirement Community, we are always happy to show you around our beautiful campus and introduce you to our residents and the benefits of living in a retirement community.
For those who prefer a location closer to Dayton, please visit our location in Union, Ohio, Mill Ridge Village, just off Sweet Potato Ridge Road between St Rt 48 and St Rt 49.
Senior Citizens Prime Target for Identity Theft -Medicare Card
Did you know that one of the easiest ways for your identity to be stolen is if you lose your Medicare card?
When you turn 65, everyone receives their Medicare card. Did you know your Medicare number is tied directly to your social security number – something identity thieves just love.
Identity theft is on the rise and senior and elderly populations seem to be a prime target for the thieves.
One of the ways seniors can lose their identy is by losing their wallet with their medicaid card - First thing you need to do is to keep your Medicare card in a safe place. Security experts recommend you do not carry your Medicare card or your social security card with you. What if you should lose your wallet? There’s your social security number. All it takes is one of these cards to steal and/or sell your identity.
There is no reason for someone to carry a social security card in your wallet. Keep it at home in a safe place.
To keep your Medicare card safe, make a copy of the Medicare card and blackout the last 4 digits of the number and keep that with you. This just shows someone that you are covered by Medicare should you need any type of medical help.
It is recommended that you make a few extra copies of your Medicare card and keep those copies in a safe place too. Make sure to give one to an adult child who may need that information if you are hospitalized and unable to give that information.
Should you need to visit a doctor, all they need is the copy of your Medicare number. You don’t have to hand them your original card and risk forgetting to get it back.
Salt Shockers Slideshow: High-Sodium Surprises
Sodium: it plays a vital role in maintaining the body's fluid balance and we need it for our muscles and nerves to function properly but most of us consume way too much of it.
Many people are quick to say they never salt anything but are surprised to learn how much "hidden" sodium they consume from processed foods and other items we buy at the grocery store.Click on the slide show to see how sodium sneaks into our bodies through our food choices.
Salt Shockers Slideshow: High-Sodium Surprises
How Old do YOU Feel?
The answer to this question depends on your age.......chances are the older you are, the younger you feel. As we age, the beginning of OLD AGE moves further and further away from where we are in our aging journey.
Click here to read an article in the New York Times about the largest study ever done in the US to gauge American's views on aging. Be sure to click on the names on the left hand side to hear their views on old age.
Cell Phone Information for Seniors
Check it out - Click here.
Crispy Fried Green Beans with Bacon
4 servings
1 pound green beans, washed and sorted with stems removed
1/4 pound sliced smoked bacon, cut into 1/2-inch pieces
1small yellow onion, peeled and thinly sliced
3 TBSP red wine vinegar
2 tsp. granulated sugar
handful coarsely chopped Italian parsley - optional
Sea salt and freshly ground pepper to taste
Bring a large pot of heavily salted water to a boil. Meanwhile, prepare an ice water bath by filling a bowl halfway with ice and water.
Place beans in the salted boiling water and cook until crisp tender, about 3 minutes. Drain and place in the ice bath to cool. Drain and set aside. (Can do this earlier in the day)
In a large frying pan set over medium heat, cook bacon until it starts to brown. Add onion and cook until it caramelizes and turns golden.
Add reserved green beans, (pine nuts) vinegar, and sugar and cook, stirring, until sugar has dissolved. Mix in chopped Italian parsley and season with sea salt and freshly ground black pepper.
MEDCottage ‘Granny Pod’ - Is it the Wave of the Future? Would you live in one?
We are all aware that America is aging and more and more people are desiring to "age in place". Granny Pods have been popular in Australia and on the west coast for several years.
"Granny Pods", are modular homes that are temporary. They are often placed in the backyards of family members, allowing the seniors to be close to family with their own "home". They connect to the house much like an RV would and have gray water holding tanks.
Now, a new test to the Granny Pod has entered the market - the MEDcottage, an invention of the Reverend Kenneth Dupin, leader of a small Methodist church in Sale, Virginia. The Washington Post recently covered a story on the MEDCottage (Va. launching portable housing for aging relatives) concept. This is no ordinary grandmother’s cottage; it is outfitted with the latest technical advances in the industry, including dynamic smart robotic features. It offers remote monitoring capabilities via Internet for the caregiver through their PC in real time. Some of the areas monitored include security, communication, environmental controls, telemetry, and medication dispensing. At a fraction of the cost of a nursing home, the Medcottage provides a flexible solution for family managed care of a loved one during rehabilitation or recovery.
The company, N2Care, has won public grants to continue to fund development of the project but is still searching for investors to fund its operations past its current development stage. The company believes that a unit could be leased for $2,000 per month and provide a variety of technology solutions for senior care as well as entertainment.
For more information, visit their web site - http://www.medcottage.com/medcottage/about.html and be sure to visit their YouTube link on their site.
What are YOUR thoughts? Would you live in one?
Trends in Senior Living
Every year, different trends take the forefront in the world of independent living. In 2010, there are several interesting new trends coming down the pipeline. The most significant ones are highlighted below for your convenience:
1.Urban Retirement – Thanks to the centralized proximity of daily necessities like grocery stores and pharmacies, the convenience of public transportation and the nearness of many prime entertainment opportunities, you can expect to see more seniors retiring to urban areas than ever in 2010. Urban retirement is a trend to watch, and the independent living industry is already taking notice. The suburbs will continue to be the predominate location of most independent living service providers, but urban areas will see a definite upswing this year.
2.Technological Amenities – Although many people consider modern technology to be the province of the young, more seniors than ever are getting into high tech gadgetry and other products. Modern technology can benefit independent living in a number of key ways, with communication being one of the primary areas. Thanks to modern forms of communication like email, social networking, text messaging and others, communication can be more easily incorporated into an independent lifestyle than ever.
3.Adventure Activities – Where trips to the mall or to the casino used to predominate in the world of independent living activities, today’s seniors are becoming more adventurous in 2010. This year, expect to see a variety of active team sports increase in popularity; track and softball are two prime examples. More and more independent living facilities are expected to offer programs in more extreme activities like sky diving, white water rafting, skiing, parachuting – and many others – in 2010.
4.Co-Housing – For seniors who aren’t ready or willing to live in an assisted living facility – but for whom total independence isn’t quite realistic – co-housing is becoming a more popular trend in the upcoming year. In a co-housing arrangement, individual seniors enjoy their own apartments or townhouses while sharing common areas with a group of other senior citizens. In this way, they have a built-in community of people who they can turn to for friendship and help while still maintaining a large amount of privacy and independence.
5.Green Building – Green – or eco-friendly – building is something that has been emerging as a trend within the independent and assisted living industries for some time. Its roots lie in the increasing awareness of people around the world about saving the planet and reducing their impact on the environment. Interestingly enough, the current economic climate is going to propel the green building movement forward significantly in 2010, since renewable energy and reusable resources – along with overall sustainability – are excellent ways to cut operating costs and save money. Independent living facilities around the world will be placing a greater emphasis on green building well into the future.
6.Low-Income Housing versus High-Income Housing – Affordable senior housing is in limited demand these days. In 2010, an increasing demand for reasonably-priced senior housing is going to surge; for that reason, it is quite likely that low-income housing facilities will be developed at a more rapid rate in the upcoming year.
7.Campus Senior Housing – An exceptionally interesting trend in independent living – and in senior housing in general – is campus senior housing. Originally started to help alumni maintain their roots with their college or university, such programs are becoming popular ways to keep senior citizens active and involved well into their golden years. For the independent living industry, this trend presents many prime opportunities and could help some facilities branch out in new and exciting ways. Thinking outside the box is definitely a trend in 2010, and you’ll be able to find evidence of it throughout the independent living industry.
http://www.bls.gov/oco/ocos078.htm
State of Ohio Launces "Take Action- Protect Yourself from Fraud" Initiative
Agencies Arm Consumers and Mature Ohioans with Tools to Protect Themselves from Fraud
COLUMBUS - The easiest weapon people can use to protect themselves from fraud is to recognize it when they see it - before their money lines somebody else's pocket.
The State of Ohio today launched a new Take Action: Protect Yourself from Fraud initiative that educates consumers about insurance fraud and financial exploitation, said Ohio Department of Insurance Director Mary Jo Hudson.
"There are growing trends in insurance and annuities fraud especially targeted at older people," Director Hudson said. "This initiative is a proactive step to arm all Ohioans with knowledge to help them avoid financial exploitation. It also serves as a resource so people know where to turn to report fraud across the state. Together, we can arm consumers with information to help them protect themselves and garner the information we need to track down the perpetrators."
Take Action initially will focus on alerting consumers to types of deceptive sales practices and schemes currently occurring in annuities, living trusts, stranger-originated life insurance (STOLI), reverse mortgages, Medicare sales and health care fraud. Take Action also assists Ohioans in safeguarding their online information and warding off unwanted telemarketers and spammers. The Ohio Department of Aging assisted in creating Take Action resources and plays a key role in the outreach to older Ohioans.
"During Older Americans Month, we encourage all older Ohioans to age strong." Ohio Department of Aging Director Barbara Riley said. "When it comes to consumer issues, this means being your own advocate. Know what you want, what to look out for and where to turn for help, should you need it. This initiative aims to give all Ohioans tools and habits they can use to be wise consumers and help stop consumer fraud for everyone."
A free consumer guide provides background facts on areas where people are exploited and serves as a workbook listing important questions to ask. The guide is available at www.takeaction.ohio.gov, an interactive Web site filled with tips on how to recognize, avoid and report fraud. Consumer stories about fraud and successful encounters overcoming it will be published on the Web site.
The Web site also directs consumers to the right offices and agencies within Ohio's state government. For instance, anyone making an investment decision needs to contact the Ohio Department of Commerce to ensure the broker is legitimate and the security is registered.
"Taking action to protect yourself from financial fraud means keeping your hard-earned money where it belongs -working for you," Ohio Department of Commerce Director Kimberly Zurz said. "Before making an investment or financial decision, call the Division of Securities at 1-877-N-VEST-411 to investigate any opportunities and avoid potential pitfalls."
In addition, senior groups and associations can request a speaker for a workshop or ask for a panel of government experts to talk about fraud. Representatives from the Ohio Department of Insurance, the Ohio Department of Aging, the Ohio Department of Commerce, the Office of Attorney General Richard Cordray, the Office of State Treasurer Kevin Boyce and the Ohio Consumers' Counsel will participate on panels.
"We are exploring ways to reach out to consumers by collaborating with other state offices, agencies and organizations," Director Hudson said. "We are all concerned about consumer protection, and this effort shows efficiency and effectiveness in government."
Seniors and their caregivers will be the target of the awareness campaign because statistics show that seniors attract 30 percent of reported fraud and are three times more likely to become fraud victims. The boomer generation will reach 71 million over the next several decades - a huge population ripe for financial exploitation.
Director Hudson emphasized that while most insurance agents are reliable and trustworthy, the small percentage who are not can have their insurance licenses revoked by the Ohio Department of Insurance. In addition, anyone posing as an agent can also face criminal or civil charges. Ohioans are also warned to watch for identity thieves, telemarketing scammers, online spammers and anyone offering deals that seem too good to be true.
Ohioans can visit www.takeaction.ohio.gov to read or order copies of the Take Action: Protect Yourself From Fraud consumer guide, stay informed on the latest fraud news and alerts, get their personal fraud stories published and e-mail the program coordinator, Dottie Howe, at takeaction@ins.state.oh.us. Consumers with specific insurance questions and complaints can call the Ohio Department of Insurance consumer hotline at 1-800-686-1526.
About ODA - The Ohio Department of Aging provides leadership for the delivery of services and supports that improve and promote quality of life and personal choice for older Ohioans, adults with disabilities, their families and their caregivers. Working with 12 area agencies on aging and other community partners, the department offers home- and community-based Medicaid waiver programs, the long-term care ombudsman program, the Golden Buckeye Card and more. Visit http://www.aging.ohio.gov/.
Benefits Check Up - Video - Find programs to help you with bills and expenses
Did you know that the government has many programs to help low-income seniors find additional resources to help with medical bills, food bills, utilities etc. ?
Click here to learn more
Strawberry Limeade
This recipe comes from Ingredients, Inc. - just in time for fresh strawberries.
Prep: 10 minutes
Yield: 6 to 8 servings
1 (16-ounce) container strawberries, stems removed
(don't have fresh? Use frozen without sugar )
1 (12-ounce) can frozen limeade concentrate, undiluted
5 cups cold water
Fresh strawberries, fresh mint (optional)
Preparation
1. Combine strawberries in a container of a food processor; light pulse until smooth. Pour in a strainer to strain pulp. Combine limemade and water in a large pitcher and stir until limeade dissolves. Stir in strawberries; pour over ice and garnish with fresh strawberries and mint, if desired.
A Caregiver's Guide to Adult Day Care - by MetLife
This is a great resource from MetLife for caregivers considering Adult Day Care for their loved one.
WikiHow
wikiHow, as it says, is an editable How-to site with 40,100 articles contributed by volunteers from different parts of the world.
Click here to see an example of WikiHow - I did a search for how to garden in a small space
To do your own search - use the search bar located in the upper right-hand corner.
YouTube
YouTube.com is a site I use often. It is a video-sharing website and registered users can upload, share and view videos.
From Wikipedia- The company is based in San Bruno, California, and uses Adobe Flash Video technology to display a wide variety of user-generated video content, including movie clips, TV clips, and music videos, as well as amateur content such as video blogging and short original videos.
Most of the content on YouTube has been uploaded by individuals, although media corporations including CBS, the BBC, UMG and other organizations offer some of their material via the site, as part of the YouTube partnership program.
Unregistered users can watch the videos, while registered users are permitted to upload an unlimited number of videos.
A little trivia - Three former PayPal employees created YouTube in February 2005.[1] In November 2006, YouTube, LLC was bought by Google Inc. for $1.65 billion, and is now operated as a subsidiary of Google.
Click here to go to YouTube.Com - once there, all you need to do is type in what you want to search for ... such as "How to use chop sticks" or something just for fun like this how to fold your shirt video.