The Benefit of Having a Doctor in the Family

I've been asked, "What is the benefit of your practice over a traditional practice?" The answer is simple. Being part of our practice means you have a doctor in the family.

What does that mean? It means, at 2am when your child has a fever that just won't go down, you have someone to call. It means if you get a UTI, you don't need to make an appointment and take time off work. You can just call the doctor and he'll answer you, send you your medication, and get you healthy again.

It also means that you have someone to support you throughout all of your life. If you become seriously ill, your doctor will act as your care coordinator and will partner with your specialists to make sure that you are getting the best possible care.

Direct primary care is the answer to a lot of medical crisis in this county, but it is also so much more. It can be the answer to your quality of care. Direct primary care can ensure you live every day in the best health and that illness is treated quickly and effectively. With us, you get a doctor for your family. 

If you would like to learn more, please contact our office at 813-540-3378. 

Blog Post From Dr. Jack

No fasting needed: new cholesterol testing guidelines

Physicians traditionally tell their patients to fast prior to a cholesterol profile blood test, and although this is a simple test, many patients do not look forward to it. This means fasting overnight, and making an early morning trip to your doctor’s office or the nearest lab facility.

However, new international guidelines are no longer recommending it. The European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recommend that "nonfasting blood samples be routinely used for the assessment of plasma lipid profiles" (total, LDL, and HDL cholesterol and triglycerides) in a joint statement that was published online April 26, 2016 in the European Heart Journal.

Basically, it was previously thought that fasting for eight to 12 hours before having blood drawn for a cholesterol test gave a more accurate assessment of total cholesterol, harmful LDL cholesterol, protective HDL cholesterol, and triglycerides, a type of fat-carrying particle.

Dr J Michael Garziano of Brigham and Women’s Hospital in Boston, MA, in an accompanying editorial wrote: "The incremental gain in information of a fasting profile is exceedingly small for total- and HDL-cholesterol values and likely does not offset the logistic impositions placed on our patients, the laboratories, and our ability to provide timely counseling to our patients. This, in my opinion, tips the balance toward relying on nonfasting lipid profiles as the preferred practice."

The international committee, however add the caveat that doctors should repeat a nonfasting lipid profile test with a fasting test if plasma triglyceride levels are above 440mg/dL, and refer any dangerous levels to a specialist familiar with lipid disorders. High triglycerides can cause pancreatitis, and can be a harbinger of heart disease, hypothyroidism, kidney disease, and certain genetic lipid disorder.

This new recommendation is a win-win for patients and physicians. Patient can have their blood drawn when it’s most convenient for them, and diabetic patients no longer have to worry about adjusting their medications to accommodate fasting. For physicians this means patients can have their blood work done during their visit, and not be lost to follow up.

At Elevated Healthcare, our self pay rate for a lipid panel is $4.00. We also offer in house cholesterol monitoring with a single finger stick. This is part of our wellness plan and is included with our DPC membership.

Blog Post From Dr. Jack

Why does healthcare cost so much in the US?

The US spent 3.2 trillion dollars on healthcare in 2015, an astronomical figure that is hard to comprehend! Yet, our health outcomes are no better than developed countries such as the UK or France. According to the non-profit organization, The Kaiser Foundation, the UK on average spends $3,749 per person vs the US which spends $9,237, while life expectancy is 80.9 years in the UK vs 79.1 years in the US.

Healthcare spending in the US is the highest in the world not because we go to the doctor or hospital more often. On average, we see a doctor four times a year, and Americans also go to the hospital relatively infrequently (126 visits per 1,000 people vs 252 in Germany) according to The Commonwealth Fund in 2015.

So what’s driving the cost?

• For the past 20 years, most healthcare is reimbursed by the fee for service model. The more services provided or tests ordered, the larger the bill. This system rewards doing more, but as mentioned, this has shown no better outcomes for the patient.

• Cost of medication. Drug manufacturers in the US have a government protected monopoly rights on new drugs, often times tweaking a drug to maintain its patent for longer. People are constantly bombarded with commercials on new drugs that do not necessarily have better outcomes than older proven drugs.

• We pay more in administrative costs. In the US, this cost accounts for 25% of hospital spending, the manpower to move claims through the system and negotiating payment rates separately with each payer.

• Fewer regulations on control cost. Outside of Medicaid and Medicare, which negotiate prices on behalf of their millions of members, it’s a free-for-all. Healthcare organizations can charge whatever they can get away with, partly because of the obscurity of cost.

How can direct primary care benefit patients?

By providing care on a membership model, the doctor can focus on taking care of the patient and not on insurance reimbursement requirements.

• We are cognizant of the cost of medications, and will offer prescriptions for proven generic medications. We also offer resources such as GoodRx that provide discounts for self pay.

• By cutting out insurance, we are able to control administrative costs. This enables our practice to pass those savings on to our patients. 

• We believe in cost transparency. All tests and services outside of what’s included in the membership, will be provided up front with no hidden fees.

Blog Post from Dr. Jack

The cost of sitting around at the doctor's office.

According to the American Journal of Managed Care, it takes on average 121 minutes for a patient to visit their doctor. This includes 37 minutes of commuting and 87 minutes at the doctor’s office. How much of this time is actually spent face-to-face with a doctor? 13-16 minutes, according to a Medscape survey. Most of the time is spent doing paperwork, communicating with ancillary staff, and just sitting around waiting.

The average out of pocket cost per medical visit is $32, but remarkably what the study also found, was the “opportunity cost”- the value of work had the person been engaged in, instead of the 2 hrs spent seeing the doctor. Researchers estimated that the cost is around $43. Therefore, the average trip to the doctor is $75 ($32 out of pocket + $43 in lost opportunity). This can be especially hard on people who do not work the typical 8-5, or those that are strictly paid by the hours that they are clocked in. 

Direct care addresses all these concerns! At Elevated Healthcare, we understand time is valuable. Our patients never have to wait for more than 2 minutes. Our face-to-face visits lasts at least 20 minutes and often can accommodate up to 60 minutes. We also provide telemedicine for those interactions that do not require in office visits, such as medication refills or going over labs. Our goal is to provide personalized medical care that’s accessible and affordable. 

Can Direct Primary Care Save Your Business Money?

There are a lot of great reasons to choose direct primary care (DPC) for yourself; no waiting to be seen, better quality of care, a family atmosphere, lower costs for primary care services, less expensive lab costs, etc. 

But, what about for employers? 

DPC has some excellent benefits for corporate partners such as reducing sick time for employees, providing preventative medicine and encouraging wellness for employees. DPC is also a valuable workplace "perk" to help entice quality employees to apply to and remain part of your company. And it could save your company money! But don't take our word for it. 

In a Forbes article, DPC saved Union County, North Carolina $1,408,089 per year in health care costs and saved the participants $333,639 per year in out of pocket expenses. To view the entire article, click here.

Obviously, DPC has been successful in North Carolina, but would it work for your company? Call us to set up a consultation and we will go over the benefits to your company and our corporate rate structure.  813-540-3378

Blog post from Dr. Jack

What’s soaring this summer may not just be the temperature!

As the summer temperature rises, so too are insurance premiums for the GOP proposed health care plans. Proposed changes would reduce requirements on health plans and change the structure of financial subsidies that the current law provides to low and moderate income Americans. According to the Congressional Budget Office, older and lower income Americans would see their insurance premiums rise significantly under the GOP plans.

“For example, under the House bill, a 64-year-old consumer with an annual income of $26,500 would see the cost of an average silver-level plan increase more than ninefold, jumping from $1,700 a year to $16,100 a year, according to the budget office.”

Under the Affordable Care Act, people using the healthcare marketplace and making less than $48,000 receive subsidies to help them buy insurance, the amount is tied to the person’s income and cost of insurance in the person’s area. These subsidies are automatically applied to the person’s monthly insurance bills.

Under the senate bill, subsidies are also tied to a person’s income, though it would stop at 350% of poverty level, compared with 400% under the current law. However, a new formula for setting the amount of subsidies would tie them to the cost of less comprehensive health plans. In other words, provides significant less health services than under the Affordable Care Act.

What in the world is OMT?

"Through Osteopathic Manipulative Treatment, or OMT, DOs use their hands to diagnose illness and injury and encourage your body’s natural tendency toward self-healing.

As part of their education, DOs receive special training in the musculoskeletal system, your body’s interconnected system of nerves, muscles and bones. Using OMT, your DO can effectively treat your muscles and joints to relieve pain, promote healing and increase overall mobility.

OMT is often used to treat muscle pain, but it can also help provide relief for patients with asthma, sinus disorders, carpal tunnel syndrome and migraines. In many cases, OMT can be used to complement, or even replace, drugs or surgery." (Doctors of Osteopathic Medicine, 2017)

As part of our commitment to our DPC patients, OMT is an included part of your membership in our practice.

If you feel you would benefit from this treatment, please email us at flelevatedhealthcare@gmail.com

What is a D.O.?

Many people believe that all doctors receive the same medical training. However, there are two different kinds of doctoring education that vary in their approach to medicine. Dr. Jack is a D.O. or Doctor of Osteopathic Medicine. The first question most people ask upon hearing this is, "What is a D.O.?"

According to the American Osteopathic Association, "Doctors of Osteopathic Medicine, or DOs, are fully licensed physicians who practice in all areas of medicine. Emphasizing a whole-person approach to treatment and care, DOs are trained to listen and partner with their patients to help them get healthy and stay well.

DOs receive special training in the musculoskeletal system, your body's interconnected system of nerves, muscles and bones. By combining this knowledge with the latest advances in medical technology, they offer patients the most comprehensive care available in medicine today.

Osteopathic physicians focus on prevention, tuning into how a patient's lifestyle and environment can impact their wellbeing. DOs strive to help you be truly healthy in mind, body and spirit -- not just free of symptoms." (2017).

At Elevated Healthcare, we strive to care for the whole person and focus on a preventative, wellness based approach that seeks to catch potential illness before they start and educate our patients on the best way to manage their own health. 

Give us a call to learn more at 813-540-3378