A Compelling Case for Clinical Documentation Webinar from Dr. Ruthann Russo - Sign up today!

Date: Tuesday, February 17th, 2009
Time: 1:00 PM - 2:00 PM EDT
Where: Your desktop
Cost: FREE

The single best way to improve patient care, receive all the reimbursement to which you are entitled, and lower your compliance risk is by increasing the quality of your clinical documentation. Please join me for a complimentary webinar on how to achieve High Quality Clinical Documentation (HQCD) with the CAMP™ Method for Clinical Documentation Training. (register now)

Question: Do doctors prescribe medicines just because they're being pushed by the drug reps?
From: Stephen W. of Toledo, OH

Answer: I doubt that anyone can truly answer your question with any certainty but I personally hope and believe that they don’t. I would expect that drugs are prescribed based on the patient’s need and history and the proven successes of the medication. Drug reps (aka, detail men) do visit physicians’ offices and share information about their company’s medicines. It is estimated that pharmaceutical companies spend $19 billion dollars a year on promotions-advertising through various media to the general public. They tend to market directly to physicians. According to the June 29, 2006 issue of the New England Journal of Medicine, the Gallup Organization conducted a survey for the American Medical Association (AMA). A national survey of physicians found that 77% of physicians were aware that pharmaceutical companies had access to physicians’ prescribing data. Pharmaceutical companies state that they use the data to learn about drug interactions, prescribing trends, long term effects of medicines, and prevention of medication errors. The AMA’s Prescribing Data Restriction Program allows physicians in the U.S. to deny all pharmaceutical sales reps access to their individual prescribing data. In 2002, Pharma adopted voluntary standards banning elaborate gifts to physicians. Additionally, some hospitals and doctors’ offices ban free lunches. Sales reps do provide physicians with samples that can be shared with indigent patients.

What your can do for yourself – part 7 of 10
Rest your mind for 10 minutes a day

Resting the mind, more commonly known as meditating, is estimated to be practiced by about 2 percent of the world’s population. Interesting because we rest our bodies about eight hours a night, but 98 percent of us do not consciously rest our minds. During sleep, our minds are still quite active, even when we don’t’ recall our dreams, which is why sleeping doesn’t count as a rest for your mind. Meditation is described by Jon Kabat-Zinn in Wherever You Go, There You Are, as mindfulness. Kabat-Zinn’s definition of mindfulness is “paying attention, on purpose, in the present, and letting go of judgment”. One way to rest your mind is by just focusing on your breath and letting go of any thoughts that enter your mind. It is important not to force the thoughts away. Rather, you just recognize that you are having them, let them go by focusing your attention back to your breath.

You can try meditating for just a few minutes at first. If you are like most of us, you will find that your mind races with countless thoughts, concerns, and fears. The Zen Buddhists refer to this as “monkey mind” because it reflects the image of monkeys wandering quickly and aimlessly from one tree branch to another. Anyone can master the art of meditating…..just like most activities that bring us healthful benefits, you need to include the activity in your daily life (even if it’s just 5 to 10 minutes a day). After you have meditated daily for at least 3 weeks, notice any differences in how you feel, think, and even how you treat others…..you may be pleasantly surprised!

I wanted to take a moment to introduce you to www.ClinicalDocumentationMatters.com, a new web site for healthcare professionals that focuses on providing high quality information and resources for anyone who is interested in clinical documentation. I am confident you'll find this information valuable so I invite you to visit the site and subscribe to the free weekly newsletter.

Question: How can I learn about the after effects of prescribed medicines?
From: G. of Sunnyvale, CA

Answer: Your question gives me a great opportunity to again urge healthcare consumers to ask questions of their physicians, pharmacists, and other healthcare providers. Side effects are the unwanted effects of medicine and may also be called adverse effects, adverse events, or adverse drug reactions. Some people will have side effects from some medicine and some medications will cause side effects in all patients (e.g., hair loss from certain cancer drugs). In a study conducted by Brigham & Women’s Hospital in Boston and published in the April 16, 2003 New England Journal of Medicine, one in four patients experienced side effects from medicine. 13% were considered serious (e.g., low blood pressure, internal bleeding) and 39% were considered preventable (e.g., patient was allergic to the medicine). Patients were given the wrong drug 45% of the time, the wrong dose 10% of the time, or too often 10% of the time.

When your physician gives you a prescription for a new medicine or changes the dosage, ASK why and what the possible side effects are. Your physician should know your medical history and other medications you are taking. Ask the pharmacist about drug interactions and how the medicine should be taken. When I pick up a prescription, I am asked if I want to speak with the pharmacist and then sign off that I did or did not. Prescriptions come with a leaflet describing possible side effects so be sure to read it. The internet has many sites that provide information on specific drugs. Remember, you are your best advocate!

A Compelling Case for Clinical Documentation Webinar from Dr. Ruthann Russo - Sign up today!

Date: Tuesday, Jan 27, 2009
Time: 1:00 PM - 2:00 PM EDT
Where: Your desktop
Cost: FREE

The single best way to improve patient care, receive all the reimbursement to which you are entitled, and lower your compliance risk is by increasing the quality of your clinical documentation. And now there is a scientifically proven way to achieve this using the CAMP™ Method to train physicians in the principles of high quality clinical documentation. (register now)

What you can do for yourself – part 6 of 10
Get in touch with your body through massage.

Although you may think of it as a pampering activity offered only in spas, massage therapy is actually a highly regulated form of alternative medicine in most states. Massage is a form of self-care that can have a positive impact on you. MassageTherapy.com claims that massage can boost immunity, improve sleep, reduce anxiety, and create a sense of emotional balance. About.com claims the top 10 types of massage include Swedish, aromatherapy, host stone, deep tissue, shiatsu, Thai massage, reflexology, sports massage, and back massage. Having a professional work out the physical impact of stress can help you become more in tune with your body on a daily basis. In fact, you can probably pick up some tips from your massage therapist about how you can use self-massage to help relieve knots, kinks and pain in your muscles.

In his book, The Healer Within, Dr. Roger Jahnke describes several different forms of self-massage that you can do whenever the time is right. He walks you easily through massaging your hands, feet, neck and shoulders. There is also a massage for your ears that is both relaxing and stimulating. If nothing else some form of self-massage can get you back in touch with your body. The more aware you are of your body, the more you can manage signals of pain, tiredness, or even need for more movement! If you do decide to try a professional massage, protect yourself by verifying that the massage therapists are certified

Question: Is there dental care for the uninsured?
From: Joy W. of Pinnacle, NC

Answer: According to www.yourdentistryguide.com, there are more than 108 million children and adults without dental insurance. Tooth decay is the most chronic childhood disease and more than 75% of Americans have some form of periodontal disease. Medicare does not cover routine dental care and 20% of Americans 75 years old and older do not have dental insurance. Medicaid provides preventive and acute dental care for children but not all dentists participate with Medicaid. Oral disease is linked to ear and sinus infections, weakened immune systems, diabetes and heart and lung disease. Lack of dental treatment can affect speech, nutrition, social development, quality of life, and even death.

The first thing to do is to contact your state dental society to check for dental assistance programs in your area. Look for neighborhood clinics, dental school clinics (cost usually reduced), or dentists who offer discounts or payment programs. Remote Area Medical (RAM) is a group of volunteers that provide free medical and dental care to needy around the world and in the U.S. The National Children’s Oral Health Foundation plans to build 500 centers, treat 5 million children, and educate 20 million people over the next few years. The Smiles Across America Program is an oral program linked to schools. The Ronald McDonald House Charities helps locate treatment for specialty cases, connecting patients with dentists and oral surgeons.

What you can do to for yourself – part 5 of 10

Move your body in a new way – try some form of yoga. Just like eating your fruits and veggies, exercise should be an important part of your daily routine. Grandma’s words ring true. The FDA’s food pyramid even has a recommendation that we exercise at least 30 minutes per day. If your health care team is worth their weight in salt, they will discuss this with you. And, hopefully you talk with your children, parents, and loved ones about their need to be physically fit. With all of the positive influences available to us, it seems unlikely that any of us would not be physically active. However, anecdotal, personal and official evidence (like the obesity rate in the United States), point to a different reality. Yoga is a good form of exercise for most of us because it can be done by almost everyone with maximum aerobic and anaerobic benefits.

Yoga, which means union, is an integrated practice for improving the mind, body and inner spirit. The system of yoga was developed specifically to ensure that the whole body would function properly. One of the functions of yoga is to keep the body in proper physical shape (as a safe haven for the soul). The physical exercises in yoga are called asanas. They are nonviolent and provide gentle stretching that acts to lubricate the joints, muscles, ligaments tendons and other parts of the body. Asanas help to tone the nervous system, improve circulation, release tension, and increase flexibility. As a result, yoga probably provides the most complete form of exercise available. You can find out more about yoga, yoga schools and teacher certification through the American Yoga Association at www.americanyogaassociation.org

Question: How much does medical malpractice insurance cost?
From: Adam W. of Geneva, IL

Answer: Most healthcare providers carry liability insurance. Most states require that physicians have malpractice insurance and most hospitals require it if a physician wants hospital privileges. Physicians may purchase medical malpractice insurance individually or through a group practice. Hospitals and other healthcare facilities also purchase their own malpractice insurance. Hospitals that employ physicians usually buy coverage for the hospital and the staff. Interestingly, physicians employed by the federal government don’t buy insurance as the lawsuit will be brought against the federal government.

There are differing points of view as to whether medical malpractice lawsuits are causing escalating malpractice insurance rates. Most articles indicate that the cost of insurance started rising at the start of this decade after a somewhat calm period. They attribute this to the growing size of claims and the decreasing number of insurance companies providing medical malpractice insurance due to falling profits. In March, 2008, the Insurance Information Institute published medical malpractice data: in 2003, medical practice cost was estimated at $26.5 billion; in 2004, that number rose to greater than $28.7 billion. The annual amount that a physician pays depends on the locality of the practice and the specialty. States regulate the industry and some states have put caps on claims in an effort to control the cost. But there are indirect costs associated with medical malpractice. You may have heard the term “defensive medicine” wherein physicians provide more healthcare coverage than normal. There are no reliable estimates on this cost.