Monday, December 29, 2014

A Technique for "Road Rage"

Road Rage an aggressive or angry behavior by a driver of an automobile or other road vehicle.  These behaviors could include rude gestures, verbal insults, deliberately driving in an unsafe or threatening manner or making threats.  Road rage can lead to altercations, assaults, and collisions that result in injury or even death.

A simple technique to combat road rage or any stress is Pranayama breathing.  Pranayama is a Sanskrit word meaning extension of the prana or breath- extension of the life force.  It is a yogic discipline with origins in ancient India.

A simple form of this breathing is a long 3 second inhale through the nose followed by a long 3 second exhale through the nose.  Easier said than done.

One of my yoga instructors stated that in 12 seconds- 2 complete breath cycles- one can eliminate stress and hostility.

The next time somebody cuts you off in your car, try 1 breath I, 1 breath out, 1 breath in, and 1 breath out.  You will be surprised by the power of the breath!

Monday, December 15, 2014

Is It Time to Start Downsizing?

The author of 12 Changes That Will Affect Doctors' income in 2015 lists major changes that should have a net negative effect on providers’ incomes due to the Affordable Care Act. I suggest you read this article.
1.      High deductibles is the new self-pay in disguise with many patients not aware of this serious issue.

2.      Decrease in malpractice premiums which will probably be a transient benefit. Caps are being overturned or litigated in most states.

3.      ICD-10 will begin in October and the true cost is not yet known. Most experts think practices should have a 90 day reserve fund to make payroll.

4.      Practices involved in Medicare Accountable Care Organizations will be losing their guaranteed contracts to avoid losing money. There is a bill in congress to keep the contracts viable for 3 more years. Not sure what will happen in new congress.

5.      The emergence of Telemedicine is affecting the growth of certain practices. The reimbursement for these services are still be battled over. The legal liability is also in flux.

6.      Retail clinic pharmacy driven practices are direct competition to the standard practitioner.

7.      Primary Care Physicians will lose their enhanced Medicaid payments. These payments will lower back to approximately 40 cents on the dollar.

8.      Meaningful use become more “mean” and will now penalize rather than reward the practitioner.  The government wants its money back.

9.      PQRS will no longer give maintenance of certification monies for meeting quality measures. Penalties will ensue.

10.   Medicare payments to specific providers are now available without context on new websites.  Bad publicity is the net effect.

11.   Medicare will start paying for chronic care outreach to providers who deal with patients with 2 or more chronic conditions. The downside is the necessary documentation to avoid future audit.

12.   New CPT modifiers to replace the 59 modifier for procedures. Make sure your billing team is ready to change. Failure to act will lead to another excuse to deny or delay

Welcome to the electronic age to save Medicare money. These trends are just the beginning to try to save Medicare. Cost shifting to the provider is an easy route because they are all “rich doctors” anyway.

Tuesday, December 9, 2014

Fighting the Most Common Chronic Financial Illness

Chronic illness is a long-lasting condition that can be controlled but not cured. As described by the Centers for Disease Control, chronic disease is the leading cause of death and disability in the United States.
In financial terms the most common chronic illness is the “Disease of Fixed Expenses”. This affects all demographics and incomes. It is the never ending list of payments and obligations that one accrues through ordinary life. It becomes an acute illness when the “patient” gets ill, fired, laid-off, and or retires where the monthly income is significantly reduced or eliminated.

This can be controlled through conscientious budgeting, but this is not in the nature of 95% of the population. The advice is always the same- Save, spend less, avoid immediate gratification, have a plan, etc., etc.

This advice is always in a vacuum that doesn’t take into account the pressures to spend by family and friends is endless. The most organized and frugal person may not control their dependent group leading to a feeling of hopelessness or just “going with the flow”.

Some easy suggestions to ameliorate the problems.

1.      Anticipate that house payments, car payments, insurance payments, and tax payments never go away.  Realize that the most expensive house and or car is not necessary and these possessions are only tools. After a couple of years, the $25-40,000 car gets you to the same location as the $60,000 vehicle. The more expensive car with insurance, maintenance et al costs over $1,000 per month for 5 years.

2.     Discuss money with your family/dependents and carefully explain “how much a broom” costs and come up with a reasonable spending approach. Let them make compromises to get what they want.

3.     Realize you are getting older, and basing your “happiness” on things is misguided and driven by television and movies.

4.     Avoid being jealous of another’s success.

5.     Stay healthy and avoid medical costs.

6.     Anticipate unanticipated disasters – things are going to happen; face it. These characteristically require significant expenditure, often all at once, and often without time to develop a less costly strategy. Thus, planning for, and having an account with, say, $100-$150K, set aside only for emergency purposes, is wise.  If you do, there are several principles: don’t touch it for anything but an emergency; never borrow from it thinking you will repay (shortly) in the future. You won’t. Are you wise?

These may sound preachy but I am guilty of all these sins and now realize the shortsighted of my lifestyle decisions.
Making more money does not improve the condition, it only changes the paradigm. More money=More expenses=More Fixed expenses.


Monday, December 1, 2014

"Melting" Your Aches and Pains Away

My spouse recently started a new program called the "Melt Method" to achieve flexibility, relaxation and pain relief.

The self-treatment system claims to restore the supportiveness of the body's connective tissue to eliminate chronic pain, improve performance, and decrease the accumulated stress caused by repetitive postures and movement of everyday living.

Benefits include:

  • flexibility & mobility
  • posture
  • results of exercise
  • range of motion
  • sleep & digestion
  • overall well-being
  • aches & pains
  • wrinkles & cellulite
  • tension
  • headaches
  • risk of injury
Does it work in real-life?  It essentially functions a directed self-massage techniques that involves using soft rollers, acupressure-type balls for hands and feet, and stress reduction attempting to improve one's general well-being.

My wife and friends claim they are 1-2 inches taller and stand up straight after a standard class.  Wanting to take a peaceful nap after the sessions is a side effect.

As one ages; stiffness pain, loss of flexibility, balance, and loss of range of motion become the reality instead of the exception.

At present my wife is involved in Yoga, TRX and the Melt Method and the combined results are pretty outstanding.  My suggestion is you might add this to your regimen.  It is a great substitute to using medications to treat chronic pain.

I recently went to a James Taylor concert and the crowd looked like (myself included) an AARP convention.  The majority could have used a physical and mental health program to walk up on down those steep stairs.