Have you ever been late to see the doctor and turned away, or showed up on time and asked to wait an unreasonably long period of time? Both Mark Alyn, host of Late Night Health, and I both agree that doctors being too busy to meet their patient is a pathetic excuse, and we talk about this frustrating phenomenon on the show.
Below is a Q&A with Andrea Koskey from the SF Examiner on the challenges in working with the insurance system.
How do you navigate the insurance system?
I look at each case individually. I don’t make certain choices based on the algorithm or try to memorize insurance — that will get you in trouble. I’m more deliberate. I look at where a patient lives and what they need.
Who’s responsibility is it to “navigate insurance” — doctors or patients?
It’s a 50–50 split. The doctor’s role is increasingly becoming that they do research and make choices so there won’t be a delay in treatment, but more knowledge on both ends will help doctors and patients in the long run.
Why is the insurance system so hard to navigate?
They are absolutely banking on patients and doctors not knowing the system. They too have a series of algorithms that are so complex even some employees don’t know them.
Top Doctors is an excellent resource for finding quality care near you and targeted for your unique needs. A USNews project, it provides information on the best doctors that have been nominated by other doctors and reviewed by a physician-led research team.
Despite having been on USNews Top Doctors for a while, I now have an official page on the website where visitors can learn exactly what I specialize in (electromyography, neuromuscular disorders, and sports injuries) as well as details about my credentials, where I work, and how to get in contact with me.
Thanks to USNews for the nomination!
Alzheimer’s disease, while one of humanity’s most ubiquitous afflictions, is also a mystery to many. This is why Dr. Naheed Ali has written a fantastic book about the disease that provides invaluable knowledge and guidance. My review of his book, Understanding Alzheimer’s: An Introduction for Patients and Caregivers:
Understanding Alzheimer’s: An Introduction for Patients and Caregivers is a remarkably-organized and astoundingly well-researched guidebook for one of the world’s foremost growing concerns. Dr. Ali has presented us with a tome that is a road map of hope for patients as well as all types of caregivers of patients afflicted with Alzheimer’s. His realistic, practical approaches in dealing with this initially frightening diagnosis should bring a degree of peace and solace to all of us. He includes a wealth of information about alternative approaches, new treatments, and the most up-to-date research available.
This book is a great read even if you are not a patient or caregiver; the writing is elegant and the content is essential. You can find the book in the Kindle store, as well as at Amazon.com.
I love sharing what I know with others and discussing my patient care philosophy. I recently had such an opportunity with Jennylyn Gleave on The Jennylyn Show. We sat down together and discussed everything from the humble beginnings of my career as a 14-year-old hospital volunteer, to how the lifestyle of a professional athlete can impact overall health. I describe how the prescription drug abuse epidemic affects the doctor-patient relationship, and we discuss the issue of “biofeedback” and how emotional barriers can prevent effective treatment. Join us for an in-depth one-on-one.
DaddyMDGuides, a website that provides advice and experiences from doctors that are also raising kids, asked me recently how to have a dialogue about death:
How do you talk to your child about death?
I often get asked about how to deal with telling children about death. I encourage parents to take an honest, open approach with this topic. Children are capable of handling a lot and need to be informed as accurately as possible about the realities of life. I thus encourage honest and open communication and counseling as necessary. When our pet cat recently died and when we came across dead insects while hiking, I took the opportunity to explain that everything on the planet stops breathing at some point and passes away from this life.
With ergonomics issues turning out the be the culprit behind many cases of chronic pain, it’s no surprise experts are discovering that some of our favorite tablet devices such as the iPad are causing a great deal of shoulder and neck pain. In this segment for KRON 4 TV I explain how this could happen and some easy ways to avoid it.
It’s no secret that it can be really difficult to maintain your fitness and overall health when so many of your days are spent in the office. Employees can develop carpal tunnel from repetitive wrist movements and a constant deficiency in circulation can cause a number of cardiovascular problems. There are, however, some great solutions to prevent discomfort and a deterioration in health while at work. Some of the best results come from employers that lead by example and implement programs such as a walking group or a push for ergonomics awareness.
A recent post on the Nuesoft Blog shares some great advice when it comes to workplace wellness. In the featured Neusoft video podcast, I talk with Lindsey Coates about how to engage in a routine that works for everyone as well as how to encourage good habits and comfort. Here are some ideas to get you started:
- Designate a coordinator to get everyone involved.
- Create a board that will centralize all wellness information (leaflets, routines, leader board – if you want to make it a competition, etc.).
- Walk as a group during lunch around the building or floor you are on.
- Sit on a yoga ball for an hour a day while working on the computer. When your hour is up pass it to another team member.
- Sign up as a group to do a 5k, softball team or other sporting activity. It’ll also promote morale!
I am pleased to announce that I will be co-hosting a new radio show! Late Night Health Radio will offer professional insight into a variety of important health issues, while providing a special focus on America’s baby boomer generation. The host, Mark Alyn, with 20 years of experience as a television host and reporter, will join me in discussing health tips, the newest studies, and tackle subjects like pain management, and dealing with diabetes and cancer. I’ll be contributing thorough coverage of my specialty in pain relief and rehabilitation, joined by special guests such as Dr. Gorodisky M.D. and many more!
Be prepared to be informed and entertained. More details are coming soon. To stay up to date on the latest Late Night Health Radio developments, visit the official website.
KTVU's John Fowler interviews Dr. Moshe Lewis on the negative aspects of normal stretching. What kind of stretches lead to less injuries and allow you to perform 11% better? Watch to find out.
Podcast Interview length: 51 minutes
Yoga Journal estimates that Americans spend over $5 billion a year on yoga classes and products. And this should come as no surprise – yoga is credited with lifting moods, revitalizing sex and reducing stress. But a recent New York Times Magazine article focused on how yoga can also cause serious injury. We discuss the safe practice of yoga.
Interview length: 56 minutes — Interview date: November 21st, 2011
In this interview with Dr. Michael A. Lenoir on KPFA Radio's About Health, we touched on acute vs. chronic pain, Michael Jackson and dietary considerations. We answered many listener questions regarding increased sensitivity to pain, acupuncture, avoiding surgery, chiropractors, arthritis, the stress caused by pain, and more.
Doctors offer plenty of advice to patients, but it's not often that a doctor weighs in on treatments to help a hangover. Dr. Moshe Lewis, chief of physical medicine and rehabilitation at California Pacific Medical Center, St. Luke's Campus, shared his ideas with me on how to alleviate a hangover when the spirit to imbibe overwhelms you.
Hangover PreventionDr. Lewis says he agrees with your grandma - don't get yourself into a hangover situation in the first place. Abstinence is the best prevention strategy of all. It allows you the ability to enjoy the sheer fun of being with close family and friends. Yet, the reality for some people is that the thought of socializing leads to anxiety, depression or fear. In turn, many people self-medicate with alcohol. Simple strategies aimed at reduction include setting firm limits. Substituting non-alcoholic drinks throughout the evening or arriving late to the party are worthy of consideration. However, if you find that you haven't followed Grandma's advice, Dr. Lewis has some tips to quickly get you back to the holiday festivities.
Hangover RemedyWhen you arrive home after significant drinking and want to avoid the hangover that's no-doubt coming, take two Ibuprofen tablets, drink peppermint tea and eat some carbohydrates, recommends Dr. Lewis. Alcohol reduces your sugar levels, so what you need is instant energy. Sugar replaces the energy your brain cells need in order to function properly, and most typical "hangover-cures" contain carbohydrates or sugar; this is why people find them to be effective.
Carbs, such as bread, chicken noodle soup and yogurt help by restoring the sugar levels in your body. Natural sugars, which can be found in bananas, apples and fiber bars, will give you instant energy, and they are healthy choices. Proteins, such as meat, milk and eggs, provide longer-term energy needs for your body.
Thus, Dr. Lewis suggests anything that metabolizes quickly - yup, even peanut M&Ms - to restore your sugar levels and give you the energy you need. Greasy foods, on the other hand - think burgers and cheese steak sandwiches - typically take longer to digest, which is why they are not ideal.
Remember: you're craving certain foods for a reason. Cravings reflect something that your body needs, explains Dr. Lewis. It's not a bad idea to go with what your body is asking for.
Contrary to popular belief, you should avoid too much coffee, as it can further dehydrate you.
Read this article on Yahoo! Voices.
The Institute of Medicine recently released a report that found around 116 million Americans, a 3rd of the US population, suffer with long-lasting pain. The numbers are staggering, and the report finds that our health care system barely supports those with chronic pain. The report concluded that chronic pain costs our nation at least $558 billion a year in medical expenses and sick days.
Americans are living longer and are living less-than-healthy lifestyles nowadays. As our population ages, chronic pain becomes more of a reality due to the “symptoms of life” such as arthritis, cancer, back problems, digestive disorders, surgery, and miscellaneous injuries. Chronic pain alone is its own disease that requires dedicated treatment and care.
Whatever the cause, effective pain management is “a moral imperative,” the report concludes, urging the government, medical groups and insurers to take a series of steps to transform the field.
The population’s getting older and less fit, and more survivors of diseases like cancer live for many years with side effects from treatments that saved them. For too long, doctors and society alike have viewed pain “with some prejudice, a lot of judgment and unfortunately not a lot of informed fact,” said Dr. Philip Pizzo. Too many patients think a pill’s the answer when there are multiple ways to address pain including physical therapy, stress reduction, weight loss, and teaching coping skills. Patients who take control of their pain fare better, but too many have unrealistic expectations.
Doctors do worry about overprescribing narcotic painkillers, and law enforcement steps to fight the serious problem of prescription drug abuse can be one barrier to pain care. But the institute countered that it’s far more likely for a pain patient to get inadequate care than for a drug-seeker to walk out with an inappropriate prescription. While newer, better medicines are needed, those narcotic painkillers are a safe and effective option for the right patient, the report said. But barriers to good care extend far beyond that issue, said the panel, which analyzed research and the reports of more than 2,000 patients and caregivers about pain’s toll.
Because pain can’t be seen like bleeding, or felt like a lump, or X-rayed like a broken bone, or heard like a skipped heartbeat, health workers who wrongly believe the intensity of pain should correlate to a specific medical finding may diminish or even dismiss a patient’s complaint, the report found. Care must be tailored to each patient. Yet too few doctors are trained in its management, the report said, citing a study that found stand-alone pain courses aren’t required in most medical schools.
The report concluded at least 116 million adults suffer long-lasting pain, consistent with some previous estimates, but couldn’t say how many cases are severe or disabling. The economic costs, however, are sure to attract attention in Congress, which mandated the report as part of the new health care law. The report found health care for pain costs $261 billion to $300 billion a year, while lost productivity adds another $297 billion to $336 billion. The federal Medicare program accounts for a quarter of those health bills.
Ken McCoy recently interviewed me on his radio show. We had a great time discussing what pain management is, what pain management specialists do, and my philosophy regarding pain management in general. Click the play button on the audio player above to listen to our segment. Here’s an overview of what we talked about:
Trying to get patients to understand their medication: Medication is extremely important to many, but some forget what their medicine is supposed to be doing for them. Sometimes they no longer need to be taking it.
Ken McCoy and I also discuss how I got started as a pain management, physical medicine, and rehabilitation specialist. * We discuss how the holistic approach to treating patients and the future of medicine/health.
I recently had the chance to talk face to face with Dr. Jerome Lisk, an esteemed colleague, about Parkinson's disease. Some of my patients have this movement disorder. Visit this article to read a summary of our discussion on the movement disorder. Here is a summary of our discussion:
1. What’s the one big thing about the disease that we should be more aware of?
Parkinson's Disease is often misdiagnosed and can be confused with other disorders that have the same physical symptoms as Parkinson's Disease but are secondary causes of Parkinson's. These chameleons of Parkinson's Disease can mislead general neurologists, primary care physicians and even sometimes the inexperienced movement disorder specialists.
Secondary Parkinson Disease usually does not respond to medication as well as Idiopathic (Primary Parkinson's Disease) and can be caused by medications, Multi-System Atrophy, Progressive Supranuclear Palsy, Corticobasal Ganglionic Degeneration, Diffuse Lewy Body Disease, Essential Tremor and other secondary causes.
2. How have Michael J. Fox and other famous people with Parkinson’s helped shape Parkinson’s disease awareness?
It has been a blessing to have people such as Michael J. Fox and Muhammad Ali contribute the millions of dollars to research, public awareness and be such a champion for fundraising for a cure. Over the years there have been many famous and wealthy people with Parkinson's Disease, but none that have been advocates for the disease such as these two individuals. Many people where shocked about how physically disabling Parkinson's Disease can be and at the same time are able to see those such as Michael J Fox still be able to continue his career. Those famous people with Parkinson's Disease have brought a disease that was rarely mentioned by the public not to the forefront of communities and made the public much more aware of this devastating disease.
3. Who’s at risk for Parkinson’s disease?
Those who are at risk of Parkinson's Disease are those over the age of 65, those with a family history (even more if they are young onset), Caucasian, blonde hair, exposure to environmental toxins (Pesticides), certain occupations such as agriculture or welding increase risk, Men have a slightly higher risk than women. Interestingly, the state of Nebraska (329.2/100,000) has the largest incidence of Parkinson's Disease in the USA because of its large agriculture industry and use of pesticides. The Amish Community, who is also largely agricultural based, has the highest incidence of Parkinson's Disease at 970/100,000. Those exposed to Manganese are also at high risk of developing secondary Parkinson's Disease. Also living in the United States has the highest risk of developing Parkinson's Disease while living in Korea or Ethiopia gives the lowest risk in the world.
4. Many people know that Parkinson’s disease symptoms include tremors and movement problems. What are some of the more surprising symptoms of Parkinson’s?
It is now known from pathological studies of brains of Parkinson's patients, that Parkinson's Disease starts usually 3- 20 years before the first physical sign. These are called Non-Motor Signs of Parkinson's Disease. They include constipation, decrease sense of smell, REM Behavior Sleep Disorder (acting out dreams), etc. Other symptoms that occur in Parkinson's Disease are rigidity, loss of postural anticipatory reflexes, drooling (beginning at night), development of a poker face, depression, anxiety, smaller hand writing and difficulty with thinking. Compulsive Gambling, Hyper-sexuality, Compulsive shopping or eating can be caused by certain Parkinson's medications especially if there is a previous history of impulsivity. Symptoms occurring later in the disease can include persecutory delusions, visual hallucinations, dementia, Autonomic Nervous System dysfunction (urinary incontinence and Orthostatic Hypotension)
For more helpful information on Parkinson's Diesease and other movement Disorders check out Dr. Lisk's educational resources page.