Posts Written By L Parker Brown

Blame Your Doctor’s Time Crunch on Insurance Companies

Do you spend more of your doctor’s appointment time in the waiting room instead of the exam room? Blame the insurance companies and insurance reimbursement. Insurance reimbursement is the payment that your doctor, hospital, or other health service providers receive for providing you with a medical service. The insurers’ service comes with restrictions, and many tend to pay health service providers only enough for 15-minute appointments.

In addition to imposing time limits on patient visits, insurance providers are increasingly refusing to cover prescribed treatments for numerous patients, including those with chronic illnesses, even though many cannot afford the out-of-pocket costs. While astute patients know that their doctor is not solely to blame when necessary treatment is denied, less informed patients may be unaware that insurance companies are sometimes instrumental in limiting access to care. Both patients and their health care providers are at the mercy of the insurers.

A few years ago, I asked my Ophthalmologist for a prescription so that I could buy an additional pair of reading glasses. I had purchased a pair a few months earlier, but no longer had that prescription. She said that she couldn’t write it because my insurance would not approve another pair of glasses so soon after my previous purchase. I said that I – not the insurance company – would pay for the glasses myself, (just as I did with the original pair). She said that it didn’t matter; she still could not write another prescription so soon. What kind of jacked-up rule is that? I thought. It made no sense to me, but I didn’t press the matter. Insurance companies certainly have an arm lock on medical service professionals.

The days of private practices where doctors have the authority to make autonomous decisions for their patients without interference from insurers are becoming a thing of the past.

The shift from the time needed – for an exam and treatment – to 15-minute sessions occurred as a result of changes in how insurance companies and the government pay physicians for medical care.

In 1992, Medicare decided to adopt the RVU (relative value unit) formula as a standard way to calculate doctor’s fees. Then in 2010 came the Affordable Care Act.  In conjunction with other significant changes, increasingly, doctors were required to document their patients’ information on a computer causing them to spend more time with their laptops than with their patients. I witnessed the angst this causes first-hand while visiting my primary care physician shortly after her manila folder files became digital. Dr. Kaye (name changed to protect her privacy) has been my doctor for 35 years.

The first few times, when she used a computer to check data pertinent to my history or previous visits I could see that she was agitated. On one occasion, she called her assistant in to help her. On my follow-up visit, she struggled to do it alone.

“I have to get used to documenting information this way,” she said, almost apologetically while I sat patiently in the chair beside her desk.

“Don’t like computers?” I asked curiously.

“Never used one until recently,” she replied. “So many changes in recent years. Okay, I’ve got your chart now. Let’s go over this.”

The time-limit/payment procedure is unknown to numerous patients who often don’t understand why they feel like they are being rushed through appointments and exams, whether they visit their primary doctor, hospitals, or clinics. Physicians feel the time crunch too as they hurry through appointments to see more patients. Some perform additional tests and procedures to make up for flat or declining reimbursements. In addition to time restraints, other factors tied to regulations instituted a few years ago, takes a toll on the doctor/patient relationship, and is forcing many physicians to give up their solo practice and join group practices.

I’ve had personal experience with this also. Two doctors’ who I’ve been with for nearly half of my life have abandoned their private practices and joined a group facility. Two years ago, my eye doctor gave up her solo practice, and then last year my primary care physician, Dr. Kaye, did the same thing.

I’ve had the same primary care physician for 38 years. When I began visiting her she was the sole doctor in her privately owned practice. She rarely seemed hurried and took time to thoroughly answer any questions I might ask. Sometimes during my exam, we even chatted briefly about non-health related issues like how my then infant twin grandsons were doing – learning to crawl or being potty-trained – or how her daughter was progressing with her singing career.

Then, a few years ago, things changed. I noticed that although she willingly answered any questions, our unnecessary dialog had practically stopped. She was still the smiling, personable person that she has always been, but she often seemed to be rushing. It wasn’t long before her assistant, who takes blood and handles other incidentals, was notably absent, and we patients were sent elsewhere for lab work.

One day I mentioned that her waiting room was more crowded than it normally is and asked Dr. Kaye if she was seeing more patients than usual. Without going into lengthy details, she said that insurance company policies and restrictions were causing doctors’ to change some of their previous methods of operation.

According to studies, more doctors who, like Dr. Kaye, once had private practices, are joining group practice facilities where two or more physicians all provide medical care within the same facility. Doctors working in a group practice experience the advantage of shorter work hours, more flexibility in scheduling, and increased financial security. The larger number of physicians and increased patient base makes it easier for doctors to manage financial risks than private practices. Group facilities also usually have the resources to better manage the administrative tasks associated with running a practice. The disadvantage is that group practices tend to be more bureaucratic. Doctors have less independence, lack of the ability to develop close, personal relationships with their patients and staff, and often require a consensus on business decisions; while the private practitioner has autonomy and the advantage of more personal freedom to develop his or her practice as they would like.

According to the American College of Physicians, “Solo practices are often at substantial financial risk due to the costs of doing business (such as hiring staff and maintaining malpractice coverage)… [There is also] the small patient base, shifting patient allegiances because of insurance issues, and lost income caused by illness or vacation.”

Occasionally, when am in the waiting room, I get into a conversation with another patient who, like me, followed our doctors from private practice to a group facility or hospital. There seems to be a consensus that most “transplanted patients” are dissatisfied with the new arrangement. The wait time is often much longer than before, and the personal attention and the quality of care have changed.

Most frustrating are the times when I’ve called to make an appointment or ask my doctor a question, and the phone goes unanswered even though I make the call during the doctor’s regular business hours. The next worse thing to the unanswered phone is the voice mail that requires callers to navigate an agitating phone tree that asks that we press what seems like 101 buttons only to ultimately be told to (1) leave a message. (My experience has been that the call never gets returned and I wonder if anyone even bothers to check the messages) or (2) that the voice mailbox is full.

Studies show that the number of physicians who own private practices is dwindling, mainly due to transformational changes, and group facilities that are actively looking to purchase the remaining practices.

In a July 2015 report, Accenture predicted that a growing number of U.S. doctors would leave private practice for group or hospital employment by the end of 2016.

Family physician Dr. Linda Girgis explains it this way, “As self-employed doctors, we are not only responsible for all the patients in our practice, we are also responsible for the business. Tax laws and accounting principles are foreign languages to many doctors. And new regulations are aimed at decimating those remaining at the reins of their own medical practice.”

This fantastic video will reveal, in a nutshell, how some doctors feel about insurance restrictions and what they are doing about it.

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Coffee — If Loving You Is Wrong

As soon as I get up in the morning I turn on my mister. (Not that mister. Get your mind right.) My Mr. Coffee automatic drip coffee machine.

Experts suggest that upon rising after a night’s sleep we should drink water; at least 2 cups or one 16oz bottle. Water rehydrates the body. It also fires up the metabolism and helps the body flush out toxins. They further recommend that coffee lovers like me delay that cup of joe until an hour after we awake.

If you – like me – wake up thinking about coffee, you’ve got a serious case of coffee on the brain. We are bonafide coffeeholics. The good and bad of that is this. We may crave caffeine, but unlike addictive drugs, caffeine doesn’t threaten our physical, social, or economic health. And as you may already know coffee has health benefits. (An hour is an excruciatingly long time to wait for that first sip).

On mornings when I go to the gym, water is my first drink of the day. I usually finish a bottle of it during my pre-dawn workout. Sip by boring sip. But on days when I don’t exercise, all bets are off. Coffee is my go-to beverage. I like it freshly brewed and strong every morning. Sometimes I drink it black, or occasionally with a little cream, but never, ever do I add sugar. Confession – decades ago when I began drinking coffee, I could only tolerate it with 4-6 heaping spoonsful of sugar. Yucky! I know. I can’t tell you how many times back then someone would flippantly say to me, “I see you take coffee in your sugar.” I stopped that. Now, when I need a sugar fix with my coffee, I have a blueberry muffin on the side.

Coffee is one of the world’s most consumed beverages, third place behind water and tea. Studies show that coffee drinkers have a lower risk of some serious diseases likely due to the high levels of antioxidants and beneficial nutrients in the beverage. Coffee improves various aspects of brain function and the body— including memory, mood, and energy levels. It increases fat burning and physical performance which is why some fitness enthusiasts drink coffee before working out. On the rare occasions when I drink coffee before exercising, I do notice that my energy level increases.

Studies also show that coffee drinkers have a lower risk of Parkinson’s and Alzheimer diseases.

Black coffee is calorie-free. Anyone trying to lose weight should avoid the cream (or milk) and sugar (and probably the muffin, too).

Excluding bacon frying in a skillet, coffee is the next best thing to smell in the morning.

Cars need gas to run, and I need coffee. I prefer it hot, strong, and fresh. I occasionally drink java after it has cooled to room temperature, but hours-old or microwave reheated coffee not only diminishes the taste it’s downright nasty.

I’m a frugal hometown girl so I rarely buy gourmet coffee, but I hear that some brands are so good they will make you jump up, click your heels together and spin in circles. Among the top five gourmet brands, you’ll find La Colombe Corsica Blend, Peet’s Coffee Big Bang Medium Roast and Death Wish Whole Bean Coffee. Billed as the world’s strongest coffee, Death Wish is highly rated and highly caffeinated. It has double the caffeine of your average cup. One bag will cost you around $20.00.  You’ll recognize the brand by the skull and crossbones on the package.

I have no taste for instant coffee so I’ll skip it. I prefer to brew one of my favorite regular brands each morning from any one of two or three 12oz packages of ground that I keep on hand. Each cost around $7 or $8.

There are over 100 brands of coffee. Over the years, I have tasted many brands though probably less than half. Among those that I’ve sampled are Maxwell House, Folgers, and Gevalia, but my favorites are Dunkin Donuts (Hazelnut), Starbucks (Breakfast Blend Medium Roast) and Seattle’s Best. Seattle’s Best is currently my go-to brand. It’s mild and delicious.

Let me share with you a mugful of more tips about coffee strength and coffee roast. Coffeeholics don’t particularly care about stuff like this, but I’ll tell you anyway. The ratio of coffee grinds to water during the brewing process determines the strength – the actual caffeine content – in a  particular amount of coffee. There are three main stages in roasting: drying stage, browning stage, and development or roasting stage. Light roast coffee is mild. Dark roast is bold. Many dark roasts are used for espresso brands. Medium roast and medium-dark – medium brands are not too light, not too bold. Breakfast blends can include different types of coffee beans and different sorts of roast levels. Like medium brands, blends are not too strong and not too weak.

Decaffeinated coffee – forget it, drink water instead. I mean without the caffeine, what’s the point? Coffee minus caffeine is like Christmas without carols, a beach without an ocean, a popsicle without the stick. Clearly, I dislike decaf coffee and that’s that.

Take note coffee lovers. To maintain freshness and flavor, packaged coffee must be kept away from moisture, heat, light, and strong odors. Refrigerating it is not a good idea because moisture will quickly deteriorate its quality. Instead store your package (especially after opening) in an airtight ceramic, metal or plastic container until needed.

As I see it, coffee tastes better when drinking it from a ceramic mug instead of a Styrofoam or paper cup.

That’s my spiel on the brown beverage. Stay grounded and take time to smell the coffee.

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Bullets and Bibles

It was early afternoon, a few days ago. I was sitting at the computer in my home office near the window that faces a quiet intersection in our usually serene neighborhood. As I often do during a lull in creative thought, I lean back in my chair, fold my arms behind my head, clasp my fingers together, and thank God for all of my blessings. Suddenly all hell broke loose outside. The silence was shattered by a barrage of what sounded like loud gunshots at least a dozen, maybe two.

Immediately, I did what any cognizant city-dweller would do. I leaped headlong out of my chair onto the carpeted floor. And then it happened again. More shots rang out, only not as many. Unlike the initial volley, this round sounded muffled.

I lay there for a few minutes waiting to hear a blood-curdling scream or at least frantic cries for help. Nothing. As I slowly pushed myself to my knees, the humorist in me had a comedic moment. I thought about the television commercial that shows an elderly person prone on the floor crying, “Help! I’ve fallen, and I can’t get up.”

Fortunately, I could get up, but before I stood, I crawled over to the open window and listened intently. Cars sounded like they were passing along the street at normal speed, not burning rubber speeding away. Some youngsters were laughing across the street near the Charter school. It seemed safe to peek through the Venetian blinds so I did so, all the while praying that a bullet would not crash through the window and shoot me in the eye. As far as I could see – down the street, across the street near the community garden, everything looked normal. People, apparently unshaken by the temporary disturbance, were walking along going about their business. The police precinct is at the end of the block. I figured if those were bullets that I had heard flying, there would have been cops and police cars with flashing lights all over the place.

Later that day, I mentioned the incident to a neighbor who told me that she had just walked outside heading to her car when she heard the first volley and saw smoke coming from the side of the building. “I hauled it back inside as fast as I could.” She said. We concluded that the incident was caused by some wisecrackers, probably school kids who thought it would be fun to set off fireworks and scare the bejeebers out of folks in our sedate neighborhood.

The fear of having to dodge bullets is one of the perils of living in the city; the suburbs are not exempt either. Sadly, many people everywhere don’t feel completely safe anywhere. We live in a state of trepidation.

Facts have shown that it is as easy to be struck by a bullet when you are inside your home as when you are outside. How often do we hear news reports about a bullet crashing through the wall or window of someone’s home and striking an unsuspecting person inside like 12-year-old Badr Elwaseem who was shot and killed while watching TV or the 21-year-old woman whose head was grazed by a bullet that crash into her home while she was sleeping in bed?

Inside schools. At the mall. In church. In today’s violent and chaotic society all sites are fair game for callous persons with weapons. It doesn’t matter where you are when danger arrives, and that reality is emotionally draining.

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When you are retired, you know that you have entered into the final chapter of your life. (Don’t let that statement rattle you. It’s true. Accept it. I do.) Every morning when I awake to see a new day, I thank God. As I revealed earlier, I give thanks for all things – big and small – all the time. For every breath that I take. I give thanks.

Some people keep what is called a gratitude journal. Psychology researchers assert the advantage of maintaining a gratitude journal. Their studies indicate that there are psychological and physical health benefits that come from the simple act of writing down the things for which we are grateful; even simple things like being in good health or having a comfortable bed to sleep in at night instead of on a park bench or cold concrete sidewalk. When I can sit down at my computer and write out a blog post within an hour, instead of a stressing over it for days with several rewrites, I say “Thank you, God.”

A growing anti-religious bias makes some people feel like criminals for saying the word, God. Some of you reading this post probably cringed every time you saw the word on this page. I don’t regularly write my appreciation in my journal, but whether I write it or say it in my mind expressing gratitude has become as normal for me as breathing.

As I’ve often said, I don’t support organized religion, but I believe in God, and I express gratitude continuously. Today I thank that Higher Power for the realization that what I heard outside my home the other day were not gunshots. Not that time anyway.

Good and evil. God and guns. Bullets and bibles. Those are the facts of life.

 

 

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Seeking Senior Bloggers

Have you ever said to yourself, “I’d love to be a blogger, if only I knew where to begin? I don’t even know how to use a computer.”

According to The Pew Research Center out of 500 million bloggers, less than 1 percent are age 65 and over. Bloggers in the 21-to-35-year-old demographic group account for over 53 percent of the total blogging population, followed by 19 percent who are 36-to-50-years-old. But enough boring statistics and more about the sparse number of senior bloggers.

I am in the 1 percent. No, not that 1 percent, the “less than” group identified by Pew. Before the door of opportunity opened 12 years ago, I had no plans to include blogger on my resume. Then, one day a friend suggested, “Why not augment your love for writing and create your own blog?” Thus, post-retirement, I birthed my second career and added personal blogger to freelance writer and published author.

In addition to writing a blog, I study them. I’ve found that the gazillion younger than 50-year-old bloggers tend to write about fashion, politics, health & fitness, music & entertainment and technical devices. Although some senior bloggers tackle those same subjects, the majority of posts written by seniors concern elder lifestyles and the challenges of advancing years. Many of their posts have titles about subjects that very young readers would call old people stuff. Healthy Aging (translation:  avoiding the decrepit zone). Fighting Aging (Good luck with knocking that out). Defying the Aging Process (enter Botox and plastic surgery). And the topic that none of us old-schoolers want to discuss, the one that keeps most of us in denial – Funeral Planning (Think Dreamgirls, “And I am telling you, I’m not going.”).

Anyone who retired in let’s say the last 15-20 years who did not learn computer skills while they were in the workforce, I will bet you my best friend’s social security check that some of them are not inclined to do so now. Sadly, I know mature people who not only lack computer skills, but some think that a hard drive is being on the road for two hours or more without making a rest stop.

For seniors who want to learn to compute – it is not too late. There are basic computer classes available everywhere. It seems pointless to ask someone who may not own a computer and lacks computer skills to check on-line for computer classes, although a tablet or smartphone might suffice. But you could ask a computer-savvy friend to help you search online, or inquire about classes at a library near you. Some libraries offer free computer classes that provide hands-on training to adults. AARP offers tech training for people 50 years and older.

Seniors, you need to get that training and start blogging so that we can increase our numbers in the blogosphere. There are plenty of things to blog about:  sports, travel, food, name it and claim it. And of course, there is the personal blog.

I enjoy being a personal blogger. That’s my forte’. However, I offer some words of caution to potential personal bloggers. Share your thoughts at your discretion.

Before jumping in with both feet, think of personal blogging as swimming nude at a public pool. Your posts will be as exposed as a naked swimmer on a diving board. It is one thing to log your personal experiences and private thoughts in a diary, but another to publish something on-line that the whole world can see. Be forewarned. Accept that putting yourself out there, placing your thoughts on display will open you up to criticism and as well as complements. But don’t let the fear of criticism deter you. Life is too short to worry about what others will say about you. Do your thing – with style and humor – and give them something to talk about.

Here are some basic tips on getting started with your blog.

  • Choose a domain name. The domain is the address of your website that people type in the browser’s URL bar to visit your site. Imagine that your website is your home and think of the domain name as your address. I chose Potpourri101 because it suggests a variety or mixture of subjects, not just old folk stuff. In the American university course numbering systems 101 often designates a course for beginners in a particular subject. Thus, potpourri101. (A blog can be set up with or without a unique domain name depending on who is hosting your site.)
  • To make your website accessible to other people on the Internet, you need a “host.” The web host provides the technologies and services required for the webpage to be viewed on the Internet. It will store all of your website files:  code, text, images, video, etc, on servers.
  • Get a blog platform. A blogging platform is a software or service that you use to publish your content. There are many platforms, but I like WordPress because it offers numerous free blog themes. Imagine having an interior designer decorate your home. The theme is the appearance or decoration, so to speak, of your website. You may want to check out Godaddy.com or SiteGround.com as sources that host WordPress sites. A downloadable copy of an excellent book WordPress for Absolute Beginners can be found here.

After you get everything in order, write, write, write on your blog! It will expand your horizons.

In the process of exchanging comments and emails about some of my posts, I’ve made friends with other bloggers as well as readers who are not bloggers. And lest you think that the lot of them are old fogies, they are not. Many of them are as young as you – or as young as you think you are.

I hope this post will encourage other seniors who may have scratched “become a blogger” off of their list. We’re waiting for you to join us. Just do it!

 

 

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Dating Across Political Lines

No one will ever win the battle of the sexes; there’s too much fraternizing with the enemy.”

I recently read an article where a guy said that 90 percent of females he encounters in DC are very liberal and seem to view conservative men as walking deal-breakers. When I was in the dating game (nearly 20 years ago before my current relationship), I dated men whose liberal views aligned with mine – except for two who were conservative Republicans.

Back then, I did not discriminate. If I liked a guy who asked me out, I’d date him. My radar has honed over the years, and I am more political than I’ve ever been. In these polarizing and contentious times, for the sake of my peace of mind, if I were still in the game, I would not be inclined to date across party lines. People who date across the political divide can make a relationship work – if they are willing to put in the work. I’m not. It is sometimes difficult enough to maintain a platonic friendship across party lines.

My first Republican flame was a speechwriter for former Secretary of State Henry Kissinger. Kissinger (is one among others) to whom the quote above is ascribed. I began dating the speechwriter on the rebound, following a breakup with my then-boyfriend. After a few dates, I found that I liked the conservative guy. He was a perfect gentleman. He was smart, had a sense of humor, and I enjoyed his company. However, there were a couple of hurdles that intruded in our relationship.

Once, when we were out together, while my date was busy buying tickets I glanced at two black men who were standing about 12 feet away. I guess they were in their late 20s or early 30s. I couldn’t avoid noticing the hateful expression on the face of the one with his arms crossed whose eyes were throwing darts at me. He and the guy who was with him were both wearing black berets. While he was giving me the cold stare-down, I overheard some of his snide comment to the fellow standing beside him. “That sister other there dating a white guy. Ought to be ashamed.” That was in the I’m-black-and-I’m-proud 1970s. Society was moving toward being racially progressive on interracial relationships, but it had not progressed to where it is now. For the next few seconds, I ignored him, until my date and I continued on our way and they went theirs.

Our second tension was more personal. It occurred one evening while we were watching an episode of Roots. The character Kizzy’s master was selling her away from her family for something that she did (I don’t remember what it was) and boyfriend commented that some masters were good to their slaves. Well, Jumping Jehoshaphat! Whether that statement was true or not wasn’t the issue. It was simply the wrong thing said at the right time. Our argument that occurred as a result of that episode wasn’t what led to our break up. We eventually smoothed things over, but I decided to get back with the guy that I broke up with before I got involved with the speechwriter.

The other Republican I dated was black like me. But if you heard him talking smack and couldn’t see him, you wouldn’t know it. He was in the entertainment business and very political. It was difficult enough trying to stomach his political views, but I wholeheartedly resent people who constantly berate members of their own racial group. His arrogance wore me down. It doesn’t matter if the intra-racial bashing is for someone’s job, their political party or because they are blinded by self-hate, in my opinion, constantly stereotyping and denigrating your own racial group does nothing to enhance your image. It makes you look bad. I don’t care whether your viewpoint is due to envy, feelings of superiority or because you think that you are economically and socially better off than other people. Don’t let it go to your head. Life is like a giant sliding board. You can be up at the top one day and down on the ground the next. It doesn’t matter if someone is high on the corporate ladder or picking up trash on the street if a person is out here trying to make an honest living then don’t negate him or her. Actions and deeds aside, as human beings, none of us is better than the other. I strongly dislike seeing black people put other black people down and I view racial animosity with more disdain than partisan animosity. My compassion compass with Republican #2 was not in synch. Thankfully, that pseudo-relationship crashed and burned.

When it comes to mixed-partisan relationships, evidence abounds that Democrats and Republicans have a hard time making relationships work. To the contrary, a high-profile couple, political strategist James Carville and his wife, media personality Mary Matalin are one example of an inter-political relationship that is working. According to USNews.com Martin had this to say about that, “That we disagree on policy was tough, but it’s not one of those deal-breakers. We’re very practical in our local politics, and we’re philosophically opposed on the role and scope of government, but we love each other.”

 

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