Bring Back House Calls

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House Calls Can Save Money and Increase the Quality of Care

As Dr. Jauhar so clearly shows in this New York Times article (and I wholeheartedly agree), revival of the house call would bring enormous benefits to the health care system, and improve care for those who need this service.

One clear benefit is preventing readmission to the hospital, an increasingly common problem that costs Medicare more than $17 billion a year. On a person-to-person level, doctors seeing patients where they live brings so many vital features to life, and can improve the quality of care significantly. 

McKinney Texas initiated a house call program involving local firemen/paramedics working with a team of doctors that has proven to reduce 911 calls, ER visits and hospital admissions up to 65 percent. House call-based programs improve health care communication, timeliness and quality of care, as well as save money – an excellent example of the public’s money saved through improved access and care vs. money saved by taking away coverage from vulnerable populations, as some politicians have recommended.

Mainstreet Clinic provides house calls to those people and families for whom in-office visits are difficult, impractical, or disruptive to the patient. The price is $150/month and includes regular visits (every 8 weeks at a minimum) as well as anytime the situation dictates, for example, upon return home after a hospitalization.

Call the clinic for more details: 580-248-9966.

Posted in: Community Health Policy, Health Blog, Your Health

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Home Exercises for Hip Strength and Stability

Hip Strength and Stability for People 50+

Hip strength and stability is the core issue for seniors in safe and secure standing, transferring and walking, either unaided or with assistive devices like a cane or walker.

David Jack and Silver Sneakers present these seven exercises you can do at home or at the YMCA.

Watch more exercise videos from The Silver Sneakers YouTube Channel.

Posted in: Health Blog, Your Health

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Beginner’s Guide to Treadmill Walking Exercise

All-Season Walking at the YMCA

Walking is the simplest, most natural exercise and walking is available to most of us. Oklahoma summers and volatile weather often discourage outside walking, and for other reasons too, the YMCA treadmill stands out as a key activity to achieve and maintain fitness.

Watch more exercise videos from The Silver Sneakers YouTube Channel.

Posted in: Health Blog, Your Health

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Shoulder Exercises You Can Do at Home

Healthy Exercise for People 50+

Shoulders are a real trouble spot for people 50+. Here is a quick video from Silver Sneakers clearly showing shoulder exercises you can do at home to strengthen supporting muscles and help keep your shoulders strong, flexible and less prone to injury.

Watch more exercise videos from The Silver Sneakers YouTube Channel.

Posted in: Health Blog, Your Health

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The Opioid Epidemic

Common Sense Family Doctor is a regular feature on our Facebook Page and on our website. Today’s topic involves the opioid epidemic. 

Some of you will remember the death of OU football standout Austin Box in 2011. His drug overdose was one of more than 50,000 deaths a year in an opioid epidemic that is now near the peak of the AIDS epidemic. Common Sense Family Doctor discusses aspects of this great challenge, and the role of primary care in meeting it.

Read the Common Sense Family Doctor here: Primary care confronts the opioid epidemic, published April 7, 2017

Posted in: Common Sense Family Doctor, Health Blog

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Orthopedic Procedures to be Avoided or Questioned

Some orthopedic procedures should be avoided, or at least questioned

Common Sense Family Doctor is a regular feature on our Facebook Page and on our website. Today’s topic involves orthopedic procedures. 

This essay from the Common Sense Family Doctor relates some interesting information that might provoke questions and even anger. But things we routinely did in the past (radiation for big tonsils, freezing duodenal ulcers, routine gallbladder removal for all gallstones) have fallen into disfavor based on better science.

This essay should at least call into question some procedures being recommended routinely.

Read the Common Sense Family Doctor here: Patients: steer clear of these six orthopedic procedures, published March 1, 2017

Sincerely,
Dr. Birdwell

Posted in: Common Sense Family Doctor, Health Blog

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The Open Health Care Economy

Priced Out of Health Insurance and Care

Brian Birdwell, MDBy Brian Birdwell, M.D.

Published in the Lawton Constitution
February 16, 2017

We enjoy quality medical facilities and excellent professional health care providers in Lawton. But these services do not help people who cannot afford to access them.

Many working people in Lawton and Southwest Oklahoma feel they have been priced out of health insurance. 

“The cost of health care in 2016 exceeded $25,000 per family.”

Health insurance coverage is expensive, both on the front end (premiums) and also on the back end (co-pays, deductibles, and co-insurance). The total cost of health care in 2016 exceeded $25,000 per family. Let that sink in, while I add that this cost per family has doubled from $12,500 in 2005, when the Milliman Index first began tracking it.*

Closed System

Prices are not open for consumers to see. The U.S. health care economy is a closed system. Actual price agreements for surgery, hospitalization, pharmacy and so forth are negotiated behind closed doors and we physicians have very little to say about what charges are permitted and what you must pay.

These are actual prices and discounts for an MRI from one of my patients with typical major medical coverage in a high-deductible plan:

Billed amount    $4,873
PPO discount    – $4,144
Actual price paid    $729

So, even with insurance, the typical “discounted” price was more than $700. And if you don’t have these “discounts,” you get a double-whammy: You’d have to pay the entire, inflated price of $4,873.

Insurance and our closed system drives up the cost for insured and uninsured alike.

By comparison, cash-paying members are referred for a comparable MRI in the open health care economy for about $350, sometimes less. These cash prices work for patients with, or without, a major medical insurance plan.

Taking Down The Barriers To An Open Health Care Economy

MainStreet Clinic is a point of entry for our members to access an open health care economy:

  • Direct primary care membership prices are viewable on our website
  • Membership is affordable: $40 to $80 per month, similar to a typical cell phone bill
  • We provide access to discounts for otherwise expensive services, such as MRIs, CAT scans and lab tests
  • We can fill prescriptions for many generic medications at low discounted prices
  • Access to MainStreet Clinic is unlimited for members; you see your doctor whenever the need arises
  • Members experience unhurried visits – time to explain, ask questions, be heard
  • Ongoing 24/7 contact via personal communications, such as cell phone, text or email – because sometimes, all that’s needed is a little information or an answer to a question

Employee Benefits That People Want and Can Afford

MainStreet Clinic membership is an ideal employer-sponsored health benefit. Clinic membership is a care-first health benefit that people can use with no insurance coverage required.

“For as little as $20 to $30 per employee per month, employers can ensure access to care for their people.”

For employers:

  • A flat monthly fee for all primary health care can be budgeted, easily
  • The membership benefit may be defined as all employer-paid or partially employee-paid
  • Employees access care quickly during office hours and after-hours, either in person or via cell phone, text or email
  • The clinic membership agreement is entered into by each employee individually; we protect the doctor-patient relationship

Vision care, too. When employers offer access to MainStreet Clinic membership, workers who subscribe may also enroll in Primary Vision Care Services.

Taking down barriers and opening the door to a new health care economy is a joint effort by all market players: health care providers, consumers and employers. Lawton’s own Keith Smith, M.D. at the Surgery Center of Oklahoma has attracted national attention for their totally transparent pricing.

Our hope is that others will follow the MainStreet Clinic lead in Lawton. The benefit to the health of Southwest Oklahoma’s people and businesses will be positive and far-reaching.

* Source: Milliman Index (www.milliman.com/mmi). Total cost includes coverage premiums plus the costs of care for a typical family of four, covered by an average employer-sponsored PPO plan.

Posted in: Direct Primary Care

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Evidence Based Sleep Apnea Screening

Common Sense Family Doctor is a new feature on our Facebook Page and on our website. Today’s topic involves sleep apnea screening.

Read the Common Sense Family Doctor Here

Screening means testing people with no symptoms. Since it is difficult to make a person without symptoms feel better, the reason to screen is to find people who are “sick” (even though they show no symptoms) and for whom treatment may prevent serious or fatal things from happening.

Taking blood pressure is a good example of a simple screening test in a person having no symptoms, and we do it all the time because finding and treating high blood pressure is known to reduce the incidence of stroke and heart attack.

MainStreet Clinic treats a number of people whose fatigue, profound sleepiness, headaches, etc. are better because of treating their sleep apnea. But for people without symptoms, screening for sleep apnea would be beneficial only if it prevented bad things from happening in the future.

Advocates of sleep apnea screening point to the belief that untreated moderate to severe sleep apnea leads to cardiovascular events — strokes and heart attacks. But the latest and strongest clinical evidence refutes this. Today’s Common Sense Family Doctor explains why sleep apnea screening for people with no symptoms is not recommended in our MainStreet Clinic practice, and indeed in any evidence-based practice.

We believe in doing for our members what is of demonstrated value, based on you and the best information available.

Sincerely,
Dr. Birdwell

Posted in: Common Sense Family Doctor, Health Blog

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Health Screening Data and Harms

Here’s a timely essay on health screening data. The Common Sense Family Doctor says, “Causing needless worry about cancer or another absent health condition can seem trivial compared to the prospect of saving a life.” But there are many harms associated with many types of screening, and the data on lives saved is actually quite surprising.

Read more about the psychological harms of screening

Sincerely,
Dr. Birdwell

Posted in: Common Sense Family Doctor, Health Blog

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National Influenza Vaccination Week December 4-10

U.S. Centers for Disease Control (CDC) Announces National Influenza Vaccination Week December 4-10

It’s not too late: Get your flu vaccine today!

This winter, when you see signs reading “Get Your Flu Vaccine,” you might ask “Isn’t it too late to get vaccinated?” No, it’s not too late! The U.S. Centers for Disease Control (CDC) recommends that flu vaccinations continue throughout the flu season, which begins in autumn and continues into spring. That’s why the CDC designates this as National Influenza Vaccination Week.

“The sooner you get vaccinated the more likely you are to be protected against the virus when flu activity picks up in our community,” said Dr. Brian Birdwell at MainStreet Clinic.

National Influenza Vaccination Week

According to the CDC, flu season peaks most often between December and March, but activity can occur as late as May. It takes about two weeks after vaccination for defensive antibodies to develop, so it’s best to get vaccinated early.

For millions of people every season, the flu means a fever, cough, sore throat, runny or stuffy nose, muscle aches, fatigue, and miserable days spent in bed. Millions of people get sick, hundreds of thousands are hospitalized, and thousands to tens of thousands of people die from flu each year.

Some people are at a higher risk for serious flu-related complications that can lead to hospitalization and even death, such as

  • pregnant women,
  • children younger than 5, but especially children younger than 2 years old,
  • those 65 and older, and
  • those with chronic health conditions, such as asthma, diabetes, and heart disease.

The CDC recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against seasonal flu viruses. This season, CDC recommends the use of injectable flu vaccines (flu shots) and not the nasal spray flu vaccine. The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) is not recommended for use this season because of concerns about effectiveness.

Flu vaccines are offered by many providers, such as your family doctor, some pharmacies, community health centers, as well as employers and schools.

MainStreet Clinic Members will receive their flu shot as a free benefit of membership. And employers who subscribe to Care First Benefits through MainStreet Clinic may request to have employee flu shots given at their workplace.

For more information about the flu and the benefits of flu vaccination, ask your health care provider or contact the Centers for Disease Control (CDC) at www.cdc.gov/flu/nivw or 1-800-CDC-INFO.

Contact Brian Birdwell, MD and MainStreet Clinic at www.mainstreetdpc.com or 580 248-9966.

Posted in: Health Blog, News, Your Health

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