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Physicians take aim at climate change

4/20/2016

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Climate change, according to the EPA, means that the Earth is warming. In fact, the average temperature has risen 1.5 degrees Fahrenheit over the past century. It is expected to rise another 0.5 to 8.6 degrees Fahrenheit over the next hundred years. Why should we care and as a physician, what does this mean to our health?

This is an important topic. So important, in fact, that the American College of Physicians (ACP) has written a position paper on this matter. The rising temperatures have led to changes in weather and climate. This means more floods, droughts, intense rain, and more frequent and severe heat waves. 

Oceans are heating up and becoming more acidic and with glaciers melting, sea levels are rising. Many bacteria, insects, and other disease causing organisms thrive in these environments. You see, insects are effective carriers and vehicles for spreading disease to large populations. The Zika virus, Lyme disease, West Nile Virus, Ehrlichiosis, and the list goes on. 

In addition, water is at risk of becoming contaminated and the air is becoming more polluted and full of allergens, which lead to significant health hazards from infectious disease to cardiovascular and respiratory illnesses. 

The health effects are already being felt by all of us, especially physicians. The number of emphysema exacerbations, sinusitis, allergies, asthma flares, and respiratory failure from these pathologies is increasing in frequency and severity. The number of strokes and heart attacks in young and healthy individuals are increasing - in fact, I tweeted a NY Times article a few months ago that raised this concern. 

I was in the doctors lounge last weekend and talking with a critical care friend of mine. As we sat there talking about our day, I asked him "how has the flu season been?" To this he responded, "we had worse years, but still lost a few." To us, the stories of healthy 18 year olds going on ECMO - life saving bypass machines- are not extraordinary. Unfortunately, it is all too common. In our experience, we have seen and heard of many young healthy folks pass away from things like the flu or an asthma flare triggered by allergies. Cases of infectious disease from contaminated water or food poisoning are also common. Ultimately, cases that come from contaminated food and water that should have been "ancient" are present and claim many lives today. 

It is hard to convince the general public about the importance of climate change and it's effect on all of us. Thus, we write position papers, use TV, radio, and journals to get the word out. But like any other health issue, as much as physicians long for conversations like this to take place before any crisis happens, it almost always ends up being at the bedside surrounded by concerned family members. 

The issue of climate change transcends countries, race, nationalities, or gender. This is a human issue. It's a international issue that must be taken seriously by each of us. Like many health challenges and pathologies, there are solutions and steps we can take today to prevent the development of global disease and fatalities.  Please read the ACP position paper published yesterday and also visit www.epa.gov to learn more about how you can help. 
ACP position paper
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Rising Health-Insurance Premiums

4/11/2016

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We are currently 9 months into the practice since my clinic opened and more than 12 months since I started doing house calls to spread the word about a new way of providing primary care. 

In the last 5 years, we have seen a shift in healthcare policy. Expanding coverage we all know does not immediately mean accessible and affordable care. In addition, we see people waving their Medicaid/Medicare or private insurance cards in the air saying, "we are insured so come see us" but there are less physicians to take care of them. More and more physicians as well as large health systems are not participating with Medicaid/Medicare or some private insurance carriers. 

So, before you start to feel comfortable having that plastic card in your pocket, you should spend the time to figure out exactly what you actually bought and which physicians participate with your plastic card. 
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Some folks who called my office would say "I already pay so much for my insurance. I can't afford you." This is a common misperception. At $50-100 per month, there are no copays, direct access to your doctor, longer visits that can solve many issues in one visit, and discounted meds, imaging, and labs for those who are interested. 

People fail to see the "indirect" costs of seeing primary care in the traditional model. These 10-15 minutes visits, unnecessary specialist referrals, difficulty getting into the office, lost time at work or home in waiting for appointments, and more importantly, participating in FREE community education events rather than asking Dr Google. 

To some, the discount meds, imaging, and labs don't matter. But what about the ability to get an EKG, suturing, skin biopsy, joint injection if needed, for FREE rather than feeling nickel and dimed. 

This model assures the patient that procedures are being done in the interest of the patient, not as a business revenue. 

Business owners to this day lose their minds when I share this with them. What! No margin on these procedures?! 

Primary care is not a business that should generate revenue from "doing stuff". It should be rewarded for its ability to establish a long term relationship, provide evidence based consultation and care, while preventing development of disease. Ultimately, the focus of primary care is optimizing your quality of life as you define it. 

Read the full WSJ article by clicking HERE. 


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  • HOME
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