How you can help physicians.

Yes, I will soon be 55. But, I have only been practicing privately for 5 years. The practice of medicine certainly is not what I expected to be. Dealing with unrealistic patients, fighting insurance companies for every penny you make, people not wanting to pay their bills, and yes, the fear of a patient wanting to sue you.
Physician reimbursements have been declining steadily since '91. Since I started private practice in '04, I have seen my physician reimbursement decline by 4.6%. You are probably thinking, "that isn't much?" But given the fact that the average cost of living goes up by 3.5% a year, I have effectively lost 22.1% in income.
I hear my patients say, "But Dr Barclay, my insurance premiums go up every year!" I know, I pay premiums myself. Do you realize that the CEO of United Health Care made a $440 MILLION dollar bonus last year!!! That money could make a bit of a dent in some of our health care costs.
Because of the potential for law suits, physicians are ordering more and more tests to protect themselves. Yes, some tests are necessary, but some or done because of this fact.
With HMO's, people seek medical treatment for conditions that really don't require a person to see a doctor. I remember as a child growing up (before the HMO era) my parents told me, "Son, we will always take you to the doctor if you are sick. But you better be sick because if you aren't, you WILL need to see the doctor." My parent's actually weren't that mean, they were just saying we didn't have the money to throw away on unnecessary expenses.
I am thankful when people come to see me in my office. But I would say about 1 - 3% of the people who visit me REALLY shouldn't have seen a physician of any kind.
During this period of economic downturn in the U.S., I ask that all of us evaluate what we utilize on any level of our daily expenses and needs. Using common sense will go along way to solving our current economic crisis including our health care system.
Tomorrow, I will discuss some do's and don'ts in your relationship with your physicians.

"The journey of life is taken one step at a time... none of them should be painful." G.M. Barclay, DPM, AACFAS

A change of direction with my blog.

The economy is hurting. I am sure it has affected you. I know it has affected me.
My intentions when starting this blog was to share health care information specifically regarding the foot and ankle. I will continue to do this. But I feel that it is important that information be shared regarding health care as it impacts us as end users (patients/insureds (remember I am an end user as well)) and providers (hospitals and physicians).
Our health care system is still very good, but in many respects, is no longer the best in the world. Our health care system is broken. Badly broken. But, it can be fixed. It will require an effort on all of our parts. But remember it starts with you (I am also pointing a finger at myself).
Insurance was never designed to be "all inclusive." Insurance started back in the middle ages originally insuring ships as they went to sea. But it is important to remember, the insured shared a good bit of the risk. Insurance then started covering homes, lives, cars, boats and yes... our health. But we have gone from a "fee for service" environment to a complicated Health Maintenance Organization (HMO) environment where people feel that everything should be paid for.
Another term that bothers me is entitlement. "I am entitled to health care." The dictionary defines entitle as "to furnish with a right or claim to something." I agree... we are entitled to access health care, but not to have health care provided for us. If that is the case, then I should be entitled to... a free home, free meals, free car and gasoline, free clothes, free... you get the point. Somewhere during my soon to be 55 years of existence, America has become a nation of "I am entitled to..." We no longer want to assume responsibility for most anything.
I know that this is not everyone, but it is a lot of people. I am in hopes that with this blog/forum I can continue to inform you about various health issues regarding our bodies as well as issues regarding our American health care system.

Numbers to watch for Heart Disease

I can't believe I haven't written anything since last October. No excuses except laziness.
I see a lot of people in my office that have some form of heart disease. Even heart disease can have devistating effects on the feet and ankles. If you have a family history of heart disease, overweight, smoke, or have diabetes; here are some tests you should have done:
Total cholesterol: should be under 200 milligrams per deciliter (mg/dL).
LDL: should be under 100 mg/dL.
HDL: should be above 50 mg/dL for women, and above 40 for men.
Triglycerides: should be under 150 mg/dL.
Fasting blood suger: should be under 100 mg/dL.
Blood pressure: should be no higher than 120/80 mmHg.
BMI: shouldn't be higher than 25. If your body mass index (your weight-to-height ratio) tops that figure, your heart risk increases 32%. Over 29 and it spikes to 81%.
Waist circumference: should be 35 inches or less for women and no more than 40 inches for men.

"The journey of life is taken one step at a time... none of them should be painful." G.M. Barclay, DPM, AACFAS