For the past year I have grown increasingly frustrated as our health care system has valued payer over patient, time and time again. Even our hospital administrators seem immune to care and compassion – the bedrock of my practice. My mission is to provide each patient with the right care, to the best of my abilities.
I want to be a resource to the pioneering group of practitioners (Direct Primary Care) who stepped out of the constraints of our current system to deliver care we all want to receive. We are trying to put the soul of health care back into the patient-physician relationship. At this time, we feel insurance companies increase friction and raise the cost of care.
~ Avinesh Bhar, MD MBA
Initial video consults (either from the patients home or the referring practice using a smartphone and desktop)
Follow up (video)
Follow up (text):
I am offering this service to provide patients the flexibility of communicating directly with their physician without the formality of video.
Home Sleep Testing (HST): to include interpretation and physical copy of report.
I am setting up a DME company to ensure I can provide patients a cost effective and efficient care continuum for their pulmonary and sleep needs.
Dr. Bhar goes on to say, “My hope is to set up an efficient workflow to facilitate communication and follow up with DPC practices and patients. Through my website https://www.sliiip.com/ I provide video consultations (for first time visits and for complex follow ups) along with text messages (through a third party HIPAA compliant partner) for simple follow ups, medication refills and results notification.
I am currently licensed in GA and SC. I am also available for curbside consults to providers.
Notes from a doctor with a laptop, a house call bag and a fountain pen
I thought to myself about how often specialists are in a position where they can simply declare “Not my department”, but primary care docs are then more or less obligated to pick up the ball again and do something.
Two weeks later, Red was a new man.
I’m sleeping through the night, and no pain”, he grinned.
I still don’t know exactly what this was, but it’s gone.
Our modern lifestyles provide nearly endless sources of distraction. Not surprisingly, recent research has shown that this constant input has a significant impact on our health. Read on to learn more about how distraction is literally rewiring our brains, and what you can do to protect yourself.
Studies have shown that increased use of a smartphone is associated with anxiety, depression, and sleep disturbance in adolescents and adults (2, 3). Other studies have shown a relationship between problematic internet use and electronic gaming and psychological distress and problem behavior in youths (4).
In short, the greater the opportunities for distraction become, the greater the necessity for a practice that centers our attention in the present moment and counteracts the negative consequences of our increasingly fragmented attention.
By studying the Hadza’s lifestyle, Pontzer thought he would find evidence to back the conventional wisdom about why obesity has become such a big problem worldwide. Many have argued that one of the reasons we’ve collectively put on so much weight over the past 50 years is that we’re much less active than our ancestors.
Surely, Ponzer thought, the Hadza would be burning lots more calories on average than today’s typical Westerner; surely they’d show how sluggish our bodies have become.
On several trips in 2009 and 2010, he and his colleagues headed into the middle of the savanna, packing up a Land Rover with camping supplies, computers, solar panels, liquid nitrogen to freeze urine samples, and respirometry units to measure respiration.
In the dry, open terrain, they found study subjects among several Hadza families. For 11 days, they tracked the movements and energy burn of 13 men and 17 women ages 18 to 75, using a technique called doubly-labeled water — the best known way to measure the carbon dioxide we expel as we burn energy.
When they crunched the numbers, the results were astonishing.
“We were really surprised when the energy expenditure among the Hadza was no higher than it is for people in the US and Europe,” says Pontzer, who published the findings in 2012 in the journal PLoS One. While the hunter-gatherers were physically active and lean, they actually burned the same amount of calories every day as the average American or European, even after the researchers controlled for body size.
I believe it was Ben Franklin that is credited with saying:
An ounce of prevention is worth a pound of cure.
I think we all pretty much understand the platitude and agree that preventing something is usually easier and less costly than fixing it after the fact.
Not to paint with too broad a brush or disparage the concept of prevention, but whole specialties and boutiques have sprung up using this moniker to lend credibility to their business model and persuade the searching public that their way is the correct path to health.
When David Sedaris purchased his Fibit last summer, this small piece of technology inspired him to walk after dinner instead of sitting on the couch. When his Fitbit died, however, walking became pointless without the steps being counted or measured. Sound familiar?
Two hours on the row machine, like Frank Underwood does, will not cancel out the pizza you ate during your House of Cards binge.
I equate using a fitness tracker or food calorie tracker as a marker of dishonesty with ourselves. We are missing a pivotal step: self-reflection. It’s really easy to buy a Nike Fuel band and wear it. It’s much harder, however, to get deep with yourself.
Fitness apps are a flawed, abbreviated version of this self-reflection process. They focus too much on the number of steps, calories, or distance traveled. Fitness tracking devices distract us from what really needs to happen: we need to look at ourselves naked in the mirror and have an honest conversation with our naked self about the status of our health. From a weight-loss standpoint, it’s critical. Then let’s unplug the TV, peel ourselves off the couch (if not get rid of both the TV and couch), and buy a few free weights and a yoga mat before throwing down for a fitness tracker. The cost is about the same, but the impacts couldn’t be more different.
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