I’ve never been a reader but recently, I’ve come to enjoy it. This is something that I read and wanted to share since it was something I took to heart.

“Ready or not, some day it will all come to an end.

There will be no more sunrises, no minutes, hours or days.

All the things you collected, whether treasured or forgotten will pass to someone else.

Your wealth, fame and temporal power will shrivel to irrelevance. It will not matter what you owned or what you were owed.

Your grudges, resentments, frustrations, and jealousies will finally disappear. So too, your hopes, ambitions, plans, and to do list will expire.

The wins and losses that once seemed so important will fade away.

It won’t matter where you came from or what side of the tracks you lived on at the end.

It won’t matter whether you were beautiful or brilliant.

Even your gender and skin color will be irrelevant.

So what will matter? How will the value of your days be measured?

What will matter is not what you bought but what you built, not what you got but what you gave.

What will matter is not your success but your significance.

What will matter is not what you learned but what you taught.

What will matter is every act of integrity, compassion, courage, or sacrifice that enriched, empowered or encouraged others to emulate your example.

What will matter is not your competence but your character.

What will matter is not how many people you knew, but how many will feel a lasting loss when you’re gone.

What will matter is not your memories but the memories that live in those who loved you.

What will matter is how long you will be remembered, by whom and for what.

Living a life that matters doesn’t happen by accident. It’s not a matter of circumstance but of choice. Choose to live a life that matters.

When it comes to patient outcomes it’s not a question of the most advanced technology that provides the best care; It boils down to communication.  At its most fundamental level the physician/patient relationship is about the interaction and what is expressed and what is understood.  

Oftentimes I will see medical practices marketing body scans and advanced blood work. While it is exciting to think of a Star Trek type of practice where one is simply scanned and all health concerns are known we simply aren’t there yet.  These body scans and extra blood work have never been proven to increase health in any way. Having an open dialogue with patients and allowing patients the time to tell their story is the best way to improve patient outcomes.  There is an old adage in medical training:  “90% of the diagnosis is the story.”  If a provider doesn’t listen to the story then getting it right is that much harder.

It is estimated that up to 40% of hospital admissions could be avoided by better communication between the physician, the care team and the patient.  It is distressing to think of all the suffering and needless waste of money that could be avoided by simply listening.  By understanding patient concerns and getting feedback on medications and symptoms providers are better able to preempt healthcare deteriorations that land patients in hospitals.

Every provider has a different style, but I typically start out appointments by asking patients about what brings them into the doctor. I know the sorts of things that I want to address to keep them healthy: preventative measures, immunizations, blood work, etc.  These are the issues that I want to address, but oftentimes you cannot get there until you address that nagging shoulder pain or other complaint that the patient has. From a patient standpoint, if you can’t take the time to deal with an ache or pain why bother dealing with an abstract issue such as cholesterol or hypertension.

At the end of every visit I review the plan and ask patients if there any questions. Sometimes I think we are communicating and in reality we just aren’t. I try as often as possible to make sure that I’m on the same page as my patients.  On top of the willingness to communicate from staff and clinicians, there needs to be a general openness. If patients feel that they are being judged or that they are being pressured for time they’re less likely to tell a physician important information.  

Sometimes questions come up after the visit has ended. Every patient has access to me via email and every email is responded to within a 24 hour period.  By keeping  messages in the patient’s own words it reduces the likelihood that information is lost in translation from staff to the physician.

Sometimes practices change over time and with the pressure to comply with government regulations and insurance demands the one-on-one that providers enjoy with their patients falls to the wayside.  We have engineered our processes so that this doesn’t happen, even as we continue to grow.  Communication is a core belief in our practice, and with such a small price and such a great reward it will always be front and center.

Adoption.

At times this word seems very foreign to me. Which is odd since I am adopted.

I think the best part of my family which is full of many different backgrounds, bloodlines, and personalities is that we love each other unconditionally. Which was taught by our parents. Some people ask how it feels to be adopted or do I long for my biological parents? I laugh because I truly don’t feel anything towards the word adopted, my parents are my parents and my siblings are my siblings. I do have the privilege of knowing and having a relationship with my biological mom and I thank God every day that she was selfless enough to give me up for a better life.

I’m apart of a large family, 7 girls, and 2 boys. My parents had 4 of their own and were foster care parents for a long time, then decided to adopt 5 kids. I happen to be one of them. The first 2 are half sisters and the next 2 are half brother and sister, which leaves me the odd ball (which is what I was lovingly called by my dad growing up). All of us were aware of being adopted our whole lives, but never felt like we weren’t family.

I often think about the life I would have had or even if I would have made it this far in life. When I was born I was addicted to heroin and had to be put on methadone to wean me off the drug. The doctor and nurses didn’t think I had much hope. My parents drove an hour every day while I was in the hospital just to make sure I was fed until it was time to take me home. I would have seizures as a baby and my parents had long nights with me turning blue and constantly crying {another nickname I had was smurf.} My parents told me I would scare the life out of them, but they never gave up on me and cared for me like their own. Most importantly they gave nonstop love for me and all my other siblings.

Adoption is a beautiful thing and it takes very special people to love someone like their own. Someone once said to me “blood is family” which shocked me because everyone that is family to me has no blood relation to me. I know it’s not for everyone but those kind of people make a huge difference in one’s lives. I can say from experience. I’m beyond blessed to belong in such an amazing family.

From the billing department…

There is often confusion when dealing with insurance companies and doctor’s offices and what we as a patient will have to pay. I have taken some of the most common questions among patients and listed them below to help give you a better understanding of the terminology used in the medical/insurance field.

What is an Explanation of Benefits(EOB)?

• An EOB is something that is used by the insurance company to inform a patient and provider’s office of the patient’s benefits for a particular office visit. An EOB lists the total amount that was billed to the insurance, the total amount the insurance will “allow” (per contract with the providers office), the patient’s responsibility (copayment, deductible, coinsurance) and the payment amount to the provider if there is one.

What is an allowed amount?

• An allowed amount is a contracted rate that the insurance and providers office have agreed upon. This is usually a percentage of what Medicare will reimburse for the same code. For example: Suppose a provider is contracted with Cigna at 70% for code 99213 (the code used for an established patient with a moderately complex office visit). That same code with Medicare is reimbursed at $100. Cigna will allow a maximum of $70 for that code.

What is a copayment?

• A copayment is a set amount that a patient would be responsible for during a visit. This amount can vary based on the type of provider the patient is seeing. For example, a primary care doctor is generally less than a specialist or the emergency room. This is based on an individual’s plan through their insurance and varies by carrier and policy.

What is a deductible?

• A deductible is a set amount that a patient is responsible for paying toward and once met, the insurance carrier will contribute toward the visit for the remainder of the plan year. For example, if a patient has a deductible of $1,000, that means that the patient will have to pay total charges for all visits until that amount is met. Once met and depending on the policy, the carrier may contribute a percentage (called co-insurance) or total of the charges for visits. This varies by carrier, plan and individual, so if you want to make sure you are financially prepared for your visit, contact your insurance company and ask for your benefits.

What is the difference between Medicare, Medicaid and Commercial insurances?

• Medicare and Medicaid are both insurances issued through the government. Medicare generally is issued to those with disabilities and retirees. Medicaid is generally provided to those that are not able to afford health care through a commercial insurance and don’t qualify for Medicare. Commercial insurances are those that are offered through a person’s job or on their own and are not affiliated with the government.

The ins and outs of insurance can be daunting, and the language can get a bit confusing.  But don’t underestimate the value of being an informed consumer, especially where  your health is concerned.

Oftentimes patients will make the declaration “My snot is green, I need antibiotics!” I’m uncertain where this popular belief that green mucous means that antibiotics are required originated from, but it just isn’t true. I wish it were – my days would be easier and the decision-making process of using antibiotics would be about as complicated as a traffic light.

The reality is that the green color in mucous comes from an enzyme called myeloperoxidase found within our immune cells. This enzyme is used to fight off viruses and bacteria, and has iron at its center. It is this iron that give mucous its green color when fighting an infection.

While your mucous may be green from fighting a bacterial infection it is more likely to be green from fighting off a virus. The amount of viral infections patients fight off is significantly more than bacterial infections that must be dealt with.

When deciding whether or not to use antibiotics there are more important factors such as age, overall health, duration of symptoms, vital signs and physical exam. The reality is that most colds will have their peak at 3-5 days with resolution at 7-10. For most patients watchful waiting with symptomatic care is all that is needed.

In this age of antibiotic resistance it is important to use antibiotics only when needed. For more information on antibiotic stewardship check out the CDC site here.

Budgeting is something we all should be doing, but let’s be honest we don’t. We tend to think about the right-now moments rather than our futures. I don’t criticize living in the moments because I’m one for random trips and adventures. Just make sure you’re not spending more than you make. Here’s a few ways that have helped me stay in check.

1. First things first: make sure you know where your money is going. Make a list of all your monthly bills from Rent/mortgage, cellphone, car insurance etc.. all the way down to the little things like Netflix and gym memberships. Take the total of income you get after taxes and minus the number you come up with for expenses. (get rid of the hulu account or gym membership if you haven’t used it in months). This is your extra money.

Example: Total Income monthly $1600, Total monthly bills $975, amount left over: $625.

2. Extra money of course has to go towards gas, groceries and living needs. Set an amount of how much you plan to use in gas and food and stick to it. Subtract this number from your fixed expenses.

Example: Money after monthly bills: $625.  Subtract gas ($120) and food ($300). This leaves $205 remaining.

3. Savings- find a number you’re comfortable with and put it in a separate account. Starting out you can start low and work your way up when you’re more comfortable.

Example: Total amount left over: $205. Putting $25 into savings leaves you with $180.

4. Spending- You now have successfully paid all your bills and put some in savings. You’re off to a great start. You can use this $180 on anything you want without worrying about paying your bills or feeling guilty that you are spending too much.

Now let’s talk about other ways that have helped me to spend less money.

One trick, which also helps your health, is cooking and eating at home. Maybe this isn’t for everyone, but for me I get comfort and satisfaction out of cooking a delicious meal. People who cook their own meals are less likely to overeat, a nice side perk leading to a healthy lifestyle.  While low in cost, fast food can add up over time.  For the cost of a few burgers a day you can cook at home for less with the added health benefits.

One of my favorite was learning how to love myself and spending quality time with me. This gives you a chance to experience what you truly love doing and hey some of those things might not cost you money. Think of all the times you’ve went out just because your friends were doing something they wanted to do and you didn’t want to spend the night alone. I did this and came to a point where I was spending money on things that I couldn’t really care less about. But when I learned to enjoy spending time by myself, I quickly realized that I didn’t always have to be surrounded by people. My favorite thing to do is sit outside, listen to some good old country music, enjoy the outdoors and possibly have a book in my hands. What does this cost me? That’s right, nothing but contentment.  While this may not be everyone’s cup of tea it sure is a great way to unwind, and you just can’t beat the cost.

Having the mindset of someone who is broke also helps save money.  When looking at something I want to buy I’ll often ask: do I really need this? This method plays a very important role in my budgeting. For one, if I tell myself I don’t have the money I won’t be tempted to go out and buy stuff I don’t need. Then, when I do cave in and go browsing I also end the trip with “do I really need this?” Usually the answer is “no.”  However if I go a few months really wanting something and holding off, I will then make sure I have the funds and get something I’ve been wanting.

You’re probably thinking what the heck do I do for fun? Well, I enjoy exploring new places and it’s not as costly as you think.  This, of course, depends on what you are travelling for. I’ve been blessed and have seen a lot of the United States for next to nothing, Why? Because I traveled to see and explore nature, random lakes, mountains, buildings, and small old towns that had such characters and stories. This doesn’t cost anything when you’re just using your eyes to enjoy things your memory can cherish forever. By changing the reasons I travelled I was able to see so much more than if I had simply saved for posh hotel rooms and expensive meals.

Hopefully you got something out of this! By following the first three points and spending your extra money wisely you can enjoy what life has to offer without suffering the stresses of worry about bills.