Tips for choosing a dentist

We cannot deny that fact that at some point in our lives, we would rely on dentists for our oral health. However, to make sure attain a disease-free teeth, we must ensure that we acquire the services of qualified dentists who will not only give us the desired results each time we seek their services but also guarantee accountability in case of improper practice. To help you choose the best in the business, here are our proven tips for selecting a dentist.



Prior to making a decision, always make sure that the dentist has the required qualifications to hold office as far as dentistry is concerned. In addition, ascertain that they are providing their services according to the law. Of course, the only way to be sure about all their claims is by taking your time to do some research. Always keep in mind that it is paramount to do a thorough research because relying on assumptions could mislead your judgment.



ZXCZXCZXCAs the saying goes, nobody is perfect. Thus, even the people who claim to have years of experience and expertise in some areas including dentistry can commit mistake every once in a while. In fact, a dentist can have the best papers backed by years of studies, but his or her bad reputation can ruin everything. Apparently, nobody wants to deal with a dentist who has a bad reputation. For this reason, you must always check the reputation of the dentist before hiring him or her.

Visit The Dentist Of Choice

The first impression is always important in any field. Most of us have the tendency to judge whether we can work with someone or not within the first few minutes of talking to them. How they answer questions, how they respond to scrutiny can apparently give you the green light as to whether you can work with them or not. So give yourself a chance to meet the dentist of choice because in doing so, you will be able to know if he or she is the right person.


Choosing a dentist should be taken seriously. This is because making a wrong choice means putting not only your finances in jeopardy but also your health in danger. Therefore, do the right thing today in order to avoid regrets in the future.

Dental Implants

Oral Surgeons Services That You Need to Know

On average, most adults end up with 32 teeth. In general, the oral health of a human being entails more than people can think. If you consult a Beverly Hills Oral Surgeon, you will be surprised that there is a lot the experts can do you restore your oral health. That is why we will discuss such services here below.

Placement of dental implants

DentistMalfunctioning of the natural teeth affects more than our oral health. They might have ramifications that impact on our speech, diet, level of self-confidence and quality of life. Treating this abnormality requires restorative surgery from a trusted oral dental surgeon. Prosthesis might be placed which might be temporary or permanent. The exact procedure involved varies on a case by case basis among different patients.

Reconstructive surgery

Very few people require reconstructive surgery throughout their lives. The patients who qualify for reconstructive surgery are those who experience severe infections that result in bone loss and structural damage, serious accidents, and oral cancer-related illnesses.

No reconstructive surgery can be likened to the other; each varies with the individual. If you have undergone an open bite, experienced breathing or chewing problems, trouble when swallowing among others, go for corrective jaw surgery.

Corrective jaw strategy

As the jaws of a patient age, they might deviate from their regular growth path. Such defects might manifest from birth and develop as one age due to environmental or genetic circumstances. This procedure can help improve the following condition; an open bite, speaking difficulty, improper breathing, or a protruding jaw.

Osteogenic orthodontics

This treatment is quite extensive and helps patients get a healthy smile. The treatment can extend for up to 3 years and will require frequent maintenance. Anyone undergoing this procedure should anticipate countless future appointments with their dentist. Another way this can be done is surgically accelerated osteogenic orthodontics. The procedure involves enhancements around the tooth and the surrounding bone. To get stable results, bone augmentation is conducted too.

Facial trauma repair

TeethFacial trauma can get the best of a patient, affecting them emotionally and physically. The procedure requires total commitment and a hands-on approach to treatment. Facial trauma involves injuries to the upper jaw, mouth, eye sockets, face, cheekbones and lower jaw. Some of the recommended procedures conducted during reconstruction are fracture stabilization, tooth replanting, tooth extraction, soft tissue suturing, and much more.

Pathology screenings

The mouth of a healthy person should appear smooth and pink. Any lesions or alterations that might appear are a sign of pathological interference. In worst cases, it can be cancerous. Usually, a biopsy is done which involves the removal of any suspicious tissue area. After this, you can transfer the sample to a pathology laboratory for further microscopic evaluation. This helps in arriving at a suitable diagnosis.

Finding a Good Dentist around your Residence

Finding a good and reliable dentist around your place is never always a simple task. This is attributed to the fact that there are many people who claim to be a dentist but when you give them the chance to give you the dental services, you will be shocked. So it is always wise that when you are in need of a good dentist, you take time to do an extensive research. Competent and reliable dentists do not come easily. Here are some of the important tips that will help you find a good dentist.


When finding a dentist, you need to ensure that you find someone you will not be convenient in any way. Choosing a dentist who is close to you is one of the best ways of ensuring that you are never inconvenienced in any way. This is because you can see and book an appointment anytime that you feel you have a problem that needs to be addressed by a dentist.

Dental schools

Apart from using the internet to do your research, you might want to consider other sources that are legitimate. Dental schools are one of the best options for you. This is because great dentists will always leave a legacy behind them. Dental schools have reliable websites that you can always use to get whatever information that you are looking for.

The reputation of dentist

This is also another important factor that you should always consider whenever you are looking for a good dentist. People will always have something to say about the quality of services that they get. This is the only opportunity that you have to get all the information that will help you choose a perfect dentist. For instances, a dentist with a good reputation will have many positive reviews, and this is enough to tell you that they can provide you with the quality services that you deserve.

Consult your doctor

You primary health doctor can be of great help when it comes finding a good and reliable dentist. This is because there are high possibilities that they share a lot in common. Also, they might have referred many of their patients to the patient. Your doctor can help you find a dentist in Palm Beach Gardens.

The internet reviews

You also need to have a close look at the internet and pay close attention to the internet reviews. While it is true that they might not be 100% reliable, the truth is that can provide you with important information that you are looking for. Always go for a dentist with many positive reviews as they are likely to provide you with the quality services that you are looking for.

man smiling with out tooth

Dental Implants for A Beautiful Smile

A missing tooth or distressing gap ruins a beautiful smile. With Advanceddentalconcept.com – Hammond dental implants offers restoration services that bring back that beautiful smile and build your confidence!

Hammond dental implants are a teeth reconstruction process that improves the teeth strength and functionality. The dentist places the dental implants where the teeth are missing in the jaw. The Hammond dental implants help maintain the facial structure and prevent bone loss. The bone grows around the implant creating a sturdy base for the artificial teeth.

The Hammond dental implants remain intact for years unlike like dentures. However, you will need regular dental visits to maintain them.

Wondering how you will look like with dental implants? The good news is that it will not ruin your looks further! The Hammond dental implants replace the missing natural teeth, and they resemble, function, and feel like real teeth. You can eat anything you want without a worry in the world.

filling toothj

Dental implant replacement requirements

Did you know that not everyone is a dental implant replacement candidate? There are specific qualifications the prime candidate must fulfill. For starters, your gums must be healthy. The patient must have the required bone density that will support the process. If a person lacks the two crucial aspects, another dental procedure will be necessary. Other factors to consider include:

The number of teeth that need replacement

Do the tooth/teeth need extraction and bone grafting before the procedure?

What to expect

dental aptDuring your appointment, the dentist will determine your current dental health. If you meet the required conditions, you will be booked for the procedure. Just like any other dental procedure, it has a slight discomfort, but dentists are committed to making the process pain-free as possible.


Lessons I learned sleeping on the floor

All of us know that sleeping on a mattress is a relatively new phenomenon. Maybe most of us cannot realize this because we have been doing it ever since we were born. But the single most question that most of us have never asked is why do human beings sleep on a mattress? Most of us will argue that they provide a comfortable surface for sleep, but is it the best for one to rest the tired body? Initially, I did not give enough thought about this, but as the time went by, I started being curious and tried to find out how our ancestors used to sleep.

Even though research findings show slight differences, most of them concur that early man used to sleep either on trees or the ground. Here’s what the experts propose as the benefits of sleeping on the floor. This aroused my curiosity, and I wanted to experiment how it feels sleeping on the floor.

Having done it for the last six months, the following are the lessons that I have learned and which make me think that you should consider sleeping on the floor.345655yrterwe

Health benefits of sleeping on the floor

It makes one feel more natural

Sleeping on the floor is something our ancestors have done since time immemorial. It is not a surprise that a large segment of the world’s population still spends their nights sleeping on the ground. But with the development of technology and the change of lifestyle, most people prefer sleeping on super soft mattresses. Even though sleeping on a mattress can feel good in the initial stages, it is more likely that it can lead to the development of chronic health problems later.

I am not saying that sleeping on a mattress is bad, but if you sleep on a mattress that is keeping and misaligned, your body will be misaligned, and this will cause real problems to your body.

It is better for our bodies

When one sleeps on a surface that is flat and firm, our bodies especially the body spine has the chance to realign back into its natural posture very easily. What a mattress dies is that it creates more space between our bodies and the floor. But when you sleep on the floor, one is most likely going to experience a wide experience of body awareness. Due to this, you will always have a full feel of your body while you are sleeping. By so doing one can develop a strong mind and body connection, a scenario that you cannot achieve when you are sleeping on a mattress.

Reduces body stiffness

43567utrterw4Most individuals have been accustomed to waking up with bodies that experience wild stiffness, not until they experience waking up without it. The major reason why one will experience this stiffness is that, when one sleeps on a mattress for long, the body will get into a hunched position when one is sleeping hence the mild stiffness. Experts argues that sleeping on the floor provides the firm type of surface you need to experience  better sleeping comfort and spine alignment. This causes muscles to tighten up hence one feeling stiff when they wake up in the morning.

It is an experience worth trying, but it is important to note that at first, you will feel uncomfortable because during the first period your body will have to adapt to the new sleeping surface.

Dangers Of Taking Too Much Sugar

Sugar is delightful when taken by anybody. At that point of intake, it does not come to your mind that it can also be awful and harmful to your health. But looking into sugar in broader aspects sugar can be very dangerous despite it being sweet. Some of the dangers of sugar are:

Enhances Weight Gain

Foods that have a lot of sugar tend to contain a lot of calories. These kinds of foods will not play a significant role in satisfying or fulfilling your hunger. More intake of sugar will lead to weight gain when the sugar is not burnt or used by the body. One needs to engage in a lot of physical exercises so that he or she can burn down the calories that enhance weight gain. On order to lose weight, it is advisable to cut intake of sugar.

Causes Insulin Resistance

Insulin is a hormone that aids your body in converting food to energy. Eating a lot of insulin will make your body to be in need of insulin. Hormone sensitivity of your body will be reduced in cases whereby your insulin levels are high, and this will lead to building up of glucose in your blood. If you are experiencing insulin resistance then some symptoms like high blood pressure, fatigue and brain fog will be evident. In most cases, individuals will not know they have developed the resistance until they have developed diabetes.

Causes Tooth Cavities

Sugar is very bad when it comes to matters related to your teeth. Sugar causes decaying of teeth. The tooth decaying scenario occurs when bacteria that are in the teeth will feed on the sugars. After that, they create acids which are essential in destroying the enamel. Candies that are sour are very nefarious.

May Cause Heart Disease

Too much sugar intake mostly in women may lead to heart-related diseases. With too much intake of sugar, your calorie intake will be very high in the body. Similarly, these calories lead to weight gain in the entire body. It is this weight gain that can enhance heart-related diseases because the heart will be overworked. Also, too much cholesterol can lead to heart diseases.

Causes Cognitive Decline

Some of the factors that show cognitive decline are diabetes and obesity. Taking diets with high sugar might lead to dulling of emotions getting aroused and can contribute to impairment of your memory. It can also lead to reduction of hippocampus

Benefits Of Cinnamon

Cinnamon serves a lot of roles in the human life. In most instances, it is used as a spice. Some small amount of cinnamon used on a daily basis can make significant changes to your health. For instance using significant doses can help in reducing the risk of heart diseases. The benefits of cinnamon are extracted from it barks and oils.

Below are some of the benefits of cinnamon;

Good Source of Antioxidants

Cinnamon has several antioxidants that are protective which help in slowly one from aging. Compared to other herbs cinnamon is considered to have the highest level of antioxidants. It is these antioxidants that do the fighting of stress that is oxidative in the body. The oxidative stress if not controlled can lead to the formation of diseases when one is aging. Cinnamon can also help in reducing building up of blood and lipid that can lead to brain disorders if not dealt with.

Anti-Inflammatory Characteristics

Anti- inflammatory effects of cinnamon are brought about by the presence of antioxidants in it. This will help in lowering the risk of brain functioning cancer and heart disease. Cinnamon also contains flavonoids that are very crucial in dealing with inflammations that are very dangerous to the body. Since cinnamon helps in lowering swelling that will help in managing of pain because it will relieve soreness of the muscles.

Promotes Heart Health

Cinnamon is known to reduce the major risk characteristics for heart diseases. It will also help in reduction of cholesterol that is in high levels and similarly helps in reducing high blood pressure. Compounds that are found in cinnamon will help in stabilizing cholesterol by doing away with bad cholesterol and remaining with cholesterol. On the other hand, it will help in preventing blood loss by forming blood clots. It will also help to increase circulation of blood.

Fight Against Diabetes

The components in cinnamon help in lowering blood sugar and can enhance sensitivity to the insulin that is very crucial in ensuring sugar levels in the blood are well balanced. For such a case cinnamon has some enzymes known as alanine that allow sugar to get absorbed into the blood. Therefore cinnamon will work in reducing sugar which will enter into the blood after taking a meal with high sugar.

Lowers Risk Of Cancer

The antioxidants in cinnamon have the capabilities of protecting damage of DNA, mutation of cells and growth of cancerous tumors. Cinnamaldehyde is a component in cinnamon will help in ensuring that growth of cancerous tumors does not occur.

Healthcare Today



Ethics, Chronic Care & Cost Prudence.

Hospitals care for thousands upon thousands of people with chronic medical conditions. The cost associated with providing chronic care is staggering. In fact the cost of providing care for patients with chronic medical conditions is so high that most insurance companies will not offer individual policies to those folks because of the high costs. Alternatively, those folks that would be given individual policies that have chronic conditions would likely not be able to afford the premiums.

Those individuals that have chronic medical conditions such as diabetes spend a life time monitoring their blood sugar, their diet, and their activity level. Several diabetics are compliant with their treatment program. They eat correctly, they exercise, and they take their medications. They also monitor their blood sugar several times a day. Despite doing the best they can to control their disease, these folks will periodically end up in an emergency department because their blood sugar is either too low or too high. They are admitted to the hospital for what I call a quick tune up and then they are back home. Their conditions is well managed.

What about those individuals with chronic medical conditions that do not follow their treatment plan? They don’t take their medications as prescribed. They continue to indulge in behaviors that put them at risk for further hospitalizations. The diabetic that eats whatever they want, and doesn’t monitor their blood sugar. Perhaps they don’t even take their medications. The alcoholic that continues to drink for a life time and ends up having gastrointestinal bleeding that requires blood transfusions and intensive care unit hospital stays. They are discharged from the hospital to only come back a short time later intoxicated and bleeding again. Other patients that spend a life time smoking and develop emphysema and are using oxygen at home twenty-four hours a day and they continue to smoke. These people frequent local emergency departments regularly and require hospitalization. Many times I hear from rescue personnel how they pick up people that are smoking while they are attached to an oxygen tank.

In 2005, 133 million people, almost half of all Americans lived with at least one chronic condition.

Chronic diseases account for 70% of all deaths in the United States.

The medical care costs of people with chronic diseases account for more than 75% of the nation’s $2 trillion medical care costs.

The direct and indirect costs of diabetes is $174 billion a year.

Each year, arthritis results in estimated medical care costs of nearly $81 billion, and estimated total costs (medical care and lost productivity) of $128 billion.

The estimated direct and indirect costs associated with smoking exceed $193 billion annually.

In 2008, the cost of heart disease and stroke in the U.S. is projected to be $448 billion.

The estimated total costs of obesity was nearly $117 billion in 2000.

The numbers are staggering. So here are some questions. Why should we as a society continue to pay for and use precious medical resources on those patients that have chronic medical conditions that refuse to be compliant with their established care plan? While most of us agree that life is a very prized thing, at what point do we draw the line? Can we as a society draw a line and say no?


Source: CDC


Presidential Hopefuls Ignoring Larger View of Healthcare Reform.

Right now taking center stage is the continuing financial saga which has most of us more than just a little worried. However, other domestic issues such as healthcare reform are of equal importance, and should not be ignored.

The presidential hopefuls are battling it out in town hall meetings and other public venues in hopes of garnering the necessary support from John Q Public who will pull levers, and push buttons that will decide the fate of this country for at least the next four years. Voters are watching closely to see how the candidates respond to questions about the “issues”.

With respect to healthcare, both candidates have laid out their broad brush strokes providing a glimpse void of any real detail about how they would reform healthcare. Senator. McCain wants to effectively create a tax credit swap of sorts which would focus on providing people with individual insurance coverage and there would be a movement away from group employer based health plans which many of us have today. Senator Obama’s plan would basically increase health insurance coverage through social programs like Medicaid and the State’s Children’s Health Insurance program. Both plans are focusing on whittling down the 45- 47 million Americans that do not have any health insurance.

Each of the candidate’s plans will put the cost of providing more insurance coverage for people into the trillions of dollars. Furthermore each of the proposed plans is estimated to reduce our current 45 million uninsured by approximately 20 million or so. This still leaves some 20 – 25 million or so folks without any healthcare coverage.

For my money it seems that the two presidential hopefuls are missing the boat with respect to healthcare. Our current healthcare system is fragmented. There are a lot of moving parts. The main focus from both candidates seems to only address the numbers of uninsured. Little discussion if any is centered on mitigating costs associated with healthcare. No one seems to be speaking of introducing some smart regulation into healthcare to cap costs.

Several months ago while most of the world was dealing with out of control healthcare costs the Japanese Health Minister was dealing with a health cost related issue for Japan. Their system is highly regulated right down to the price hospitals can charge for tests such as an MRI – which is $98.00 there. The Health Minister had to raise the prices because healthcare costs were too low and hospitals were not being paid enough. A one night stay in hospital in Japan costs $10.00.

I am not suggesting we introduce regulations as tight as Japan has into healthcare. I am suggesting that if our government leaders are planning on reforming healthcare in a fragmented way, then we are likely not going to be solving much of anything. Our fragmented system needs an inclusive approach in developing solutions.

Source: Yahoo News


Healthcare has Highest CEO Turnover Rate.
The corporate ladder as most of us know is not an easy climb on a good day. Many dream of getting to sit in the CEO chair and directing operations, enjoying the perks, bonuses, and just plain “living the dream” if you will. Well being number one has its drawbacks. Even CEOs have to answer to someone.

This year 1,132 chief execs have left their position. Some have retired, some have left for better jobs, and some have been pressured to leave by displeased boards and shareholders due to economic reasons. It is yet another sign of the poor economic times that we are in. When companies report losses someone is usually left holding the bag. The smoking gun quickly gets pointed at top level executives, especially those that have mismanaged company operations.

Being a CEO is a high visibility position, like working and living in a fish bowl. These days CEOs are expected to deliver even more than before. Compensation packages that CEOs receive have garnered much attention of late and shareholders and boards expect results for shelling out such large salaries. I suspect the bottom left hand drawer of many CEO desks in which a bottle of scotch used to reside has now been replaced with Tums, Protonix, Pepcid, and an airsickness bag.

Challenger, Gray & Christmas Inc., a consulting firm who tracks such statistics in a recent survey that they have on their blog showed that CEO turnover was likely to reach record levels before this year is over. Healthcare had the highest level of CEO turnover with 206 changings of the guard. Financial firms were second on the list with 133 CEOs walking. Once again healthcare is not so recession proof after all.


Patients Use Express Lane to Access Emergency Department Care.
Emergency departments (EDs) are busy places these days and with the winter cold and flu season fast approaching the work load is likely to pick up. Despite that the kids are back in school and colleges are in session, and people are back from their annual trek to what ever vacation spot they went to this summer, EDs are still seeing large volumes of patients. There are still waiting rooms filled with any number of patients with minor injuries, kids with broken bones from sports, and the usual ills that seem to target the elderly all year long without any sort of abatement.

Patient’s tolerances for waiting to be seen by an emergency department physician have also not changed, and in all honesty will never change. In fact as time goes on patients with non-emergent medical problems will likely not tolerate waiting times of any sort as our society becomes used to having things done in the now time frame.

Savvy patients that use local emergency departments for their primary care have learned however to bypass the normal triage and registration processes when they seek care. Waiting in line is not an option for these folks. Instead, many times these patients will come to the ED by using the local 911 rescue service that are typically provided at the behest of the local fire department. While many emergency medical services (EMS) cost several hundreds of dollars plus mileage, there seems to be little concern for spending or should I say squandering precious healthcare dollars on an ambulance ride for a laceration (cut) on one’s leg or hand. The goal here is to get into the ED by way of EMS and bypass the waiting room for many patients.

Several times I have heard patients who are in the ED waiting areas say: “I should have taken an ambulance here.” “I would have gotten in sooner.” Despite healthcare’s best efforts it would seem that most people do not understand that emergency medicine is not about who came first. It is about acuity. How sick or injured are you? The closer you are to dying, the sooner you get seen. Perhaps a blunt measure, but it makes the point.

Other than the added cost of a $500 taxi ride in the back of an ambulance for minor injuries and illness where patients could have used alternate transportation to get to the hospital, there are several other issues here. Inappropriate use of EMS ties these very finite resources up when they could be available for other more appropriate reasons. In some cases municipal EMS vehicles will not be available due to high demand volumes for minor medical problems and someone who is suffering a cardiac arrest will have to wait until another ambulance becomes available, or one is dispatched from a neighboring town using a program called mutual aid. In both instances there are delayed response times. Seconds and minutes count when a life hangs in the balance.

Secondly when patients use EMS services for minor problems it only compounds the already problematic issue of emergency department crowding. To help solve some of this, ED managers and nursing staff will send patients who are not seriously ill that present to the ED by ambulance out to triage to be processed as if they came in through the ED front door. On several occasions I have seen this and done this myself and many patients become indignant when they find out they are not going to an ED bed right away. Again it is about acuity.

Furthermore, there is an increased risk of injury for EMS workers and the general public when ambulances are responding to a 911 call. When these resources are used inappropriately again, the cost can be very high. While many of these people [EMS workers] have advanced driving skills, bad things still happen when other motorists are not paying attention.

Patients that are entangled with local law enforcement and those patients that are requesting detox from addiction have also learned to say the magic words that put them close to if not at the head of the line in the ED, or get them out of a holding cell for a while. “I am having chest pain.” “It is going to my arm.” “I am a little short of breath.”

Once again the ED is misused by the more savvy and less savory patients causing back ups, longer waiting times, and adding unnecessary cost, and misusing EMS services. In time my hope would be that EDs will be able to turn away patients that misuse services or at least if that scenario carries too much liability for risk managers to sleep at night than some sort of financial penalty could be levied against them.


Got Flu?
It is that time again when the ads for flu shots hit the airways, pharmacies, physician offices, and hospitals. Last year’s influenza vaccine seemed to miss the mark and most emergency departments were inundated with patients with the flu.

Each year a new vaccine is prepared based on the most likely strain of influenza. Due to the high mutation rate of the virus the vaccine is typically only good for a year, and as we all know the makers of the vaccine have to have some luck in picking the right recipe.

The first influenza pandemic was recorded in 1580; since that time various methods have been utilized to eradicate its cause. Other notable flu outbreaks included:
1889–90 — Asiatic (Russian) Flu, mortality rate said to be 0.75–1 death per 1000 possibly H2N2
1900 — possibly H3N8
1918–20 – Spanish Flu, 500 million ill, at least 20–40 million died of H1N1
1957–58 – Asian Flu, 1 to 1.5 million died of H2N2
1968–69 – Hong Kong Flu, 3/4 to 1 million died of H3N2
This year’s flu season is fast approaching and most of us should get the vaccine. However not everyone is a candidate for the vaccine and if they are unsure they should check with their own primary care provider before getting the shot.

The other side of the equation which is yet to be written is what kind of impact will this year’s flu season have on local hospitals? What will the cost be to businesses in terms of sick time? How much will insurance companies dole out reimbursing medical costs associated with the flu? Emergency department crowding took on a new meaning last fall and winter with large numbers of patients flooding local hospital acute care services with flu symptoms. The cost alone of providing care had to have been staggering.

In any event let us hope that this year’s flu cocktail hits the mark. Best of luck to all of us.


Call for 2009 Healthcare Summit.
Perhaps Wall Street’s latest troubles that have many in a near state of being apoplectic are better equated with disasters like Katrina. Reporters have been thumbing through their thesaurus’ to come up with some different meanings for disaster. That being said, healthcare economists are saying that healthcare will remain essentially untouched, unscathed, and otherwise immune to this latest wave of financial discord that is effecting I dare say millions of us.

Even though healthcare economists may have a more rosy outlook than most, their outlook is related to the access that healthcare organizations will have to capital assets and triple A credit ratings. What healthcare economists are not seeing is the equally important and alarming changes that are sweeping healthcare organizations from coast to coast now.

Healthcare leaders are pondering future organizational moves. Do we go ahead with the cancer center expansion project? Do we break ground on the new emergency department? Are our investments still in good standing? While healthcare leaders are mulling over such issues their employees such as their nursing staff, housekeeping members, lab technicians and others are wondering if they will have a job to take them through the winter.

Every day more and more headlines tell stories of hospitals that are laying staff off and not filling already vacant positions. Hospitals are experiencing higher operating costs, budget shortfalls and increasing debt. Money is tight and reimbursements are low. The year 2008 can not come to a quick enough end for many of us.

Perhaps a new year will bring a clean slate and a chance to right the wrongs of old. There will be a new group in the dugout on Pennsylvania Ave. Perhaps by next summer we will be sipping our beers on the deck and making jokes about 2008. Perhaps this is just the beginning and the worst is yet to come.

I think healthcare leaders more than ever before need to open the lines of communication with their staff. People need to know what is going on so that rumors and inaccuracies do not become realities. People need some level of assurance that “things” are OK. Even if things are not OK healthcare leaders need to communicate organizational worries accurately to their staff. No body likes to be surprised by bad news. The road ahead likely has some pot holes and will be a bit bumpy. Some of us may need to wear our seat belts over the coming months.

I should think it is time for healthcare leaders to establish state healthcare delegates and have their own version of the G-8 summit so they can collaborate together and collectively improve healthcare for all us. Call it HC50 – Healthcare 50.


Healthcare Reform Not #1 Issue.
Healthcare reform will take a back burner position for now. For most of us this should not be surprising in light of the financial crisis and other national issues that are competing for legislator’s time. Barry Welsh, Democratic candidate for the 6th District House seat in Indiana said “It’s [healthcare] not the No. 1 issue in the election right now, but it’s certainly the top priority when you get sick.” Statements like that epitomize the advanced cerebral activity that politicians are so well known for.

The question here is at what point will healthcare reform move to the front burner and garner the appropriate attention from law makers that it needs? Clearly one worry is that other agenda items will circumvent reform activities and force healthcare to the back burner again once it gets to the active to do list? In time if law makers and healthcare leaders do not mitigate the current problems affecting healthcare the issues will reach critical mass as our current financial crisis has. Should that happen it will likely take more than $700 billion to bail healthcare out.

Neither one of the presidential hopefuls have developed plans that would alleviate the high costs associated healthcare today which is the single most pressing issue healthcare faces. Obama’s plan would have the government take a stronger role in reducing the number of uninsured Americans which would increase reimbursements for healthcare organizations but this is not likely to curb costs. McCain’s plan would tax workers for the value of their employer-provided health plan and at the same time give tax credits of $2,500 to single people and of $5,000 to families. The idea is for the employees to use the money to buy individual health insurance plans. In my mind this does little or nothing to improve the current state of healthcare too. In fact obtaining individual health insurance policies can be more difficult than employer group plans.

At the end of the day healthcare reform is unlikely to get much attention in 2009. Perhaps 2010 will see some headway on the issue. A lot can happen between now and then.

Source: Business Courier


EMRs Turn Providers into Cashiers.
With the implementation of electronic medical records and charting programs nurses are slowing changing their vocation from professional healthcare providers to professional cashiers. Most if not all electronic charting systems are tied into ICD-9 (International Classification of Diseases) and CPT (Current Procedural Terminology) codes, and other point based systems that are translated into billing charges that will be sent off to patients and insurance companies for remuneration. Simply put, each time a nurse or physician enters data about a patient into an electronic medical record (EMR) they are not only documenting assessment findings, they are ringing up the bill if you will. Like going through the check out counter of your local grocery store every time that bar code scanner beeps another charge is registered. Similarly each time nurses document procedures the bill grows for patients.

Healthcare leaders in organizations that use EMRs are banging the drum hard about more and more documentation, almost to the point of nit picking staff. Staff meetings, intraorganizational e-mail and face to face talks about dotting the “i”s and crossing the “t”s are daily occurrences. How long did you have that IV running? How many times did it take to start that IV. What was the total time for this that and the other thing. Electronic medical records have all kinds of places to check off for procedures that cost patients money. Points and codes are even generated for giving patients warm blankets.

With today’s ill fated healthcare economy, managers are pushing bedside nurses hard to spend more and more time making sure documentation is complete. “We can’t get reimbursed for that if you don’t chart such and such.” It’s gotten to the point where a shift is being made from patient centered care to computer centered care.

While EMRs clearly have some great attributes such legibility and improving revenue capture for organizations the problem of allocating finite amounts of time to care for patients and then write about what you did often causes conflict. On one hand if the documentation of patient care is poor, then so will be the reimbursement rate, but more time is spent caring for patients. On the other side, if more time is spent ensuring completeness of documentation then less time is spent caring for patients which is also a problem. A fine line exists between balancing patient care and the documentation of that care so that the EMR is complete. As EMRs come into vogue this issue will become more prevalent. Nurses and healthcare leaders must develop strategies to ensure completeness of EMRs and ensure that the appropriate care is delivered to patients based on standards of care and evidence based practices without over taxing provider assets.

An Ounce of Prevention is worth a Pound of Cure.
For years many healthcare leaders and professionals have been promoting a change in our current medical model of “disease care” to one of prevention. The desire is to shift focus. To instill a paradigm shift if you will within the patient community where there are incentives to develop healthy life styles and behaviors. The U.S. spent $2.1 trillion (16.5 percent of GDP) last year on disease care – treating medical problems after they had occurred. Almost every cent of every healthcare dollar – 95 cents – went to treat diseases after they had occurred. Millions of dollars were spent on chronic conditions like heart disease and diabetes.

Clearly our current methodology of providing healthcare is not working. A change is needed. The problem has been changing people’s views and minds about healthcare and their own health. Day after day emergency departments are flooded with patients with chronic diseases and injuries that are largely considered the result of poor health choices or the involvement in high risk behaviors. People that spent a life time smoking and now have emphysema. People who have spent a life time drinking excessively and are now looking to healthcare providers to help them with a failing liver. People who drive under the influence and crash their cars and are brought to busy emergency departments for care. People who are morbidly obese and suffer from horrible cardiovascular disease because they spent a life time eating fast food and never exercised. There are countless examples of how Americans do not engage in healthy behaviors.

Americans need an incentive to change. Perhaps one suggestion is to incorporate the application of fines and penalty costs for those that habitually live a life style that is not considered low risk. Specifically I am speaking of shifting some of the current cost that insurance companies pay for medical care away from the insurance company and on to the patient. Those patients that have been deemed to have preventable medical conditions would be responsible for a much larger portion of their medical bill than they are now. Preventative healthcare cost less than our current retrospective approach to care. Some $81 billion could be saved annually with a full implementation of health information technology and health prevention programs. The question is not will we change but can we change?


Developing Innovation to Improve Healthcare.
Breaking out of experience dependent categorization to develop new neural pathways to enhance our innate creativity is what neuroscience experts suggest so that we can develop the ability to see what could be and not just what is. Fast Company has an interesting article that discusses the ability that some of us seem to have and others do not. That is to see the possibilities of something, that innovative idea that makes the rest of us say “what a great idea”.

Through new experiences we – all of us – can grow new neural pathways so we can develop those visionary ideas and improve our businesses. Many companies use off site meetings to bring a collective think tank together in a relaxed and sometimes exotic location and as the article states “plop” them into a conference room similar to the one at work which does nothing to stimulate creativity.

Gaining new perspectives and developing new experiences away from the office seems to help generate these neural pathways. I guess that’s why so much business is conducted on the golf course. Not only does it get you out of the office for a few hours it lets your mind relax and wonder a bit.

“By deploying your attention differently, the frontal cortex, which contains rules for decision making, can reconfigure neural networks so that you can see things that you didn’t see before. You need a novel stimulus — either a new piece of information or an unfamiliar environment — to jolt attentional systems awake. The more radical the change, the greater the likelihood of fresh insights.”

Most of us can recall coming into a situation as a third party and we analyze a process. A thought comes to us and we wonder why that process isn’t done a particular way. The rest of the room that deals with the process day in and day out has never had the outside look in that we have. When we bring up our idea it is like a light bulb goes off over everyone’s head. New experiences.

So what does this have to do with healthcare? Everything. Healthcare, as we are all finding out is not immune to recession. In fact healthcare I would say is very vulnerable to market changes. Those that are in executive medicine, the ones in the front office should start looking outside the box for new innovative ideas to help improve operations, patient safety, quality of care, and organizational responsiveness to changing environments. Some of you may say we already do that. I would argue that you don’t, or at least don’t do in a way that you could get more out of your frontal lobes than you do.

How many hospital CEOs, Directors of Nursing, etc. spend an entire day in the clinical areas of your hospitals just watching what goes on? How many of you go to to other hospitals to see what they do? How many healthcare leaders look outside healthcare for ideas to improve day to day operations?

“Chemist Kary Mullis came up with the basic principle of the polymerase chain reaction, or PCR — the fundamental technology that makes genetic tests possible — not hunched over his lab bench, but on a spring evening while he was driving up the northern California coast. Walt Disney was a decent illustrator, but he didn’t imagine the possibilities of animation until he saw his advertising illustrations projected onto the screen in a movie theater. In an extreme example, the preeminent glass artist Dale Chihuly didn’t discover his sculptural genius until a car accident led to the loss of an eye and literally forced him to see the world differently. Only when the brain is confronted with stimuli that it has not encountered before does it start to reorganize perception. The surest way to provoke the imagination, then, is to seek out environments you have no experience with.”
Mark Twain said, “Education consists mainly in what we have unlearned.” It is time for healthcare leaders to unlearn and few things so that they can learn a few things.