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Information on Direct Primary Care and Reflections on Medical Practice

Mindful Monday: Awareness of your Phone

10/22/2018

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  • Find out how phones activate the pleasure center in your brain and cause dopamine release, very much like a slot machine habit or addiction!
  • Learns ways to set limits with technology so you can be in control
  • Use mindfulness to figure out how to have healthy technology habits
Articles to consider, read and share:
  • http://sitn.hms.harvard.edu/flash/2018/dopamine-smartphones-battle-time/
  • http://www.tristanharris.com/2016/01/distracted-in-2016-welcome-to-mindfulness-bootcamp-for-your-iphone/
  • http://humanetech.com/take-control/
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Open Enrollment is Coming—How much could you save with DOPC?

10/22/2018

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Open House for Open Enrollment: Why Add Direct Primary Care to a High Deductible Plan?

Thursday November 1 from 5:15-6:30 PM.  
RSVP so we can save you some hors d'oeuvres!
This time last year, I decided to do the math to see how much our clients can save when they switch to direct primary care. We know that many people choose to see us because they like the that we offer traditional primary care for the whole family combined with a holistic approach. However, at the end of the day healthcare dollars drive many decisions and we want to be sure that we generate not only value, but savings.

I compared this year to last, which was fun at first but not much has changed. Unfortunately what is being offered on the insurance exchange has even higher premiums than last year. I performed a search on the Colorado exchange, Connect for Health Colorado.

Using a family of four here’s what I found:
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Combining a high deductible plan and Direct Osteopathic Primary Care, a typical family of four ends up saving an average of $849 per month on premiums compared to having a low deductible plan. That is a 44% savings!

But high deductible plans make people nervous. That is where direct primary care comes in. For our members, the deductible is reserved for a “collision” with the healthcare industry - a true emergency or surgery.
A typical family of four ends up saving an average of $849 per month with DOPC plus a High-Deductible Insurance Plan.
Our clients don’t need to save money for an unnecessary urgent care or an emergency room visit. Because patients can always get a hold of us when something comes up and many urgent visits can be handled quickly when care is at your fingertips. That way, health care dollars can go further and be applied to prevention and proactive health habits.

Your health insurance becomes more like your car insurance - there to cover you when you need it. Direct primary care acts like your oil changes and gas - you don’t expect your insurance to cover this low cost maintenance but you do it because it keeps your car healthy for longer.
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​When it comes to health care costs, we all know that this isn’t just about your premiums.  It's about all of the hidden costs of care that direct primary care eliminates. Co-insurance, co-pays, bewildering bills that come months after care, unanticipated. This past year we have seen healthcare bills brought to us that are appalling.  

More and more, we see the value of circumventing insurance for the little things because our patients benefit.  Save your insurance for high cost care, that is what it is designed to cover.
Our in-office pharmacy beats Walmart and Walgreens on generic medications.
Then we come to prescription drug costs.  Some of our current members do not even know that we can beat Walmart and Walgreens on generic medications through our in office pharmacy. 

So let’s say that your family of 4 joins direct Osteopathic Primary care and one of your family members is fatigued, gets a lab panel with a discount.  The other moves their prescription for lisinopril over to our in house pharmacy.  Now look at the money saved!
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How Much could a Family of Four Save with DOPC?

Savings on One Year of Premiums
$10,188
Savings on a Single Lab Panel
$1136
Savings on One Year of Supplements
$204
Savings on One Year of Prescriptions
$444
Total Savings
→$11,972←
This doesn't even include the cost savings we provide by including all office visits in the membership fee and not charging extra for procedures or urgent visits! 

​At the end of the day our office uses the direct primary care model because we love establishing and building relationships with families. It is also nice to know that our clients can save money too. We hope you can join us and bring your loved ones! 

Open House for Open Enrollment: Why Add Direct Primary Care to a High Deductible Plan?

We know you probably have questions about how all of this is possible.  Open Enrollment starts November 1st for the Colorado Health Exchange. Join us for an open discussion, questions and answers about adding direct primary care for your family this year. 
Thursday November 1 from 5:15-6:30 PM.  
RSVP so we can save you some hors d'oeuvres!
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Fall Focus: Nutrition and the Role of Elimination diets

10/22/2018

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One of the most frustrating things in family medicine is when a patient comes to me with a host of symptoms, I order testing, and everything comes back normal. It’s NOT in your head, I swear! For some people, the more obvious stomach ache or change in bowel habits gives a clue to food being the culprit, but for others, it’s a change in behavior, headaches, or mood changes. Other times it can be breathing problems, joint pain, rash, weakness or just not feeling well. These latter symptoms don’t always lead people to look at their diet.

Just about everyone has heard of the saying, “You are what you eat.” And nowadays, research is clarifying a fascinating connection between your gut and your mind. I often turn people to elimination diets to help parse out the relationship between their symptoms and food. Of course, we can do food allergy testing, but these test results don’t always add up to real-life symptoms: One can test positive for egg allergy, for example, but has eaten eggs all of their life without problems. This can be because the test is looking for a true allergy (immune reaction) and what the person is experiencing is actually an intolerance (difficulty digesting). Even then, sometimes the problematic agent is not something we can easily test for. People can be affected by food additives or coloring too.

Elimination diets, while there are many, are generally made up of 2 phases: elimination and reintroduction. They are pretty straightforward, but do require commitment and planning. The majority of elimination diets, are about 6-8 weeks long for both phases.
  • Elimination: Usually, by categories of food, such as grains, dairy, nightshades, rather than a specific food, like potatoes. Depending on the program and/or your symptoms, this phase can last 3-8 weeks. Most people feel better during this time, though some will feels worse for the first 1-2 weeks through the detox phase. The most common foods to eliminate are: gluten, dairy, soy, egg, corn, shellfish.
  • Reintroduction: Bringing back foods is usually done in a stepwise fashion, with a new category every 3-5 days. If no symptoms or problems are triggered, this is considered a “safe” food. During this phase, you may consider introducing specific foods rather than categories because your body may be reacting to an individual food within a broader category. This phase can also last several weeks depending on your approach.

Some popular elimination diets include the Whole30 (cutting out inflammatory foods), Conscious Cleanse (changing the way you pair foods), low FODMAP diet (FODMAPs are short-chain carbohydrates that some people cannot digest), and the Feingold Diet (removing food additives and coloring). Gastroenterologists found that the Six Food Elimination diet helped reverse Eosinophilic Esophagitis, a condition of the immune system that masquerades as gastroesophageal reflux but is really allergy related.  Depending on your current diet and your symptoms, one may be better for you than another and you may need to try more than one type of elimination diet (avoiding histamine provoking foods and food additives, for example).

My general approach in working up symptoms through diet is to start with an elimination diet as a way to collect more information. Keeping a diary/journal is very important during an elimination diet, I recommend it during the elimination phase as well, starting with an inventory of symptoms before you eliminate anything. Be sure to be slow and methodical about the reintroduction phase. It’s best to work with your doctor or a nutritionist especially during this phase so you can maximize learning from the sneaky delayed reactions that happen with some food groups.

At Direct Osteopathic, we also add in supportive supplements, hoping to reverse reactions by rebalancing and healing the microbiome.  This fosters resilience in your gut so that minor food reactions don't cause significant symptoms, which allows people to maintain a more balanced diet.

Getting back into the driver's seat with food that makes you sick is very empowering. Many elimination diets are too restrictive to continue on an on-going basis (unless, of course you are affected by ALL of the foods you cut out!). Ultimately, eliminating what causes problems and keeping in what doesn’t is more sustainable and, frankly, more enjoyable. You are what you eat, but you can’t let what you eat control who you are!

Have you thought about doing an elimination diet? Need some guidance? Schedule your visit or consultation with us, we can dive right into it with you.  

Dr Lisa
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Facebook live: the why behind the fall focus on nutrition with Dr lisa and dr brie

10/5/2018

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In case you missed it watch our video to find out: 
  • Why we are focusing on nutrition this fall
  • What we have done to prepare ourselves and nutrition focused family doctors
  • Upcoming events 
  • Details about our new book club!
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October Newsletter

10/4/2018

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Welcome Fall! 
It is officially here and I am overjoyed! I am among many who enjoy Fall. Like others, I love taking in the briskness each morning, sweater weather, cozying up to a warm drink, a sense of getting to slow down a bit, and of course, FOOD! Besides all the chilis and soups and stews that you can make, there's football, Halloween, Thanksgiving, Hanukkah, Christmas and MORE football! This always seems to be a double edged sword for people: on the one hand, it is such a social time, family and friends, so many excuses to get together. On the other hand, there is SO MUCH FOOD! And with that, we are faced with so many temptations to pull away from our healthy habits.  
The International Food Information Council Foundation found that 36% of Americans have tried a specific eating plan in the past year. Interestingly, this past year the fad diet of choice was intermittent fasting (stay tuned, we are going to dive into that).  Nowadays, it's not just for weight loss. Countless people are realizing that some foods are making them sick. Or they just don't feel well and want to explore whether food is the culprit. Others have been diagnosed with a condition that forces their diet to change forever more.
As we approach the season of celebration, being on a diet becomes more than just discipline, it is exponentially more stressful. You'd think I was crazy then, when I decided to do the Whole30 a couple of years ago, in October. The Whole30 is an easy to follow diet that is essentially an elimination diet with a paleo focus. But it was hard for me. We were ramping up for cold and flu season and all I could think about was food. Planning food. Cooking food. The next time I could eat food. But by the end of it, I felt better: my face was clearer, I had more energy, I didn't get "hangry", I hadn't realized that I was perpetually bloated until I wasn't anymore. And then Thanksgiving and the rest of the holiday season came and habits returned.  The benefits were short-lived, but the experience was eye-opening. I know that I would feel better repeating the Whole30, when I muster up the focus and determination again.
Starting this Fall, we are launching an educational series, with a new topic each quarter.  As we continue to learn, you can too! Our first topic, in light of the nature of this season, will be on Nutrition.
In family medicine, I get a variety of patients, from those who are dealing with health problems such as diabetes, thyroid problems, or IBS to those who just want to lose some weight and I often get asked, “What diet should I be on?” This is a difficult question to answer and in fact, I don’t often have a "one size fits all" answer! Each person is so different and the health problems they have are so varied, there is never just one answer, let alone an easy one, to that question. However, this fall, we will review the most popular eating plans so that you can understand what's out there and decide if any of them are right for you.  If you want a more detailed, personalized plan you can always see me for a consult, I love guiding people through this process.What if you just want to lose weight?? We'll talk about that too, from factors that impact weight to all the different options, including medications and surgery.
As your healthcare providers, we strive to stay up to date and are constantly learning. Our goal is to build a platform to facilitate information sharing and exchange so that you can make informed decisions about your health as you head into the extravagance of the holiday season.  Join us as we all continue our journey towards wellness.

Dr Lisa Nguyen  
Don't miss Dr Lisa's Nutrition Focus Facebook Live Friday 10/5 at 12:30
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Mindful Monday 10/1/18: Mindful Eating in the season of FOOD

10/2/2018

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October brings the beginning of holiday foods and habits.  Listen to this video for mindful tips on: 
  • How to bring your awareness into habits by "urge surfing" 
  • Bringing in your full mindful awareness while eating to savor delicious foods (and eat less of them because you pause to actually appreciate them) 
  • Why it is important to slow down and let your "rest and digest" nervous system do its job
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