​It is that time again.  Time to understand Direct Primary Care Math and healthcare options for 2019.  

​When it comes to those already knowing membership benefits, may this serve as your annual reminder of why you are so smart.  It might even provide ideas on how you can save further. If you are looking at open enrollment like a deer in headlights, may this shed light on approaching your health care dollars differently in 2020.  If you are worried about your addiction to health insurance, you can read more here.  It’s not that we think you shouldn’t have it (you should) it's just time to give up the 1990s notion that there is such a thing as “good insurance”.  Get what you need to cover yourself in a collision with the healthcare industry.  For everything else, let our membership help you save.  

Every year, I go on the exchange and shop for my family of four to compare premiums, deductibles and learn the new insurance players on the market.   Turns out, again, we can save you money.  Here’s how it shakes out:  

The caveat? For one, our family is not in the age bracket that gets the astronomical rates, the 55-64 group.  If that is you, we are sorry, your rates can get close to the family of four for one person alone to get a “low deductible” plan. Definitely come and talk with us.  
 
Secondly, looking at deductibles and premiums does not tell the whole story.  When it comes to cost savings check out our article from last year, the same per visit, lab and prescription savings continue to apply.  In fact, our lab costs went down this year and we now include our basic lab panel after 6 months of membership.  
 
This year, like every other, we hear more about astronomical health care costs.  Shockingly, a local hospital charged $46,000 to our patient when we had to send him for symptoms of a stroke.  During his stay he was charged $16,000 for one MRI.  With our membership discounts, the MRI would have been $485.80, if it had not been an emergency.  Most of the time we can prevent these high cost visits all together.  If we can prevent you needing the ER one time, you save your whole year of our membership (just $900 for one person).  Good preventative medicine, a proactive team and your motivation go a long way to prevent emergencies.  
 
I am a small business owner, health care savvy and cost conscious (as many of you are).  So here’s what we did this year.  We looked at a health share option for our employees and their families.  Nextera Healthcare has been partnering their DPC with Sedera for over a year and they have had good experiences.  I have been wary of health shares in the past, but Sedera seems to know what they are doing.  Read more about their approach to medical cost sharing here.  Having a direct primary care membership gets you an even lower rate for Sedera.  Sign up with us, or if you are already a member, ask for our link to get more information.  
 
Oh, and did you hear?  Sesame Health, a cash based healthcare marketplace, is coming to Denver.  Check out their Kansas City page and search to see what it will look like when they launch their network here in 2020.  

​If you change your mindset and realize that healthcare is cheaper with cash, then Direct Osteopathic Primary Care + Sesame + Sedera is for you.  
 
Direct Osteopathic Primary Care covers primary care and preventative health.  Visits, labs, prescriptions, imaging and our unique holistic approach.
 
Sesame helps you find ways to stretch your healthcare dollars outside of our office - specialty practices, eye and dental.  
 
Sedera covers you in an emergency.  Sharing your costs if there is an accident or hospitalization.  ​Get on the direct primary care bandwagon, it just makes sense.

Please share this article for anyone who might need us.

This week, Dr. Brie and our Physicians Assistnt Torey Ivanic PA-C talk about Direct Osteopathic Primary Care's philosophy of the doctor-patient relationship.

​Fall is here
Change is among us
Leaves are dropping
Pumpkin Spice Lattes are back 

What happens to you this time of year? Do you go inside and begin the first steps of the winter retreat? Do you throw the last hurrah for the rays of sunshine that remain? 

In the face of changing seasons, when it comes to taking care of YOU, how can you bring the fun back?

So this weekend on 9/21/19 I decorated for Halloween with the kids. It’s a first, this early readiness. I usually dread the decorations as a working mom, feeling there is never time to do it but having unlasting mom guilt about not doing it big or bold enough every time. You know, those people that pull out all the stops—they have the skeletons and the talking heads and the fog machines and infinite fake cobwebs out front. That is not me. I hand 2-4 things tops and call it good. My kids are young, they think it is still great. 

This weekend, not only did they want to decorate, they wanted to pick out their costumes. Off we went to galavant around town to get our creative inspiration going. On 1st and Broadway (where the real costume shops were that they were not interested in at all) I found the wig section. Now my birthday is in January and I will be 40. On my 21st birthday I got an electric blue wig as a gift and it transformed the winter doldrums and became my good luck charm through the rest of college. I wore it through physics tests and even the MCAT to get into medical school. My 30s, however, have been a bit of a slog. I did three years of residency, working 80 hours a week. Followed by having two babies and opening two medical practices. It’s been, lets just say, busy. Sometimes I worry I am not as FUN as I once was. Which, of course, prompted me to get this lovely new purple wig. 

Sunday afternoon I got lost in a 2019 twilight zone. Suddenly, headed across town to a friend’s house I had not yet visited, my phone went on the fritz. It was completely unresponsive. Unusable. No reset possible. Just a death circle of lock and unlock and receiving calls that couldn’t be answered but no other functionality. As a doctor, on call often (and at the time) this was a nightmare. Not to mention, it rendered me completely powerless. I could not find my friend, nor call or text her my problems. I drove along the frontage road of a deserted I-70 (which was weird enough) and wandered into Northfield mall. I got out of the car thinking, I should take this wig off, I don’t even feel like wearing it. 

Then I remembered, this was exactly what the wig was for. Bringing light heartedness to the situation. I found a Verizon store and waited, and waited. The wig and I struck up a conversation with several other nice people patiently waiting for their new devices. They kindly let me have a phone, a link to the outside world to reach across the Apple casm and find a repair solution. I walked into Best Buy and said to the geek squad agent, wig and all. “This is my phone it needs CPR. It is completely unresponsive. I have heard you are a doctor.” He fixed it in two minutes flat. We all left with smiles (and I in wonder, if only humans were as easy as a ‘hard reset’ when you need one)! 

In the face of adulting, summer leaving and winter coming here we have arrived at fall. You can see the tidal wave of the holidays coming and smile or sink inside. You can thank goodness for the waning heat or lament its departure. You can dream of the coming snow or abhor it. At the end of the day, you can also choose to mindfully and fully dig in, right here right now. 

So close your eyes. Dig into the moment. Take a few deep breaths. Think of something fun. Something silly. Something that brings a smile to your face before you have even invited it. Breathe in that lightness. If you can’t think of anything, don’t beat yourself up. Think of me, traveling aimlessly around town in a bright purple wig, hopelessly disconnected and ironically, reconnecting. 

Happy Monday. 

Join Dr. Brie and Psychotherapist and Hypnotherapist Victoria Bresee of Technologies of the Self to discuss how to identify if your child is suffering from stress or anxiety related to school, and the role of mindfulness activities in helping with your child's back to school anxiety

Often this is the part of the year where we become self deprecating about unsung New Years Resolutions that have not come to fruition.  Ironically, it is also the time that we can  start getting outside again in Colorado.  The nicer temperatures are coming, sure to be dotted by snow and rain.  What does that mean for you?

This quarter we are going to have a DOPC Movement focus.  This isn’t to challenge you to one up your peers or become the most fit person in our practice.  The challenge is for you and only you.  Here’s how it works:

1. Think of your own movement journey.  How does exercise or fitness fit into the values that you were raised with? As a child was movement emphasized or avoided?  Did you grow up with guilt, shame or pride around fitness?  How did that change as you became an adult?  How have you shared the value of movement with your current family or partner? 
2. Think about where you are now with movement.  Are you where you want to be?  Take honest stock of what you are doing well and where you have work to do.  What are the barriers to getting movement into your life regularly right now?  We know the story, time time time.  Work and life juggling, this is often the culprit for squeezing out our own self care.  Some people are on the opposite side and need to back off a bit and schedule rest.  
3. Next set a movement goal.  Make it realistic.  Don’t climb Everest (unless that is your thing).  Understand where you want to be with your own fitness level and when you want to get there.  Then write 2-3 discrete steps that will help you implement your plan.  Be sure to think about what barriers you are up against.  Brainstorm creative ways to work within the structure of your life so that your goal can be achievable.  For example, if you are not a morning person, don’t plan to get up earlier to work out.  That might work for a few weeks but your night owl nature will take over eventually.  Instead, find a doable work out that can be done at night from home, fit in a walk over lunch or capture an hour between work and home to do a new exercise class.  
4. Send us your reflections on Elation.  Only if you want to.  This “publicizing” helps you to be accountable.  Sharing helps to put your weight behind your goals.  We are happy to support you on your health journey.  If you are feeling extroverted, tag us in social media with something movement related, a good idea to share, your favorite app or fitness class suggestion.  Tag it with #DOPCMovement so we can follow along. 

Each of our team members that wants to will share with you over the coming quarter.  
Here is mine: 

1. I grew up in Lake Tahoe.  Nature was our playground.  My dad taught me about skiing, hiking, camping and being outside.  My mom didn’t “exercise” much at that time. (She is an avid biker now, she caught that fire in her 60s and has more miles under her belt weekly than I do, ironically).  I started with organized sports outside of school in 8th grade.  I was an “athlete” in high school and college, primarily with track and soccer.  In college and med school I played a little club soccer and ran but that is when my movement journey started to take a back seat to my academics.  
2. As an adult my favorite activities are skiing, climbing and doing yoga.  Running seems to hurt my knees but I like it on the rare occasion that I do it.  I can’t seem to be regular with it.  I recently found barre and like it a lot.  I struggle with fitting in classes.  As a working mom I fall regularly into the “weekend warrior” routine and get at best 1 day of movement in during the week, both weekend days.  My husband being very typical “Colorado outdoorsy guy” gets us out most weekends and my kids love getting outside with us and climbing, camping, hiking or skiing.  
3. My goal since having kids has been to feel like I am “in the best shape of my life” by 40.  I am 40 next January.  I want to get back to a place where my cardiovascular fitness is strong.  There is a time in your life when you want to exercise and a time in your life that you have to exercise for your health.  Beyond 40 our bodies demand it from us.  My short term goal is to consistently get in 4 days a week and slowly work up to 5.  I think that if I can get in those movement reps, the sense of “fitness” will follow.  Here’s what I am doing: engaging friends to go to classes with me (our DOPC team is going to try a group Orange Theory class this month). I invited friends to a yoga class this weekend.  I am biking to and from work on days where the stars are aligned to so do.  I am looking to add other options that can help me get in a work out at home when the kids are in bed so I can work around my barrier of not having time that isn’t doctoring or mothering related.

I want to hear from you!  We are looking to share ideas so that people who need a tailored fitness routine can find a new one that works.  We are looking for suggestions on apps, online classes, favorite classes to attend in person, etc.   Email suggestions for our next newsletter or message them to us on Elation.  

​Cheers to #DOPCMovement!

This week our counselor and Licensed Clinical Social Worker Sarah Rasche joined us to talk about the concept of "self care".

Like mindfulness, diet, and exercise, self care has become yet another aspect of mental health that is the subject of paid classes, books, workshops, and special methods that all are aimed at making money off the fact that people are becoming more aware of their mental health.

​But you don't need to pay to take care of yourself. Watch our video to learn about the many ways you can give yourself the care that you need without pulling out your wallet.

Using essential oils in conjunction with mindfulness practices, can be a powerful tool in supporting emotions, focus, memory retention, and anchoring in new patterns and beliefs.

Today we talked with Midwife and Health and Wellness Coach Angela Seeling, who uses different Essential Oils in her practice to elicit specific emotions and use the power of our sense of smell to access deep feelings and memories.

Angela will be hosting a workshop on Mindfulness, Emotions, and Essential Oils at our office on Friday, March 8th at 5:30pm. We'll talk about aroma as a direct pathway to to the lymbic system in the brain, and the science behind how essential oils work. Participants will make their own emotional aromatherapy blend to take home, and incorporate into daily practices. Sign up here!

Announcing DOPC's focus for Winter: Mental Health. Following up on our fall focus of Nutrition, we are turning our attention to what can we do to feel good so that taking care of ourselves is something that follows more easily. Drab weather got you down? Did you fall off your New Year's Resolution wagon? Watch today's video to find out about the programs and events coming up over the next few months.

Happy New Year!

Hope the holidays treated you well and you are full with family, fun, and food! I know I am. When we started our quarter, we knew it was going to be a hard one. With high stress, lots going on, colds and flus and short days to top it all, we often seek comfort in the most familiar ways: tasty food, warm drinks and cozy blankets. 

This is probably why one of the top New Year’s resolutions are some variation of be healthier, eat healthier, exercise more, cut back on (insert less than good thing we are consuming to excess). Inc. reported that 5 of their top 10 resolutions were the above, with 71% wanting to diet or eat healthier. 

You probably already know this, but the stats are against you achieving your resolution. Why? Well, most likely because it’s far more complicated than the simple statement that makes up the resolution. Take healthy eating and weight loss, for example: after having read my blog on the different diets, you may have chosen to pick one and start it in the New Year. Did you also know that there are other factors that contribute to your dietary needs and weight control than just which diet you are on? Read on!

Stress

This seems like a no-brainer. When we are stressed, we don’t make the best food decisions (we can even make really bad ones). We forego our plans to exercise and we indulge instead. Most people are this way. Did you also know that when we are stressed, our body releases cortisol and this makes us GAIN weight? It does! Cortisol is responsible for regulating our metabolism, helps to regulate our blood sugar, regulates salt and water balance, our heart rate, blood pressure, our sleep, and our memory. When we are stressed, these functions alter then return to normal balance afterwards.

But when we are chronically stressed, we may see things such as poor digestion, increased blood sugar (even diabetes), increased blood pressure, poor sleep and memory, poor immune function (getting sick often), hair loss, slowed metabolism, low energy. How is this going to make it any easier to eat better and lose weight?!

Sleep

While sleep is not something that comes to people’s mind with nutrition or weight loss, it is so important! The average adult needs between 7-9 hours of sleep per night. If you get less once in a while, it’s what Dr. Brie likes to call NABD (not a big deal). But many people get less than 7 hours on a regular basis. When we don’t get enough sleep, our body doesn’t sense hunger/satiety normally. We tend be more hungry and crave high calorie, high fat and high carb foods. Not to mention, poor sleep also impairs our decision making and we are not able to resist cravings/temptations very well.

Poor sleep can slow your metabolism--your body is trying to conserve energy for increased waking hours. Being sleep deprived is also a condition of stress, and you know what that means? You got it, increased cortisol levels, which we just talked about. You’re also more tired and less likely to do physical activity.

Physical activity

While it would be easy to say,” Work out more and you’ll lose the weight,” it’s actually not that easy. Yes, physical activity will cause a deficit in calories. But often times, when you are working out, your body needs fuel to be able to sustain the activity and then repair itself afterwards. Some people eat more when they work out for this reason. It is important to eat enough calories when you are working out so your body does not become stressed (read: releases cortisol). It is important to note that exercise alone will not result in significant weight loss, but ongoing exercise can help tremendously with weight loss maintenance (see one of many studies).

Not only that, exercise helps to increase heart, bone and muscle health (your doctors will thank you), it helps manage stress and keeps you happier (bye bye, excess cortisol), and it will help you sleep better (regulate that hunger!).

Your social life

Humans are social beings and Coloradans especially love to celebrate everything that makes this state so fun to live in: the grand outdoors and our craft beer, all booze, really. (Anyone read this article in 5280?) Even if you don’t ski, mountain bike, rock climb, etc, social gatherings are yet another time where your healthy eating plans can fall by the wayside. Call it peer pressure, call it indulging, call it what you want. It’s harder to resist the beer or bar food when you’re with a group of friends. Seeing, smelling and being able to reach out to the french fries or wings or whatever is temptation waiting to win. Alcohol also can impair judgement, make you hungrier and adds calories!

Your job

Besides work adding the obvious stress, your work situation may make it difficult for you to stay on your bandwagon. On the go all the time? This makes it easier to want to pick up fast food or skip a meal. No lunch hour? You may be more prone to snacking throughout the day or bingeing when you do eat. Traveling? Less chance for a home cooked meal or meal planning. We won’t even talk about catered lunches/lunches out and office snacks or candy/cookie jars that park themselves at the end of everyone’s desk for convenience.

Your gut bacteria

Say what?! Yep, if you didn’t know it already, your gut bacteria may be playing a part in keeping your weight the way that it is. This Scientific American article is one of many that summarize current research on this association specifically. We know that the bacteria in our gut help digest things we can’t, making more calories available to us. They also can affect hormone production, altering the signals that tell us we are full or hungry. The bacteria can affect inflammation in our gut, calming it or increasing it by releasing certain chemicals based on our diets, thereby causing us to gain weight. No, there isn’t a probiotic for weight loss yet, but having a good diversity of bacteria and eating a variety of prebiotics (foods that feed our gut bacteria, usually high-fiber foods) is a good place to start.

Your medications and your health conditions

Yet another example of why it may be more elusive than you think to maintain a healthy diet and/or weight. Certain health conditions limit what you can eat and you may only be able to choose what you can eat rather than what you should eat. Take those who are doing a FODMAP elimination diet, for example, foods like asparagus, apples and some seafood are considered healthy, but are high in FODMAPs and thus need to be limited.

Certain medications can cause weight gain too, like medications for seizures and insulin, and it would not be easy to “avoid” these medications in some individuals.

It is important to remember that while it may seem easy to modify one or several of these factors, the reality is that eating healthy and maintaining a healthy weight are not easy things to do. Because, as I always like to say, “If they were, I’d be out of a job!” This doesn’t mean you don’t try to modify one or several of the factors mentioned above, it means that you modify what you can and don’t beat yourself up over the rest of it. Just keep at it, one step at a time. Healthy eating and maintaining a healthy weight should be lifelong goals, not just a resolution for this year.  And really, if getting better sleep, having less stress, being more active and having a healthy social life are things you can fold into your lifestyle and actually enjoy (who wouldn’t??), you’ll get full bragging rights on those successes, whether or not you lose weight—I promise.

Dr Lisa