Lately, we have been very very busy with the virus and bacterial party that is going on around town. Did you hear? The world is full of influenza B, strep, laryngitis, bronchitis, pink eye, and a wicked sore throat viral infection that has been coming with a nice 2-3 week cough. Yuck! You may be one of the sick ones. You definitely need to wash your hands fervently right now because the bugs abound.
So what is the role of your DPC doc this time of year (and all year for that matter)?
We are here!
We are busy, yes, but we are not so overloaded that you will be sent to urgent care when all you need is a phone call. When I worked in corporately-owned medicine, our clinic had 5,000 patients. We typically had 25-30 on the schedule on a typical midwinter day so we had to start sending coughs and colds to the emergency room or urgent care by 10 AM because we were already up to our eyeballs in visits. The emergency room is no place for a sinus infection. This was not effective care for anyone.
This is what we do differently:
1) We know you
We know if you are prone to lung infections or sinus infections, we know that you are a person to get sick quickly and dangerously or if you never get sick and this is really unusual for you to call. We know if you prefer early antibiotics or none at all.
2) We listen
If you don't have a fever over 101, shortness of breath, a history of asthma or other concerning symptoms we can call you first and see if a phone visit will help us gather the information needed treat you over the phone. You might get a text message with details about your symptoms so we can make the right decision about a visit or a phone call even easier.
3) We are your advocates
If you are not getting better with the plan we discuss at your visit, you can talk with us right away and see what adjustments need to be made. In the traditional model, you would be paying for another copay, another visit, or moving on to urgent care. This is not necessary when you have a doctor you can trust to be there when you need it. If you have to go to the emergency room because we are really worried we call ahead, tell them who you are and give details they need to know. We follow up after you are seen and make sure we can see you soon as you recover.
We have some people that see direct primary care as a bridge to when they have "good" insurance again. This is a limited way to see DPC services. I personally have had "good" insurance for 4 years AND my DPC doctor. Why? Not because I am rich, lucky, or entitled. I pursued adding a DPC doc to my insurance even when I was between jobs and building this practice. It was a stretch on the finances, but worth it.
Once my daughter got super sick with a stomach bug when she was really little. She had vomiting and diarrhea for five days, much beyond the usual 24 hour bug. She had pain near her appendix. I was worried. Like most doctor moms - I thought she was either "fine" or dying of something major, like appendicitis. I called my insurance-based doctor. The phone tree led to a message. The message led to an RN. The RN read off an algorithm and told me to go to the ER. It was not that the advice wasn't sound or that the steps were inefficient. What I wanted was to talk with another health professional that treated me like a person, like the worried doctor mom I was. I wanted someone to talk to me about my rational and irrational worries and gather actual data from me on if it was important for my daughter to be seen immediately or if we could try some other options first. I signed my kids up for a DPC doctor then and never looked back.
So if you hit the insurance jackpot, good for you! This will help you should you ever have a collision with the healthcare industry that requires some big time care - surgery, hospitalization, fancy drugs. But don't leave DPC, that would silly! We are your gas, your oil changes, and your day to day maintenance.
We are the practice that knows you in the good times and the hard. We can be there by your side through it all. We know you, we listen, we care. There is no insurance, good or bad, that pays for that.
Stay healthy and well!
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.
What does this mean for you?
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.
Our Vision at Direct Osteopathic
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.
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:
Each of our team members that wants to will share with you over the coming quarter.
Here is mine:
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.
In typical twenty first century fashion I am listening to 10% Happier by Dan Harris instead of actually reading it. Usually while doing dishes at the end of the night. Always multitasking. The thing that got me to pause and write in my journal after was his description in the first few chapters of constantly seeking The Next Big Thing.
The book starts off as an autobiography of the life of Dan Harris, a news anchor and reporter for ABC news who has a panic attack on public television. In getting to chapter three I can tell the introduction of mindfulness is around the corner. However, in the early chapters he seems to be laying the groundwork for why he needs mindfulness.
How does one really “need” mindfulness? For a long time in his life Dan describes a lot of mindlessness. Mindless chasing of The Next Big Thing. I see threads of myself woven in that story, echoing what I hear from many patients too. Everyone has their own Big Things as they go along. Some people, amazingly, are “type B” and not driven by the motor that seeks the peaks and valleys of life. They are content and “trucking along” like my best friend Jen who always answers “how are things with you?” With “Good”, and she means it. Here’s how the journey of The Next Big Thing has gone for me:
First big thing, my parents got divorced. I was two and a half and remember the moment they told me it was happening. I was in a pizza parlor. I had no real idea what it meant. My next memory is being at a stop light when I realized a parent was in each car and I could only be in one. That is when the crying for the one ensued.
The Next Big Thing, I moved to a town of one hundred and fifty people in the eastern Sierra outside of Lake Tahoe. I thought my mom and my step dad were trying to “ruin my life”. Turns out it was just beginning. I met friends I have to this day that became my soul sisters. Small town life was incredible. Also, boring.
The town I lived in was too small to have a high school, so we bussed to Nevada for a new school had four hundred kids in a class. With eight graduating in my eighth grade class it was a big transition. High school was both fun and painful, in the way that teenage years are hard. I graduated valedictorian of my class. The Next Big Thing.
Off to college, and UC Berkeley blew my mind. Academically I was swimming, and eating it up. I majored in a subject I had never even heard of before - medical anthropology. I could eat pizza at 2 AM (a true delight for a lifetime lactose intolerant country girl). I thought I would become a vet since I was a child until one day my chemistry teacher told me I was “smart enough to be a doctor”. Her husband was the town vet so I figured maybe she was trying to tell me to do something different. I also felt that humans needed more help than animals. I didn’t have any physicians in my family, in fact the generations before me never completed to college. After health challenges of my own that were helped by a chiropractor and acupuncturist, I started to explore the many directions the medical path could take me. Enter, The Next Big Thing. One could say I didn’t have a clue what I was getting into.
The journey to and through medical training is cultured around seeking The Next Big Thing. A classic carrot on the stick routine. First you need the MCAT (i.e. big test), then med school, then test after test after test for the first two years. Next the clinical experiences of third and fourth year. Enter Colorado, where I was selected by lottery to spend my third year. I landed in Castle Rock for my very first rotation, with a family doctor father/daughter combination. The older physician reminded me of Sherlock Holmes, twirling his glasses when thinking about hard cases. His daughter showed me that you could be a mom and be a doctor too. I was falling in love with Colorado and family medicine.
Love was the Next Big Thing. I met my husband my third year and moved back to California shortly thereafter to teach Osteopathic manipulation in a teaching fellowship. Enter a new, long distance relationship. Over the next three years, I traveled back and forth between California and Colorado (here’s looking at you loneliest highway in America) going between teaching and clinical rotations. One Big Thing to another. All the while residency loomed.
Residency is what they make doctor shows about. It’s when there are interns and “attendings” and life as you know it is pretty much all medicine all of the time. For “type A” carrot-on-the-stick folks it's the fact that you can’t control “the Match” into residency that drives you wild until it is settled. Residency determines where you live for three to seven years of your life AND what kind of medicine you will practice. For me, I was checking my palm pilot obsessively on a nice spring day eating crepes on 16th street mall when The Match results came in: Swedish Hospital, family medicine, my number one choice. The Next Big Thing.
After residency I started a clinic for a large corporation. We built it, they would own it (or did they own me?). Soon, I saw further to the medical system I did not want to be a part of. I wanted to do things differently. I had ideas brewing that solidified as I learned about direct primary care. I knew I could bring together the medicine I was passionate about practicing AND the people I loved to serve, my patients. I simply needed a different model. Direct Primary Care became my Next Big Thing.
Of course there were other great encounters along the way. I had my daughter literally the day after I finished residency. Between my two practices, I had my son. Parenting has been, quite possibly, The Biggest Thing I have done. Markedly the best. And sometimes the hardest.
Recently I had been fantasizing about moving out of the urban Highlands area where we have a lovely house and nice yard on a busy street. I grew up in the middle of nowhere on 6 acres and I miss quietude and stars. Don’t worry I wasn’t imaging anything drastic, but Golden and Arvada were looking nice. When I started listening to Dan Harris’s book I realized the treadmill I was jumping right back on. I see so many people do the same. As adults, we jump on the treadmill of life and start running 70-100 miles per hour. At first it seems like a lot. At Berkeley I remember feeling that pace, it felt hard and exhilarating and exhausting at times. Somehow, along the way I became habituated. I stopped realizing that running at a 7-10/10 on the stress scale wasn’t normal. Seventy miles an hour started to feel like walking and only once in a while do I realize I am moving 100 miles per hour. This is where mindfulness comes in. One day I’ll tell you more about my journey with that but shockingly I have been using some form of mindfulness to balance my “type A” nature since I was seven years old.
The next step in my mindfulness journey is to take the modified Mindfulness Based Stress Reduction class with you. This is a way to learn a new practice or cultivate a deeper one. Something that can help you change the treadmill habits. We have 3 more spots, is one yours? Register today. It really is your last opportunity to join.
It is mindfulness that keeps me grounded in my moment to moment awareness. Brings me back into my body and time checks my warp speed with the world around me. It lets me breathe bigger and deeper. It helps me to remember what it feels like to get out of fight or flight, to settle into myself. To let my nervous system calm down and stop seeking The Next Big Thing. Dan Harris chased adrenaline in war time news reporting. It is no wonder his adrenal system eventually crashed and needed the rescue of mindfulness to bring him fresh air (after boosting it up on the crutches of cocaine for a while). I appreciated the reminder that I don’t need to move houses. I can recognize the desire to move is my nervous system looking for The Next Big Thing. We start jumping back on the treadmill again because we are habituated to do so. Our adrenal system becomes wired for our stressful pace and unlearning this stress becomes the next real challenge.
I look forward to hearing more in the book about how mindfulness enters the stage for Dan Harris and how it transforms him. Are you reading along? You have until April 4 before we meet, plenty of time to start reading along. Leave a comment, let me know what you think about it so far. Tell me about YOUR Next Big Thing.