It seems every summer we arrive at the month of August with feelings excitement and sadness. “Summer just started! Where did the time go?”  The beach lowers on our priority list and mixed feelings begin to stir as fall preparations are in order.

The DocASAP intern team faces a very bittersweet day as we quickly approach the end of our amazing experience. The seven of us worked with such fluency. There was never a question unanswered or help offered when needed. It was important for each individual to walk away with knowing something they hadn’t known before.

So now that the London 2012 Olympics are over, our internship is ending and those mid-July back to school commercials continue to bombard our televisions, we seem to think, now what? Instead of dwelling on summer’s end, we are thinking positive. Each the interns are excited to use our experience with DocASAP and apply it to our lives. Intrapersonal skills were gained, not to mention sustainable relationships. We look forward to see how DocASAP grows over the next few years and happy to be a part of this great company.

As many of you already know, this week is Shark Week on the Discovery Channel. Curiosity brought us to research Shark Bites on WedMD (pretty gruesome, I know) to see if there were any informational points about shark attacks that are not already common knowledge.

The ones that stood out:

-  Many people do not immediately know if the sea creature that bit them was actually a shark or another sea animal, such as a barracuda.

-  Most species of sharks are not documented attackers of humans (360 out of 400 species.)

-  Though sharks are most notorious for causing bite injuries, shark skin can also cause injury (scrapes) when it comes in contact with human skin because of its coarse texture.

-  According to WebMD, most shark bites do not cause significant deep wounds that result in blood vessel or nerve injury.

-  A significant factor for shark attack victims to consider is wound infection, since many bacteria exist in seawater that are not prevalent on land.

To treat a shark bite, apply pressure to any bleeding source. Provide warmth to the victim when out of water and take the person to a hospital for a doctor to treat life-threatening injuries.

As Shark Week reminds us of the potential (but admittedly improbable) dangers of beach-going, the DocAsap intern team is rather happy learning about these fascinating animals on our desktops instead of finding out firsthand (yikes.) Happy Shark Week!

It’s that time of year. Kids are getting ready to head back to school…and school nurses are getting ready to see the seven most common school-borne illnesses. Seeing as many DocASAP users are family-oriented individuals (with young ones dearly holding onto the last month of the summer), we figured we’d give families the heads up to remind their kids how to stay healthy in school.

So Here’s The List: (some of these are looking pretty familiar…)

Colds. Stomach flu. Strep throat. Chicken pox. Mononucleosis. Pink eye. Head lice.

We’re no doctors, but there are a couple tips out there that should be common knowledge to every parent (and child!) to avoid catching these illnesses. Here are a couple of points to reiterate to your child:

1. Wash your hands! After using the restroom, after recess, after arts and crafts…you get the idea.

2. Don’t share food and drink. Many illnesses (such as mono) are spread by saliva, and it’s just not sanitary to share food in general.

3. Cover your mouth when sneezing and coughing – and try not to use your hands. Sneezing or coughing into the crease of your elbow, although not entirely effective, does curb the amount of germs spread to others and especially curbs the amount spread by hands.

Here’s to a happy and healthy rest of the summer and school year!

http://www.rexhealth.com/school-borne-sicknesses

Photo Credit: http://www.insuranceproviders.com/what-is-a-copay/

Physician visits in the US are much more costly than in other countries. Take this statistic into consideration: the average physician visit costs $89 in US, $30 in Canada and $16 in India. Corrected for price parity, the average cost of a physician visit is five times as expensive in the US compared to Canada and twice as expensive compared to India.

Why? Let’s look at a breakdown of the overhead expenses doctors have to consider in pricing a patient visit:

• Medical licensing fees
• Medical malpractice fees
• Compensation for the uninsured
• Medical equipment/supply costs
• High tech advancements in the office
• Compensation for the work of receptionists, office managers, nurses and others
• Rent, utility and janitorial expenses

Which factors listed above pose significant differences for the US compared to other countries?

Medical malpractice fees. Generally speaking, the practice of defensive medicine in the US is widespread, which exists in other countries but only to a limited degree. In many other countries, lawyers do not render services on a contingency basis and instead are exclusively paid for their services in malpractice cases by the hour. This can make the cost of hiring a lawyer extremely expensive and dissuade wronged patients from initiating lawsuits. Some hospitals in other countries even create their own medical malpractice policies to set compensation rates, which are meager in comparison with US malpractice settlement rates. If there is less of a chance of being sued for malpractice in other countries (because of higher expenses and lesser rewards for those suing), the demand and cost for malpractice insurance in those countries will decrease.

The uninsured. The price of a patient visit may increase according to the amount of uninsured patients a doctor treats free of charge or at a reduced rate. Dr. Manoj Jain, a writer for the Washington Post, inflates the cost of a visit for all patients in his practice to make up for the cost of treating uninsured patients, which comprise about 10% of his patient base. This practice may differ from countries that have universalized healthcare systems in place to provide a base level of care for all citizens.

Medical equipment costs. According to the New York Times, the use of high tech medical equipment is more widespread in the United States compared to other countries. These devices are expensive to purchase and maintain, which results in increased patient fees to compensate for the cost. This may derive from the increased amount of specialist referrals in the US, which nearly doubled from 2001 to 2011 and is higher than the referral rate of any other country. Since specialists order the tests that involve the use of these machines, more specialist referrals means more machine-related costs.

Other high tech advancements. Other forms of high tech advancements that the United States dominates in terms of market share are electronic billing services and medical records, both of which bill users monthly. According to Accenture, the US EMR market share in 2010 was $7.4 billion, compared with Asia Pacific’s 2.3 billion, and Europe, Africa and Latin America’s collective $5.8 billion.

Services provided by other staff in medical practices. Medical transcriptionists, receptionists and office managers are an integral part of medical offices around the globe. What set US practices apart are the responsibilities these positions take on with respect to insurance companies: patient coverage checks to determine co-pays, calls to get approval for future referrals and tests, and paperwork resubmission in instances where insurance won’t pay a bill, among others. Countries with single payer systems spend significantly less time and money performing similar functions, which is reflected in lower patient visit costs.

Though many other considerations exist that are presumed to affect the going rate for patient visits (such as med school costs), overhead expenses are a major reason why patient visits are more costly in the US. It’s an uphill battle to practice cost containment and maintain patient satisfaction, and the argument as to whether increased cost means increased quality continues.  What do you think?

Cindy J. Chang, MD, Team USA’s Chief Medical Officer in London with US Athletes (Photo credit: http://www.newswise.com)

The Olympics are all about competition, and that doesn’t just apply to the athletes. According to New York orthopedic surgeon Dr. Scott Rodeo, US team physicians for the 2012 London Summer Olympic Games underwent a rigorous testing process to earn a spot to work alongside the best physicians, coaches and trainers the nation has to offer to ensure athletes’ health at the Games.

Candidates needed to apply almost two years in advance to fill only 80 spots on the 2012 US physician team. Apart from their work as practicing physicians, candidates needed to prove their extensive experience in sports medicine by having volunteered at one of the nation’s three Olympic Training Centers and working through the ranks to advance from domestic to international competitions.

Testing for candidates’ eligibility to work at these competitions usually entails a two week testing process at one of the training centers, where US Olympic Committee members judge doctors on criteria such as how well doctors work under pressure and how effective they are in communicating with athletes and coaches. Once they received the go-ahead from Committee members, doctors had to be licensed by the UK’s General Medical Council to be considered volunteers for the London Organising Committee of the Olympic and Paralympic Games. After all that, it was on to London.

But it doesn’t stop there. Doctors are on call throughout the duration of the games jumping from venue to venue as needed, and 16-plus hour work days are not uncommon. Doctors also have to make tough calls about whether injured athletes can compete.  It’s a lot of pressure. But the docs are enjoying the experience immensely, citing the sense of community and honor they feel in being able to volunteer for such a special event.  According to Dr. Peter Donaldson, one of the US team doctors alongside Dr. Rodeo, “There are few opportunities that come up in life that are as unique as this.”

The DocAsap team applauds all the athletes and doctors in the London Olympics for working their hardest and making us proud. We’d love to hear if any of our own docs are part of the team!