As you look ahead, what do you envision? If you’re like most people, you are probably eager to stay healthy and enjoy your life in the most vibrant, vigorous way possible. No magic pill or secret potion can deliver a long, healthy life. To some extent, your genes are responsible however, abundant research shows that the actions you take today matter the most. Simple lifestyle choices — what you eat, how active you are, whether you smoke — have an enormous impact on your longevity and quality of life.

A 2007 study in the American Journal of Medicine focused on adults who adopted a healthier lifestyle during middle age. The researchers followed ~15,000 adults (ages 45+) for a decade and noted that 970(~9%) of these people embraced a healthier lifestyle by the sixth year of the study. These individuals ate five or more daily servings of fruits and vegetables, worked out at least two and a half hours per week, didn’t smoke, and avoided obesity. Benefits appeared quickly. Just four years later, the group of individuals who made these four changes had a 40% lower rate of death for any reason and 35% fewer cases of heart disease compared with the participants who made fewer of these changes. No matter what your age or stage of life, you have the power to change many of the variables.  Actions you can take to increase your odds of a longer and more satisfying life span are really quite simple:

1. Don’t smoke.
2. Enjoy physical and mental activities every day.
3. Eat a healthy diet rich in whole grains, vegetables, and fruits, and substitute healthier monounsaturated and polyunsaturated fats for unhealthy saturated fats and Trans fats.
4. Take a daily multivitamin, and be sure to get enough calcium and vitamin D.
5. Maintain a healthy weight and body shape.
6. Challenge your mind. Keep learning and trying new activities.
7. Build a strong social network.
8. Follow preventive care and screening guidelines.
9. Floss, brush, and see a dentist regularly.
10. Ask your doctor if medication can help you control the potential long-term side effects of chronic conditions such as high blood pressure, osteoporosis, or high cholesterol.

An insured patient checking out form the physician’s office paid $100 for just 10 minutes with the doctor.  What exactly this $100 covers? Why patients get shocked seeing this type of bill? Here is what that $100 is covering…

• First, doctor office schedules an appointment. It took several people to take the message, pull the medical record (paper charts), call the patient to assess the problem, determine the need for the appointment and schedule it.
• When the patient arrives, staff double checks the patient’s contact info and insurance details to make sure that it is updated on the file.  The nurse gets notification of the patient’s arrival.
• The nurse called the patient from the waiting area, measures blood pressure and weight.  And then patient goes into the exam room where nurse again takes vitals, make notes around the visit reason, medication, last visit, etc.
• The physician came in to see the patient, asked about any changes since last been seen, reviews history of present illness and examines the patient. He talks about the illness and the treatment plan and prescribed a medication. He updates patient’s medication list and makes a copy of the diagnosis form and hand it out to the patient for the records.  The patient goes to the check out desk.
• The physician refiled the medication reconciliation in the chart, finished documenting the visit, and placed the chart in the bin to be refiled.  The chart was filed, and the encounter form was sent to the billing office.
• At the billing office the charges and any payment gets posted and the claim was filed.  If there is no problem with the claim, it electronically gets processed.
• If payment was not denied, the payment arrives at the billing office and would be posted.
• If patient did not pay at the check-out desk, the patient-responsible balance is billed to the patient.  If the patient pays on the first statement, it has taken 45 to 60 days to receive complete payment.

The 10 minute office visit involved the work of the phone operator, the medical records clerk, the triage nurse, the check-in person, the nurse, the doctor, the check-out person and the biller.  It took 8 people, and at least 45 minutes of work to make that appointment happen.  In addition, that visit paid the expenses for the rent, the utilities, malpractice insurance, medical supplies, computers, phones and janitorial services.  We all want efficient and quality health care but it is not cheap.

Thanks to KevinMd for giving this useful insight.

A new form of E.coli (Escherichia coli-STEC) is causing lot of trouble in Germany, so far 17 people have died and several got infected.   It is causing bloody diarrhea and affecting Kidneys and considered to be “highly infectious and toxic”

As recorded by BBC, Dr Dilys Morgan from the Health Protection Agency says the E. coli outbreak is “alarming, it mainly affects young children and older adults, but what we’ve seen is predominantly young females getting this condition. It’s a very rare organism that’s causing this and it’s thought it has particular properties where the toxin it produces is particularly virulent and therefore is affecting this population more than we would normally expect.”

Professor Hugh Pennington, a microbiologist from the University of Aberdeen, said: “This outbreak is unusual in that it doesn’t seem to be targeting young children, usually children under five have had a very hard time with this kind of bug in the past, they seem to be escaping it, maybe just due to the nature of the food that’s causing the problem.”

According to the Centers for Disease Control and Prevention, to prevent Shiga toxin-producing E. coli (STEC) infection, you should just follow these simple things:

• Wash your hands thoroughly after going to the bathroom or changing diapers
• Wash your hands thoroughly after handling animals, animal bedding, or any material contaminated with animal fecal matter
• Eat only thoroughly cooked ground beef, pork, sheep meat, or sausage.
• Cook ground meat products to an internal temperature of 160ºF
• Avoid drinking unpasteurized milk and juices
• Wash fresh fruits and vegetables thoroughly before eating raw
• Prevent cross contamination in food preparation areas by washing hands, counters, cutting boards, and utensils after they touch raw meat.
• Keep raw meat separate from ready-to-eat foods

As long as you are doing aforementioned, you shouldn’t worry too much.  Ask your physician if you have any more concerns around this.  Just remember prevention is the key to a good health!

Use DocAsap for timely appointments. 

The Government’s vision to create a Health Information Exchange (HIE) has the potential to provide a comprehensive patient history at the point of care. In addition to this data exchange, Internet and “meaningful use” of electronic health records will have a positive and significant impact on the delivery of healthcare and its associated costs. This new arrangement will improve the collaboration among providers and health facilities.  The integrated medical groups like Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic, and University of Pittsburgh Medical Center are extensively utilizing technology to improve access.  These big groups are combining doctors, clinics, hospitals and often some insurance and capturing the financial savings from electronic health records.

However, despite all the benefits, adoption of technology is slow in most of the small practices.  It is surely a change in “status-quo”, and as such small practices do not get financial incentives to use computerized medical records and for some practices it is very time consuming process to convert paper records into electronic records.

“And there are privacy and patient centered concerns as well” said Dr. Donald Tavakoli; a Philadelphia based Psychiatrist. “Obviously for psychiatrists, mental health issues and therapy notes raise a major concern of “discoverability” and differ from the rest of medicine (at least in some people’s minds).  Not to mention, typing with a patient in front of you, which happens a lot with electronic systems, takes away from the doctor patient relationship.  On the other hand, legibility, access to records, and streamlining for billing purposes can increase efficiency and decrease redundancy in testing etc.”

Dr. Tavakoli said “technology being incorporated into practice is a good thing as it increases access (as DocAsap proves), increases efficiency, and decreases risk of errors.  And at the end of the day, it is inevitability.  Increasingly, I’m hearing about things like Ipad’s being considered as notepads for clinicians, which could offer simply touch screen checklist items to mark off during evaluations, this not only reduces medical error but healthcare costs as well.  And it is possible increased technology and Electronic record systems dovetails with increased “checklist” medicine.  The big concern is that in healthcare, sometimes the art of medicine can have immeasurable value, and the doctor patient relationship is crucial (and mental healthcare tops that list, especially with psychotherapy, but it is true in all of medicine).”

Please check Dr. Tavakoli’s profile at DocAsap

We are excited to announce that DocAsap has officially launched today, and that you can now use our service to find and book online dental appointments in Philadelphia!

On DocAsap, patients can instantly find and book available appointments 24 / 7 from local doctors and dentists who take their insurance, and can research providers based on their backgrounds.  Our rationale for starting in Philadelphia is not only because we commenced the venture while Wharton students, but also because Philadelphia, which has the second longest doctor appointment wait time of any U.S. city, could use a service that helps its residents get more timely care in a quick and convenient manner.

Right now, DocAsap only provides online appointment booking for Philadelphia dentists.  But in coming months, we will launch more specialties, add more content on our doctors and dentists, and roll out other features to improve the efficiency of finding and visiting a doctor.  In addition to providing us with any feedback, we would love for you to tell your friends in Philadelphia to book their next dentist appointment through DocAsap, join our Facebook group to get future updates, and spread the word to those you think might be interested in our service.

Anyways, thanks again for your help along the way, and we look forward to hearing from you.

The DocAsap Team

We tell just about anyone we come into contact about DocAsap. When we first tell people about the idea of “doctor appointments at your fingertips”, the reaction of the listener most often starts, “Wow! that’s a great idea! I would definitely use a service like that!”  Then, as we get deeper into the conversation, the “yeah, but….” comments start to come out  (e.g. “yeah, that’s a great idea, but patients won’t actually book appointments online!”).  We love the objections, and want to respond below with data supporting the need for DocAsap.com.

Objection 1. Patients aren’t going to want to go and see just any doctor. They won’t switch doctors because they only want to see their own doctor!
In fact, a recent McKinsey study involving more that 2000 patients found that 2/3 of patients are willing to switch providers for improved scheduling and 77% would switch for more timely appointments.

Objection 2. Most patients already have strong relationships with their doctors and aren’t often looking for new doctors.
56 million Americans across all demographics of income, race, geography and insurance coverage do not even have a regular primary care physician relationship. Specialists relationship is even lower.

Objection 3. Patients here in the U.S. can’t just book an appointment to see a specialist, they need referrals.
First of all, patients with referrals will certainly be able to use DocAsap to book appointments.  In addition, from a macro-perspective, HMO enrollment continues to decline , falling 5.8% to approximately 44 million from July 2007 to January 2008. At the same time, PPO enrollment grew 4.4% to 110 million, increasing the number of patients who can book directly with specialists, without a stringent referral requirement.

Objection 4.  All doctors are overbooked and there aren’t going to be open slots available!
New and emerging practices and doctors are constantly looking for new patients. Even well-established doctors know that they need a certain fraction of total patients to be new patients in order to keep their practices thriving. In addition, surprisingly high cancellation rates reduce doctor utilization significantly. Anecdotally, in practices and clinics in the West Philadelphia area where we go to school, the cancellation/no-show rate is regularly up to 50% of appointments!

Objection 5. I can’t imagine patients booking doctor appointments on line, this is something that people only do over the phone.
Even without the benefit of statistics, we know that online appointment booking in general for major service sectors continues to grow rapidly. People manage a large percentage of their “offline” lives online, and we don’t see that trend reversing.

Let us know what you think! We appreciate more of your feedback on your service and we’d love to hear what you think of our responses.  Also, let us know if you have any additional data supporting the need for online doctor appointment booking.