affordable healthcare
SUMMER VIBES! BEAT THE HEAT!
NATIONAL BLOOD DONOR DAY
Direct Medical Care supports:
June 14th
“Each year, approximately 6.8 million people in the U.S donate blood. Annually, this adds up to about 13.6 million units of whole blood collected for donation in the U.S. The Red Cross provides about 40% of our nation’s blood and blood cell components to donors. Your blood donations are used for patients in need of surgery, cancer treatment and transfusions for blood loss from traumatic injuries.” (https://www.redcrossblood.org/)
Eligibility: In Missouri, people who are at least 17 years of age (or 16 years of age with signed American Red Cross parental or legal guardian consent form), weigh at least 110 pounds and are in good general health on the day of donation, are usually eligible to donate blood.
Jessica Whiteman, MSN,APRN, FNP-C
Welcome Dr. Parker to the Team!
On the eve of Dr. Parker’s first day in the clinic at Direct Medical Care I thought it only appropriate to share a little more information on her. Check out her bio:
Dr. Parker was born and raised in the Kansas City area. She is one of six children of Dr. and Mrs. C. Phillip Pattison who reside in Weston, Missouri. After spending her freshman year of high school at Shawnee Mission Northwest she moved with her family to Rolla, Missouri where she graduated from Rolla High School in 2001. She returned to Kansas City later that year to attend the University of Missouri-Kansas City, School of Medicine. Upon graduation, she was chosen as the recipient of the Society of Academic Emergency Medicine Award. Dr. Parker spent one year at the University of Indiana Emergency Medicine Program in Indianapolis. After a year of Emergency Medicine training she chose to return to her passion for primary care medicine. She completed a residency in Family Medicine, followed by a Fellowship in Geriatric Medicine at St. Vincent Hospital. During her time in Indianapolis, Dr. Parker married her husband, Dr. Matthew Parker, and had three sons. Dr. Parker and her family returned to the Kansas City area in 2013 and they reside in Weston, Missouri. She was employed as a Family Medicine physician at the Cerner Corporation through August 2017. During her time at Cerner she was the recipient of multiple patient service excellence awards. Dr. Parker chose to pursue a new path in medicine by joining Dr. Ann Riggs, Beckie Moore, and staff in her Direct Medical Care clinic in January 2018. Dr. Parker is thrilled to be providing affordable, comprehensive, and most importantly, compassionate care for her patients.
Welcome to Dr. Parker and her family to Direct Medical Care and our community!
Ann Riggs, DO and Staff
When our model hits home–the proof is in the pudding.
Pudding Proof
I recently had the opportunity to experience the pitfalls of my own commercial health
insurance. I tell patients all the time “the proof is in the pudding.” Well it was my turn to see how this pudding really was in the health insurance world.
Recurrent Strep
This past fall my daughter was hit with yet another bout of strep throat. She has fought it throughout her young life. At the age of seven I made the call to consult with one of my favorite ENT docs. It was an easy decision that she would do better if we proceeded with tonsillectomy and adenoidectomy.
High Deductible
I, like so many of my patients, have a high deductible plan that I have married with an HSA(Health Savings Account). I knew the bulk if not all of the cost of the procedure would be my responsibility. I did not hesitate to ask for cash pricing.
Insurance Negotiated Pricing vs Cash Pricing
Pricing for any surgical procedure needs to include the following fees:
- Surgeon’s Fee
- Anesthesiologist’s Fee
- Surgical Facility’s Fee
INSURANCE NEGOTIATED PRICING:
| Surgeon | $372.51 |
| Anesthesiologist + Facility | $2624.00 |
| Total Cost | $2996.51 |
CASH PRICING:
| Surgeon | $402.50 |
| Anesthesiologist | $578.00 |
| Facility | $879.83 |
| Total Cost | $1860.33 |
FINAL PRICING AND SAVINGS:
I was actually able to pay the insurance negotiated pricing for the surgeon and the cash pricing for the anesthesiologist and the facility. My final pricing was $1830.34 for the entire procedure. And there lies the proof in the pudding:
Almost $1200 in Savings
Happy Healthy Kid at Great Cost Savings by Paying Cash
Ann Riggs, DO
Magnificent Magnesium
Role of Magnesium
Magnesium is #12 on the Periodic Table and is a mineral that plays a role in many bodily functions. There are over 300 reactions in your body that depend on this vital mineral.
Magnesium Deficiency
It is estimated that 80% of individuals would benefit from magnesium supplementation. Magnesium is not checked on routine lab evaluations. Common signs of possible magnesium deficiency are below:
Magnesium Sources
Dietary sources:
dark leafy greens- nuts
- seeds
- fish
- beans
- whole grains
- avocados
- yogurt
- bananas
- dried fruit
- dark chocolate
Magnesium supplements:
There are so many forms of magnesium salts used for repletion and supplementation.
- Magnesium Ascorbate
- Magnesium Aspartate
- Magnesium Bicarbonate
- Magnesium Carbonate
- Magnesium Chloride
- Magnesium Citrate
- Magnesium Fumarate
- Magnesium Gluconate
- Magnesium Glutamate
- Magnesium Glycinate
- Magnesium Hydroxide
- Magnesium Lactate
- Magnesium Lysinate
- Magnesium Malate
- Magnesium Orotate
- Magnesium Oxide
Which is best??? And to be honest until writing this blog I had never considered the differences. In my research, I now recommend one of the following:
Magnesium Citrate–induces more gastrointestinal side effects for individuals that may suffer from constipation
Magnesium Glycinate–induces less gastrointestinal side effects for individuals that do not have any constipation issues
Magnesium Oxide–most available, affordable and side effect profile more neutral
Ann Riggs, DO
**disclaimer: noted misspellings/grammatical errors in graphics but felt graphics value outweighed the errors.
Beckie Moore, APRN Brings “More” to DMC
Direct Medical Care Introduces Beckie Moore, APRN
Beckie Moore, APRN was born in Wichita, Kansas and raised in Platte County, Missouri. After 12 years in Platte City, Missouri, she and her family settled just north of Dearborn, Missouri, where she enjoys her time away from patient care on her farm. Beckie graduated valedictorian from North Platte High School in 1983. She has been an RN since 1987. Beckie went on to earn her Master’s degree in nursing from the University of Missouri, Kansas City in 1999. As a Family Nurse Practitioner in the Northland for over a decade, Beckie noticed patients interested in and seeking alternative options that were not taught in her traditional western medicine education. Seeking answers and education for herself, she discovered that the University of Arizona offered a two year medical fellowship in Integrative Medicine. Beckie completed her fellowship in 2016. She hopes to compliment patient care with her new knowledge base. Her passion is treating root causes of illnesses and promoting wellness at every turn.
The Calorie Creep
But Doctor I am not eating that much…
While there are always exceptions rarely does one become overweight by not eating.
The balancing act of creating a calorie deficit is key for weight loss. Please see my prior blog post regarding the fundamentals of weight loss:
Calories Consumed < Calories Expended= Weight Loss
It can be one misstep in your day that will sabotage all your good efforts. Stealing the term introduced to me by an inspiring patient, I would like to bring “the calorie creep” to life in the pictures below:
Keep in mind it does not have to be junk food that can be your calorie creep–avoid the creep in whatever form!
Ann Riggs, DO
Sneezing, Runny Nose, Itchy Eyes are Here
ALLERGY SYMPTOMS
- Cough
- Runny nose
- Sneezing
- Itchy nose
- Sore throat
- Watery eyes
- Puffey eyes
- Itchy eyes
- Asthma flares
- Difficulty breathing
TIMOTHY GRASS ALLERGIES
One of the most common allergens is grasses and specifically timothy grass. We are seeing these right now. While preventive treatment is ideal, treatment is currently focused on relieving the symptoms. There is a new option for allergy sufferers of common grasses for future seasons. The middle of freezing temperatures is when the grasses are dormant. It is that time that preventive treatment needs to start.
The newest option to treat for the timothy grass allergen is Grastek. This is immunotherapy in a pill. For those that have endured the weekly shots this is a novel, relatively painless approach to immunotherapy that can be done in the comfort of your own home.
Grastek covers Timothy grasses but also has cross coverage to other grasses.
It should be started for seasonal care 12 weeks ahead of pollen and throughout the season or taken consecutively for 3 years.
Click on the following link for more information on administration of Grastek.
RAGWEED ALLERGIES
Another common allergen that is on the horizon is ragweed. Fortunately, our timing of discussing this form of treatment is ideal. The same manufacturer of Grastek has developed a similar treatment for ragweed with the prescription drug Ragwitek.
Ragwitek like Grastek should be taken 12 weeks before the allergen season. In this geographic area the typical ragweed season begins about August 15. That gives an estimated start date of the medication in mid-May.
Ragwitek is taken similarly to Grastek with pre-seasonal and seasonal administration or continuous administration for 3 years.
TRADITIONAL ALLERGY CARE
Many other treatments remain the mainstay for allergy treatment: 
Oral Medications:
Antihistamines
- Cetirizine–Zyrtec
- Diphenhydramine–Benadryl
- Fexofenadine–Allegra
- Loratadine–Claritin, Alavert
Decongestants
- Phenylephrine
- Pseudoephedrine
Leukotriene Antagonist
- Montelukast Sodium–Singulair
Nasal/Ocular Medications:
Steroids
- Flonase
- Nasacort
- Nasonex
- Qnasl
- Rhinocort
Antihistamines
- Astelin
- Pataday
- Patanase
- Pazeo
- Zaditor
Decongestants
- Ephedrine
- Oxymetazoline–Afrin, Sinex
- Phenylephrine
Cromolyn
- Nasalcrom
Anticholinergics
- Ipratropium Bromide–Atrovent
Nasal Irrigation
- Navage
- NeilMed
- Neti-Pot
Avoidance:
While avoidance can be difficult here are some pointers that may help:
- Stay indoors when the pollen count is high especially between 5AM to 10 AM when pollen counts are highest
- Wear a mask when mowing or avoid mowing altogether
- Choose grasses for your lawn that produce less pollen–dichondra and irish moss are some examples
- Mow frequently to keep grass short
- Keep windows closed
- Avoid attic fans
- Bathe pets frequently
- Do not dry clothes outdoors
- Minimize alcohol intake as it leads to dehydration and increased sensitivity to allergens
Another topic to come…How do I know what I am allergic to?
Ann Riggs, DO
Richer in More Ways than One…
Smoking Cessation
No better time to discuss smoking cessation than when we are at the new year and resolutions are starting to fade while the freezing temperatures outside continue. I tell my patients that are contemplating smoking cessation that if successful they will be richer in more ways than one. The health benefits of smoking cessation are clear. The often overlooked benefits of smoking cessation are the return of significant time and money.
Health Benefits
decrease in bronchitis, COPD- decrease in blood pressure
- decrease in heart rate
- decrease in ALL cancers
- decrease in diabetes
- decrease in osteoporosis
- decrease in rheumatoid arthritis
- decrease in erectile dysfunction for men
- decrease in ectopic pregnancies, miscarriages, small birth weight in pregnancy
- decrease in second hand smoke decreases sudden infant death syndrome, ear infections, respiratory illnesses, and asthma
Non-Health Benefits
We never seem to have enough of either time or money and smoking cessation recaptures both.
- Money
- Time
- Time=Money
The actual cost savings can be calculated here. The following depicts the savings realized when smoking 1 pack per day with a cost of $5.70 per pack:
The amount of time spent smoking is estimated at 6 minutes and 20 seconds per cigarette. Calculations for smoking 1 pack per day equates to over 2 hours per day. 
If you extrapolate the value of your time then your costs rise exponentially.
Smoking Cessation Aids
So you are ready but want some help. There are over-the-counter, prescription, and alternative options to help you be more successful.
Over-the-counter options:
- Nicotine patches
- Nicotine gum
- Nicotine lozenges
Prescription options:
- Nicotine inhalers
- Nicotine nasal sprays
- Bupropion is a common anti-depressant medication that was once marketed as Zyban. This medication can diminish the cravings and withdrawal symptoms from the nicotine.
- Chantix is for smoking cessation only and can diminish the cravings and withdrawal while also blocking nicotine effects from smoking.
Alternative options:
- E-cigarettes–long term safety has been unclear but recent studies identify significant concerns on safety and effectiveness
- Hypnosis
- Acupuncture
- Support groups
No better time than the present to kick the habit as you will be richer in more ways than one!
Ann Riggs, DO
Direct Medical Care 