Beckie Moore, APRN Brings “More” to DMC

Direct Medical Care Introduces Beckie Moore, APRN

BeckieFB

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 Losswtmgt4

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

Patient-Driven Affordable Healthcare
Patient-Driven Affordable Healthcare

 

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
Grastek5TIMOTHY 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
ragweed

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: Grastek4

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

Patient-Driven Affordable Healthcare
Patient-Driven Affordable Healthcare

Richer in More Ways than One…

Smoking Cessation

Smoking0No 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
  • Smoking4decrease 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.timeandmoney

  • 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:Smoking5The 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.  Smoking7

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.

Smoking8Over-the-counter options:

  • Nicotine patches
  • Nicotine gum
  • Nicotine lozenges

 

 

Prescription options:

  • Nicotine inhalerssmoking9
  • 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 groupsSmokingQuit

No better time than the present to kick the habit as you will be richer in more ways than one!

Ann Riggs, DO

Patient-Driven Affordable Healthcare
Patient-Driven Affordable Healthcare

Alternative Affordable Healthcare “Insurance” Option

 

The Alternativeaffordablecare

My patients often prove to be my best resource in providing patient-driven affordable healthcare.  A viable health coverage plan eludes many of us and often those with a plan quickly discover its shortcomings.  One of our earliest members at Direct Medical Care introduced me to a great alternative to healthcare “insurance”–health cost sharing plans that are truly affordable.  These plans have been around for over 20 years and I anticipate they will become more and more favorable with the current direction of healthcare.

Health Cost Sharing Plans
  • Health Cost Sharing Plans(HCSP) do qualify as approved health insurance coverage by the Affordable Care Act.  
  • The general philosophy is in line with Direct Medical Care’s as HCSPs “seek to return health care to a private, patient-centered model” and “(are) designed to restore and protect the doctor-patient relationship.”
  • Our patients using these plans attest that their experiences have exceeded their expectations.

Check out the following cost sharing plans:

 

samaritanSAMARITAN MINISTRIES

Samaritan Ministries was established in 1994.  Their focus is Christians helping Christians.  Not only are they focused on the financial burdens taken on by the community of Christians but the physical, emotional, and spiritual burdens as well.

 

 

MEDI-SHAREMedishare

Christian Care Ministries was established in 1993.  Their focus is on carrying each other’s burdens while utilizing not only financial resources but individual talents, networks, and their faith.

 

 

LIBERTY DIRECTLiberty-Direct-Logo

Liberty Direct was also established over 20 years ago and interestingly has the same share amounts today that they did when they began.   They focus on helping like-minded individuals who are committed to their individual health and well being of their community.

 

Ann Riggs, DO

Patient-Driven Affordable Healthcare
Patient-Driven Affordable Healthcare

 

 

 

 

 

 

 

 

 

As the Sun Sets…Vitamin D Deficiency


Vitamin D Deficiency

I often joke with patients that we never checked Vitamin D levels until Dr. Oz brought it to the forefront.  Thankfully he did and we are identifying more and more individuals with vitamin d deficiency and treating appropriately.

VitD8

The Centers for Disease Control and Prevention (CDC) reports that 32 percent of children and adults throughout the US are vitamin D deficient. Estimates of over 95 percent of elderly are deficient. 

 

Vitamin D Deficiency SymptomsVitD5
  • Fatigue
  • Bone pain
  • Muscle pain
  • Memory issues
  • Depression
  • Cardiovascular Disease
  • Diabetes
  • Hypertension
Vitamin D AKA the Sunshine Vitamin

VitD3

How much sun is enough?  You need your skin exposed without sunscreen or protective clothing interfering to be able to convert/produce Vitamin D.  There is an interesting calculator here to shed some “light” on it: Sun Exposure Calculator.  Keep in mind there really are so many factors(skin color, time of year, cloud cover, time of day, etc.) and to depend on the sun for your vitamin D is not ideal.

 

Vitamin D in our DietsVitD2
  • Fish
  • Egg yolks
  • Fortified dairy
  • Fortified grains

 

 

 Risk Factors for Vitamin D Deficiency
  • VitD0Diets limited in the above food sources
  • Limited sun exposure due to occupation, climate, or darker pigmented skin
  • Age
  • Obesity
  • GI issues that impact absorption

 

Vitamin D Supplementation

First and foremost check your levels before supplementing above the daily recommended allowances.  Vitamin D is a fat soluble vitamin and too much can lead to toxicity issues.  Basic guideline for baseline supplementation is 800-1000 International Units daily.   Multi-vitamins often fall short of the baseline supplementation.  Verify how much you are truly getting.   If you are found to be deficient supplementation would be much higher.

 

Ann Riggs, DO

Patient-Driven Affordable Healthcare
Patient-Driven Affordable Healthcare

 

Direct Medical Care’s Top Ten List

TopTenDirect Medical Care’s Top Ten Patient Experiences

1—“Dr. Riggs your glow is back.  You seem so happy!”

2—A patient gets access to care for $400.00 vs $2400.00 that literally saved his life

3—A patient is reimbursed $300.00 of his $500.00 annual membership with his first claim submission.  “I feel like I hit the jackpot!”

4—Access to CT scan for cash at $350.00 vs hospital quote of $3382.00

5—The proof is in the pudding:  a patient puts families expenses into a spreadsheet with previous year’s expenses and finds marrying his plan with our services would have resulted in over $7500.00 in savings in one year

6—Our Medicare patient not only gets it but loves our model–he knows how doctoring used to be and the true costs of using your health insurance

7—Wholesale drugs that offer convenience and lower cost of short and long term medications.  $140.00 for one month of blood pressure medication dropped to $28.00 for the same medication.   Annual savings of $1344.00.

8—“The nose doctor(AKA Dr. Riggs) is right next to sonic—that is genius!”

9—“I really feel like I should pay you more.”

10—Every time a patient says, “It just makes sense.”

Ann Riggs, DO

Patient-Driven Affordable Healthcare
Patient-Driven Affordable Healthcare

“My Personal Experience with Direct Medical Care and Dr. Ann O. Riggs”

Background

EricCashinMy name is Eric.  I am a 48 year old male.  I have a history of chronic back pain, pre-diabetes,
recurring respiratory infections (at least annually) and many other miscellaneous health issues.  Last year I was diagnosed with coronary artery disease and had a stent placed in a major artery in my heart.

Because of my long history of health issues, having a skilled medical team and good health insurance has always been important to me and my family.

So why would I change from a traditional insurance based primary care facility to a practice using the direct pay model?

Best Doctor but Direct Pay?

I first became a patient of Dr. Riggs in 2012 when she worked for a traditional medical practice.  I was impressed with her knowledge, skill, and bedside manner.  I was cared for as a friend not just another patient to be pushed through the assembly line.  When she left the practice and started Direct Medical Care, I panicked.

She is the best physician I have ever worked with but how could I afford to pay her direct without using insurance?

A Light Came On

I was motivated to find a way to continue to have Dr. Riggs be my doctor. I began to

EricCashin2research what I had been paying out of pocket, what my insurance options were and how I could incorporate the direct pay model.

What I learned opened my eyes to the true costs of medical care.  It was like I had been sitting in a dark room and someone turned on a light.

Oh… I Think I’m Going to be SickEricCashin3

Being someone who prefers to make decisions based on sound analytical processes, I undertook the task to run a comparison between what my out of pocket expenses were with the standard medical insurance model and what they might be by marrying a High Deductible Plan with a Health Savings Account and membership at Direct Medical Care.  This is what I found out:

Out of Pocket Expenses

Actual(Standard Medical)

$6918.65

Comparison(HSA & Direct Medical Care)

$1863.45

SAVINGS

$5055.20

EricCashin8
This realization hit me like a ton of bricks.  Not only could I afford to join Dr. Riggs’ new practice, I could have saved $5,000.00!

 

 

How Is That Possible?
  • Changed to a High Deductible Plan with an associated Health Savings Account (my coinsurance dropped from 15% to 5%)
  • Insurance automatically contributes $1,500 per year into the HSA
  • Added another $2600 in HSA contributions (offset from prescription drug costs and change in dental plan)
  • All co-pays, co-insurance, prescriptions and membership in DMC paid for by HSA
  • Insurance reimbursed 65% of membership with DMC (net cost for annual family membership was $350.00)
Here Are The Numbers

DMC Membership, deductible, copay, co-insurance and prescriptions covered by $4,100.00 from HSA (no net change in monthly costs).EricCashin5

●     Save $700 family deductible
●     Save $475 on copays
●     Save $875 on prescriptions
●     Save $3,000 on co-insurance

Total Projected Savings $5,050.00

Not Just about $$

In 2013, after Dr. Riggs left the traditional practice (prior to getting DMC open) I began to see another doctor in that practice.  While this doctor was very capable, the assembly line medicine forced on physicians in these corporations caused my heart condition to be misdiagnosed for 6 months.

EricCashin6After joining DMC in December 2013, Dr. Riggs was able to determine that the symptoms I was having could be related to heart disease.  Her office scheduled an appointment with a cardiologist.  The condition was found and a blockage in my heart was repaired.  A potentially catastrophic heart attack prevented.

How Have The Numbers Worked Out?

In 2014,  I saved $7,522.23 compared to what I would have spent out of pocket on my old plan (that does not include the money DMC saved me by shopping prices and negotiating on my behalf for 2 tests – an additional $3,600.00 in savings).

My experience may be extraordinary, however, I am convinced that any individual or family will benefit from the superb medical care and cost savings found through joining Direct Medical Care.

Conclusion

Not everyone’s situation will result in the same savings that I have found.  But here are some examples of how DMC may make financial sense for you:

  1. I don’t have an HSA option where I work.
    • You can benefit by joining DMC and saving on copays and coinsurance for primary care services.  Additionally, membership costs count towards your deductible or may be covered by your insurance.
  2. I am in good health and never meet my deductible.
    • Fantastic, consider selecting a High Deductible plan and save on monthly premiums.  Savings will offset membership or you can join as a “non-member” and pay for a la carte services.
  3. I have Obamacare with a high deductible plan already.
    • DON’T WAIT!  You can’t afford not to join.

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Patient-Driven Affordable Healthcare