Specialists at Your Service

We Do Know a Little Bit about a Lot…

As family practitioners we are expected to know a wide range of topics and health conditions.   And while we pride ourselves on knowing as much as we can about all things medical, it is impossible for us to know all the intricacies of specialty medicine.   We realize that a physician or colleague that focuses on one area of medicine has insight in that area that we might not have.

 

 

A Team of Specialists

Never fear at Direct Medical Care we have a team of hundreds of specialists available to us for consultation.

 

 

Rubicon MD

Over the past year we have been utilizing an online service called Rubicon MD.  It is an online eConsult platform that gives us access to hundreds of specialists and subspecialists in medicine.   What often takes three to six months to get consultation we can get in less than 24 hours.   Not to mention the cost to see that specialist after that long wait is estimated to exceed $200.

Quality Care that is Timely

Last night I was reminded what an incredible offering it really is for our patients:

I had an interesting case that had me puzzled and decided to ask the specialist via Rubicon MD for some input and guidance.   I put together the clinical history and data at 6PM and had a response by 9PM.   The patient’s case was reviewed and reassurance that we were managing things correctly with added precautions on what to do moving forward.

Better care for patients that is affordable and timely is another added bonus at Direct Medical Care.

 

Ann Riggs, DO

Patient-Driven Affordable Healthcare

 

 

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

Patient-Driven Affordable Healthcare

Cori Then and Now…Transformation Tuesday

Cori is an avid football fan and is loyal to our Kansas City Chiefs.  Last spring she set out on a transformation that has changed her life.

Not only does she look fantastic but she feels healthier and happier with her progress. She is a mother of three active children and is excited to be setting a good example for them by being healthier and taking care of herself.

Cori’s encouragement for others is to be prepared for hard work.  The results will not be instant and expect setbacks.  It really is about making small steps towards a bigger goal.

How did she do it?  Hard work.  Nothing compensates for hard work.  She began running and really watching her diet.  Her diet focus was not only about healthier choices but also portion control.   Cori has completed two half-marathons and has plans for more.

Go Cori and Go Chiefs!

 

Ann Riggs, DO

Patient-Driven Affordable Healthcare

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:

1.  Surgeon’s Fee
2.  Anesthesiologist’s Fee
3.  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

Bear was Free!

Ann Riggs, DO

Patient-Driven Affordable Healthcare

 

Poison Ivy Prevention–Are you ready to ditch the itch?

Leaves of three, let them be!! Hairy vine, no friend of mine!! Raggy rope, don’t be a dope!! Berries white, run in fright!! Growing up in the midwest, most of us are well informed of this itchy summer issue. We know to avoid the plant, wear protective clothing, and wash the oil off as soon as exposed.

As a young child I was never allergic and spent most of my summers exploring the woods, marveling at the wonders of nature. When I developed a rhus (poison ivy, poison oak, poison sumac) allergy as a young adult, it seriously impacted my enjoyment of the summer!!

Five years ago I heard of a pharmacy in Warsaw, Missouri offering a poison ivy prevention treatment. My husband and I had recently purchased a farm with extensive poison ivy actively growing. I had spent the last 3 summers requiring multiple steroid injections for poison ivy so both of us decided to give this a try.

And it WORKED!! Each year it works even better. Some people get complete immunity. I have never been that lucky but have significant less skin eruption with direct contact of the plant and no spread. I have not required steroid treatment for 4 years now and might get one small blister in the area of direct skin contact with the plant.

This is a homeopathic treatment and does not impact medications or supplements. Poison Ivy Oral Solution is designed to work as a preventative to help protect against getting poison ivy. The cost for members is $40 and the cost for non-members is $60 at Direct Medical Care.  This solution is held in the mouth for 30 seconds and then swallowed. Poison Ivy Solution is best taken between meals. Mint flavored foods or mouthwashes must be avoided 30 minutes to one hour before and after administration. The first dose of the medication should be administered in a physician’s office, the other’s may be taken at home. Patients taking the Poison Ivy Solution during the plant’s active growth phase (late spring and summer) should keep away from the plant until all three vials have been taken.

First dose monitoring in the doctor’s office is related to the active ingredient in the solution. It contains a dilution of the resin of the plant Rhus Toxicdendron. I have not seen a case of allergy to the solution, but it is theoretically possible.

The treatment success I have experienced is part of the reason I pursued integrative medicine. It opened my eyes to the possibilities of alternative treatments. I typically order my own solution in March and will be putting an order in soon.

Are you ready to ditch the itch?

Beckie Moore, Integrative Family Nurse Practitioner

 

 

 

 

 

 

 

Baby Boomers Beware

The Scare

The recent commercial promoting screening for hepatitis C in the Baby Boomers has scared many of my patients and their friends. Scare tactics usually work for a desired action, but is this really necessary?  I would argue it is not.

Hepatitis C Commercial

The Facts

Hepatitis C is a virus that is transmitted by blood exposure.  It is estimated that almost 3.2 million people in the United States have the virus.

The hepatitis C virus can cause liver damage, can cause cancer, and can cause death because of the liver damage or cancer.  You can also have the virus and never develop symptoms.

Risks for acquiring hepatitis C:

tattoos, blood transfusions, organ recipients, accidental needle sticks, IV drug use, and sexual intercourse

 

 

 

My Thoughts

Pharmaceutical companies that have a vested interest in the drugs used to treat hepatitis C have a lot to profit with increased diagnosis.  With increased screening, we get increased diagnosis which leads to increased usage of medications which leads to huge monetary gains for the pharmaceutical companies.  While we do not include hepatitis testing in our routine labs we do recommend annual evaluation of liver enzymes which indirectly looks for the presence of hepatitis C.

And while I have certainly lost patients from a variety of disease processes, I have never had a patient die from hepatitis C…don’t be scared regarding this issue, talk to your doctor.

 

Ann Riggs, DO

 

Patient-Driven Affordable Healthcare

 

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

Patient-Driven Affordable Healthcare

 

 

 

 

**disclaimer:  noted misspellings/grammatical errors in graphics but felt graphics value outweighed the errors.

 

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

Patient-Driven Affordable Healthcare

 

To Flu or Not to Flu

“I have the flu…”

Influenza strikes every year and leaves much to be discussed.  The flu statistics reveal that the highest risk groups are those 65+ years of age followed by those 0-4 years of age.  The other high risk groups include pregnant women and those with chronic respiratory illness or those with weakened immune systems.

Seasonal influenza is typically the following with rapid onset:

Symptoms of Influenza

• fever
• chills
• profound fatigue
• headaches
• joint pain
• runny nose
• cough
• sore throat

 

Seasonal influenza is not typically:

• nausea
• vomiting
• diarrhea

Diagnosis

The only absolute is a positive influenza swab.  Unfortunately the test can be inaccurate.  Some studies suggest the influenza swab is only 30% accurate while others suggest 70% accuracy. The best case scenario it misses 3 out of 10 individuals with influenza.  This makes clinical suspicion and evaluation by your physician key in diagnosis.

Treatment

Tamiflu or other antivirals are the only prescription form of treatment but have their limitations.  They need to be started within 48-72 hours of onset of symptoms. Antivirals when started early in the course of the illness can decrease the severity of symptoms and length of course but are not a cure. Large families or those with high risk individuals may opt to take antivirals as preventive or prophylactic care when a known influenza carrier has been diagnosed.

Supportive care is the true mainstay of care for anyone with influenza:

• fluids
• rest
• acetaminophen

Flu Vaccine

There are always lots of opinions regarding vaccination.  While it is not a perfect vaccine as far as guaranteed coverage for influenza, it is safe.

The CDC recommends annual vaccination for everyone 6 months of age and older.

Vaccination is one way to protect yourself from influenza and can reduce the severity of illness if contracted and prevent hospitalizations in addition to doctor visits and time off work.

Common questions:

• Does the flu shot cause the flu?

            No but can cause a flu-like response with mild headache, joint pains, and fever

• How long until I am covered after receiving the vaccination?

           2 weeks

Common Sense Prevails

• avoid contact with those with symptoms
• wash your hands
• eat healthy
• exercise
• rest

Stay well!

 

Ann Riggs, DO

Patient-Driven Affordable Healthcare

 

 

 

 

 

Direct Medical Care’s Top Ten List

Direct 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