2011-05-20 / Columnists

Health & Harmony

TeleHouseCalls
Commentary By Dr. Nancy Gahles


DR. NANCY GAHLES DR. NANCY GAHLES A new day is dawning in healthcare. They are calling it telemedicine. “They” are the big corporations like Bosch and Intel and GE who make technology. They make technology for medicine these days by creating devices for home use that monitor vital signs and provide patient education in order to manage complex chronic diseases. These devices are part of pilot studies to determine if their use will keep patients in their homes, out of nursing homes and limit hospital readmission after heart conditions especially. Cost savings to Medicare is the impetus here. The system that is already overburdened and threatening to break under the pressure of the emerging baby boomers into the complex chronic diseases arena.

My attendance at the recent American Telemedicine Association conference revealed the state of the art of telemedicine. It is in its infancy and it is all about the aging at home population (70-80) and Medicare reimbursement.

As a healthcare futurist, my plea has always been to return the power to the people. Empower people with the education and the tools to make informed healthcare decisions for themselves and their families. Give them choice of several systems of medicine and give them access to practitioners. Allow them to buy low premium insurance policies with high deductibles similar to the old catastrophic insurance policies. Health savings accounts (HSA) are attached to these policies. Health savings accounts offer you the ability to take a certain amount of pre-tax dollars and invest it in an interest bearing money market to use for the health care option of your choice. HSAs roll over from year to year so if you are having a good health year, your savings grow. HSAs are also inheritable which means your money doesn’t die with you.

One unfortunate situation has occurred this year, however. According to the new Healthcare Reform Act, HR 3590, effective January 1, 2011, tax free HSA dollars may no longer be used to purchase over the counter drugs NOT prescribed by a doctor. That means that if you want to purchase Tylenol, ear drops, cough syrup, you must first make an appointment with your MD, take time off to go sit in the waiting room for an hour or more in order to get a prescription so that you can deduct the $7-10 item from your Health Savings Account. As of January 1, 2011, the tax on HSA distributions that are not used for qualified medical expenses will increase to 20 percent from 10 percent. Clearly, the government is NOT in favor of allowing the average citizen any sway when it comes to pre-taxable dollars. When we do not have freedom to use our money as we see fit for our own healthcare, we are a captive audience in the theatre of the mind of the medical/industrial complex.

There are two solutions that come to my mind. One is to contact your legislator and ask him/her to support the Patient’s Freedom to Choose Act. HR 605 in the House and S312 in the Senate. Go to ANH-USA for more information and a form letter that will go directly to your legislators. The second solution is to begin to understand the principles of self care. Self care is the use of natural remedies combined with common sense and some professional advice to address a majority of health issues. I have created a service called TeleHouseCalls to help people learn how to care for themselves. I created this service to educate, inform and advise people to responsible selfcare for self-limiting conditions. For instance, the average time an MD spends with you is seven minutes. The average fee for service reimbursed by insurance companies is $35-40. Data shows that every person leaves with at least one prescription for a drug. There are many situations that one might visit a doctor for that do not warrant a pharmaceutical or surgical intervention. Generally, these conditions are referred to a specialist. Another visit, more time lost and more money spent. There are conditions for which medicine has no answer. Menopause for one, viruses for another. There are conditions that are self-limiting. That means that left alone they will resolve in 3-7 days. For example, earaches, colds, some allergies, simple fevers. There are home remedies, herbs, nutrition, diet, lifestyle and stress management solutions for many of these conditions. More often than not, your primary care physician has not studied a specialty in any of these areas and is wont to discuss them with you. Studies show that most people who use Complementary and Alternative Medicine (CAM) do not discuss it with their doctor, either because they know their doctor isn’t educated in this area or because they fear reprisal if they disclose that they use alternative medicine.

TeleHouseCalls presents a format that is safe, easy to use and cost effective. For example, I was on vacation in Mexico when I scanned my e-mails to find a patient asking for an appointment for severe sciatica pain. I answered that I was away and gave her an appointment for a future date. She responded that she couldn’t make that appointment as she had a dermatologist appointment for that day for an “unrelated “rash on her back. Immediately, I asked her to send me a photo of the rash. Within minutes my diagnosis was confirmed. She had shingles. The rash was indeed related and the cause of the sciatic nerve pain in her leg. I advised her of my diagnosis and referred her to her dermatologist and then to see me for correction of the sciatica following that visit. She was also given self care advice as to topical pain relief. All in a matter of 10 minutes from my beach chair in Mexico. The fee was $40. No office visit, no wasted time and a timely diagnosis. The patient was relieved to know the cause of her pain and to have a treatment to use while awaiting the dermatologist appointment on Monday.

As a recognized expert in the field of integrative healthcare for over 30 years, I have studied and become certified in several of the CAM modalities. As a doctor in this community for close to 25 years, I have a resource network of qualified practitioners in all fields of conventional medicine and Complementary and Alternative Medicine that I refer to.

TeleHouseCalls answers the need for people who want to become educated and informed about CAM and its uses in common conditions. This is not for medical emergencies or chronic complex diseases. It is not intended to replace conventional medicine or the treatments your doctor has prescribed. The beauty of integrated healthcare is just that … it can be integrated, used with, conventional medicine to achieve better resolution and faster return to health. TeleHouseCalls is for all of us who know that we have common sense, intuition and hardly any time to handle all the “stuff” of the day. Tele- HouseCalls encourages personal responsibility and is priced affordably so that everyone can pay for themselves regardless of insurance coverage.

TeleHouseCalls empowers people to begin to take back their right to decision making and payment for their own healthcare. It is a first step in the process. Referrals to specialists, support groups, etc. are made where appropriate and the process continues from there.

We all need to take that first step. We all need support while doing so. TeleHouseCalls is simple. E-mail me at askdrnancy@aol.com. Describe the issue. I will schedule a time to speak on Skype, computer or old school telephone. Fees are pro-rated on an hourly basis. I will confer with your primary care physician if warranted.

Personalized, individualized, healthcare with empowered people working together is the best medicine I have ever studied and foremost in prevention and health promotion.

May The Blessings Be!

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