The Tangent Edition

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—View from the far side of the recliner

I usually take a wandering path, thinking, talking, writing and trying to get my pants on. This time the beginning of November, in an even number year, brings up all kinds of things.

No Shave November.

It turns out that no shave November is a real thing. Check it out at http://www.no-shave.org Basically you stop shaving for November to raise awareness for cancer. There is some connection to making a donation to the cause. I like the idea of doing something by not doing something. I stopped shaving my back years ago, it doesn’t seem to make a difference. Alright there has never been anything to shave on my back and barely anything on my chest. I can grow a beard and have been told I look like a short version of the uni-bomber, when in full gray fuzziness. So the beard returns after over a year’s hiatus.

Today is Election Day.

I’m pretty involved in politics although there is a lot I don’t like about either of the two major parties. For about ten years I’ve been the American Physical Therapy Association District Liaison for the congressional district in which I live. Just about every year I go to Washington DC with other PTs from around the country to meet with our legislators about health care issues. We also meet with our legislators in the districts. In that time I’ve met quite a few Representatives and one Senator. There has been a number of very positive interactions with both Republicans and Democrats. I’ve also met with state legislators and candidates which has been a mixed bag. Locally, there have been conversations with a mayor and a few council members all of which have been positive. I have been very involved in the last four campaigns of a candidate which has been rewarding, interesting and the feelings that come with both winning and losing. It’s going to be close so I’m not sure which emotion/s I’ll be experiencing tonight at the election party.

Obamacare.

Taking a position on Obamacare (ACA) is a guaranteed way to make enemies. Here is my attempt at a realistic view of the situation as it currently exists. I hope that anyone who likes me will continue to do so.

As a Physical Therapist who sees the struggles of people without insurance and as a person who has been unable to get regular health insurance because of a preexisting condition I can appreciate the need for change in the health care system. As the parent of a son in college, I see the benefit of being able to keep him on the family insurance until age 26.  In my late teens and much of my twenties I had no health insurance. It didn’t seem like a big deal at the time but since having a bunch of health related life experiences with family and me I see the big deal.

As a Physical Therapist who has had to deal with the increased expense and needless paperwork brought on by Obamacare, I know the program has been poorly implemented by a dysfunctional bureaucracy.  As a person who tried to get through healthcare.gov to sign up I have experienced the train wreck of incompetence of this administration. As someone who eventually got through healthcare.gov, I know that the “Affordable Care Act” is not affordable.

The reality is that no matter who wins the election today, Obamacare is not going to be repealed for at least the next two years, if ever. Shutting down the federal government did not achieve anything positive for anyone. Healthcare is too important to individuals, healthcare providers and is such a large part of the economy that the ACA needs to be fixed. If “politics is the art of the possible”, then once the dust of this election settles the members of Congress need to do what can be done to make things better for the citizens of this country in a bipartisan way. Feel free to contact your legislators, they are supposed to represent you and your voice can make a difference on the issues you care about.

Veterans.

Next Tuesday, 11/11 is Veteran’s Day. No matter how one feels about the various wars and armed engagements that our military has been ordered into, the veterans who served deserve our appreciation. We can show our appreciation in many ways; paying attention to veteran’s issues and letting Congress know that you want the veterans taken care of, volunteering to support veterans, contact a veterans group to see what you can do. In that light I have been offering free sessions for veterans to help with PTSD or related issues for a while now but haven’t done much to publicize it. So if you know anyone might benefit from some help have them contact me or contact me yourself to discuss what I can offer. On Friday I should have this service for veterans posted on the website.

Tom Magliozzi.

I learned yesterday that Tom Magliozzi, the elder brother of the Car Talk duo, died from complications of Alzheimer’s disease. Listening to that NPR show on Saturdays always made me laugh, even the “classic” segments which had me laughing even before they did. Today I heard a clip in which Tom completely lost it, totally unable to continue to speak without breaking into uncontrolled laughter. I laughed until I cried, then just kind of cried, a bit. All better now. The world can always use more clean humor and those guys were two of the best.

Enough already.  So vote, volunteer, be grateful and laugh.

Thanks for bearing with me. No more politics for two more years.

Feel free to contact me with any comments and of course if you know someone who might be interested in these posts please send them on.
Thanks,
Don Berlyn

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Why I Love that there is (almost) no paperwork with Hypnotherapy!

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View from the far side of the recliner

What good is having a blog if you can’t rant? Well this is my blog and here is my rant.
I just spent a couple of hours today trying to finish a report for a Medicare Physical Therapy patient and I’m still not done. This patient has a long list of relatively common medical issues but also on that list is a rare neurological condition which had been misdiagnosed as another more common neurological disease. I was seeing this patient for a simple activity related neck and shoulder pain complaint with an onset about four months ago. In a rational system the initial evaluation and medical history should have been a thirty minute write up, a page and a half at the most. My patient didn’t understand that further Physical Therapy would have to be approved and that she isn’t allowed to pay us until we have billed her Medicare plan and secondary. It is not clear if this patient wants to continue or will go somewhere else. She is somewhat confused so I am somewhat confused.
Welcome to crazy town. All medical records now have to be electronic. This means that if there are nude pictures in your medical records they will likely be leaked any day now. Hope you look good in that blue gown with the open back! If hackers can get into secure sites of defense companies, banks and government agencies what chance is there that the people that brought you HealthCare.gov will do a better job. Even if a site isn’t hacked, theoretically anyone in a medical office or insurance company that has access to your records can help themselves to that information. Theft of information in the electronic age can happen so much faster and in incredible amounts compared to the old days of paper medical billing and tabbed patient files.
Medicare requires an incredible amount of irrelevant information. Levels of disability or function need to be chosen somewhat arbitrarily from lists. The function limits are from redundant, overlapping lists. The time spent doing all of this, is time not spent treating patients and is not reimbursed. The costs of the various programs and the monthly fees to use the documentation to be in compliance are an added burden. The effect of all this on medical providers has not been pretty. I know a number of family or general practice physicians who have closed their practices and either retired, become hospitalists or gone to work for large hospital based clinics. It is very difficult to find a physician that will take a new Medicare patient. It is harder and harder to make it as a small practice. I think something is being lost in the process and it’s not just old magazines in the waiting room.
A friend of mine who is a Physical Therapist and Certified Hand Therapist, recently became a Licensed Massage Therapist, teaches a bit at a massage school and runs a bed and breakfast. This very experienced, skilled specialist is only occasionally seeing hand patients and won’t bill insurance companies. The non-treatment parts of healthcare are taking the pleasure out of serving people. The reason people go into healthcare (hopefully) is to work with patients and not be mind-melded with an uncaring electronic bureaucracy.
One of the beauties of Hypnotherapy that I really appreciate, is the ability to really help people achieve their goals without dealing with insurance, paperwork, billing or bureaucracy. It is so simple, the client wants to make a change, comes up with a goal, determines who or what can help him/her achieve that goal, makes an appointment, receives the service and pays for the service. Just a person wanting to get somewhere, hiring another person to help them get there. Strange no one thought of that way of doing healthcare before.
I love that about Hypnotherapy and would like to see it happen with Physical Therapy.
Next week I’ll write about something. I got off track this week due to my paperwork issues. I’ve actually had a couple of hypnotherapy sessions on this curse of mine. Guess I need some more work on that, maybe a lot more work.
Feel free to contact me with any comments and of course if you know someone who might be interested in these posts please send them on.
Thanks,
Don Berlyn