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Journal of Internal Medicine

Telemedicine may seem complicated, but it’s actually simple. Use it once and you’ll see that it makes life easier for everyone, particularly seniors. You get convenient, inexpensive healthcare on-demand from licensed professionals, and you can help control the spread of contagious diseases.

Here are some details about the advantages of telemedicine for seniors.

You have easy, around-the-clock, access to healthcare professionals who can diagnosis and treat common illnesses, help you manage chronic conditions, and provide trustworthy answers to your health and wellness questions.

You don’t need to travel to get basic healthcare. When you’re feeling sick the last thing you want to do is get cleaned up, dressed, and travel to a doctor’s office or clinic, right? It’s so much more comfortable to just stay home and chat with a doctor.

You can save money. Telemedicine is typically much less expensive than in-person visits. The usual cost for telemedicine services with insurance is $50-$55, and $75+ without insurance.

You can get a prescription for medication sent right to the drugstore of your choice, if needed. (And many drugstores will then deliver it right to your home). Super convenient!

You help control the spread of infectious diseases. Telemedicine grew fast in 2020 specifically because it was a safe way to get healthcare while social distancing. This holds true even when there isn’t a pandemic – and telemedicine is predicted to be a preferred choice for many people going forward.

You may find that you’re taking better care of yourself since it’s so easy to see a doctor with telemedicine. Rather than putting off a visit to check in about a symptom or annoying health problem, like a rash caused by an allergic reaction or sinus congestion that just won’t go away, you can call a doctor. When professional help is so easy to access, you’ll likely deal with simple concerns before they become bigger worries.

Telemedicine is simple to use, even for the ‘not so tech-savvy’. If you use a computer, tablet or smart phone already you have everything you need. If you’re not fond of technology, you can simply use whatever phone you have – no fancy equipment or skills required. Click here to find out more about virtual doctor visits.

Ready to try telemedicine? If you have private insurance or a Medicare Advantage plan, check to see what virtual healthcare services are included, and how much you might need to pay out of pocket. Medicare temporarily expanded its coverage of telemedicine services to respond to the pandemic, to help ensure that recipients could safely receive care without the risk of exposure to COVID-19. The situation is fluid right now, so check with Medicare or your Advantage plan provider for details.

Heart Healthy Tips – July 2020

1. Full of Antioxidants

Dark chocolate is famous for its incredible delivery of antioxidants; it’s actually in the top 10 sources for dietary antioxidants. Antioxidants are linked to reduction of plaque formation that can block arteries and become dangerous – so you can eat the chocolate, and your body will thank you. 

If you’re trying to maintain a heart-healthy diet, eating sweets usually isn’t encouraged. But we have some good news: There’s a loophole to this theory. Dark chocolate may feel like an indulgent treat, but it actually has a plethora of health benefits. You may have heard of some of these benefits, but dark chocolate can offer way more than the basic nutrients publicized. It can be an amazing tool when consumed in proper moderation. Below, take a look at some of the best things about this tasty treat.

2. Improve Your Circulation 

A study published in the American Heart Association’s Circulation Research, indicates consuming the cocoa found in dark chocolate can help to lessen the symptoms of peripheral artery disease (PAD), which limits blood circulation. Patients who ate dark chocolate were able to walk further and longer due to improved circulation attributed to the sweet treat.

3. Manage High Blood Pressure

Eating dark chocolate is a great way to incorporate more cacao into your diet, which can help to lower your high blood pressure! The flavonoids in dark chocolate have been found to produce nitric oxide, which causes blood vessels to relax and lower high blood pressure. As long as you mind the amount you consume and consider your intake of fats, sugars, and calories carefully, dark chocolate is a great way to indulge in a sweet treat without messing up your heart-healthy diet.

4. Linked to Lowered Stroke Risk

A Finnish study from 2012 indicates chocolate can be closely tied to a lowered risk of stroke. This is exceptionally helpful for those living with atrial fibrillation (AFib), who are five times more likely to suffer from a stroke than those without AFib, 

5. Lower Your Cholesterol

Dark chocolate contains compounds such as polyphenols and theobromine that can decrease levels of low-density lipoprotein (LDL) cholesterol in the body and increase levels of high-density lipoprotein (HDL) cholesterol. In layman’s terms, it heightens your “good” cholesterol levels and lowers your “bad cholesterol” levels. 

6. Level Out Blood Sugar and Inflammatory Markers

Dark chocolate also contains several anti-inflammatory components that can be immensely beneficial to your overall heart health. A study from 2018 noted that participants who consumed higher levels of dark chocolate consumption had reduced inflammatory biomarkers (among patients with type 2 diabetes). This indicates a correlation with blood sugar regulation – an important part of a heart-healthy lifestyle that affects blood sugar, muscle exertion, and obesity. Overall, dark chocolate was found to be a beneficial addition for certain diabetic patients. 

Greg Says believes that properly taking care of your heart is a key contributor to living a long and healthy life – so make sure to exercise and eat a bit of dark chocolate every now and then.

FRIDAY, June 26, 2020 (HealthDay News) – More than 2 million Americans buy prescription drugs from other countries as a way around rising prices in the United States, a new study finds.

The analysis of nationwide survey data showed that 1.5% of adults got their prescription meds from outside the United States between 2015 and 2017.

Immigrants and people who were older or who had inadequate health insurance coverage and tight budgets were more likely to do so. Those who use the internet for health care information were, as well, the findings showed.

The number of Americans looking for cheaper prescription drugs is likely to rise due to the spike in unemployment stemming from the coronavirus pandemic and the loss of work-based health insurance, according to the University of Florida (UF) researchers.

“With the economic and health consequences of COVID-19 disproportionately impacting minority and low-income populations, more people in those groups may be seeking an alternative way to meet their medication needs,” said lead study author Young-Rock Hong, an assistant professor of health services research, management and policy at the UF College of Public Health and Health Professions.

Safety is a big concern with international medication purchases, the researchers said in a university news release. One in 10 medications sold in the world are substandard or fake, the World Health Organization estimates.

Study co-author Juan Hincapie-Castillo, an assistant professor of pharmaceutical outcomes and policy, stressed that “patients might not be getting what they think they’re getting.”

He said this is particularly dangerous for patients for whom even a small deviation in dose can have severe consequences.

With more Americans likely to buy prescription drugs outside the United States, patient education and stringent quality control are crucial, Hong said.

“Patients should be informed of these potential risks they can encounter, and policies that seek to pursue drug importation should reinforce quality assurance and strict monitoring processes to promote safe administration of imported medication in the U.S. market,” Hong said.

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Greg Says advises caution when considering the purchase of prescription drugs from overseas sources.  It’s important to know where the medication was manufactured as there is far less government oversight in some countries compared to the US.

By Rich Holmes – HealthDay Reporter

WEDNESDAY, June 24, 2020 (HealthDay News) – With opioid addiction soaring in the United States, it should come as good news that an opioid painkiller may not be needed after a sports-injury repair.

A mix of non-addictive medicines may be safer and equally successful in managing pain after shoulder or knee surgery, a study from Henry Ford Hospital in Detroit indicates.

Concerned about the opioid abuse epidemic, doctors there tested a different regimen for pain relief. They treated post-surgical pain with a combination of non-opioid medications, including anti-inflammatories, muscle relaxants and nerve pain relievers.

“It’s a complete change,” said lead author and orthopedic surgeon Dr. Vasilios Moutzouros. He added that he was taught in medical school “the only mode of pain relief is opioid medication.”

Opioid overdose is the leading cause of accidental death in the United States, and orthopedic surgeons write a substantial number of opioid prescriptions, the authors said in background notes.

The study builds on earlier research showing use of opioids after orthopedic surgery can be reduced, but goes further in suggesting that the drugs may be eliminated. Changing how pain is treated could keep people from ever being introduced to opioids, Moutzouros said.

The study focused on 141 patients who underwent anterior cruciate ligament (ACL) reconstruction, or repairs for a torn knee meniscus or rotator cuff and shoulder injuries.

All received a combination of five drugs for pain relief before surgery. During surgery, a cocktail of three drugs was injected into surgical sites. Five drugs were given postoperatively, and icing of affected areas was encouraged.

Patients also were prescribed an opioid – 10 oxycodone pills (5 mg) – to be used if pain became too much. But they were asked not to take them, if possible, and to contact the on-call physician for help. One week after surgery, all of the patients said they were satisfied with pain management, and 45% avoided the available oxycodone. One patient required a prescription refill, the study authors noted.

Those who did use the oxycodone (OxyContin) were more likely to report more pain, be female, and have a history of anxiety or depression. Of the four surgeries studied, ACL reconstruction was found to be the most painful, and 30 of the 49 patients who had that surgery used their oxycodone prescription, the researchers said.

Moutzouros said the specific drugs used were less important than employing a range of non-opioid pain relievers. His next goal is to expand the method to all orthopedic surgeries at Henry Ford Hospital.

The approach “definitely makes sense,” said Dr. Joshua Dines, an orthopedic surgeon specializing in sports medicine at the Hospital for Special Surgery in New York City. He was not involved with the study. Opioids not only pose an addiction risk, he said, but have side effects. “Patients on opioids, they’re out of it, and constipated,” Dines said.

Doctors following the protocol would have to coordinate several pain relievers after surgery instead of one opioid, Moutzouros said. However, Dines pointed out that patients on opioids may end up also needing stool softeners, laxatives and anti-nausea medicines.

One potential concern was the protocol’s use of ketorolac and other nonsteroidal anti-inflammatory drugs (NSAIDS), which animal studies indicate may inhibit tendon healing, Dines said. Both Moutzouros and Dines said that patients have turned against extended use of opioids.

“People actually prefer the non-opioid approach,” Moutzouros said, urging patients to discuss pain relief options with their doctor. Part of managing pain is managing patient expectations, Dines said. There is going to be pain after surgery, especially in the first week or two.

Of the need for opioids after sports surgery, Dines said that “most people can get by with none.”

Hospitals lost 27,000 jobs in May, showing they have yet to recover financially.

By Mallory Hackett, Associate Editor, Healthcare Finance

June 5, 2020

WHY THIS MATTERS

The COVID-19 pandemic has affected the economy and unemployment in record numbers. The uptick in jobs announced today follows an historically high unemployment rate of 14.7% in April, the highest since the Great Depression.

The employment report shows an economy fighting to rebound. The overall unemployment rate declined by 13.3% in May, as 2.5 million jobs were added to the economy. The Bureau of Labor Statistics attributes this to the recent re-opening of many states’ economies.

However the numbers also show that hospitals have yet to recover financially from the surge of COVID-19 patients and the loss of revenue from postponed or cancelled elective procedures. Many were forced to furlough or lay off staff because the billions earmarked for hospitals in the Coronavirus Aid, Relief and Economic Security Act was not enough for most hospitals to operate at previous expense levels.

Hospital visits started to drop nationwide in March as state and federal officials called for postponing non-covid-19 treatments when possible to free up health-care resources. These cancellations included surgeries, outpatient procedures and even preventive services.

By mid-May, almost 94 million adults had delayed medical care because of the coronavirus pandemic, the Census Bureau reported in its Household Pulse Survey. Some 66 million of those needed but didn’t get medical care unrelated to the virus.

“Whether you have a lot of cases, or don’t have a lot of cases, you’re going to have a financial hit,” said Will Ferniany, chief executive of the UAB Health System. While covid-19 patients never came close to filling intensive care beds at its Birmingham, Ala., hospital, occupancy of other beds dropped to less than half. Ferniany’s system is losing $70 million a month in patient revenue, which it must try to make up with cost-cutting and federal aid.

Under the Cares Act, the Department of Health and Human Services says $175 billion was allotted for health-care providers, including hospitals in rural and high-impact areas and places treating uninsured covid-19 patients. But hospitals could miss out on some aid if they hadn’t treated a minimum of 100 covid-19 patients, despite the pandemic’s widespread financial damage.

THE LARGER TREND

Overall education and health services employment increased in May, adding 424,000 jobs, after suffering a decrease of 2.6 million in April.

Other industries that saw employment increase last month were leisure and hospitality, construction, education, and retail trade. Government employment, on the other hand, continued to decline.

It’s unlikely that all the lost hospital jobs will come back.  Instead, a future where hospitals continue to cut costs, eliminate duplicated services and cast a critical eye on their need for buildings is more likely.